简介：【简要病史】患者袁XX,女性,10岁,汉族,山东青岛人,小学生,以＂颈部肿痛伴发热7天＂入院。患者7天前感冒后出现咽喉痛、颈部疼痛伴发热（38度）,吞咽时疼痛加重,但不伴呼吸困难、咳嗽等,在我院门诊按＂颈部包块伴感染＂给予＂头孢哌酮钠舒巴坦钠＂抗感染治疗症状无好转,遂急诊入院。

简介：Cisplatindamagescochlearhaircellsandspiralganglionneuronsthroughcelldeathsignalingpathwaysthatarenotfullyunderstood.Weusedfocusedapoptosisgenemicroarraystostudyearlychangesingeneexpres-sionincochlearculturesfromP3neonatalratstreatedwithcisplatin(0.2mM).After12hoursofcisplatintreat-ment,morethan50%ofthe96genesonthearrayshowedasignificantdecreaseinexpression,consistentwithwidespreadcelldeath.However,after3hoursofcisplatintreatment,10genesshowedsignificantincreaseinex-pressionintotalcochleartissue.Inexperimentswithsubsetsofcochleartissues,at3h,cisplatininducedincreasedexpressionof12genesinthecochlearsensoryepithelium(basilarmembrane)and11genesinthespiralganglion(tissueofRosenthal'scanal,containingthespiralganglion).Theseincludedpro-andanti-apoptoticgenesin-volvedinthep53signalingpathway,TNFreceptorfamily,NF-kappaBpathway,deathdomainfamily,deatheffec-tordomainfamily,Bcl-2family,CARDfamily,TRAFfamily,andGTPsignaltransduction.Althoughthechangesingeneexpressionshowedanoverlapbetweenbasilarmembraneandspiralganglion,otherchanges,whichmayreflecttheuniqueresponseofeachtissue,werealsoobserved.Pifithrin-αblockedcisplatin-inducedup-regulationofgenesinthep53signalingpathwaywhenassayedbybothsuperarrayandrealtimePCR.Thedataaddtoourunderstandingoftheinvolvementofp53incisplatin-inducedototoxicityandotoprotection,conferredbythep53inhibitorPifithrin-α.

简介：NuclearfactorkappaB(NF-κB)isoneofthebest-characterizedtranscriptionfactorsplayingimportantrolesinmanycellularresponsestoalargevarietyofstimuli,includinginflammatorycytokines,phorbolesters,growthfactors,andbacterialandviralproducts.TheaimofthisstudyistodemonstrateNF-κBexpressioninthemousecochleaanditsenhancementinresponsetolipopolysaccharides(LPS)andkanamycin(KA)treatment.MethodsKAtreatmentconsistedofsubcutaneousKAinjectionsat700mg/kgtwiceadaywithaneight-hourintervalbetweenthetwoinjectionsfor3or7days.ForanimalsintheLPStreatmentgroup,asingledoseof0.3mgLPSdissolvedin0.2mlsterilesalinewereinjectedintobothbullaethroughthetympanicmembraneandkepttherefor3hours.Animalsinthecontrolgroupreceivedsubcutaneoussalineinjectionfor7days.Followingimmmunohistochemichalprocessingwithrabbitpolyclonalanti-NF-κBp65antibodies,cryosectionsofthecochleawereexaminedforexpressionofNF-κBp65invariousstructuresinthecochlea.ResultsNF-κBp65expression,identifiedbypresenceofbrownreactionproductscharacteristicofDABimmunohistochemistry,wasvisibleinthespiralligament,spiralprominence,tectorialmembrane(TM),spiralganglionandnervefibers.RelativelyweakNF-κBp65expressionwasalsovisualizedintheorganofCorti.WithintheorganofCorti,theinnerhaircells(IHC),outerhaircells(OHC),innerpillarcells(IP),outerpillarcells(OP),Deiter'scells(DC),andBoettcher'scellsexhibitedstrongerstainingthantheinnersulcuscells,Hensen'scells(HC)andClaudius'cells.NoNF-κBp65expressionwasseeninthenucleusoftheIHCandOHC.NF-κBp65expressionwasincreasedinanimalsexposedtoLPSorKA,demonstratingsignificantdifferencesinthestainingbetweencontrolanimalsandLPS/KA-treatedanimals.NF-κBp65expressionwasnotsignificantlydifferentbetweenLPStreatedandKAtreatedanimalsorbetween3and7daysinKA-treatedanimals.Conclusio

简介：摘要目的研究“集中培训+交流合作+自主发展”干预模式在预防糖尿病足中的应用效果。方法选择158例2型糖尿病合并糖尿病高危足患者为研究对象，随机分为观察组和对照组各79例，对照组实施糖尿病常规护理，观察组施行“集中培训+交流合作+自主发展”的干预模式。结果观察组在遵医用药、足部护理、血糖监测、饮食控制、加强运动各维度得分、糖尿病足知识及足部自我护理优良率均高于对照组，糖尿病足发生率(1.27%)明显低于对照组(8.86%)（P<0.05）。结论“集中培训+交流合作+自主发展”干预模式能提高2型糖尿病患者自我管理水平，有效预防糖尿病足的发生。

简介：Managingmicrotiapatientsisalwaysachallenge.Multidisciplinaryapproach,goodfamilysupport,wellestablisheddoctorepatientrelationshipandwellorganisedpatient-supportgroupsaretheessentialelementsforsuccess.Withtheadvancementofimplantablehearingdevices,moreoptionswillbeavailableforthemicrotiapatients.Otologistsplayaleadingroleinthewholemanagementprocess.Theynotonlyprovideproperguidancetothepatientsinchoosingthecorrectpathofthetreatment,butalsoplayakeyroleinorganisingandmaintainingacosteffectivemultidisciplinaryrehabilitationteamforthemicrotiapatients.

简介：Applicationofsurgicalendoscope,usedaloneorincombinationwiththesurgicalmicroscope,fortheoperativemanagementofearandtemporalboneconditionsmayallowimprovedaccessandclearanceofdisease.Preservationofnormalstructuresmayalsobeimproved.Astheuseofthistoolisincreasing,theneedforbetterunderstandingoftheanatomyoftheearisbecomingevident.Thisisparticularlysoforendoscopicsurgeryaimingatremovaloflesionsinvolvingtheinfra-cochlearcorridorand/orpetrousapex.Humantemporalbone-derivedlabyrinthcasts(molds),originallymadeforendolymphaticductandsacanalysiswhichgenuinelyrepresentthemembranouslabyrinthanditsadjacentsofttissues,weremorphometricallyanalyzedintermsoftheanatomicrelationsbetweenstructuresinandaroundtheinfra-cochlearcorridor.Thedistancebetweenthepetrouscarotidartery(PCA)andthebasalturnofthecochlea,thedistancebetweenPCAandinfra-cochlearvein(ICV)/cochlearaqueduct(CA),andthedistancebetweenthelowersurfaceofbasalcochlearturnandthepointwherethecarotidarteryandjugularvein(JV)meetclosetothejugularforamen,weremeasuredtobearound1.3mm,6mmand8mmrespectively,thusconstitutinganapproximate68mm2infra-cochlearcorridor.Thisanalysisandfurtherstudywithlargersamplesmightbehelpfulforoperationviathiscorridorledtothepetrousapexwherecholesterolgranuloma,cholesteatomaandotherlesionsarenotuncommon.

简介：ObjectiveAlongwithchangesintheecologysystemandundertheinfluenceofvariousenvironmentalfactors,theincidenceoftumorhasbeenincreasingyearafteryear.Thereisatrendincancertherapytomovetocombinedtherapiesinvolvingsurgery,radiationchemotherapyandgenetherapy.Cancergenetherapyinrecentyearshasbroughtnewopportunitiesfortreatmentoftumor.Itsadvantagesincludelowrateoftolerance,insensitivitytocellcycles,highspecificityandcoverageforbothprimaryandmetastatictumors1,2.However,thisisanewfieldofclinicalresearch.RegardingthecorrelationamongtheSTAT3,CyclinD1andP21genesandtumors,researchhasfocusedontheirexpressionandregulation.Thisarticleprovidesasummaryofrelatedresearch.

简介：Background:Currently,thereisasignificantlackofdataconcerninglong-termoutcomesfollowingpaediatriccochlearimplantationintermsofqualityoflife.Thereisaneedforalong-term,prospectivestudyinthisregard.Thisstudyaimsathighlightingthepreliminaryresults,oneyearpostsurgeryofafiveyearprospectivestudy.Methods:TheCochlearTMPaediatricImplantedRecipientObservationalStudy（P-IROS）isaprospective,patientoutcomesregistryforroutinelyimplantedchildren.Thestudycollectsdatausingquestionnairespost-surgeryandatregularintervalsuptofiveyears.Results:AtourCentre,159cochlearimplantsurgeryprocedureswerecarriedoutbetweenJanuary2014andDecember2014.CategoryofAuditoryPerformanceIIscoreincreasedfrom‘0’to‘3’atsixmonthsandto‘5’at12monthsforchildrenaged0—3years,althoughthiswasnotstatisticallysignificant.However,thesametrendwasstatisticallysignificantfortheage3—6yearandage6—10yearbrackets.Thequalityoflifeofthechildimprovedsignificantly.Analysisofcommunicationmoderevealedastatisticallysignificantoverallshifttotheauditory-oralmodefromtotalcommunication.Conclusion:Cochlearimplantationisalife-changingintervention.Theevidenceinsupportofwhatitcanachievesafelyisclear.However,thecostsassociatedwithitraisethequestionifitwillremainaneffectiveoptionforlifeinallchildren.TheCochlearP-IROSisanattempttoanswerthesameoverafiveyearperiod.OurstudyinNewDelhi,sofarconcludesthatcochlearimplantationinapopulationwithlimitedaccesstofundsisveryeffective,oneyearaftersurgery.

简介：目的构建含有人E2F2基因和绿色荧光蛋白基因（pEGFP）的腺病毒载体,为聋病的基因治疗奠定实验基础。方法根据已知的E2F2基因序列设计并合成相应的双链DNA,将其与酶切线性化的pDC315-EGFP载体片段连接,构建穿梭质粒pDC315-GFP-E2F2,并将其与腺病毒骨架质粒pBHGlox△E1,3Cre共转染HEK293细胞,同源重组产生重组腺病毒。对重组腺病毒进行扩增、纯化及滴度测定,用聚合酶链反应和测序方法验证穿梭质粒pDC315-GFP-E2F2穿梭质粒的构建;通过荧光显微镜和Westernblot（蛋白质印迹）方法,分别检测质粒pDC315-GFP-E2F2和重组腺病毒表达E2F2蛋白情况。结果经聚合酶链反应鉴定和测序分析,证实穿梭质粒pDC315-GFP-E2F2与设计一致;经荧光显微镜检测,分别由穿梭质粒pDC315-GFP-E2F2、重组腺病毒转染的HEK293细胞均可观察到GFP表达;经WesternBlot检测出在72kDa～95kDa处有条特征带,其大小和E2F2-GFP融合蛋白（～76kDa）相吻合;滴度测定为1×1011PFU/ml（PFU,plaqueformingunit,空斑形成单位）。结论成功构建了人E2F2基因重组腺病毒载体,并能在HEK293细胞中表达。

简介：目的研究10号染色体缺失张力蛋白磷酸酶（phosphataseandtensinhomologuedeletedonchromosometen，PTFEN）、磷酸化Akt（P—Akt）及核转录因子-KB（NF—KB）在中耳胆脂瘤上皮中的表达，探讨P13K（phos—phatidylinositol-3-kinase，磷脂酰肌醇-3激酶）-Akt信号通路在中耳胆脂瘤上皮细胞过度增殖机制中的可能作用。方法采用免疫组织化学SP法（辣根酶标记链霉卵白素连接法，streptavidin—peroxidaseconjugatedmethod）检测30例中耳胆脂瘤组织标本与15例正常外耳道皮肤标本中PTEN、P—Akt及NF—KB蛋白的表达。结果PTEN蛋白阳性表达主要定位于上皮细胞核，其在中耳胆脂瘤上皮中阳性表达率为36．7％，明显低于正常外耳道皮肤组的9313％（P〈0．01）；P—Akt蛋白阳性表达主要定位于上皮细胞胞质，其在中耳胆脂瘤上皮中阳性表达率为70．0％．明显高于正常外耳道皮肤组的26．7％（P〈0．01）；NF—KB蛋白阳性表达定位于上皮细胞核．其在中耳胆脂瘤上皮中阳性表达率为63-3％，明显高于正常外耳道皮肤组的20．0％（P〈0．01）。在30例中耳胆脂瘤上皮组织中，PTEN分别与P—Akt、NF—KB蛋白的表达之间呈显著负相关（P〈0．01），而P—Akt和NF—KB蛋白的表达呈显著正相关（P〈0．01）。结论PTEN、P-Akt和NF—KB在中耳胆脂瘤上皮的异常表达可能在胆脂瘤的发生、发展过程中起重要作用。胆脂瘤上皮中P13K—Akt信号通路的激活可能参与了胆脂瘤上皮细胞过度增殖机制。

简介：从医58年来，王天铎教授以其精湛的技术、高尚的医德、严谨的学风，努力工作，勤奋耕耘，把全部身心都致力于耳鼻咽喉头颈外科事业的发展，取得了极其丰硕的成果，为科室发展及我国的耳鼻咽喉头颈外科事业作出了巨大贡献。特别是在咽喉肿瘤的手术治疗方面不仅在省内、国内耳鼻咽喉头颈外科学界享有极高的威望，而且在国际学界也享有较高声誉。