OBJECTIVE:To observe therapeutic efficacy and safety of batroxobin in the treatment of senile sudden deafness. METHODS:Totally 102 senile patients with sudden deafness were randomly divided into control group(51 cases)and observation group (51 cases). Control group was given routine treatment as Ginkgo biloba extract injection 105 mg+Dexamethasone sodium phosphate injection 30 mg+Methotrexate tablets 6 mg orally. Based on control group,observation group was additionally given Ba-troxobin injection 10 BU added into 0.9% Sodium chloride injection 100 mL intravenously,running out within 1 h,every 2 days, and then given 5 BU added into 0.9% Sodium chloride injection 100 mL intravenously,running out within 1 h. Both groups were treated for 10 d. Clinical efficacy,hearing recovery time,ear drowsiness disappearance time,dizziness disappearance time and tin-nitus disappearance time of 2 groups were observed. The levels of pure tone threshold,plasma specific viscosity(ns),high shear rate of whole blood viscosity(nbh),low shear rate of whole blood viscosity(nbl),hematocrit(HCT),erythrocyte sedimentation rate (ESR),Fb,endothelin (ET) and nitric oxide (NO) were observed before and after treatment as well as the occurrence of ADR. RESULTS:The total response rate of observation group was significantly higher than that of control group;hearing recovery time,ear drowsiness disappearance time,dizziness disappearance time and tinnitus disappearance time were significantly shorter than control group,with statistical significance(P<0.05 or P<0.01). Before treatment,there was no statistical significance in the levels of pure tone threshold,ns,nbh,nbl,HCT,ESR,Fb,ET and NO between 2 groups(P>0.05). After treatment,the levels of pure tone threshold,ns,nbh,nbl,HCT,ESR,Fb and ET in 2 groups were significantly lower than before;the observation group was significantly lower than the control group. The levels of NO in 2 groups were significantly higher than before;the obser-vation group was significantly higher than the control group,with statistical significance(P<0.01). During treatment,no obvious ADR was found in 2 groups. CONCLUSIONS:Based on routine treatment,batroxobin is effective in the treatment of sudden deaf-ness in the elderly,can effectively relieve the symptoms,improve the recovery of local blood flow and inner ear microcirculation disturbance with good safety.

ObjectiveTo summarize the early postoperation complications and treatments in children with total anomalous pulmonary venous connection (TAPVC).MethodsThirty TAPVC children who were treated with corrective operation and transferred into PICU were collected.Patients were monitored routinely for electrocardiogram,blood pressure and SpO2.The routine treatment measures included mechanical ventilation,sedation,hemostasis,positive inotropic agents,diuresis,vasodilator,antibiotics and symptomatic treatment.Adrenaline or isoproterenol was used when low cardiac output syndrome appeared and temporary pacemaker was employed in the case of bradycardia.Alprostadil and sildenafil were added instantly after corrective operation when severe preoperative pulmonary hypertension or reactive postoperative pulmonary hypertension was present.ResultsThe early postoperation complication was found in 30 cases of TAPVC,which included 13 cases of pneumonia (43.3％ ),8 of arrhythmia (26.7％ ),7 of low cardiac output syndrome (23.3％),6 of respiratory failure (20.0％ ),4 of pulmonary hypertension ( 13.3％ ),3 of pulmonary edema or atelectasis( 10.0％ ) and 1 of pneumorrhagia ( 3.3％ ).Two cases died postoperatively.The interval of stay in PICU was 1 ～ 21 d and the mean time was (5.95 ± 4.94) d.ConclusionOccurrence of respiratory complications is high among early postoperative complications of TAPVC.Therefore,preventing pulmonary infection and maintaining pulmonary function should be viewed as the key points in early postoperative monitoring and managing.In addition,more attention should also be paid on correction of arrhythmia,prophylaxis and treatment of low cardiac output syndrome and pulmonary hypertension crisis,which may improve the postoperative survival rate and care quality of TAPVC.

Objective To investigate the common causes of hypokalemia of inpatients in department of endocrinology.Methods Fifty-nine inpatients with hypokalemia were analyzed retrospectively.Results 84.7％(50/59) of patients with hypokalemia was clearly caused by endocrine diseases,among which 33.9％ (20/59) was diabetes mellitus,25.4％ (15/59) was hyperthyreosis,others were rare endocrine diseases,for example primary hyperaldosteronism and Cushing syndrome,et al.Conclusions Endocrine disease is an important reason of hypokalemia.The doctor should attach importance to the diagnosis and treatment of hypokalemia caused by endocrine disease.

Objective To study the relationship between juvenile transient synovitis of the hip and enterovirus.Methods EV-IgM antibody was detected with ELISA in blood and arthrocentesis. At same time, sample with coxsackievirus B(CVB) IgM positive was tested by serptype.Results IgM antibody was detected in 38.27% in blood of the patients and in 76.19% in arthrocentesis.CVB-IgM was found positive in 16.05% of blood and in 42.86% of arthrocentesis.AdV-IgM was in 11.73% and in 23.81%,respectively.Most of the CVB-IgM positive individuals were infected with CVB3.Conclusion The results of this study suggest that there may be a significant correlation between juvenile transient synovitis and CVB, especially CVB3.

Objective To explore the clinical nursing methods for the treatment of the skin degloving injury in foot by the combination of free femoral anterolateral skin flap transplantation and vacuum sealing drainage (VSD) technique. Methods From January 2010 to January 2014, 18 cases of the skin degloving injury in foot were treated by debridement and implant skin, negative pressure drainage and irrigation at first period, then the operation to repair the foot wound by transplant femoral anterolateral skin flap were done at second period. Nurses applied the key technology of VSD into postoperative nursing. Nurses should master the observation method and characteristics for the flow of blood to the flap skin, the method for foot position nursing, afford effective analgesic care, and flap local high flow oxygen therapy,improve the local tissue oxygen partial pressure and introduce the foot early functional exercise during postoperative. Results Eighteen cases flaps all survived. Clients were followed-up for 6 to 12 months,the discovery showed that all of the clients had good flap blood supply,the skin was soft and elastic,and the function of foot were recovered well. Conclusions The combination of of free femoral anterolateral skin flap transplantation and VSD technique apply into foot degloving injury repairation postoperative care,by application of high quality nursing, it really can improve the success rate of surgery and reduce the pain for clients.

Objective To study the influence of postural intervention on ambulation of patients after video-assisted thoracoscope surgery? Methods One hundred and forty eight patients having undergone chest cardiac surgery were randomly divided into the control group(n = 75)and the observation group(n = 74)? The former received routine nursing intervention and the latter postural intervention besides routine nursing? The two groups were compared in terms of the time for ambulation and the ability in ambulation? Result The ambulation in the observation group was earlier than the control group and the ability in ambulation was better compared to the control group(both P < 0?05)? Conclusion The postural intervention after thoracic surgery is effective in pushing patient’s ambulation and improve their ability?

Objective To determine the correlation between serum asymmetric dimethylarginine (ADMA) and non-spoon-shaped blood pressure of non-dialysis chronic kidney disease (CKD) patients,also to observe the impact of the serum ADMA level on the structure and function of left ventricle.Methods One hundred and twenty cases of non-dialysis CKD patients underwent 24-hour ambulatory blood pressure monitoring were divided into three groups:CKD1-2,CKD3,CKD 4-5.Serum ADMA concentration was measured using liquid chromatograph and other clnical data such as uric acid (UA),left ventricular mass index (LVMI),24 h urine protein,and high-sensitivity C-reactive protein (hs-CRP) were collected for further statistical analysis.Results (1) With the decline of renal function,ADMA concentration was increased,from CKD 1-2 (1.70±0.48) μmol/L rose to CKD 4-5(4.46±1.56) μmol/L (P ＜ 0.05).(2)There were 42 cases of CKD patients with hypertension and 78 cases of CKD patients with normal blood pressure.The serum ADMA levels in hypertension group was significantly higher than those in non-hypertensive group [(3.53±1.70) μmol/L vs (2.01±0.65) μmol/L,P ＜ 0.05].(3)There were 50 cases of non-spoon-shaped normotensive CKD patients and 28 cases of spoon-shaped normotensive CKD patients.Serum ADMA level and LVMI in non-spoon-shaped group were significantly higher than that in spoon-shaped group when kidney functions appeared to be equal (P ＜ 0.05).(4)Serum ADMA level was positively correlated with UA(r=0.352,P ＜ 0.01),LVMI (r =0.345,P＜ 0.05),24 h urine protein(r =0.200,P ＜ 0.05),and high-sensitivity C-reactive protein (r =0.309,P ＜ 0.01),but negatively correlated with the left ventricular ejection fraction (LVEF)(r =-0.329,P ＜ 0.01) and estimated glomerular filtration rate (eGFR)(r =-0.011,P ＜ 0.01).Multiple regression results showed that eGFR,UA,LVMI,hs-CRP,24 h urine protein were associated with ADMA level.The regression equation was Y =1.991-0.011 × [eGFR] + 0.002 × [UA] + 0.008 × [LVMI] + 0.036 ×[hs-CRP]-0.084× [24 h urinary protein].Conclusions Serum ADMA level begins to increase in early stage CKD and it progressively increases with the decline of renal function,also the non-spoonshaped blood pressure ratio and the left ventricular damage increase.Kidney function,urine protein and microinflammatory state may impact on the serum ADMA level.

Objective To study the impact on pregnant outcome of reducing the number of embryos transferred from three to two in women at age less than 35 who received frozen-thawed embryo transfer (FET). Methods The analysis was performed on 90 FET cycles (77 infertile couples,less than 35 years old) with slow-freezing/rapid-thawing method, including 48 cycles with two embryos transferred and 42 cycles with three embryos transferred. The embryo survival rate, high quality embryo rate, clinical pregnancy rate, implantation rate and multiple pregnancies rate were analyzed. Results No significant differences in embryo survival rate (88.9% versus 88.1%), high quality embryo rate (89.6% versus 81.0%), clinical pregnancy rate (37.5% versus 42.9%), implantation rate (26.0% versus 18.3%) and multiple pregnancy rate (38.9% versus 16.7%) were observed between two and three embryos transferred group (all P > 0.05). However, there were 2 triple pregnancies in three embryos transferred group while none in two embryos transferred group. Conclusion Reducing the number of high quality embryos transferred from three to two in women at age of less than 35 years old who received FET,could decrease the incidence of triple pregnancy and keep the similar clinical pregnancy rate.

Objective To investigate the expression of insulin resistance on glomerular podocyte lesion of patients with IgA nephropathy.Methods Fifty-one patients with IgA nephropathy diagnosed by renal biopsy were selected as our subjects.The expression of WT1,a marker of podocyte of the renal tissue of patients with IgA nephropathy,was detected by immunohistochemistry.The density of podocyte per glomerulus was calculated by using specific software.The insulin sensitivity index (ISI) was severed as the degree of insulin resistance.Results There were strong negative correlations between ISI and WT1,mean arterial blood pressure,triglyceride,plasma uricemia,serum creatinine,body mass index,glomerular sclerosis integral,integral,mesangial proliferation of vascular lesions integral(r =-0.521,P ＜ 0.05 ;r =-0.544,P ＜ 0.05;r =-0.646,P ＜ 0.01 ;r =-0.559,P ＜0.05 ;r =-0.741,P ＜0.01 ;r =-0.561,P ＜0.05 ;r =-0.740,P ＜ 0.01 ;r =-0.695,P＜0.01;r =-0.535,P ＜ 0.05 respectively).There was no significant relationship between ISI and 24 h quantitative urinary protein (r =-1.425,P ＞ 0.05).Conclusion Insulin resistance was involved in glomerular podocyte lesion and may contribute to the progression of IgA nephropathy.

Objective To investigate the effect of hyperlipidemia on glomerulus podocyte injury with IgA nephropathy.Methods Fifty-one IgA nephropathy patients with biopsy-proven were selected.Immunohistochemistry was applied to detect the expression of WT1,a marker of podocyte,in the renal tissue of patients with IgA nephropathy.The density of podocyte per glomerulus wascalculated using specific software.Results Triglyceride (TG) was positively correlated with glomerulus podocyte injury,serumcreatinine and glomerulosclerosis in IgA nephropathy (r =0.549,0.770,0.698,P ＜ 0.05 or ＜ 0.01 ),and there was no correlation with 24 h proteinuria.The expression of WT1 was significantly decreased in glomerulus of patients with IgA nephropathy (P ＜ 0.01 ).There was no correlation between the expression of WT1 and 24 h proteinuria,but the expression of WT1 was positively correlated with serum creatinine and glomerulosclerosis (r =0.765,0.679,P ＜0.01).Conclusion Hyperlipidemia may induce glomerulus podocyte injury in IgA nephropathy,and it may contribute to the progression of IgA nephropathy.