OBJECTIVE To evaluate the therapeutic efficacy of simple myringoplasty with three different kinds of autologous substitutes. METHODS The patients (107 ears)with tympanic membrane perforation underwent myringoplasty using autologous temporal fascia, perichondrium or tragus cartilage-perichondrium compound. The postoperative healing effects and hearing levels of all cases were studied. RESULTS In healingeffects and hearing levels of the patients with small tympanic membrane perforation, there was no difference among the three kinds of autologous substitutes. Cartilage-perichondrium compound was much better for the patients with large tympanic membrane perforation in primary healing than temporalis fascia and perichondrium(P

Objective To investigate the relationship between the serum uric acid (SUA) levels and the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Methods Consecutive patients with spontaneous intracerebral hemorrhage admitted within 24 hours after onset were prospectively included.SUA levels was measured on the next morning after admission.Modified Rankin Scale (mRS) was used to ascertain clinical outcome at 30 days.The patients were divided into a good outcome group (mRS＜2) and poor outcome group (mRS≥3).Results A total of 92 patients with spontaneous intracerebral hemorrhage were included,and 46 of them (50％) were men,the mean age was 63 ± 12 years.At 30 days after onset,22 patients (23.9％) had a good outcome and 70 patients (76.1％) had a poor outcome.Univariate analysis showed that the Glasgow Come Scale (GCS) score in the good outcome group was significantly higher than that in the poor outcome group (13.85 ± 2.80 vs.11.21 ± 2.51; t=4.186,P=0.000),while hematoma volume (25.65 ±5.33 cm3 vs.34.60± 8.97 cm3,t=4.430,P=0.000) and SUA levels (324.90± 86.02 μmol/L vs.458.63 ±72.77 μmol/L; t =7.193,P =0.000) were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that the lower GCS score (odds ratio [OR]1.810,95％ confidence interval [CI]1.382-2.382; P =0.001),larger hematoma volume (OR 1.156,95％ CI 1.045-1.280; P=0.005) and higher SUA levels (OR 2.127,95％ CI 1.055-4.287; P=0.035) were the independent predictive factors for the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Conclusions The increased SUA levels may predict the poor short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.

Objective To observe the ultrasonic features of cystic renal cell carcinoma. Methods Ultrasonic features of 18 patients of cystic renal cell carcinoma confirmed with operation and pathology were analyzed retrospectively.Results Among 18 patients, 7 were clear-cell carcinoma of cystis degeneration, 5 were cystic renal cell carcinoma (clear cell type), 3 were multilocular renal cell carcinoma, 1 was corpora mammillaria renal cell carcinoma, and one clear-cell carcinoma was on capsule wall of cyst and 1 was nephroblastoma. Ultrasound diagnosed 15 patients and misdiagnosed 3 with a diagnostic rate of 83.33%.Conclusion Cystic renal cell carcinoma has specific ultrasonic characteristics, and having an intimate knowledge of these characteristics may be helpful to diagnosis.

Objective To explore the ultrasonographic appearance of dermatofibrosarcoma protuberans. Methods Clinical data, sonographic features and color Doppler flow imaging characteristics of 12 patients surgically and pathologically confirmed dermatofibrosarcoma protuberans were retrospectively analyzed.Results Single mass was detected in 11 patients (11/12, 91.67%) with the diameter ranged 0.9-8.0 cm. The tumors distributed in the trunk (8/12, 66.67%), proximal limbs (2/12, 16.67%) or face and neck (2/12, 16.67%). Most of the tumors (10/12, 83.33%) developed from skin and subcutaneous fat layer of the trunk and limbs and were hypoechoic and heterogeneous (11/12, 91.67%), some (8/12,66.67%) with distinct boundary and regular shape without liquification, calcification nor regional lymph node metastasis. Affluent color Doppler flow signals of tumor were found in 11 patients (91.67%).Conclusion Ultrasonographic characteristics of dermatofibrosarcoma protuberans include distinct boundary, regular shape, heterogeneous hypoechogenicity and rich color Doppler flow signals without regional lymph node metastasis.

Objective To explore the types and drug resistance of pathogens in patients with type Ⅰ incision surgical site infection in orthopedics department.Methods Patients with type Ⅰ incision surgical site infection in orthopedics department at Peking University Third Hospital from January 2005 to December 2013 were retrospectively collected.Clinical characteristics of patients,distribution and drug resistance of pathogens were analyzed.Results A total of 58.2 thousands patients with type Ⅰ incision surgical site were hospitalized from January 2005 to December 2013 in orthopedics department,and among them 442 patients had infection in the type Ⅰ incision surgical site.The infection rate was 0.8％.Infection was mainly observed in elderly patients.The most common diseases were lumbar canal stenosis (21.7％),cervical spondylosis (20.6％) and lumbar intervertebral disc herniation (14.0％).A total of 453 pathogenic strains were detected,of which 52.9％ were gram-positive bacteria,45.5％ were gramnegative bacteria and 1.6 ％ were fungi.The common pathogens were Staphylococcus aureus (25.2 ％),Staphylococcus epidermidis (14.1 ％),Escherichia coli (11.5 ％),Enterobacter cloacae (7.3 ％),Pseudomonas aeruginosa (6.2 ％) and Acinetobacter baumannii (6.0 ％).The percentage of Meticillinresistant Staphylococcus aureus (MRSA) was 23.7％ and the percentage of Meticillin-resistant Staphylococcus epidermidis (MRSE) was 43.8％.Vancomycin or linezolid-resistant Staphylococcus aureus or Staphylococcus epidermidis were not detected.Proportion of extended-spectrum beta-lactamases (ESBL) producing strains in Escherichia coli was 53.8％,and proportion of ESBL-producing strains in Klebesiella pneumonia was 50.0％.The resistance rates to impenem and meropenem of the three different species in Enterobacteriaceae,including Escherichia coli,Enterobacter cloacae and Klebsiella pneumonia,were 0.Resistance rates of Pseudomonas aeruginosa to cefoperazone-sulbactam,piperacillin-tazobactam were less than 10 ％.Resistance rate of Acinetobacter baumannii to minocyline was 11.1％ and resistance rates of it to other drugs were more than 20％.Conclusions The rate of type Ⅰ incision surgical site infection in orthopedics department is low.Gram-positive and gram-negative bacteria each account for half of the pathogens.The proportion of resistant pathogens is high and empirical treatment is needed to cover these pathogens.

Objective To analyze and compare the incidence of cerebral vasospasm (CVS) in patients with aneurismal subarachnoid hemorrhage(aSAH) in China and in Europe.Methods A literature search was performed for all the papers investigating the incidence,diagnosis, treatment or prognosis of CVS after aSAH using the MEDLINE and China Knowledge Resource Integrated Database (CNKI) from January 1, 1990 to December 31, 2010.The incidences of angiographic CVS, symptomatic CVS and CVS-related infarcts were recorded.The incidences of CVS between Chinese and white men in Europe were compared. Results A total of 237 articles were searched via CNKI and reference reviews, and 9 of the studies met the inclusion criteria. A total of 172 articles were searched via MEDLINE and reference reviews, and 18 of the studies met the inclusion criteria. The risk of occurring symptomatic CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe (relative risk,2. 063, 95％ confidence interval 1.816-2. 343, P ＜0. 001). Conclusions The incidence of CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe,indicating the pathogenesis of CVS may have genetic basis.

Objective To investigate the diagnostic values of (1,3)-β-D-glucan (G) and galactomannan (GM) for invasive fungal infection (IFI) in patients of acute radiation sickness (ARS).Methods Samples of periogeral blood,pharyngeal secretion,urine,and feces were collected from 316patients with ARS and suspected to suffer from IFI,192 males and 124 females,aged 60.50(1-96),with the underlying diseases of blood or respiration systems.Platelia Aspergillus EIA kit was used to detect the plasma BG (G test),and ELISA was used to detect the serum GM (GM test).Fungal culture and bacterial culture were performed.Results The positive rates of G test,GM test,and fungal culture were 36.33%,35.84% ,and 34.18% respectively,but the positive rate of fungal culture of blood sample was 1/316 only.Pearson correlation analysis showed that G test,GM test and fungal culture test were positively correlated with IFI clinical diagnosis respectively (x2 = 0.564,0.357,0.727,P ＜ 0.05).Conclusions Easy to operate,rapid,and highly sencitive,G test and GM test can be used as adjunctive methods for early IFI diagnosis in ARS patients.

Objective To study the best processing technology of Xanthii Fructus by determining the contents of chlorogenic acid and 3,5-dicaffeoylquinic acid in which processed by different temperature and time. Methods Sixteen batchs samples of Xanthii Fructus were propressed by stir-frying with sand, and the propressed temperature and time were set at 150-220 ℃ and 0.5-7 minutes. Two phenolic acid components in Xanthii Fructus were simultaneously determined. The column was UPLC Acquity BEH C18 (2.1 mm×100 mm, 1.7 μm). The mobile phase was acetonitrile-0.1% phosphoric acid, gradient elution. The flow rate was 0.25 mL/min, and the detection wavelength was 327 nm. Results The sample with highest contents of chlorogenic acid and 3,5-dicaffeoylquinic acid was the batch processed by stir-frying with sand at 160 ℃ for 7 minute, which was 2.498, 2.004 mg/g, respectively. Conclusion According to the appearance of processed sample and the content of chlorogenic acid and 3,5-dicaffeoylquinic acid, the optimal processing technology of Xanthii Fructus was stir-frying with sand at 160 ℃ for 7 min.

To obtain the immunized mouse spleen cells, we immnnized the female BALB/C mice I.P. with schizonts or merozoites of the cultured blood forms of Plasmodium falciparum. The immunized spleen cells were fused with the SP2/0 myeloma cells, by which we obtained two strains of hybridoma secreting monoclonal antibodies against human Plasmodium falciparum. Using indirect immunofluorescence assay, we identified that the antibodies reacted only with the surface membrane antigens of the schizonts. These hybridomas were cultured continuously in vitro for over ten months and stably produced antibodies-IgG. The two hybridoma cell lines were designated as AEB2 and AGA4, and the number of their chromosomes was 98 and 100 respectively. The hybridoma cells were injected I. P. into the paraffin oil treated BALB/C mice to obtain the hybridoma ascitic fluid containing monoclonal antibodies. The ascitic fluid inhibited the growth of P. falciparum in vitro up to 89%. The inhibition test showed that antibodies were protective.

Tropheryma whipplei (TW) is an opportunistic pathogen that can cause Whipple′s disease (WD). Recently, the biomedical field is concerned about whether the bacteria cause pneumonia. When BALF was detected by PCR, the TW positive rate was about 6.1%. Etiology status is generally described as “associated” or “probable”. Immunocompromised status is the susceptible factor; Different species of the same genus have been reported. The current method may have missed detection. All relevant information needs further study. This article reviews the acute pneumonia caused by TW and the detection technology.