220 cases of tympani membrane perforated were summarized retrospectively. The tympani membrane perforated of injury was different from otitis media's because they had marked or extreme marked difference in sex, age, ear distinction, shape, position, size, degree of hearing damaged, time of healing, cause of perforating and adhesive substance. This difference was relative to mechanism of tympani membrane perforated. The distinction gist of two sorts of tympani membrane perforated was expounded through comparison and analysis. It would be of great value to clinical forensic medical examination.

AIM　To research the chemical constituents from dried roots of Uncaria yunanensis Hsia.C.C. METHODS　Modern chromatography was used to isolate chemical components. Their structure were identified by spectral analysis. RESULTS　Seven compounds were isolated and identified as 3β,6β,19α-trihydroxyurs-12-en-28 oic acid (I), 23-nor-24-esomethylene-3β,6β-19α-trihydroxyurs-12-en-28 oic acid (II), 3-oxo-6β,19α-dihydroxyurs-12-en-28 oic acid (III), oleanic acid (IV), 5,7,3′,4′-tetrahydroxy-flavan-3-ol (V), β-yohimbine (VI) and diangoutengjian I (VII). CONCLUSION　All of the above compounds were isolated for the first time from the root of this plant. Among them, compound VII is a new one.

To investigate the therapeutic effect of ascitic fluid ultrafiltration refusion and perfusion of ?-elemene milk into abdominal cavity on carcinomatous ascites. Seventy-two cases of malignant tumor complicated with carcinomatous ascites were randomized to two groups: group A treated with perfusion of ?-elemene milk into abdominal cavity after ascitic fluid ultrafiltration refusion and group B with perfusion of ?-elemene milk into abdominal cavity after letting-out of ascitic fluid by regular and repeated abdominal paracentesis. Therapeutic effect was compared and ascitic protein (AP) , plasma albumin(PA) content, urine volume and Karnofsky scores were observed before and after treatment as well as the toxic and side effects.In group A, 9 cases were completely relieved (CR) , 22 partially relieved (PR) , 12 not changed (NC) and the effective rate was 86.1%;in group B,4 were CR, 20 PR, 12 NC and the effective rate was 66.7% respectively, the differences being significant (P

Objective To investigate the clinical value of antibody D5F3 and Survivin in patients with non small cell lung cancer.Methods 200 paraffin embedded specimens of patients with non small cell lung cancer tested by RT-PCR(including EML4-ALK mutant and wild type)from October 2012 to June 2014 were selected.The gene protein expression were tested by ALK new antibody D5F3 and the sensitivity and specificity were compared by negative and positive(+～3+).ResultsTest results show(+)the coincidence rate is 15.78％,(+ +)the coincidence rate is 27.27％and(+ + +)compliance rate was 87.5％,the difference was statistically significant(P<0.05).The expression of Survivin protein in NSCLC tissues was correlated with clinicopathological features.The positive rate of Survivin protein expression was correlated with the degree of differentiation(P<0.05),but not with other clinical and pathological features,with the decrease of differentiation,the positive rate of Survivin protein expression was significantly increased.Conclusion D5F3 and Survivin antibodies are highly sensitive and specific in patients with NSCLC,with the screening value,save social resources,for the majority of patients with lung cancer services.

Objective To study molecular biology and clinicopathologic characters of peritoneal metastasis of advanced gastric cancer and their relationship to prognosis. Methods Based on the molecular biology and the clinicopathologic characters and prognosis single-factor analysis of relevant factors and risk assessment was made in 193 cases of gastric cancer.Results The younger the patient was with the earlier the time of occurrence of peritoneal metastasis of gastric cancer. There was a high expression of ICAM-1 and MMP-2,but low expression of TIMP-1 and p53 in gastric cancer patients with peritoneal metastasis.Conclusions ICAM-1,MMP-2,TIMP-1 and p53 can well predict the occurrence of metastasis and the prognosis of patients with gastric cancer,and these factors can be used for preoperative assessment of the development of metastasis of gastric cancer.

220 cases of tympani membrane perforated were summarized retrospectively. The tympani membrane perforated of injury was different from otitis media's because they had marked or extreme marked difference in sex, age, ear distinction, shape, position, size, degree of hearing damaged, time of healing, cause of perforating and adhesive substance. This difference was relative to mechanism of tympani membrane perforated. The distinction gist of two sorts of tympani membrane perforated was expounded through comparison and analysis. It would be of great value to clinical forensic medical examination.
Adolescent ; Adult ; Aged ; Child ; Diagnosis, Differential ; Female ; Forensic Medicine ; Humans ; Male ; Middle Aged ; Otitis Media/complications* ; Retrospective Studies ; Tympanic Membrane/injuries* ; Tympanic Membrane Perforation/etiology*

Objective To investigate the characteristics and prevention of deep fungal infection (DFI) complicated by severe acute pancreatitis (SAP). Methods Clinical data of 135 SAP cases admitted from Oct. 1998 to Oct. 2009 were studied, the prevention and management of SAP with DFI ( 32cases) were investigated, among them there were 19 males and 13 females. Results Seven patients (21.9%) died of these 32 cases. The SAP patients with DFI were of more critical condition, longer course and having to stay in ICU about (21±6) d, most needed surgical debridement, on long-term indwelling catheters, intubation and mechanical ventilation, parenteral nutrition, long-term use of broad-spectrum antibiotics. These patients remained in the hospital for about (78 ± 14) d. Conclusions DFI is a common complication in SAP cases causing a significant mortality hence necessitating comprehensive prevention and control measures such as proper handling of the original disease, aseptic operation, prophylactic antibiotics and antifungal agents, which can reduce the incidence and mortality of SAP with DFI.

Objective:To investigate the value of anti-hexokinase1 antibodies (anti-HK-1) and anti-kelch-like 1 antibodies (anti-KLHL12) antibody in evaluating ursodeoxycholic acid (UDCA) response in patients with primary biliary cholangitis (PBC).Methods:112 PBC patients who had been treated with UDCA for more than 12 months with relatively complete clinical data were analyzed. Serum was collected and the expression of anti-mitochondrial antibody (AMA), anti-HK-1 and anti-KLHL12 antibodies were detected by ELISA. The response to UDCA was based on Paris standard. According to the expression of new antibodies, the patients were divided into the new antibody positive group and negative group. In addition, PBC related baseline indicators were collected, and Spearman correlation analysis was used to study the correlation between antibody expression and baseline indicators in PBC patients.Results:Positivity of anti-HK1 and anti-KLHL12 antibody in AMA-positive PBC patients were 44.7% and 41.2% respectively. Positivity of anti-HK1 and anti-KLHL12 antibodies in AMA negative PBC patients were 33.3% and 22.2%. Anti-HK1 positive patients had higher serum levels of Alaninetransaminase (ALP), aspartate aminotransferase, (AST), γ-glutamyl transpeptidase (γ-GT) and total bilirubin (TBIL) compared with anti-HK1 negative patients, with statistical significant differences ( P<0.05). Notably, correlation analysis showed significantly positive correlation between anti-HK1 antibody expression and ALP, γ-GT and TBIL serum levels ( r=0.735, P<0.05; r=0.332, P<0.05; r=0.491, ( r=0.466, P<0.05). The UDCA response rate in anti-HK-1 antibody positive group was lower than that of the negative group (36.2% vs 60%; P<0.05). Conclusion:Anti-HK-1 and anti-KLHL12 antibody can help to diagnose PBC, and the expression of anti-HK-1 antibody is correlated with the severity of PBC, which could help to predict the reaction of PBC patients to UDCA.

Objective To identify the configuration of the fascial sheath of the sciatic nerve in the adult pelvis . Methods A total of 14 cadaveric pelvic specimens and 20 living subjects were used for cadaveric examination and magnetic resonance imaging ( MRI) observation , respectively .The cadaveric specimens were investigated by the local latex injection method ( n =10 ) sectional anatomy ( n=2 ) or histological staining methods ( n =2 ) .The MR images were collected and analyzed from twenty patients without pelvic disorders .Results The injected latex did not diffuse along the pelvic segment of the sciatic nerve .Sectional anatomical and histological data showed that the architecture of the fascial sheath of the sciatic nerve varied at different levels .An intact circular sheath around the nerve was rarely observed .There was no fascia barrier between the obturator and sciatic nerves .Appearance on MRI was consistent with the cadaveric observation.Conclusion No intact fascial sheath exists along the pelvic segment of the sciatic nerve , thus sciatic anesthesia may block the obturator nerve .

ObjectiveTo compare liver pathology changes of patients with Budd-Chiari syndrome (BCS) and intrahepatic portal hypertension (IPH) after portosystemic shunt surgery. MethodsFrom January 2010 to December 2011,liverbiopsy was taken during shunt surgery (9 BCS patients,4 IPH patients),and 6-9 months after surgery on follow-up.Collagen type Ⅳ ( Col Ⅳ ),procollagen m (PC Ⅲ ),matrix metalloproteinase (MMP-1),tissue inhibitors of metalloproteinase(TIMP-1) were tested using SABC (immuonohistochemistry) method,and HE staining to observe the morphology of liver tissue.Free portal vein pressure before and after shunt was measured. ResultsIn BCS group,Col Ⅳ,PC 1Ⅲ and TIMP-1expression downregulated after surgery (127 ±15) vs.(137 ±16),t =4.896,P-0.013; (115.2 ± 10.6) vs.(127.3±9.5),t=4.877,P=0.003; (119.2±11.3) vs.(131.2±l9.6),t=2.841,P=0.023.MMP-1expression did not change ( P ＞ 0.05 ),while MMP-1/TIMP-1was not significantly correlated with liver fibrosis (0.95 ±0.16) vs.(0.98 ±0.15),t =-0.710,P =0.504.In IPH group,the expression of Col Ⅳ,PCⅢ,MMP-1,and MMP-1/TIMP-1did not change significantly after surgery (P ＞0.05).Compared with that in IPH group the expression of PC Ⅲ,Col Ⅳ and TIMP-1downregulated significantly in BCSgroup (127±15) vs.(150 ±12),U=3.000,P=0.038; (115.2 ±10.6) vs.(128.1±2.8),U=2.000,P=0.023; (119.2 ± 11.3) vs.(131.4 ±2.5),U=3.000,P =0.038.By HE staining in BCS group there was significant intrahepatic congestion which alleviated after surgery.While in PHT group liver pathology did not change significantly after surgery.FPP in BCS and IPH patients significantly decreased after shunt surgery (25 ±8) vs.(41±8) cmH20,t=17.816,P=0.000;(31±8) vs.(45 ±9) cmH20,t =5.745,P =0.010 ). Drop of FPP of BCS group plays a key role in reversal of liver fibrosis.ConclusionsIn BCS group liver pathology improved after shunt surgery probably by removing the intrahepatic obstruction,but in IPH group liver pathology remained unchanged after shunt.