BACKGROUND: Old people above 80 years old have a high incidence of dizziness and tumble, which are associated with weakening vestibular function, balance function and optokinetic function.OBJECTIVE:This study was designed to make a quantitative evaluation of vestibular function,balance function and optokinetic function in people over 80 years old.DESIGN:It was a quantitative study on posture function(vestibular and balance function),auditory function(frequency audiometry)and visual function (optokinetic function) in elderly persons.SETTING:Department of Otolaryngology ,General Hospital of Chinese PLA.PARTICIPANTS:Totally 41 old male inpatients with systemic diseases in Rehabilitation Department of the General Hospital of Chinese PLA, with an age from 80 to 94 were selected from March 1993 to January 1994.Of them,12 had tinnitus,20 had dizziness.During the same period,old cadres including 11 males and 7 females aged from 60 to 79 years with normal findings of physical examinations were selected as controls. No participant in this group suffered from tinnitus, deafness and dizziness. All the participants were voluntary.METHODS: Patients underwent full-scale otolaryngological examinations.Audiometry consisted of battery of tests including frequency audiometry and evoked auditory brainstem responses(ABR). Vestibular function (posture) was assessed by vestibular-ocular reflexes. Participants accelerated from 1 /s to 90 /s. Then, the angular speed was kept until the nystagmus disappeared,at the time a sudden stop was made.Changes in nystagmus during the tests were recorded.The eyes firstly turned to left and 10 minutes later turned to right.Slow-phase angular velocity was recorded and the imbalanced left/right rate was calculated.Vestibularspinal reflex (VSR) was measured using balance beam and the length of the sway of the center of gravity (CG) and the sway velocity of CG were all calculated. Balance tests using a cursor were employed to examine the central optokinetic system, including sweeping, tracking, and optokinetic responses.MAIN OUTCOME MEASURES: Frequency audiometry, vestibular-ocular reflexes, and vestibular-spinal reflex and optokinetic responses were examined to assess the posture function, auditory function and visual function in elderly persons over 80 years old.And the results were compared with those of balance function tests and visual function tests in old population aged from 60 to 79 years old.RESULTS:Practically,the number of old participants over 80 years old receiving the tests of frequency audiometry, vestibular-ocular reflexes, and vestibular-spinal reflex and optokinetic responses were 41,24,39,40 and 34 respectively;The number of 60-79 participants receiving balance tests and visual tests were 18 and 10.Individuals refusing to participate were omitted. ① Auditory function:In 41 elderly persons ＞80 years,13 ears (16％) had a normal middle frequency audiometry, 69 ears (84％) had a loss of hearing. ② Posture function: 15 (62％) had normal vestibular-ocular reflexes, and 9 (38％) had abnormalities in vestibular-ocular reflexes.Ten (26％) had a normal vestibular-spinal reflex and 29 (74％) had an abnormal vestibular-spinal reflex.③ Balance function:Of all the variables of balance function,the length of the sway of CG and the sway velocity of CG were most valuable. In populations in both brackets, the length of the sway of CG and the sway velocity of CG in eyes-closed condition were longer and faster than those in eyes-opened .condition (P ＜ 0.01). In over 80 years group,the length of the sway of CG and the sway velocity of CG were longer and faster than in 60-79 group (P ＜ 0.01). ④ Optokinetic responses:Optokinetic plus were not obviously different between over-80 group and 60-79 group (P ＞ 0.05) and the latent period of sweeping and the distortion of tracking were significantly longer and greater in former group than in later(P ＜ 0.05-0.01 ).CONCLUSION:Most of the elderly persons over 80 years have a decrease in auditory and posture functions.Their optokinetic and balance functions are degenerated more severely than 60-79 years old population.

This study was carried out to observe the hemodynamic changes in patients with BuddChiari syndrome(BCS) during venoauricular bypass. Twenty-one patients with BCS,ASA grade Ⅱ-Ⅲ, aged 33.4 years on average, were involved. The anesthesia was induced with intravenous midazolam, fentanyl and atracurium. The hemodynamic parameters were measured by Swan-Ganz catheter at various times during whole procedures. As cdmpared with those before anesthesia. CO, CI, SI, LVSWI and RVSWl reduced significantly following general anesthesia(P

Objective To analyze the effect of individualized care on prevention of postoperative urinary retention of malignancy patients undergoing hysterectomy and pelvic lymph node dissection.Methods 74 cases of patients with malignancies undergoing total hysterectomy and pelvic lymph node dissection in our hospital from June 2009 to December 2011 were chosen as the research object.They were divided into the control group and the observation group with 37 cases in each group.The control group was given traditional routine care,while the observation group was given individualized nursing assessment and intervention.The grasping level of knowledge about prevention of urinary retention,the cooperation degree with nursing,incidence of urinary retention,the residual urine volume and satisfaction degree of patients were analyzed and compared between two groups.Results The grasping level of knowledge about prevention of urinary retention,the cooperation degree with nursing,incidence of urinary retention,the residual urine volume and satisfaction degree of patients in the observation group were better than those of the control group,there were significant differences.Conclusions The effect of individualized care to prevent postoperative urinary retention of malignancies patients after hysterectomy and pelvic lymph node dissection is better.It plays an active role in improving mastering of knowledge about prevention of urinary retention and cooperative degree with nursing.

ObjectiveTo explore the effect of problem-based health education on self-care ability and psychological situation of gynecological cancer patients after surgery.Methods68 cases after gynecological cancer from January 2009 to December 2011 in our department for treatment were chosen.By taking mechanical sampling method,45 cases were randomly set as the observation group,which took problem-based health education.Other 23 cases were set as the control group,which adopted general health education model.The effect of health education was compared between two groups.ResultsIn the observation group,the self-care skills score was (20.4±5.8),self-responsibility score(27.6±9.4),the self-concept score (15.7±8.3) and self-care ability score (111.6± 20.3),significant higher than those of the control group,which were (11.6± 4.4 ),( 17.3 ± 6.5 ),(7.4 ± 5.1 ) and (53.2 ± 12.8).The SAS score was (1 1.6 ± 4.4) and SDS score was (17.3± 6.5) in the observation group,significantly lower than (20.4 ± 5.8) and (27.6± 9.4) of the control group.ConclusionsApplication of problem-based health education in gynecological cancer patients can significanfly improve their self-care capacity and patients＇ anxiety and depression.

ObjectiveTo inspect the real-time heart rate changes of middle aged and older women when practicing Wuqinxi exercise.Methods35 healthy women, Wuqinxi exerciser, were selected randomly, whose heart rates were inspected during exercise.ResultsDuring once Wuqinxi exercise, the average heart rate of middle aged women reached the target heart rate after 9 minutes, and the average maximal heart rate was 122 beats/min, increased by 44 beats/min compared with sedentary heart rate. The same data of older women were 11 minutes, 131 beats/min and 55 beats/min respectively.ConclusionWuqinxi exercise is a healthy sport fitting for middle aged and older women.

Objective To investigate the cause of air emboli during hysteroscopic surgery.Methods Thirty-five ASA Ⅰ or Ⅱ patients,aged 22-59 yr,with a body mass index of 18-25 kg/m2,undergoing hysteroscopic surgery under spinal anesthesia,were involved in this study.Electrocision and electric coagulation were performed using the electrotome during surgery.Air emboli in the common iliac vein,superior vena cava,inferior vena cava and heart were continuously monitored using color Doppler ultrasonic imaging.The patients were divided into 2 groups according to the occurrence of the air embolus:air embolus group and no air embolus group.The possible factors which induced air emboli were analyzed.Results Air emboli developed in 15 patients at ( 19 ±10) min after perfusion with 5％ glucose injection and the incidence was 43％.A small number of air emboli (the numberof bubble ＜ 10/s) occurred in 4 cases.A moderate number of air emboli (10/s≤ the number of bubble≤20/s) occurred in 7 cases.A large number of air emboli (the number of bubble ＞ 20/s) occurred in 4 cases.Compared with no air embolus group,the using time of electrotome was significantly prolonged in air embolus group ( P ＜ 0.05).Conclusion The cause of air emboli during hysteroscopic surgery may be related to the using time of electrotome.

Objective To investigate the effect and mechanism of valproic acid in preventing astrocyte proliferation around the central canal of rats following spinal cord injury.Methods Forty-five Wister rats were divided into normal control group (n =5),injury group (n =20) and treatment group (n =20) according to random number table.Animal models of acute spinal cord injury were produced at T10 using Allen' s method by dropping a 10 g weight from a 15 mm height.Rats in treatment group received intraperitoneal injection of valproic acid (300 mg · kg-1 · d-1 in two divided doses) at 30 minutes postinjury.Instead,rats in injury group were injected with an equal volume of saline in the same way.Hindlimb function was evaluated using BBB scoring system at 1,3,7,and 14 days postinjury.Astrocytes proliferation around central canal and expression of glial fibrous acid protein (GFAP) were examined.Results In normal control group,few astrocytes around spinal central canal and a low expression of GFAP were detected.In injury group,astrocytes began to increase at 24 hours postinjury; fluorescence intensity for GFAP was 24.6 ± 3.6 at 24 hours,reached a peak of 69.2 ± 6.4 at 3 days,maintained a high level of 56.7 ± 5.6 at 7 days,and reduced to 35.4 ± 4.3 at 14 days,a level that remained higher than that in normal control group (11.2 ± 1.6).Whereas in treatment group at 3 and 7 days,astrocyte proliferation around spinal central canal was lower than that in injury group; GFAP expressions (47.8 ± 5.3 and 42.2 ± 6.7) were lower than those in injury group (F =177.6,P ＜ 0.05).At 3,7,and 14 days,BBB scores in treatment group (7.80 ± 0.83,12.00 ± 1.58,and 16.60 ± 1.12 respectively) were significantly higher than those in injury group (4.60 ± 0.54,6.65 ± 0.67,and 9.40 ± 1.14 respectively) (F =1 113.6,P ＜ 0.05).Conclusion After spinal cord injury,valproic acid reduces astrocyte proliferation around central canal via inhibiting GFAP expression to promote functional recovery.

Objective To explore the effect of quality control circle (QCC) on nipple maternal breastfeeding by parturients with nipple defects. Method A QCC with a theme ofimprove the maternal breastfeeding rate among the partureints with nipple defectswas established to investigate the current status, analyze the main causes, propose countermeasures and finally carry out countermeasures and check the effects according to the PDCA principles. Result The post-QCC adverse events of maternal breastfeeding in not enough lactation, breast swelling, cracked nipples, failure in the first suck and unqualified breastfeeding at discharge were significantly lower than those of pre-QCC ones (P<0.01). Conclusion Quality control circle can effectively solve the problems in nipple maternal breastfeeding and meanwhile improve the nurse work enthusiasm as well as their ability to solve problems.

Objective To investigate the effect of continuous blood purification (CBP) on pro-or anti-inflammatory immune function and prognosis in patients with sepsis. Methods One hundred and two patients with sepsis were randomized into the CBP group (60 cases) and the control group (42 cases). The patients in the control group were treated with conventional therapy, and the patients in the CBP group received at least 72 h CBP treatment additionally. The APACHEⅡ score, SOFA score, the 28 day survival rate and ICU length of stay were recorded and levels of spleen Th1, Th2 were assessed by FACS flow cytometry. Enzyme linked immunoadsordent assay (ELISA) was used to determine the levels of serum IL-1, IL-10 and TNF-α before and at 24, 48, 72 h after the treatment. Results The APACHEⅡscore and SOFA score decreased markedly in the CBP group after the treatment (Р <0.05). The period of staying in ICU of patients in the CBP group was shorter than that of patients in the control group (Р < 0.05). There was no significant difference of the 28 day survival rate between the two groups (91.6% vs 71.2%, Р > 0.05). Compared with the control group, levels of IL-1, IL-10 and TNF-α were decreased markedly, and the ratio of Th1 / Th2 was increased significantly at 72 h after the treatment in the CBP group (Р < 0.05). Conclusion CBP can eliminate inflammatory mediators, and help to enhance the immune function, and restore the balance of Th1 / Th2 in patients with severe sepsis.

Objective To explore the influence of Helicobacter pylori (Hp) on the proliferation, apoptosis and expression of p27kipl protein of gastric epithelial cells in vitro. Methods SC, C-7901 cell pro-liferation was examined by flow cytometry after incubation with different concentration of NCTC11637. The effect of NCTC11637 on cell apoptosis was also evaluated by flow cytometryo And the expression of p27kipl of gastric epithelial cells was detected by immunohistochemical analysis and in situ hybridization, respectively. Results Cell proliferation was enhanced when co-incubated with the Hp in low concentration (3.4 x 104 to 1.9 x 105 CFU/ml) but inhibited in higher concentration (≥4.8×106CFU/ml). However, cell apoptosis was increase when co-incubated with the Hp in high concentration (≥9.6 ×105 CFU/ml) showing concen-tration dependent picture. In addition, the co-incubation of SGC-7901 with Hp led to decrease of the expres-sion of p27kipl protein but not mRNA in a Hp concentration dependent way. Conclusion Hp could effect the gastric epithelial cells apoptosis and proliferation directly and influence the expression of p27kips protein which might facilitate gastric carcinoma.