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.

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.

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 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 explore the psychological status of patients after hand tenolysis and the pertinent nursing countermeasures. Methods 47 patients after hand tenolyais were selected and investigated their psychological status and relevant influencing factors with serf-designed questionnaire and symptom checklist-90(SCL-90). Besides, corresponding psychological nursing were applied. The SCL-90 results of Chinese Norm were adopted to undergo comparison with them and t test was chosen. Results On the first day after operation, the score of the investigation objectives was significantly different compared with that of the Chinese norm. After pertinent mental nursing, their symptoms alleviated, and no significant difference was seen between them. Conclusions There are obvious psychological obstacles in patients after hand tenolysis. The pertinent mental nursing has important effect on rehabilitation training and functional rehabilitation after hand tenolysis.

Objective: To study the role of auto-antibody in the diagnosis of patients with PBC. Methods: ANA, SMA and AMA in serum of 58 PBC patients were tested by indirect immune fluorescence and Western blot. Such auto-antibodies as Anti-type AMAM2,anti-SLA/LP, anti-LKM-1 and anti-LC-1 were also identified. Results: Auto-antibodies existing in patients with PBC were mainly AMA(96.5%) and AMAM2(93.1%) and the titer was beyond 1∶100. 8 cases of those patients were positive with ANA and SMA simultaneously. One case had positive AMA and SLA/LP in serum and the clinical appearances were the same as those of type Ⅰ and type Ⅲ autoimmune hepatitis. 19 patients with positive AMAM2 in serum had liver-puncture and the results suggested the diagnosis of PBC in 63.7%(12/9). Conclusion: Test of auto-antibodies is clinically significant for the diagnosis of autoimmune hepatitis.

Objective To understand the status and features of nursing care adverse events and to offer scientific basis for improving patient safety management of nursing at high altitude area. Methods Data such as categories, causes, time distribution and other factors of nursing care adverse events were collected from January 2013 to August 2014 in the People′s Hospital of Tibet Autonomous Region were analyzed. Results Over the study period, 50 adverse events were recorded and the most common types were tube emersion(26%,13/50), pressure sores(14%,7/50) and scald(12%,6/50) respectively. The proportions of different severity of adverse events were hidden events (48%,24/50), events without bad consequence(36%,18/50), adverse events(14%,7/50) and warning events(2%,1/50) respectively. The ineffective communication, inadequate assessment, and not abiding by the rules accounted for 70%(35/50) of the causes of adverse events. 7:00-10:59 and 19:00-22:59 period was the high incidence of adverse events, respectively accounted for 32%(16/50) and 26%(13/50). Conclusions The management of nursing adverse events at high altitude area need to consider the geographical characteristics,besides, to guarantee the implementation of the system,reduce the bed / nurse ratio, improve the comprehensive quality of nurses and other measures can be taken to reduce the occurrence of adverse events.

Objective To explore the effect of chromofungin (CHR), a chromogranin A (CGA) derived peptide CGA47-66, on hyper-permeability of blood brain barrier in septic mice. Methods 120 healthy male C57BL/6 mice were randomly divided into groups, with 12 mice in each group. Seventy-two mice were used for dynamic observation of the contents of water and Evan blue (EB) in brain tissue after being treated with lipopolysaccharide (LPS). Another 48 mice were divided into normal saline control group (NS group), LPS induced sepsis model group (LPS group), low-dose CHR pretreatment group (CL+LPS group), and high-dose CHR pretreatment group (CH+LPS group). The septic model was reproduced by intraperitoneal injection of 10 mg/kg LPS 0.1 mL, and the mice in NS group was given equal volume of normal saline. The mice in CL+LPS group and CH+LPS group were intraperitoneally injected with 15.5 μg/kg and 77.5 μg/kg CHR 10 minutes before LPS injection. Six hours after LPS injection, 4 mL/kg of 2% EB was injected via caudal vein, the contents of water and EB in brain tissue were determined, and EB immune fluorescence in brain tissue was determined to assess the changes in permeability of blood brain barrier. Brain pathology was observed with hematoxylin and eosin (HE) staining. Results With the extension of time after LPS injection, the contents of water and EB in brain tissue were gradually increased, and the time of difference with statistical significance appeared earlier when compared with that of control group in the contents of water than that in EB contents (3 hours and 6 hours, respectively). The contents of water and EB in brain tissue in LPS group were significantly increased as compared with NS group [water content: (79.77±0.62)% vs. (78.28±0.44)%, P < 0.01; EB content (μg/g): 13.87±4.50 vs. 7.13±1.76, P < 0.05]. CHR pretreatment with either of two dosages could reverse the increase in water and EB contents in brain tissue induced by LPS, and the effect was more significant in CH+LPS group [water content: (78.15±0.73)% vs. (79.77±0.62)%, EB (μg/g): 7.09±2.59 vs. 13.87±4.50, both P < 0.05]. It was shown by EB fluorescence observation that the fluorescence signal displayed only in the meninges in NS group, and EB fluorescence was widely distributed in brain parenchyma in LPS group, indicating that the EB leakage in LPS group was more marked than that of NS group. In CHR pretreatment groups, EB fluorescence was decreased in brain parenchyma, indicating that EB leakage was significantly less marked, while it was more obvious in high dose CHR group. It was shown by HE staining that cerebral blood vessel structure was intact in NS group, and the gap around blood vessel was not significant increased. On the other hand, brain structure in LPS group appeared loose, with widening of small perivascular spaces and obvious edema. Brain edema in CHR pretreatment groups was improved as compared with that of the LPS group, and it was more apparent in high dose CHR group. Conclusions LPS induced change in blood brain barrier permeability in mice in a time-dependent manner. Exogenous CGA derived peptides CHR can inhibit LPS induced hyper-permeability of blood brain barrier in septic mice, thus reduces brain edema, protects the brain tissue, and the effect is more obvious with a high dose of CHR (77.5 μg/kg).