Objective To study the clinical application of the complete audiologic evaluation battery consisting of ABR,ASSR and behavioral audiometry in sound field for the identification of sensorineural losses in children.Methods In the study 48 children were divided as group PTA of the children assessed by pure tone audiometry and ABR and ASSR test,and group BA of the children unable to perform on behavioral evaluations.Results The analysis of the audiometric results of group PTA showed significant correlation between the ASSR thresholds and pure tone thresholds(P＜0.01) at various frequencies.The correlation coefficients were 0.75,0.76,0.76,and 0.83 at different frequencies.The ASSR-PTA linear regression was utilized.The comparison of the ABR and ASSR results of group BA indicated that 23 ears responded in ASSR but without responses in ABR.Those without ASSR responses also had no ABR There were 116 tests in total four frequencies for the 29 ears.83 responses were obtained from ASSR,89 responses from behavior audiometry and 96 from the use of the both tests.Conclusion The comprehensive audiologic evaluation battery could be used to test younger children with severe heating loss children as compared to the pure tone audiometry alone.More detailed data can be obtained thus from children to assist in rehabilitation in a more effective mariner.

Objective To investigate effects of volume,distribution and leakage of bone cement in ver- tebroplasty on the adjacent intervertebral bodies using an experimentally calibrated and anatomically accurate fi- nite-element model of elderly L4-L5 vertebral bodies.Methods Computed tomography(CT)scanning was done,at 1 mm intervals,on L4-L5 vertebral bodies of the lumbar spine of an old man cadaver that had no abnormal findings on rnentgenograms.The L4-L5 motion segment data were obtained from the CT scans to establish in computer a three-dimensional finite element model of L4-L5 functional spinal unit(FSU)with the software Ansys 7.0.Compressive load after virtual vertebroplasty on the damaged model,unipedicular and bipedieolar injections and leakage of cement into the intervertebral space,and the resulting endplate and disc stresses of the adjacent vertebral bodies were analyzed in various spatial distributions of the filling material and different loading conditions. An anatomically accurate finite-element model of elderly L4-L5 vertebral bodies was developed.Results The FSU study suggested that changes in stress and strain at adjacent levels were minimal.Furthermore,endplale and disc stresses of the adjacent vertebral bodies were not influenced by bone cement filling volumes or distributions except under bending,whereas asymmetric distribution and leakage of bone cement to the disk increased the stress of adjacent endplates.Conclusion Since asymmetric distribution and significant leakage of cement into the intervertebral space can increase the stresses of endplates of adjacent vertebral bodies and may lead to a fracture, symmetric placement of cement in operation should be achieved and leakage of cement avoided.

ObjectiveTo evaluate the osteoinductivity of cationic liposome mediated recombined human bone morphogenetic protein-2 gene (rhBMP-2) transfer in skeletal muscle stem cells (SMSCs) of rabbits. MethodsSMSCs were transfered by pAGFP rhBMP-2 liposome complex. Gene transferred SMSCs were evaluated with immunohistochemistry.ResultsThe transfection rate of SMSCs transferred by cationic liposome mediated pAGFP-rhBMP-2 was 14.18%. Positive stain of rhBMP-2, alkaline phosphatase(ALP),collegenⅠhad been found in the transferred SMSCs.ConclusionQuantity of SMSCs is enough to be target cells of gene therapy. Cationic liposome can mediated bone morphogenetic protein-2 gene transfected SMSCs in vitro. Compared with AdrhBMP-2,the transfection rate of liposome mediated bone morphogenetic protein-2 gene transfected SMSCs is lower.

ObjectiveTo observe the effect of rabbit skeletal muscle stem cells (RSMSCs) modified by adenovirus mediated bone morphogenetic protein-2 (BMP-2) gene ex vivo in combination with demineralized bone matrix (DBM) on repair of longer bone defect in rabbit.MethodsModel of radial bone defects (20 mm) of rabbits was established. 50 rabbits were divided into 5 groups, group A (AdrhBMP-2 trusduced RSMSCs/DBM group), group B (adGFP trusduced RSMSCs/DBM group), group C (not trusduced RSMSCs/DBM group), group D (DBM group), and group E (untreated group). Roentgenographic, histologic, biomechanical, bone density of all animals were examined at the end of 4th and 6th week after surgery.ResultsAt 4th week, radial bone defects healed in group A. The healing rates from group A to group E were 100%, 50%, 33%, 0%, and 0% respectively at 6th week.ConclusionRSMSCs modified by AdrhBMP-2 ex vivo in combination with DBM can repair radial longer segemental defect in rabbit. It's possible to be used in the clinical treatment of longer segemental bone defect.

Hepatitis, Viral, Human ; drug therapy ; Humans ; Prostaglandins E ; therapeutic use ; Randomized Controlled Trials as Topic ; Research Design

Objective To evaluate the conditions and risk factors of esophageal stent dys-seal phenomenon (ESDP) .Methods Ninety-eight patients with malignant esophageal obstruction underwent metallic stent placement and 7 patients with ESDP were analyzed.The possible contributing factors,including age,gender,obstruction segment,esophagorespiratory fistula,surgical intervention,radiotherapy,the degree of upper obstruction segment expansion,stent with bellmouth,application of covered stent were investigated.All factors mentioned above were analyzed with Logistic regression analysis.Results ESDP was observed in 7 patients (7/98,7.14%) and defined as a space between the esophageal wall and the proximal part of stent without contrast agent obstruction within stent.The clinical situations of patients with ESDP included dysphagia,bucking and constantly chest pain,especially at foodintake.The results of Logistic regression analysis indicated radiotherapy (P=0.005) and the degree of upper obstruction segment expansion (P=0.017) were significantly correlated with ESDP.Conclusion ESDP is one of the complications after esophageal stent placement.It is prudent to implant esophageal stent for those patients with radiotherapy and significant upper obstruction segment expansion.

Objective To investigate audiological characteristics of patients with intact tympanic membranes and conductive or mixed hearing loss .Methods A retrospective study was carried out among 30 patients (42 ears) with intact tympanic membranes and conductive or mixed hearing loss who underwent exploratory tympanotomy . The preoperative outcomes of pure tone audiometry ,tympanometry ,resonant frequency of middle ear and temporal bone CT scan were analyzed .Results Among 42 ears ,30 ears with otosclerosis and 12 ears with ossicular chain dis-ruption were confirmed in exploratory tympanotomy ,but only 5 ears showed positive findings in CT scan .The mean thresholds of bone conduction ,air conduction and air -bone gap at frequencies of 0 .5 ,1 and 2 kHz were 27 .5 ± 1 .3 dB HL ,67 .0 ± 1 .8 dB HL ,39 .5 ± 1 .1 dB HL ,respectively .An analysis of tympanometric data of all patients re-vealed that 50% of all ears (21/42) were type A tympanograms ,42 .9% (18/42) were type As tympanograms ,and 7 .1% (3/42) were type Ad tympanograms .The mean of the resonant frequency of the middle ear in otosclerositic patients (1 079 .0 ± 67 .4 Hz) was significantly higher than ossicular chain disruption patients (633 .3 ± 43 .6 Hz) . Conclusion Otosclerosis is the most common in the patients with intact tympanic membranes and conductive or mixed hearing loss .The middle ear resonant frequency of otosclerositic patients is significantly higher than that of ossicular chain disruption patients .

Objective To investigate the influence of acupuncture therapy on neural stem cell (NCS) proliferation and differentiation in the hippocampus of the senescence-accelerated prone-8 (SAP8) mouse. Methods Twenty-four SAP8 mice were randomly and equally divided into a model group and an acupuncture group. Twelve senescence-accelerated resistant ( SAR1 ) mice served as the control group. Acupuncture was administered at the Baihui (DU20) point to mice in the acupuncture group once daily for 21 consecutive days. Bromodeoxyuridine (BrdU) was used to detect the proliferation and differentiation of NCSs in the hippocampus through double-labeled immunofluoresSAR1 group, the positive cells in the SAP8 group were significantly fewer Compared to the SAP8 group, positive cells markers of neuron or glia cell positive cells appeared. Compared to the SAR1 group, the expression of BrdU/GFAP increased in the SAP8 group, and decreased after acupuncture but not significantly. BrdU/S-100 β cells decreased significantly in the SAP8 group, and increased after acupuncture, but again not significantly. Compared to the SAR1 group BrdU/GalC positive cells increased significantly in the SAP8 group and decreased significantly after acupuncture.Conclusions After acupuncture treatment for 21 days, the differentiation of hippocampal NSCs into oligodendrocytes was inhibited, but there was little effect on their differentiating into neurons and immature astrocytes.

Objective To evaluate the efficacy of Fluency stent-graft (Bard Corp) in transjugular intrahcpatic portosystemic shunt (TIPS).Methods The clinical data of 21 consecutive patients treated by TIPS using Fluency stent-grafts were retrospectively reviewed.All of them were recurrent variceal bleeding secondary to portal vein hypertension,1 was bleeding secondary to primary hepatic carcinoma with port vein thrombns,and 1 was Budd-Chiari syndrome.They were followed-up after (10.1 ± 4.6) months (2.0 to 24.0 months).Stent-grafts patancy,portal vein pressure and liver function were recorded and compared.Results Twenty-five stent-grafts were successfully implanted in 21 patients,23 stent grafts were 8 mm 2 were 10 mm in diameter.The covered length of the stents varied from 6 to 8 cm.The bleeding was stopped and the portal vein pressure decreased significantly from (25.4 ± 3.5) mm Hg to (15.4 ± 2.8) mm Hg (t = 12.495,P < 0.01).During the follow-up period,The patient with primary HCC and portal vein thrombosis died 4 months after the procedure. One case had a new primary HCC during the follow-up and died 24 months after the procedure.One ease with variceal bleeding secondary to portal vein hypertension died of muhisystem organ failure.One case occluded in the hepatic vein and had another stcnt graft implanation.The other 17 cases had no stenosis after 7 to 17 months follow-up.Ultrasound showed that the stents were patent 1 week before the patients died.Three cases had transient symptoms of hepatic encephalopathy and recovered after treatment.The Child scores of the 19 patients survived more than 6 months were 6.3 ±1.4 before and 6.4 ± 1.9 after the procedure without significant difference (t = 0.645,P > 0.05).Conclusion The Fluency stent-grafts could increase the patency of the TIPS,but its efficacy on the long-term effect and hepatic encephalopathy need further investigation.

Objective To investigate the effects of transcatheter arterial chemoembolization(TACE) on the expression of nm23, tissue inhibitor of metalloproteinase-2 (TIMP-2) and extrahepatic metastasis in hepatocellular carcinoma (HCC). Methods The specimens were collected from resectable HCC in 72 patients. Patients were divided into two groups. In one group, TACE was performed before tumor resection (Group A, n=36). In another group, the tumors were resected directly without preoperative TACE (Group B, n=36). The expression and distribution of nm23, TIMP-2 in the tumor tissue and liver parenchyma in the two groups were compared. All patients were followed up for 24 months,and the incidence of extrahepatic metastasis was compared between the two groups. Chi-square test was applied to compare the expression levels of nm23-H1 and TIMP-2. Results The number of cases of strong, moderate and no expression of nm23 were 24, 6 and 6 cases in group A respectively, and were 9, 6 and 21 cases in group B. Statistical differences were found between the two groups(X~2=15.52, P<0.01). The number of cases of strong, moderate and no expression of TIMP-2 were 21,3 and 12 cases in group A respectively, and were 9, 9 and 18 cases in group B. Statistical differences were demonstrated between them (X~2=9.00, P<0.05). There were 13 cases in group A and 15 cases in group B being diagnosed to have extrahepatic metastasis within 24- month period of follow up, but there was no significant difference between the two groups(X~2= 0.23, P>0.05). Conclusions TACE could enhance the expression of nm23-H1 and TIMP-2 in tumor tissues. Therefore, the potential of metastasis of tumor cells might be prohibited by TACE.