Objective To observe the effects of the re-therapeutic on later stage of sudden deafness.Methods Patients who met the criteria for sudden deafness and showed poor response tO conventional therapy over two months were recruited and assigned randomly for re-therapy.The pure tone audiometry was conducted before and after re-treatment in 103 patients(112 ears).Sodium bicarbonate and dexamethasone were iniected by intravenous drip for two days and batroxobin 5 BU for 6 days.Statistics were made in the effecency of the re-treatment.Results The effective rate of re-treatment group was 46.43% and the difference was significant before and after retreatment(P<0.01).Conclusion Combined use of sodium bicarbonate dexamethasone and batroxobin is effective in re-treating later sudden deafness.

AIM: To investigate the expression and functional role of p38MAPK in the kidney after unilateral ureteral obstruction in rats. METHODS: Unilateral ureteral obstruction (UUO) models were induced by ligating the left ureter. Rats were sacrificed at 1 h, 3 h, 6 h, 12 h, 1, 3, 5, 7, 14, 21, and 28 days after UUO was initiated. p38MAPK activity was assayed by immunohistochemical staining and specific substrate phosphorylation with immunoprecipitation and Western blotting. TGF? mRNA and protein expression were analyzed with in situ hybridization and immunohistochemical stainning. RESULTS: A basic p38MAPK activity was detectable in the normal kidney(0.22?0.06). p38MAPK pathway was rapidly activated at 1 hour(0.45?0.14 vs control, P

AIM: The aim of this study was to reveal the regulatory role of glutathione (GSH) in the transcriptional activity of activating transcription factor-2 (c-Jun/ATF-2) and nuclear factor-?B (NF-?B) of macrophages induced by angiotensin Ⅱ(AngⅡ). METHODS: Macrophage intracellular GSH was determined by fluorophotometry, and buthionine-[S,R]-sulfoximine(BSO)was used for depletion of intracellular GSH. The phosphorylation of c-Jun/ATF-2 and expression of NF-?B p65 were determined by immunoblot, and the activity of NF-?B was determined by electrophoresis mobility shift assay (EMSA). The c-Jun/ATF-2 was also determined by Immunohistochemical staining. RESULTS: The GSH content in the macrophage was decreased in cells that were lipid-peroxidized with AngⅡ (1.0 (?mol/L)) for 30 min and 60 min, respectively, followed by an adaptive GSH increase in the presence of AngⅡ (1.0 (?mol/L)) for longer time. In parallel, exposure to AngⅡfor 60 min also decreased macrophage GSH content in a dose-dependent manner. The GSH of RAW 264.7 cells were depleted by BSO, a specific inhibitor of GSH synthesis, and incubation for 18 h with 0.5 mmol/L BSO was sufficient for complete depletion of intracellular GSH. The phosphorylation of c-Jun/ATF-2 could be induced by the AngⅡ (1.0 (?mol/L)), whereas it did not occur in glutathione-depleted RAW 264.7 macrophages. The activation of NF-?B could also be induced by the AngⅡ (1.0 (?mol/L)), but it did not occur in glutathione-depleted RAW 264.7 macrophages. CONCLUSION: These data provide evidences that the intracellular glutathione redox may participate in the regulation of transcription activity of c-Jun/ATF-2 and NF-?B in macrophages. [

Objective To investigate and eompare the diagnostic values of linear reference region model (LRRM) and Extended Tofts model in quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis of benign and malignant breast lesions under different temporal resolutions.Methods Eight five suspicious breast cancer women underwent bilateral DCE-MRI exam, 37 patients were benigns and 48 patients were malignants.Among those, 31 patients(15 malignant, 16 benign) were scanned with 18 s per phase, and 54 patients(33 malignant, 21 benign) were scanned with 7 s per phase, and they were assigned into breast cancer group, benign lesion group and healthy gland group proven by surgery or biopsies.For the same model, Ktrans values of the three groups under different time resolution were first analyzed using Kruskal-Wallis H rank sum test.Receiver operator curve (ROC) was used to analyse the diagnostic efficiency of K values.Results Under high and low temporal resolutions, K values of the healthy group were (0.048 ±0.022) and (0.090±0.040)/min for extended Tofts model,(0.301 ±0.197) and (0.287±0.225)/min for LRRM model respectively.K values of the benign group were (0.289±0.163) and (0.211 ± 0.080)/min for extended Tofts,(0.624 ± 0.358) and (0.593 ± 0.165)/min for LRRM respectively.K values of the malignant group were (0.959±0.451) and (0.524±0.285)/min for extended Tofts,(1.576±0.935) and (0.956±0.180)/min for LRRM respectively.There were significant differences among the three different groups(P＜0.05).Area under the ROC to differentiate benign and malignant breast lesions for Extended Tofts in high temporal, LRRM in high temporal, Tofts in low temporal and LRRM in low temporal were 0.941, 0.876, 0.850 and 0.933, with Ktrans cutoff values of 0.304, 0.917, 0.252 and 0.789/min,and sensitivity of 93.9％, 80.0％,80.0％, 80.0％;specificity of 85.7％, 90.5％, 81.2％, 87.5％ respectively.Conclusion Under low temporal resolutions, Ktrans of LRRM model had better sensitivities and specificities in differentiation of benign and malignant breast lesions than Extended Tofts model, which was the opposite in high temporal resolutions.

Objective To identify risk factors associated with repeat use of pulmonary surfactant ( PS) in the treatment of respiratory distress syndrome ( RDS ) in the term and near-term neonate. Methods There were 130term and near-term new borns with RDS who were treated with pulmonary surfactant were enrolled. These infants were categorized into two groups: single-dose group (85 cases) and repeat-dose group (45 cases). The differences in basic information were compared between the two groups, and logistic regression analysis was used to identify the risk factors for repeat use of pulmonary surfactant.Results TherepeatutilizationrateofPSwas34.6℅.The incidence of asphyxia,maternal gestational hypertension, X-ray RDS grade 3-4, the age of first dose PS,respiratory support time in the repeat-dose group was significantly higher than in the single-dose group (P<0. 05). PaO2/FiO2 and the cure rate in the repeat-dose group were significantly lower than in single-dose group ( P<0. 05 ) . The incidence of sepsis, pulmonary hemorrhage, shock and patent ductus arteriosus ( PDA) in the repeat-dose group was significantly higher than in the single-dose group ( P<0. 05). Further logistic regression analysis showed that birth asphyxia ( OR=5. 674 , 95℅CI 1. 378 -23. 354 , the age of first dose of PS (OR=1.092, 95℅CI 1.002 -1.191)and PDA(OR =23.499, 95℅CI 2.348 -235.152)were the independent risk factors for repeat use of pulmonary surfactant.Conclusions Birth asphyxia,the age of first dose PS and PDA are the risk factors for repeat use of pulmonary surfactant in the treatment of RDS in the term and near -term neonate.

Objective To investigate the protective effects of ischemic preconditioning on myocardial ischemia/reperfusion injury in diabetic rats.Methods Twenty-eight healthy male rats were injected streptozotocin at dose of 45 mg/kg by tail and be fed with normal diet for 4 weeks,then rats were randomly divided into iscbemia/reperfusion (I/R) group and ischemic preconditioning (IP) group.ST segment of electrocardiograph changes and arrhythmias of all rats were recorded before ischemia and 0,15,30 minuets after ischemia and 0.5,2 h after reperfusion.TTC staining was performed to determine myocardial infarct size.TUNEL assay was used to assesse cardiomyocyte apoptosis.The expression of antiapoptotic gene (Bcl-2) and proapoptotic (Bax) was determined by immunohistochemistry.Results Compared with I/R group,ST segment elevation of patients in IP group decrease from (0.675 ±0.150) mV to (0.489 ±0.161) mV at 30 min after ischemia(P ＜0.05).Meanwhile the onset of ventricular premature contraction(VPC) in IP group was (18.21 ± 5.36) min,later than that of control group ((6.47 ± 4.28) min,t =5.241,P =0.000).The duration of VPC was (6.07 ± 4.33) min,shorter than that of I/R group ((16.71 ± 5.48) min,t =4.924,P ＜ 0.01)).The incidence of ventricular tachycardia (VT) and ventricular fibrillation (VF) of lP group remarkably decreased compared with I/R group (VT:57.14％ (8/14) vs.14.29％ (2/14),x2 =5.600,P =0.018 ; VF:50.00％ (7/ 14) vs.14.29％ (2/14),x2 =4.094,P=0.043).The myocardial infarct size in IP group was (12.50 ± 9.45) ％,smaller than that of I/R group ((37.50 ± 11.40)％,t =3.211,P =0.006).Cardiomyocyte apoptotic index (AI) was attenuated in IP group than that of I/R group((24.31 ± 3.12)％ vs.(19.01 ± 4.32)％,t =3.227,P =0.006),which was correlate with increased the ratio of Bcl-2/Bax((0.103 ±0.045) vs.(0.221 ±0.101),t =2.670,P =0.015).Conclusion IP treatment for diabetic rats shows a protect effect on myocardial I/R injury through attenuating myocardial apoptosis,and increasing the ratio of Bcl-2/Bax.

Objective To characterize the image morphology and time-intensity curve of renal cell cancer and angiomyolipoma on contrast-enhanced harmonic sonography. Methods A total of 57 patients with 58 renal masses were enrolled in this study prospectively. The renal masses included 47 renal cell carcinomas (RCC) and 11 angiomyolipomas (AML). All patients were evaluated by tradi-tional gray-scale sonography, color Doppler sonography and contrast-enhanced harmonic sonography. Imaging findings and time-intensity curves of all renal masses were analyzed. The contrast-enhance-ment features between RCC and AML were analyzed. Results 57.4% of RCCs were hyperechoic masses and peripheral surrounding vessels and / or penetrating vessels were noted in 83.0% of RCCs on color Doppler sonography. 54.5 % of AMLs were hyperechoic masses while peripheral surrounding vessels and / or penetrating vessels were only noted in 27.3% of AMLs on color Doppler sonography. On contrast-enhanced harmonic sonography, hyper- or iso-enhancement were noted in 83.0% of RCCs, while hypo-enhancement were noted in 81.8% of AMLs (P<0.01). Statistically significant differences were noted between RCC and AML in the values of peak time (P=0.03), wash time (p= 0.02), peak intensity-basic intensity (P=0. 01), AT/R (△A tumor/△A renal) (P=0.00), k (P= 0.02), and Aok (P=0.02). Conclusions Contrast-enhanced sonography is useful in the differentia-tion of renal masses. Most RCCs are hyper- or iso-enhanced while most AMLs are hypo-enhanced. Time-intensity curves are helpful in differentiating RCC and AML.

Objective To investigate the association between peripheral white blood cell (WBC) count and the carotid intimal-medial thickness (cIMT) in middle-aged and elderly Chinese of suburban area of Shanghai.Methods A total of 2 519 subjects aged 40 years or older from Jiading District,Shanghai were recruited to undergo questionnaire interview,anthropometric measurements,fasting blood sampling,and carotid B-mode ultrasonography.After excluding subjects with biochemical index missing,WBC count ＞ 10× 109/L as well as those with known myocardial infarction,cerebral infarction,coronary heart disease,and those taking lipid-lowing agents,2 239subjects were included in this analysis.Results Increased WBC count was associated with more unfavorable metabolic risk profiles.With the increasing quartiles of WBC count,cIMT were 0.558,0.570,0.573,and 0.587mm respectively(P for trend ＜ 0.01).As compared with participants in the first WBC quartile,the risks of cIMT thickening were increased by 79％,109％ in males and 29％ in females (P＞ 0.05 in females).Multiple linear regression model showed that peripheral WBC count was an independent risk marker for cIMT thickening,especially for neutrophil and monocyte count.Conclusion A high-normal WBC count was significantly associated with cIMT thickening in middle-aged and elderly Chinese of suburban area of Shanghai,especially in males.

Objective To investigate the effects of intravenous fluid restriction on complications after biliary surgery.Methods The clinical data of 168 patients who received biliary surgery at the Nanjing General Hospital of Nanjing Military Command from October 2006 to March 2008 were prospectively analyzed.All patients were randomly divided into test group(85 patients received fluid restriction treatment)and control group(83 patients received conventional treatment)by the sealed envelope method.The difference in the fluid volume between the 2groups was observed.Differences in systemic complication rate,local complication rate,general complication rate,time to bowl movement,length of hospital stay and mortality between the 2 groups were compared.All data were analyzed using the chi-square test,t test,Fisher exact test,Results The median total volumes of fluid in test group and control group were 1450 ml and 2420 ml,respectively,with significant difference between the 2 groups (t=-5.067,P<0.05).The median volumes of erystalloid solution in the test group was 850 ml,which was significantly lower than 1500 ml of the control group(t=-15.190,P<0.05).The postoperative systemic complication rate and general complication rate of the test group were 9%(8/85)and 19%(16/85),which were lower than 22%(18/83)and 30%(25/83)of the control group.There was a significant difference in the postoperative systemic complication rate between the test group and the control group(x2=4.837,P<0.05).The time to bowl movement and length of hospital stay were 2 days and 9 days in the restriction fluid group,which were significantly shorter than4 days and 12 days in the control group(t=-8.102,-2.003,P<0.05).The mortalities of test group and control group were 2%(2/85)and 4%(3/83),respectively,with no significant difference between the 2 groups(P>0.05).Conclusion Fluid restriction reduces the complication rate,shortens the length of hospital stay and accelerates recovery after biliary operation.

Objective To summarize the clinical technique and experience of one stage combination of renopancreatic transplantation(SKPT) with portal venous drinage of pancreatic endocrine and enteric drainage of exocrine(PE).Methods Five patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with PE drainage.The clinical data,operative techbuque,and the prevention of non-technical complications were summarized.Results This procedure was successfully applied in the 5 patients.Three patients recovered excellently;but 2 died perioperatively,one died of sepsis due to pancreatic leakage,and one of FK506 toxicity.On postoperative day 3,in the 3 survivors,blood creatinine and urea nitrogen levels returned to normal;insulin administration was discontinued on 7d postoperatively,and the endogenous and exogenous secretory functions of the graft were normal.Conclusions SKPT with PE is a resonable procedure,because of its potential physiologic,metabolic,and immunologic advantages.PE drainage may become the prefer technique of pancreas transplantation.Intensive perioperative managements are effective methods to prevent complications and to improve the therapeutic effects.