Objective To analyze the coincidence situation of the results of neonatal ABO blood group reciprocal stereotypy with crossmatching test of allotype blood and to investigating the limitations of cross-matching test in infant blood transfusion and effec-tive measures for ensuring the neonatal safe blood transfusion.Methods The micro-column gel test was adopted to identify the ABO blood group and conduct the crosshatching test of allotype blood in 1 095 cases of neonatal blood samples.Results Among the 1 095 samples,the detected rates of weak A and weak B antigen were 3.99% and 17.93% respectively,and the weak B antigen was predominant.The negative rates of anti-A and anti-B antibody were 53.72% and 60.70% respectively;in the cross-matching test with allotype blood,the main side without appearing agglutination accounted for 52.87% and weak agglutination accounted for 33.27%,and the secondary side appearing weak agglutination accounted for 9.49%.Conclusion The maturity of antibody and an-tigen and the coincidence rates of group typing and reciprocal stereotypy in the newborns are less than those in the adults;so blood transfusion according to the cross-matching test results has certain limitation;high attention should be paid to the accuracy of neo-natal ABO blood type,the individual blood transfusion strategy in the newborn should be determined in order to avoid hemolytic blood transfusion reaction caused by ABO allotype blood transfusion and ensure the blood transfusion safety in newborns.

To investigate the efficacy and adverse effects of venlafaxine in the treatment of depression, patients were given venlafaxine or amitriptyline for 6 weeks. The efficacy of the drugs were assessed by using HAMD and HAMA at the 4th, 7th, 14th and 42nd day before and after the medication. The adverse effects were evaluated by TESS. Our results showed that the effect time of venlafaxine was (8.52±4.47) d, which was fasler the that of amitriptyline. The effective rate of venlafaxine was 83%, which was faster the that of amitriptyline. but venlafaxine caused less dry mouth, constipation, blurred vusion, tachycardia and anorexia etc. It is concluded that venlafaxine worked faster with less side effect in the treatment of depression as compared with amitriptyline.

Objective To establish a scientific and feasible evaluation index system of the quality of health education among the elderly in the community.Methods Based on the results of literature review,theory analysis,cross-sectional study and interviews,a draft evaluation index system was formulated.Then Delphi method was conducted on 28 specialists around the country,the weight of each index was determined by hierarchy analysis.Results After three rounds of Delphi procedure,the response rates of the three round consultation were all above 85％,and the authority coefficient and coordination coefficients was 0.858,0.210,respectively.An evaluation index system which covered three first-level items,7 second-level items and 35 third-level items was formulated.Conclusions Based on survey of the elderly and interviews of health education staffs in the community,and using the method of Delphi to collect experts' suggestion,a strong maneuverability and high reliability quality evaluation index system was formulated,which provided guidance for community health education of the elderly,and promoted its development towards scientization and standardization.

Objective To evaluate the clinical value of iohexol contrast agent in patients with malignant tumor by spiral CT scan combined with endoscopy.Methods 100 patients with pathologically confirmed malignancies were selected and randomly divided into two groups, with 50 cases in each group, the experimental group received iodohexanol contrast agent combined with spiral CT scan and endoscopy , the osmotic pressure of iohexol at 37℃600 mOsm/kg, 5 minutes before the injection of intravenous injection of 10 mg prophylaxis of dexamethasone, and then spiral CT scan was performed.The control group were treated with diatrizoate contrast agent combined with spiral CT scan and endoscopy.The osmotic pressure of diatrizoate was 1500 mOsm/kg at 37℃, and 10 mg of prophylactic drug dexamethasone was injected intravenously 5 minutes before the injection.And then a spiral CT scan was performed.Results The adverse reaction in experimental group was 4%, which was mild compared with 12% in control group ( P<0.05 ) .The tolerance and spiral CT image quality of experimental group were better than those of control group ( P<0.05 ) .Conclusion Iohexol contrast agent, whether adverse reaction or image quality than the effect of diatrizoate contrast agent , in the spiral CT scan combined with endoscopy in patients with malignant tumors of higher clinical value, can be more accurate diagnosis of malignant tumors.

Objective To screen the active tuberculosis patients among HIV infected patients,and investigate the diagnostic methods for active tuberculosis among TB/HIV co-infected patients.Methods From August 2006 to March 2007,660 HIV/AIDS patients were enrolled.The study was conducted at 4 authorized hospitals for AIDS in Nanning and Liuzhou.Chest X-ray(CXR),acid-fast stain test of sputum smear and fast culture were applied if CD+4 T cell counts were below 350 cells/mm3 or the patients at least have one suspected symptom.Result The CD<;+>4 T cell count in 76.1% (502/660) of the patients was less than 200 cells/mm3.TB/HIV coinfection was found in 22.9% (151/660) of the HIV patients.Among them,74.8% (113/151) of them were pulmonary TB patients.One third of them were extra-pulmonary TB patients,and 68.1% of them involved lymph node.In 264 patients with negative sputum smear test and CXR,20.1% (53/264) of them showed positive results in fast culture tests.In addition,the non-tuberculosis mycobacterium (NTM) infection accounted for 38.5% culture positive cases.Conclusions The TB/HIV coinfection rate is 22.8%.Liquid rapid culture of sputum plays an import role in diagnosing of active tuberculosis among HIV patients.There are considerable proportions of NTM or extra-pulmonary TB coinfection in HIV patients.

Objective To investigate the effect of non invasive cardiac output monitoring(NICO)system in pig model with acute respiratory distress syndrome(ARDS),and to provide experimental basis for clinical application. Methods Eleven anaesthetized and ventilated ARDS male pig models were induced by intravenously infusing 0.2 mL/kg oleic acid. Lung recruitment was condocted by pressure control ventilation on pigs with ARDS. The optimal positive end-expiratory pressure(PEEP)was determined by optimal dead space fraction〔the ratio of dead space to tidal volume(VD/VT)〕. Cardiac output(CO)was determined by NICO,the respiratory function was monitored, and the VD/VT,dynamic compliance(Cdyn),oxygenation index(PaO2/FiO2),the volume of alveolar ventilation(Valv) and arterial blood oxygen saturation(SaO2)were recorded before infusing oleic acid,after stabilization of ARDS model and at optimal PEEP level,and the intrapulmonary shunt fraction(Qs/Qt)was calculated. CO was also determined by application of pulse indicated continuous cardiac output(PiCCO),and the linear regression analysis between CO determined by NICO and CO determined by PiCCO was conducted. Results Seven experimental ARDS pigs model were successfully established. The optimal PEEP identified by the lowest VD/VT method was(15.71±1.80)cmH2O (1 cmH2O=0.098 kPa). Compared with before infusing oleic acid,VD/VT and Qs/Qt after stabilization of ARDS model were significantly increased〔VD/VT:(72.29±8.58)% vs.(56.00±11.06)%,Qs/Qt:(21.04±15.05)%vs.(2.00±1.32)%,both P<0.05〕,and SaO2 and Valv were significantly decreased〔SaO2:0.888±0.108 vs. 0.999±0.053,Valv(mL):92.06±35.22 vs. 146.11±45.43,both P<0.05〕. VD/VT,Qs/Qt,SaO2 and Cdyn at optimal PEEP level were improved to the levels before infusing oleic acid〔(61.07±9.30)%,(3.21±6.10)%, 0.989±0.025,(117.14±41.14)mL〕. Cdyn and PaO2/FiO2 after stabilization of ARDS model were significantly lowered compared with those before infusing oleic acid〔Cdyn (mL/cmH2O):14.43±5.50 vs. 38.14±6.72, PaO2/FiO2 (mmHg, 1 mmHg=0.133 kPa):78.71±23.22 vs. 564.37±158.85, both P<0.05〕. Cdyn and PaO2/FiO2 at optimal PEEP level〔(19.71±4.86)%,(375.49±141.30)mmHg〕were elevated compared with the levels after stabilization of ARDS model(both P<0.05),but still lower than those before infusing oleic acid(both P<0.05). Compared with the levels after stabilization of ARDS model,CO at optimal PEEP level showed obvious decrease from(4.18±2.46)L/min to(3.95±2.69)L/min without significant difference(P>0.05). There was linear correlation between CO determined by NICO and CO determined by PiCCO(r2=0.925,P<0.001). Conclusions NICO technique provides a useful and accurate non invasive estimation of CO and respiratory function.VD/VT provided by NICO can titrate the optimal PEEP in patients with ARDS.

OBJECTIVE: The purposes of this study was to analyse the significant of low frequency air-bone gap in enlarged vestibular aqueduct (EVA) patients according to the pure tone audiogram and the benefit for clinic diagnosis of the EVA. METHOD: The audiology testing include (1) play audiometry or pure tone audiometry, tympanometry, middle ear muscle reflex thresholds and stapedius muscle reflex; (2) High-resolution computed tomography (CT) scan of the temporal bone and magnetic resonance imaging was used for diagnoses the EVA. RESULT: All the 78 patients (154 ears) were diagnosed as the typical EVA by CT or MRI. Inner ear malformations were found in 3 ears otherwise the structures of middle ear in all the patients were absolutely normal. The audiology analysis showed 154 ears were type A tympanogram including 126 ears with typical A, 25 ears with As, 3 ears with Ad type. In the 250 Hz pure-tone test:A-B gap were observed in 126 ears(126/154,81. 8%) with the different hearing loss degree: 1 ear mild, 11 ears moderate, 19 ears moderate severe, 40 ears severe and 53 ears profound. In the 500 Hz pure-tone test: A-B gap were found in 102 ears(102/154, 66. 2%) with the different hearing loss degree: 9. ears moderate, 17 ears moderate severe, 35 ears severe and 41 ears profound. CONCLUSION Our study suggested a 66. 2% -81. 8% possibilities to find the EVA through the pure-tone audiometry firstly in the basis of the normal tympanograms with the significant A-B gap.
Acoustic Impedance Tests ; Adolescent ; Audiometry, Pure-Tone ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Vestibular Aqueduct ; Vestibular Diseases ; physiopathology

Objective There is still a lack of effective clinical prognostic factors for predicting outcomes and guiding treatments in extranodal nasal-type NK/T-cell lymphoma (NKTCL).This study was aimed to investigate the clinical features and prognostic role of primary tumor burden (PTB).Methods A total of 1383 patients were recruited from ten hospitals, including 947 stage Ⅰ patients (68.5%), 326 stage Ⅱ patients (23.6%), and 110 stage Ⅲ-IV patients (8.0%).There were 751 patients (54.3%) presenting with high PTB (H-PTB).The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was conducted for survival difference analysis.Meanwhile, a multivariate analysis was performed using the Cox regression model.Results H-PTB was associated with high invasive potential, high frequency of B symptoms, advanced stage, regional lymph node involvement, lactate dehydrogenase elevation, and poor performance status.The patients with H-PTB had significantly lower 5-year overall survival (OS) and progression-free survival (PFS) rates than those with low PTB (L-PTB)(OS:50.2% vs.72.1%, P=0.000;PFS:41.8% vs.62.5, P=0.000).PTB was an independent prognostic factor for both OS (HR=1.851) and PFS (HR=1.755) according to the Cox multivariate analysis.Moreover, H-PTB was associated with significantly lower locoregional control (LRC) in early-stage NKTCL, and the 5-year LRC rate was 71.6% in patients with H-PTB and 84.3% in those with L-PTB (P=0.000).Conclusions H-PTB is associated with multiple adverse clinical features in NKTCL, and it is an independent indicator for poor outcomes and LRC.H-PTB can be used as a reliable indicator for risk stratification and treatment decision.

The metastasis of contralateral adrenal gland and gallbladder following radical nephrectomy is extremely uncommon in clinical practice. We presented one such case. The patient underwent laparoscopic radical right nephrectomy. Postoperative pathology revealed clear cell carcinoma of the right kidney. Five years after operation, CT revealed occupying lesions in the left adrenal gland and gallbladder. Transperitoneal laparoscopic left adrenalectomy and cholecystectomy were performed. Pathological examination showed that the left adrenal tumor and gallbladder tumor were clear cell carcinoma. The patient received targeted therapy and tumor-free survived for 10 months.

Tuberculosis, caused by Mycobacterium tuberculosis, is an infectious disease that most often affects the lungs. China is still among the high-burden tuberculosis countries in the world. Although the estimated incidence of tuberculosis in China has declined in recent years, the declining rate is slow. It still faces major issues such as a slower rate of decline, a widening gap between estimated and notified incidence, higher risk among middle-aged and older adults, a high number of cases among agriculture and related workers, and a heavier disease burden in the country's western regions. In addition, latent tuberculosis infection, drug-resistant tuberculosis, tuberculosis coinfection with HIV, and extrapulmonary tuberculosis have also exacerbated the disease burden of tuberculosis to some extent. This paper reviewed the epidemic characteristics of tuberculosis, the epidemiological triad, three links and two factors in the transmission process, the disease burden, and other aspects to provide a reference for formulating prevention and control strategies on tuberculosis.