0.05) between the two group. Conclusions:No significant difference, concerning efficacy and toxicity ,is shown between domestic made and imported vinorelbine plus cisplatin combination chemotherapy in treating non small cell lung cancer.

OBJECTIVE: To investigate the current situation of early diagnosis and intervention in 0-9 months old infants with hearing loss and analysis factors that will affect early diagnosis and intervention. METHOD: One hundred and eighty-six infants referred to the West China hospital from February 2014 to September 2014 were included. All 186 children were referred due to the fact that either they failed infant hearing screening or outer ear malformation. Early diagnosis and/or intervention were performed on those 186 children and their records of early diagnosis and intervention were analyzed. RESULT: Among the 186 infants, 167 (89.8%) were diagnosed with an average age at (4.0 ± 1.4) months. Among the 167 infants with final diagnosis, there were 31 (18.6%) infants diagnosed as conductive hearing loss (CHL), and 99 cases (59.3%) diagnosed as sensorineural hearing loss (SNHL), among whom, there were 75 (44.9%) bilateral SNHL and 24 (14.4%) unilateral SNHL. There were 2 cases (1.20%) with SNHL on one side and atresia on the other side. 5 (2.99%) of all conductive hearing loss cases with unilateral atresia and 2 cases with auditory neuropathy (AN) were found. 33 infants (19.8%) were found to have normal hearing. 30.7% (23/75) infants diagnosed as bilateral SNHL and 8.3% (2/24) infants diagnosed as unilateral SNHL were fitted with hearing aids. The fitting rate in infants with bilateral SNHL with mild, moderate, severe to profound degrees were 0 (0/23), 24.0% (6/25), 66.7% (6/9), 61.1% (11/18) respectively. The average intervention age was (5.0 ± 2.1) months. CONCLUSION Although the early diagnosis and intervention situation in this study are very close to international standard, there are still infants without final diagnosis and infants with hearing loss without hearing aid fitting. Further studies and efforts to promote early diagnosis and intervention in infants with hearing loss are needed.
China ; Deafness ; Early Diagnosis ; Hearing Aids ; Hearing Loss, Bilateral ; Hearing Loss, Central ; Hearing Loss, Conductive ; diagnosis ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Tests ; Humans ; Infant ; Infant, Newborn

OBJECTIVE:To establish the quality standard for the leaves of Nauclea officinalis. METHODS:Microscopic identi-fication and TLC methods were used for qualitative identification of N. officinalis. The moisture and ash of medicinal materials were determined. HPLC method was adopted to determine the content of strictosamide in medicinal materials. The determination was per-formed on Lichrospher C18 column with mobile phase consisted of acetonitrile-0.1% phosphoric acid solution(gradient elution)at the flow rate of 1 mL/min,injection volume was 10 μL. The detection wavelength was set at 226 nm,and the column temperature was 30 ℃. RESULTS:Microscopic identification of the leaves of N. officinalis had strong characteristics,and TLC sports were clear and well-separated without interference from negative control. The linear range of strictosamide were 0.0105-0.21 mg/mL(r=0.9995);RSDs of precision,stability and reproducibility tests were all lower than 2.0%. Average recoveries were 96.25-101.82%(RSD=1.86%,n=9). Total ash of medicinal materials was 5.27%-6.44%,acid insoluble ash was 0.23%-0.36%,water content was 9.48%-11.46%,strictosamide was 0.124%-1.003%. CONCLUSIONS:Established standard can be used for quality evaluation of N. officinalis.

Objective To study the imaging features of primary mediastinal cysts,and to improve the diagnostic ability of these diseases.Methods The imaging findings of primary mediastinal cysts proved by pathlolgy in 42 cases were retrospectively.All of cases underwent posteroanterior and lateral views of chest.The plain and contrast-enhanced CT scans were performed in 28 and 15 cases.MRI examination was done in 6 cases.The location,size,shape,density,edge,wall and adjacent structures of the primary mediastinal cysts were observed.According to imaging features all of cases was divided into typical group and atypical group.Results The mediastinal cysts were located in anterior mediastinum in 28 cases,in middle mediastinum in 7 cases,in posterior mediastinum in 7cases.Bronchogenic cyst was in 9 cases.Cystic lymphangioma was in 4 cases.Thymic cyst was in 11 cases.Pericardial cyst was in 5 cases.Mature cystic teratoma was in 13 cases.The typical group was in 38 cases.The atypical group was in 4 cases.Conclusion 90% of the typical primary mediastinal cysts can be diagnosed.The final diagnosis of the atypical group desponds on pathology.

Objective To construct eukaryotic expression plasmid of human B7-H1 extracellular region-hIgG1Fc-pCI-neo eukaryotic expression vector,and express the functional fusion protein in mammalian CHO cell.Methods Full-length human B7-H1 encoding sequence was amplified from human activated T cell cDNA library by PCR,fused with hIgG1Fc,then transformed into pCI-neo expression vector and verified by sequencing.The validated recombinant was transfected into mammalian CHO cell by lipofectamine reagent.The supernatant of the cultured cell was collected and analyzed by the sandwhich ELISA to detect if there was the fusion protein,and the fusion protein was purified by HiTrap recombination protein Protein A affinity chromatography.The concentrated supernatant or purified fusion protein were used for Western blotting after SDS-PAGE to identify the molecular weight and immune activity of the fusion protein of B7-H1.Results The extracellular region of hB7-H1 about 727 bp was cloned from human T cell cDNA library and was inserted with hIgG1Fc into the eukaryotic expression vector pCI-neo.After the transfection of recombinant into mammalian CHO cell by lipofectamine reagent,the expression of B7-H1 fusion protein was detected in the cultured CHO cell supernatant by the sandwhich ELISA.The immune activity of the fusion protein was verified by Western blotting,and its molecular weight was about 51.76?10~(3),very close to the expected value.Conclusion The hB7-H1-Fc chimeric molecule was successfully constructed and the expression of its functional fusion protein in mammalian CHO cells lays a foundation for further research on the role of B7-H1 in immune tolerance,autoimmune diseases.

Objective To study the cause and treatment of chronic instability of the elbow.Methods Between August 1998 and August 2002,12 patients with chronic instability of the elbow were treated in our de- partment:They underwent complete medical check-ups and imaging examinations.Surgical exploration was done to determine the causes of their conditions.Their radial and(or)ulnar collateral ligaments were repaired respectively or simultaneously through the medial and lateral approaches for all the patients.All the patients were followed up for two to six years,with an average of three years.Results The follow-ups revealed no recurrent dislocation of elbow in this group.The stress valgus test and lateral pivot shift test(PST)were negative for all the patients.No elbow pain occurred.The mean flexion and extension of elbow ranged from 0 to 135?.The mean pronation was 85?and mean supination 80?.According the evaluation system of Chinese Medical Association,eight cases were rated as excellent and four as fine,with the excellent and fine rate of 100%.Conclusions Lesions of radial and(or) ulnar collateral ligaments are the major cause for chronic instability of the elbow.Surgical reconstruction of the collateral ligaments can obtain good effects in treatment of recurrent dislocation of the elbow.

Objective:To observe the expression of miR-30c-5p and Toll-like receptor 4(TLR4) in colon cancer tissues and cells, and to explore their relationship with clinicopathological features.Methods:As a prospective study, 30 cases of colon cancer surgical specimens and matched normal tissue samples were selected from the Cancer Hospital of China Medical University from May 2016 to may 2017.The expression of miR-30c-5p mRNA was detected by quantitative real-time polymerase chain reaction(qRT-PCR), and the expression of TLR4 Protein was detected by western blot (WC). The expression differences of miR-30c-5p mRNA and TLR4 protein in different TNM stages, differentiation degrees and diameters were observed.The correlation between the expression of miR-30c-5p and TLR4 Protein was analyzed by Pearson Rank method.Results:The expression of miR-30c-5p was lower in colon cancer tissues(0.311±0.147) than in adjacent normal colon tissues(0.881±0.266)( t=10.613, P<0.001). TLR4 protein was higher in colon cancer tissues(0.729±0.274) than in adjacent normal colon tissues(0.361±0.168)( t=6.310, P<0.001). Expression of miR-30c-5p was lower in colon cancer cell lines(0.394±0.045, 0.435±0.098, 0.533±0.092, 0.272±0.069) than in normal colon epithelial cell line(1.371±0.101)( t value were 6.744, 6.432, 6.865 and 6.201, respectively; P<0.001). The expression of TLR4 protein was higher in colon cancer cell lines(1.108±0.169, 1.035±0.177, 1.114±0.253, 1.116±0.157) than in normal colon epithelial tissues(0.358±0.094)( t value were 5.789, 4.799, 5.311 and 5.292, respectively; P<0.001). Pearson rank correlation showed that miR-30c-5p was negatively correlated with TLR4 protein expression( r=-0.487, 95% CI: -0.721--0.154, P<0.01). MiR-30c-5p was decreased with TNM stage increasing( F=31.406, P<0.001), pathological differentiation degree decreasing( F=9.960, P<0.001), tumor diameter increasing( F=10.267, P<0.001). TLR4 was increasing with TNM stage increasing( F=37.634, P<0.001). TLR4 increased with the decrease of tumor differentiation( F=38.027.35, P<0.001). TLR4 increased with tumor diameter ( F=20.717, P<0.001). Conclusion:The low expression of mir-30c-5p and high expression of TLR4 in colon cancer were correlated with TNM stage and tumor volume.

Objective To analyze the risk factors of fevers after percutaneous nephrostolithotomy (PCNL) and to determine a more effective prophylaxis method.Methods A retrospective analysis of 320cases who underwent PCNL for renal calculi from 2008 to 2011 (men 233,women 87,age between 22 years to 72 years) was made.The average age of the patients and the average diameter of the stones were 42 years and 3cm(0.8 -6 cm),respectively.We analyzed factors such as age ( ＞60 years and ≤60 years),stone size ( ＞2.0 cm and ≤2.0 cm),operative time ( ＞60 min and ≤60 min),irrigation pump pressure ( ＞120 mm Hg and ≤ 120 mm Hg),obstructive conditions,preoperative urinary tract infection and fever.Wethen compared the fever rate with each of the risk factors.Results There were 59 cases with fever after PCNL; 18.4％ of the cases had a temperature over 38 ℃.There were two cases of pyemia.The patients whose stone diameter ＞ 2 cm had a post-operative fever rate of 22.4％.The fever rate in patients whose stone diameter ≤2.0 cm was 10.4％.The fever rate in patients with an operative time ＞60 min and ≤60 min was 27.2％ and 10.4％,respectively.Patients with irrigation pump pressure ＞ 120 mm Hg and ≤ 120mm Hg had post-operative fever rates of 28.3％ and 11.0％,respectively.There was statistical significance between each post-operative fever risk factor group.Conclusions The post PCNL fever risk factors are stone diameter ＞ 2.0 cm,operation time ≤60 min and irrigation pump pressure ＞ 120 mm Hg.The effective prophylaxis policy of post-operative fever are the pre-operative using of broad-spectrum antibacterial agents,shorter operative time and lower irrigation pump pressure.A two-stage operation procedure will also reduce the post-operative fever.

OBJECTIVEIn the recent twenty years, the diaphragmatic contraction, relaxation functions and electric activity have been explored through electromyography (EMG) and transdiaphragmatic pressure (Pdi) determination. But these techniques required some complex and expensive instruments, so the diagnosis and treatment of children's diaphragmatic fatigue have not been well evaluated. The present study explored the diagnosis of children's diaphragmatic fatigue through measuring ribcage-abdomen motion and analyzed its asynchrony.

METHODSFifty-three children (male 37, female 16, and age rage from 1 months to 9 years) with respiratory rate > 30 breaths/min, heart rate > 110 beats/min, and respiratory dysfunction had asynchronized ribcage-abdomen motion showed by impedance respirograph (IRG). The authors observed whether ribcage-abdomen motion was synchronic and calculated M levels (staggered peak time/total duration of the breathing cycle). The ribcage and abdomen outputs were displayed on vertical (for rib cage) and horizontal (for abdomen) axes of X-Y instrument. In addition, the change of respiratory frequency and heart rate was observed and arterial blood-gas analysis was also performed.

RESULTS(1) M levels in one-dimensional IRG were positively correlated with alpha angle in two-dimensional IRG (r = 0.956, P < 0.001). Asynchronized respiratory motions could be divided into three types. type I showed completely contra-directional movements of respiration, M levels for (48.1 +/- 4.4)%, an irregularly clockwise loop in the two dimensional IRG, and alpha angle for (138.3 +/- 15.0) degrees. In type II, one dimensional IRG showed displaced peak of the chest and abdomen motion curves, M levels were (16.5 +/- 4.7)%, two dimensional IRG was displaced in a counterclockwise direction, and alpha angle was (55.3 +/- 10.8) degrees. In type III, abdominal motion curve of one dimensional IRG had double peaks, M levels were 0, two dimensional IRG was presented as 8-shaped double circles, alpha angle was (41.3 +/- 3.8) degrees; (2) pH levels in the patients with type I and type II diaphragmatic fatigue were significantly lower, and PCO(2) levels were significantly higher than those with type III or in the normal subjects (P < 0.001 for all), but there was no statistically significant difference between type III and the normal subjects (P > 0.05); (3) Both of respiratory rate and heart rate in type I, type II and type III were higher than those in the normal subjects (all P < 0.001), and the differences among the three types were significant (P < 0.001 for all); (4) Both M levels and alpha angle were negatively correlated with pH levels (r = -0.514, P < 0.001 and r = -0.497, P < 0.001), while positively correlated with PCO(2) levels (r = 0.672, P < 0.001 and r = 0.625, P = 0.01).

CONCLUSIONS(1) IRG can be reliably used to diagnose children's diaphragmatic fatigue. This technique is simple and easy to perform and non-invasive. It is therefore worthy of recommending for further clinical investigations. (2) According to the characteristics of IRG, diaphragmatic fatigue can be divided into three types. (3) The development of children's diaphragmatic fatigue has a series of characteristic changes. (4) To avoid the patients suffering from respiratory failure, it is the key time to adopt the policies of prevention and treatment when IRG shows signs of type III diaphragmatic fatigue.

Child ; Child, Preschool ; Diaphragm ; physiopathology ; Fatigue ; classification ; diagnosis ; Female ; Humans ; Infant ; Male ; Respiration ; Respiratory Function Tests ; methods

Animal operation training is an important course that medical students need to study before they get into their clinical practice.Because there is no cavity mirror operation training standard and teaching experience for interns,we have put forward and conducted the animal laparoscopic teaching applications in surgery teaching,and evaluated the teaching effect.Through training,the clinical medical students have personally experienced and learnt basic operation skills of laparoscopic surgery,which is an organic link from textbooks to clinical practice,and at the same time they have improved the ability of clinical practice,cultivate and strengthen their interest in laparoscopic surgical skills training and operation,which help them lay a good foundation for clinical practice.