Objective To investigate the nursing intervention of pregnant women with antiphespholipid syndrome(APS). Methods In experimental group 40 cases with APS positive and control group 40 cases with APS ACA-negative for comparison. Results The abortion occurred in 6 cases(15. 0%) ,2 cases of stillbirth(5.0%) ,loss of pregnancy(abortion+stillbirth) 8 cases (20. 0%) in experimental group. The abortion occurred in 2 cases (5.0%), no stillbirth in control group. The loss of pregnancy in experimental group were significantly higher than the control group (X2=9. 54, P＜0. 005 ). The rate of positive in ACA-IgG (40. 0%) after treatment lower than before treatment (52. 5 %) (X2 = 3.85, P＜0. 05). The rate of positive in ACA IgM (37. 5%) after treatment lower than before treatment(40. 0)% (X2=3.81 ,P＜0. 05 ). Conclusion The APS positive rate and the loss of pregnancy were closely related. The overall nursing intervention conld improve efficacy and reduce the complications.

Objective To investigate the efficacy to pregnant outcoule with antieardiolipin antibody(ACA) of qualitative and quantitative before treatment and after treatment in women pregnant with antiphospho-lipid syndrome (APS).Methods The heparin combined with aspirin therapy APS 40 patients before and after treatment to momtor the change of ACAIgG,IgM.Results 40 patients were treated 37 eases of live births,success rate were92.5%,the rate of pregnancy loss were3 cases(7.5%);The lever of ACA-IgG and ACA-IgM were(67.63±2.53)u and (49.40±3.64)u beforetreatment andlever of ACA-IgG and ACA-IgM were(23.87±1.54)u and(21.60±2.59)u after treatment.The lever after treatment were significandy Iower than the before treatment(P＜0.01);The level of ACA were overall downward in 40 cases after treatment by dynamic observation;The rate of positive in ACAIgG (40.0)% after treatment lower than before treatment(52.5)%(X2=3.85,P＜0.05);The rate of positive in ACA IgM(37.5)% after treatment lower than before treatment(47.5)%(X2=3.81,P＜0.05).Conclusion Hepfinar treatment combined with aspirinmay be a safe and effective method for patients with APS.

OBJECTIVE: To explore and summarize the operation method and operation stage for cochlear implant with chronic suppurative otitis media, to provide the clinical reference for cochlear implant with chronic suppurative otitis media. METHOD: The clinical data of 6 cases of cochlear implant with chronic suppurative otitis media from Jun 2006 to Mar 2009 in our hospital was analyzed retrospectively. The operation stage. surgical skill, possible risk and prognosis was analyzed and summarized. RESULT: 3 of 6 cases received single stage subtotal petrosectomy and cochlear implant. 3 of 6 cases received subtotal petrosectomy, they received staged cochlear implant 1 to 6 months later. No complications occurred, all of the cochlear implanted had good open set speech perception. CONCLUSION Staged operation was the first choice for cochlear implant with chronic suppurative otitis media. Single stage operation took potential risks, it should be done cautiously. The key points for the operation was the clearance of the pathological tissue totally, this required good surgical skill and operation instrument.
Adolescent ; Aged ; Chronic Disease ; Cochlear Implantation ; methods ; Female ; Humans ; Male ; Middle Aged ; Otitis Media ; surgery ; Retrospective Studies ; Treatment Outcome

BACKGROUND: In the past, a lot of researches used one-time lead level in umbilical cord blood at birth for investigations,however, one-time lead level in umbilical cord blood at birth can not represent lead caused cumu lative injury to neonatal nervous system during the whole period of preg nancy. Lead in meconium is mainly from digestive juice secreted by fetal alimentary tract, exfoliative epithelia from neonatal intestinal tract and am niotic fluid and sebum cutaneum swallowed by fetus, which is excreted from the very start of pregnancy to 24 hours after birth of neonates and re flects the lead deposit in neonatal intestinal tract during the whole period of pregnancy. OBJECTIVE: To explore the relationship between neurobehavioral devel opment in neonates with intrauterine exposure to lead at low level and the lead level in umbilical cord blood (CBPb) and meconium (MPb). DESIGN: Take lead levels in umbilical cord blood and meconium as neonatal intrauterine exposure indicators and scores of neonatal neurobe havioral development as effect indicators, and descriptive analysis is used to evaluate the correlativity. SETTING: Wuhan University of Science and Technology; Laboratory of Occupation Disease and Epidemiology, Tongji Medical College, Huazhong University of Science and Technology; Wuhan First Metallurgical Con struction Company Hospital for Workers and Staff. PARTICIPANTS: A total of 103 cases of full-term and healthy neonates were selected as objects of observation. The neonates were born in Depart ment of Gynecology and Obstetrics, Wuhan First Metallurgical Constrction Company Hospital, Qingshan District of New Industrial District of Wuhan from January to October 1999. Their parents were agreed to participate in the study and filled in the questionnaire, and provided neonatal meconium and performed neonatal tests on schedule. METHODS: ① Collection and assay of sample: 5 mL umbilical cord blood were collected and reserved in refrigerator at -4 ℃. Meconium with in 24 hours after birth, with dry weight between 5 to 10 g was collected, the lead levels in umbilical cord blood and meconium were assayed with the method of graphite furnace atomic absorption spectroscopy. ② Group ing: The neonates were divided into two groups with high and low-exposure to lead based on the cutoff value of CBPb of 0.483 μmol/L and MPb of 127.78 mg/kg. ③ Neonatal neurobehavioral development examination: Neonatal neurobehavioral development examination method was used for examination 3 days before delivery. Meanwhile, self-designed questionnaire was used to conduct a survey in puerperas. MAIN OUTCOME MEASURES: ① Lead levels in neonatal umbilical cord blood and meconium. ② Scores of neurobehavioral development of neonates with different lead levels of umbilical cord blood and meconium. RESULTS: All the 103 cases of neonates entered results analysis. ①There was significant difference only in scores of neonatal behavioral neurological assessment (NBNA) and biological visual and auditory orientation reaction (BVAOR)between groups with high and low-exposure to lead in umbilical cord blood (P ＜ 0.05). However, there was no rank correlativity between lead level in umbilical cord blood and scores of NBNA,non-biological auditory orientation reaction (NBAOR), non-biological visual orientation reaction (NBVOR) and biological visual and auditory orientation reaction (NBVOR). ②here was significant difference in scores of NBNA,NBAOR, NBVOR and BVAOR between groups with high and low-exposure to lead in meconium (P ＜ 0.05-0.01). The lead level in meconium clearly correlated reversely with scores of NBNA, NBVOR and BVAOR.CONCLUSION: Lead level in meconium is more sensitively related to the scores of neonatal neurobehavioral development, which could be used as indicator for lead deposit in the fetal body during the period of pregnancy.

OBJECTIVE: To study clinical characteristics, diagnosis, pathological types and therapy methods of nonsquamous cell neoplasm in subglottis, in order to improve comprehension of this rare disease. METHOD: To analysis 3 patients' clinical data with noosquamous cell neoplasm in subglottis by reviewing related literature, and to generalize the symptoms, differentiation and treatment experience of nonsquamous cell neoplasm in subglottis. RESULT: Among the 3 patients, one's main complain was hoarseness and the other two's main symptom was inspiratory dyspnea. As diagnosis was definite and acute obstruction of airway was relieved, the neoplasms were removed totally. Two patients were undergone operation through oral cavity by using suspended laryngoscope, and one patient was done surgery by neck approach. Paraffin wax result showed that one patient suffered epithelial-myoepithelial carcinoma, who received radiotherapy after surgery. There is no recurrence in all patients by following up more than 1 year. CONCLUSION The occurrence of nonsquamous cell neoplasm in subglottis is relatively low, and the subglottis should be inspected carefully to avoid missed diagnosis. Operation is the preferred method to treat this kind of disease. To choose a suitable operational manner according to size, location of the neoplasm is crucial.
Female ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; surgery ; Male ; Middle Aged

OBJECTIVE: To explore the clinical characteristics, diagnosis and surgical management of tympanosclerosis. METHOD: The data of 73 patients who underwent surgery for tympanosclerosis were retrospectively analyzed with respects to the clinical characteristics, diagnosis and management. RESULT: Seventy-three patients with tympanosclerosis (involving 73 ears) , including 17 patients with sclerosis of tympanic membrane (type I), 23 patients with fixed Malleus-incus complex (type II), 8 (type III) with fixed stapes, and 25 (type IV) with extensive typannosclerosis. Sclerosis was seen most frequently in the malleus, incus and attic, followed by the tympanic membrane, incudomalleolar joint and other regions. Audiometry was performed for all the patients 1 weeks before and 1 year( the least) after operation, which were (51.70 ± 14.93)dB HL and (36.24 ± 11.58) dB HL respectively, with success rate 83% (61/73). CONCLUSION Most of the patients suffer from conductive hearing loss. Teatment of the sclerosis around stapes is a key point. Acording to the sites of lesion and hearing level, hearing structures should be reconstructed by the rules of tympanoplasty and stapes surgery.
Audiometry ; Ear, Middle ; pathology ; Hearing ; Hearing Loss, Conductive ; complications ; Humans ; Incus ; pathology ; Malleus ; pathology ; Myringosclerosis ; diagnosis ; surgery ; Retrospective Studies ; Stapes ; pathology ; Stapes Surgery ; Tympanic Membrane ; pathology ; Tympanoplasty

OBJECTIVE: To evaluate the diagnostic value of modified Berlin questionnaire on predicting obstructive sleep apnea-hypopnea syndrome (OSAHS)in Chinese adults. METHOD: Differ from the original version, BMI cut-off point was adjusted to 25.0 in modified Berlin questionnaire according to the Asia -Pacific obesity definition. A total number of 244 samples who experienced polysomnography (PSG) were included. After well informed, each patient finished questionnaire by an interview. The results of the original and modified questionnaires and polysomnography reports were compared with polysomnography reports to evaluate the diagnostic accuracy of the modified Berlin questionnaire. RESULT: In male population, the sensitivity and specificity of original Berlin questionnaire were 74.03% and 65.71%, respectively. The percentage of diagnostic consistency was 72.49%, and Kappa coefficient was 0.304 (P < 0.01). In aspect of modified version, the sensitivity and specificity were 92.21% and 48.57%. The percentage of diagnostic consistency was 84.13%, and Kappa coefficient was 0.437 (P < 0.01). In female population, the sensitivity and specificity of original version were 50.00% and 61.90%, respectively. The percentage of diagnostic consistency was 54.55%, and Kappa coefficient was 0.110 (P > 0.01). When comes to the modified Berlin questionnaire, the sensitivity and specificity were 76.47% and 47.62% in female subjects, and the percentage of consistency agreement was 65.45%, with a Kappa coefficient 0.248 (P > 0.01). CONCLUSION Compared to the original version, the modified Berlin questionnaire has a better diagnostic consistency with a considerable sensitivity and specificity in male population. However, in female subjects group, the consistency of the modified Berlin questionnaire was still not significant remains unsatisfactory, although P value has been improved. Modified Berlin questionnaire could be. used as a primary screening tool for male OSAHS patients. However, but the screening questionnaire for female should still be need to be further explored.
Adult ; Female ; Humans ; Male ; Middle Aged ; Obesity ; Polysomnography ; Sensitivity and Specificity ; Sleep Apnea Syndromes ; diagnosis ; Sleep Apnea, Obstructive ; diagnosis ; Surveys and Questionnaires

Objective To investigate the predictive value of T,B,and NK lymphocyte subsets jointly detected in poor prognosis in patients with sepsis.Methods Totally 101 patients with sepsis were enrolled for prospective study.The percentages of lymphocyte sub-populations in peripheral blood were detected within 48 h after admission.The outcomes of patients during hospitalization were observed by follow-up study.The predictive value of lymphocyte sub-populations jointly detected in death risk was assessed.Results The percentages of CD3,CD3 +/CD4 + in patients with septic shock were lower than those in patients with mild/moderate sepsis and severe sepsis.The percentages of CD3+/CD8+,CD3-/CD19 +,CD4 +/CD8 + in patients with severe sepsis and septic shock were lower than those in patients with mild/moderate sepsis.The percentage of CD (16 +56) + in severe sepsis and septic shock was higher than that in mild/moderate sepsis group (P ＜ 0.05).The total number of monocytes in the deaths was higher than that in survivals.The percentages of CD3,CD3-/CD19 +,CD3 +/CD4 +,CD4 +/CD8 + were lower in deaths than those in survivals (P ＜ 0.05).The CD3-/CD19 +,CD3 +/CD8 and CD4 + / CD8 + were protective factors against sepsis with their OR values of 0.235,0.006 and 0.108,respectively.The ROC curve of lymphocyte subsets jointly detected,APACHE]] score and SOFA score to predict the risk of death were 0.993,0.877 and 0.848,respectively.The misjudgment rate of discriminating disease severity function of lymphocyte subgroups jointly detected was 19.8％,and that of outcomes was 4％.Conclusion The percentages of lymphocyte sub-populations in patients with sepsis is abnormal,and therefore,the lymphocyte subgroups jointly detected has value in the judgment of disease severity and prognosis in patients with sepsis.

Objective To explore the mechanism of the formation of glioma cells derived vessels (GCDV).Methods The tubular formation assay was performed on 3D cell cultures of U87,U251,U373,SF295,T98G,SKMG-4 and C6 glioma cell lines.The expression of Notch1 、Dll4 were examined by western blot analysis.Result The mean number of vasculogenic channels of cell lines C6,U373,U87,T98G,SF295,U251 and SKMG-4 per area (100×) were 25.2±5.0,36.4±3.2,19.0±2.2,12.6±2.4,4±2.2,0.2±0.4 and 0,respectively.The relative protein densities of Notchl in U87,U251,T98G,SF295,SKMG-4,C6 and U373 were 0.34,0.21,0.79,0.04,0.28,1.75 and 1.19,which were significantly related with the tubular formation ability (P＜0.05).However,the expression of Dll4 was not associated with tubular formation ability (P＞0.05).Conclusion Notch1 may play a key role in tubular formation of glioma cells while the role of Dll4 in the process needs further study.

OBJECTIVE: To describe our experience in the clinical manifestation and treatment of malignant tumors of the external and middle ear. METHOD: The study reviewed 39 patients between 1994-2011 in our hospital, including 15 pinna tumors, 18 external canal tumors and 6 middle ear tumors. 23 males and 16 females were enrolled in this study. The mean age of patients at the time of surgery was 59. Radiotherapy or radiotherapy and chemotherapy were the only possible treatment in 6 cases. Thirty-three patients were treated surgically, and 9 patients also received radiotherapy after surgery. RESULT: All of the patients had been followed up over 3 years, except for 1 case of external canal and 1 case of middle ear tumor. The 3-year survival of pinna, external canal and middle ear tumors were 86.7%, 82.4% and 60.0% respectively. At the last follow up, the pinna tumors showed that the survival rate was 100% in T1, T2 and Tx stage, and 0% in T4 stage; the external canal tumors showed that the survival rate was 90% in T1 stage, and 66.7% in T2, T3 stage; the middle ear tumors showed that the survival rate was 100% in T1 and T2 stage, 0% in T3 stage. CONCLUSION The T staging system is for an important prognostic factor, and it is important for an early diagnosis and radical surgery to achieve a better therapeutical result.
Ear Auricle ; pathology ; Ear Canal ; pathology ; Ear Neoplasms ; pathology ; Ear, Middle ; pathology ; Female ; Humans ; Male ; Neoplasm Staging ; Retrospective Studies ; Survival Rate