Objective To observe the respiratory system adverse drug reaction ( AREs) in obese patients in anesthesia recovery incidence and treatment outcome .Methods This was a control prospective trial .Study was con-ducted on 27 cases of obesity and the same amount of normal with body mass index (BMI)<30(control group).The sex distribution ,age and the type of operation and operation was similar between the two groups .The hospitalization rate of AREs in PACU was observed .Descriptive analysis on the variables ,use Mann-Whitney U,compared with chi square test and Fisher exact test of variables .The relationship between variables and AREs was studied by using uni-variate and multivariate Logistic retrospective analysis .Results Obese patients with the STOP-Bang≥3 ( 89% vs 11%,P<0.001)occur more frequently,obese patients had a lower rate of underwent high risk operations (7% vs 41%,P=0.005) and big operation (4% v s15%,P=0.008).Obesity in PACU patients were more susceptible to getting AREs(33% vs 7%,P<0.018).Multivariate analysis indicated that obesity and residual muscle relaxation effect was the independent risk factors of AREs .Obese patients in PACU had a longer periods of time treatment (120min vs 84min,P<0.001).Conclusion Obesity is an independent risk factor for PACU in patients with AREs . Obese patients in PACU were treated time more longer .

Speech therapy in China, as speech pathology in the other countries, is one of important parts in rehabilitation therapy field. With the development of rehabilitation college education, speech therapy was also set as a common test course in college. This field has its particular characteristics within rehabilitation therapy practice in order to improve the effect of teaching during short period class time in college. This article reviewed the curriculum characteristics and class time allocation of speech therapy course in China college education currently, and summarized the curriculum content and characteristics with the speech therapy course of the rehabilitation therapy profession in Chinese college, and analyzed its class time allocation, methods and practice of the teaching techniques. As a result, the practice course was thought to be very important in order to improve the practice course of speech therapy, and arouse the students' interest and understanding with this part. Five new teaching thoughts were introduced to enhance the practice of speech therapy.

The A/G polymorphism of cytotoxic T lymphocyte associated antiger 4(CTLA-4) was determined by PCR-RFLP in 120 patients with recurrent Graves′ disease (GD), including 85 cases with early relapses within 3 years and 35 cases with relapses more than 3 years after withdrawal of antithyroid medication.66 initial GD patients and 100 healthy controls were included in the present study.The results suggest that A/G polymorphism of CTLA-4 was associated not only with GD, but also with early relapes after withdrawal of antithyroid medication.

Objective To discuss prognosis and relevant factors of the advanced age patients ( over 75 years old) with acute coronary syndrome two years after treated by percutaneous coronary intervene ( PCI ) and conservative treatment .Methods divided 134 cases of advanced age inpatients with acute coronary syndrome were into the obser -vation group and control group in accordance with the different therapies .To 71 inpatients in the observation group treated with standard PCI therapies and treated 63 inpatients in the control group with conservative treatment .Compare the clinical data and their cardiovascular event occurrence rate , case fatality rate and influencing factor of the two groups two years after they left the hospital .Results During the hospitalization ,there were 2 patients in the observa-tion group died,the case fatality rate was 2.82%(2/71),during 24 months follow-up visit,the cardiovascular event occurrence rate was 16.90%(12/71),and cardiac mortality was 5.63%(4/71).Well,in control group,there were 3 patients died,the case fatality rate was 4.76%(3/63),during 24 months follow-up visit,the cardiovascular event occurrence rate was 36.51%(23/63),and cardiac mortality was 11.11%(7/63).The fatality rate of the two groups during the hospitalization had no significant difference (χ2 =0.352,P=0.553),the cardiovascular event occurrence rate and cardiac mortality of the patients in the observation group was superior to that of the control group 24 months after they left hospital,the difference between the two groups was significant (χ2 =6.650,P=0.010).Conclusion PCI treatment to advanced age patients with ACS could reduce their myocardial infarction risk and case fatality rate and improve the symptom obviously ,effectively reduce the patients ’ cardiovascular event and cardiac death occurrence rate in two years .

Objective The deformed nasal bone is commonly seen in clinical practice of plastic surgery, and up to now, there is still lack of systemic classification to direct clinical treatment. Attempt was made in this study to classify the deformed nasal bone and present their plastic surgery treatment. Methods According to the orientation of the nasal bone deviation, the nasal bone deformities were divided into seven types, including the depressed, deviated, combination of the depressed and deviated, convex, widened, shortened ones and others. Of the 78 cases with the deformed nasal bone, 52 cases were corrected by the bone osteotomy techniques, and 26 cases by augmentation rhinoplasty. Results The satisfactory repair outcomes were achieved in 48 nasal bone deformities of the 52 cases (92%), and then secondary procedures were performed in 4 cases for further improvements (8%). Augmentation rhinoplasty in 26 cases showed good results. Conclusions Those types of classification are relatively simple and comprehensive, which is conducive to clinical treatment. The nasal bone osteotomy is effective to repair the deformed nasal bone.

ObjectiveTo investigate the changes of lymph flow by microwave heating whichhad achieved an excellent result in the management of lymphedema of extremities. Methods26 caseswith lymphedema of the extremities had been evaluated by means of lymphoscintigraphy using 99mTc －Dextran and SPECT to examine the lymph flow speed and half－ time(T1/2)clearance of the injection siteas well as lymphatic images of the affected limbs before and after treatment. Results The averagelymph flow speed in the affected limbs was significantly lower than that of the contralateral normal limbswith 7.82cm/min and 10.41cm/min respectively before treatment, and they increased significantly from7.82 to 9.36cm/min after two courses of treatment; in contrary, T1/2 was higher in the lymphedema-tous limbs with an average value of 154.21 min in comparison with 91.55 min contralaterally, and de-creased significantly to 115.38 min after treatment. In addition, lymphatic image disturbances improvedmarkedly in 22/26 cases(84.6% ) after treatment, especially in the patients with infectious lymphede-ma, and showed no changes in two cases. ConclusionThe results demonstrated that there was evi-dent lymph flow stasis in lymphedematous limbs, based on the preliminary calculation of lymph flow in-dexes; microwave heating could promote the lymph flow in lymphedema of extremities.

Objective To investigate the clinical effect of mesocaval shunt and selective coronary vein ligation for portal hypertension caused by cavernous transformation of the portal vein in adults.Methods The clinical data of 26 adult patients with portal hypertensive variceal bleeding caused by cavernous transformation of the portal vein treated by mesocaval shunt plus splenic artery and coronary vein ligation were analyzed retrospectively from 2001 to 2011.Results There was no operative deaths,free portal vein pressure decreased postoperatively,differences were significant before and after shunt (34.4 ± 4.7) cm H2O vs.(24.8 ±2.7) cm H2O,t =12.30,P ＜0.01.Postoperative complications included slight hepatic encephalopathy in 1 case,stress ulcer bleeding in 1 case,which were cured by conservative treatment.23 cases were followed up from 6 months to 4.5 years,and there was no bleeding case.Conclusious Mesocaval shunt plus selective vascular ligation for portal hypertensive variceal bleeding caused by cavernous transformation of the portal vein in adults is safe and effective.

Objective To investigate gene expression of transforming growth factor-β(TGF-β) in local bony callus in traumatic brain injury combined with extremity long bone fracture in rats.Methods Eighty male SD rats were randomized into 2 even groups: the experimental group were models of traumatic brain injury combined with extremity bone fracture and the control group were models of simple extremity bone fracture. Samples of bony callus were harvested at 1, 2, 3, and 4 weeks in both groups, each time from 10rats respectively, for detection of gene expressions of TGF-β by reverse transcription PCR techniques.Results Levels of gene expression of TGF-3 in local bony callus in the experimental group were significantly higher than in the control group at one week ( P ＜ 0. 05); but significantly lower at 3 weeks( P ＜ 0. 05) .Peak values occurred at 2 week in both groups, though, significantly higher than at other times, there was no significant difference between the 2 groups( P ＞ 0. 05) .Conclusion Changes in gene expression of TGF-β in local bony callus in traumatic brain injury combined with extremity long bone fracture indicate that TGF-β may play a role in the process of increased fracture healing.

Objective To explore the sleep problem and its related factors,and to provide evidence for improving sleep quality of patients with ankylosing spondylitis (AS). Methods Pittsburgh sleeping quality index (PSQI),self-rating depression scale (SDS),self-rating anxiety scale (SAS) and a self-designed questionnaire were applied to survey 318 patients with AS.Data were analyzed by the SPSS 17.0 software.The relationship between the various relevant factors were revealed by t-test,x2 test,Wilcoxon rank-sum test and Pearson correlation analysis.Results The mean total score of PSQI was 6.6±3.6, and 35.4％ of AS outpatients showed poor sleep quality.The difference of PSQI scores and detection rate of poor sleep quality between male and female were not statistically significant.There were significant difference of early morning stiffness(Z=-3.077,P=0.002),BASFI(Z=-4.766,P=0.000),BASDAI(Z=-6.880,P=0.000),nocturnal pain VAS(VAS)(Z=-6.502,P=0.000),total back pain VAS(Z=-6.675,P=0.000),ESR(Z=-2.370,P=0.018),CRP(Z=-2.063,P=0.039) between the poor sleep and the good sleep patients (P＜0.05).The PSQI score was positively correlated with age (r=0.165,P=0.003) but not gender and disease duration (r=0.078,P=0.165; r=0.094,P=0.097).PSQI score difference were also observed between patients with negative mood and patients without negative mood (t=-7.613,P=0.000; t=-7.287,P=0.000).Conclusion High incidence of sleep disorder exists among AS outpatients,and it is closely related with age,anxiety,depression and activity of AS.Attention should be paid to AS patients with sleep problems.

Objective To investigate the therapeutic value of Shuxuetong injection in patients with acute coronary syndrome(ACS).Methods 89 ACS patients were divided randomly into two groups: control group(n =44) and experimental group(n=45).The conventional therapy was used in the control group while Shuxuetong was added in the experimental group.The course of treatment was two weeks.Thromboxane B2(TXB2) and 6-keto-prosta-glandin F1a (6-K-PGF1a) were detected by radio-immunity before and after therapy.Homocysteine were tested by corpuscle enzyme linked immunosorbent assay.Results TXB2 was obviously lower in the experimental group [(554.2±303.2) ng/L] and the control group [(737.2±299.3 ) ng/L ] after treatment than that before treatment (P<0.05).Homocysteine was obviously lower in the experimental group [(10.42±2.99 )μmol/L ] and the control group [(16.39±2.29) μmol/L ] after treatment than that before treatment (P < 0.05 ).6-K-PGF1a was obviously higher in the experimental group[(328.4±99.6) ng/L] and the control group[ (234.5±96.2) ng/L] after treat-ment than that before treatment (P<0.05).TXB2 and homoeysteine in the experimental group were obviously lower than those in the control group after treatment(P<0.05). 6-K-PGF1 a in the experimental group was obviously high-er than those in the control group after treatment (P<0.05).Conclusion Shuxuetong injection could degrade the level of TXB2 and HCY, increase the level of PGF1 a and improve the balance of TXB2/PGF1a, so Shuxuetong is ef-fective in treating acute coronary syndrome.