Objective To investigate the characteristic changes of the auditory brainstem response (ABR) of normal hearing newborn and infants .Methods One hundred and forty -five cases (290 ears) normal hearing new-born and infants were enrolled for ABR test .Before that they passed the distortion product otoacoustic emissions and acoustic immitance test previously .According to age ,13 (26 ears) of 145 were included in the 1~7 days age group ,17 (34 ears) was in the 30~59 days age group ,20 (40 ears) in the 2~4 months age group ,19 (38 ears) in the 5~7 months age group ,17 (34 ears) in the 8~10 months age group ,18 (36 ears) in the 11~13 months age group ,12 (24 ears) in the 14~16 months age group ,13 (26 ears) in the 17~19 months age group ,16 (32 ears) in the more than 20~24 months age group .The control group was 20 (40 ears) normal hearing young persons (18~25 years old) .The variation of the peak latency and interpeak latency of waves were observed ,and compared with the normal young people .Results In 70 dB nHL click sound stimulus ,the peak latency and interpeak latency ofⅠ ,Ⅲ ,Ⅴ waves of normal hearing neonates and infants progressively shortened as they grew older .As they ap-proach 18 months or more old age ,their peak latency and interpeak latency of Ⅰ ,Ⅲ ,Ⅴ waves may be same as nor-mal young people .Conclusion With the growth of the age ,the peak latency and interpeak latency of Ⅰ ,Ⅲ ,Ⅴwaves of normal hearing newborn and infants gradually shortened .The reason may be related to the maturity of the auditory system .

Objective To investigate the related factors of hemichorea.Methods 15 patients with hemichorea were analyzed retrospectively,including their clinical features,characteristics of neuroimaging and treatment.They were followed up for 0.5～4 years.Results The serum glucose increase in 11 cases.The lacunar cerebral infarctions in the area of basal ganglion were found in 5 patients,and the microvessel lesions in the area of basal ganglion resulted from diabetes mellitus in 10 patients.13 patients accepted medicine treatment,11 cases improved,1 case was ineffective,1 case deteriorated.Conclusion The hemichorea mainly related with cerebrovascular disease.The hemichorea due to diabetes mellitus may related with the ischemic or hemorrhagic microvessel lesions.

Objective To investigate the aging features of pure leukoaraiosis (LA) in nondemented outpatients. Methods The outpatients with age older than 40 years, without taking cholesterol lowering and B vitamin medications and with mini-mental state examination more than 24 scores were selected from July 2008 to December. 2009 in Beijing Tiantan Hospital. LA was defined with MRI. Patients were classified into two groups i. e. LA group consisting of 138 patients with leukoaraiosis but without lacunar lesions and cortical infarcts and a control group consisting of 124 patients without any lesion in brain. Age and other vascular risk factors were also investigated. Results Age of the patients in the LA group was significantly higher than that in the control group (P< 0.001). Multivariable logistic regression analysis showed that age was independently associated with pure LA ( OR 1.080, 95% CI 1.042-1.120), after adjusting sex, vascular risk factors and presence of atherosclerosis in cervical arteries. If age-stratification was further considered, logistic regression analysis showed that OR (95% CI) for LA was 2.693 (95% CI 1.103-6.575) in a 60-69 year group and 13. 527(95%CI 3.319-55.131) in a≥70 year group as compared with a 40-49 year group. Conclusion Age is a determining risk factor for pure LA and patients with age older than 60 years are at high risk of LA.

OBJECTIVE:To optimize the decolorization condition for polysaccharide extract of Mongolian medicine Vicia amoena,and to establish the method for its extraction and content determination. METHODS:The water extract-alcohol precipita-tion was used to extract polysaccharide from Mongolian medicine V. amoena. Using decolorization rate as index,orthogonal test was designed to investigate the effects of the dosage of activated carbon,decolorization temperature,decolorization time on the de-colorization of polysaccharide,so as to optimize the conditions for the decoloration of polysaccharide. Using glucose as control, phenol sulfuric acid method was adopted,and the content of polysaccharide in crude polysaccharide was determined by UV spectro-photometry at 490 nm. RESULTS:The optimal decoloration condition was as follows as actived carbon of 3%,decoloration time of 40 min,decoloration temperature of 60 ℃. On this basis,the average decolorization rate reached 19.77%(RSD=1.85%,n=3) by the verification test of the decoloration. The average extraction yield for the crude polysaccharide was 4.56%(RSD=2.38%,n=3),of which the polysaccharide content was 1.98%(RSD=2.18%,n=4). CONCLUSIONS:This experiment has relatively good reproducibility in polysaccharide yield;established method for content determination of polysaccharide is stable and feasible.

Objective To summarize the experience in application of the bovine jugular vein valved conduct in right ventricular outflow tract (ROVT) reconstruction. Methods Totally 14 patients [6 male, (6.3?5.4) years old] underwent ROVT reconstruction from February 2004 to March 2005 was recorded, and the function of the implanted bovine jugular vein valved conduit was evaluated by Doppler echocardiography one month later after operation. Results There was no perioperative morbidity related to the bovine jugular vein valved conduit. 14 patients were discharged well. One month after operation, echocardiography showed that reconstructed ROVT was patent, and only four implanted conduits had mild regurgition. Conclusion The bovine jugular vein valved conduit provides the favorable hemodynamic performance and thus could be an excellent substitute for the homograft in the reconstruction of ROVT. The mid- and long-term outcomes required further study.

Objective To summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment for adult acute respiratory distress syndrome (ARDS) caused by lung infections,so as to explore the clinical efficacy and application value of ECMO.Methods The patients with 7 ARDS who were responded poorly to mechanical ventilation in Zhongshan Affiliated Hospital of Sun Yat-sen University from January 2003 to January 2015 were collected.All patients were divided into a study group (7 cases) treated by ECMO and a control group (7 cases) treated by traditional methods.The percutaneous incision on femoral vein-internal jugular vein (V-V) was selected to carry out ECMO intubation,and the V-V ECMO model was used for auxiliary bypass of flow.The comparisons between the two groups for the results of hemodynamics,blood-gas analysis and oxygen metabolism were performed to evaluate synthetically the adjuvant effects of ECMO.Results Seven ARDS patients caused by lung infections were treated by ECMO,including 4 cases with bacterial pneumonia,2 cases with H7N9 and 1 case with H1N1.Thc duration of ECMO was (21.00 ± 10.06) days;2 cases were weaned from ECMO successfully,and 1 case recovered and discharged.Seven cases with ARDS caused by severe lung bacterial infections in control group were all not recovered on discharge.After treatment,the heart rate (HR),pulmonary arterial wedge pressure (PCWP),venous partial pressure of oxygen (PvO2),arterial blood lactic acid (Lac) in study group were significantly lower than those in the control group [HR (bpm)was 100± 12 vs.120± 19,PCWP (mmHg,1 mmHg =0.133 kPa) was 8.8 ± 2.6 vs.11.6± 3.8,PvCO2 (mmHg) was 40.8 ± 13.1 vs.48.9 ± 16.2,Lac (mmol/L) was 2.1 ± 0.8 vs.5.2 ± 0.6,all P ＜ 0.05],the mean arterial pressure (MAP),cardiac output index (CI),arterial and venous blood pH values,arterial partial pressure of oxygen (PaO2),arterial partial pressure carbon dioxide (PaCO2),arterial oxygen saturation (SaO2),oxygen delivery (DO2),oxygen consumption (VO2),oxygen extraction (ERO2) were obviously higher in study group than those control group [MAP (mmHg) was 83.6 ± 8.2 vs.72.2 ± 94,CI (mL· s-1 · m-2) was 93.35 ± 3.33 vs.81.68 ± 8.33,pH of arterial blood was 7.4 ± 0.1 vs.7.1 ± 0.3,PaO2 (mmHg):98.5 ± 20.4 vs.49.3 ± 12.6,PaCO2 (mmHg):38.9 ± 16.2 vs.26.1 ± 17.4,SaO2:0.95 ± 0.02 vs.0.58 ± 0.04,pit of venous blood was 7.1 ± 0.2 vs.6.4 ± 0.3,PvCO2 (mmHg) was 40.8 ± 13.1 vs.48.9 ± 16.2,SvO2 was 0.75 ± 0.07 vs.0.49 ± 0.08,DO2 (mL· min-1 · m-2) was 651 ± 36 vs.400 ± 81,VO2 (mL· min-1 · m-2) was 245.0 ± 11.2 vs.103.0 ± 14.8,ERO2 was (35.6± 3.9)％ vs.(21.3± 5.2)％,all P ＜ 0.05].Conclusions ECMO can improve hypoxemia.So it can improve the metabolism and maintain hemodynamic stability,in the mean time the patients may gain more time for diagnosis and treatment of their primary lung diseases.The key points of a successful ECMO are suitable selection of patients and forceful prevention of complications.

ObjectiveTo investigate the clinical guiding significance of Guideline for diagnosis and treatment of herb-induced liver injury in the diagnosis of herb-induced liver injury (HILI). MethodsA retrospective analysis was performed for the clinical data of 595 hospitalized patients who were admitted to 302 Hospital of PLA from January 2009 to January 2014 and diagnosed with HILI according to HILI diagnostic strategies recommended by American College of Gastroenterology. The chi-square test was used for comparison of categorical data between groups. ResultsAccording to the Guideline for diagnosis and treatment of HILI, all 595 patients (100%) were diagnosed with suspected HILI, 234 (39.3%) were diagnosed with clinical HILI, and 52(8.7%) were diagnosed with definite HILI. Among the patients with clinical and definite HILI, 85.0% and 94.2%, respectively, had a clinical type of cell injury, and 52.6% and 423%, respectively, had a severe disease. There were no significant differences in prognosis between the patients with suspected, clinical, and definite HILI, and 81.5%, 82.5%, and 80.8%, respectively, were cured. ConclusionGuideline for diagnosis and treatment of HILI can effectively guide the diagnosis of HILI, avoid misdiagnosis in clinical practice, and guarantee the safe application of Chinese herbal medicine. Its clinical guiding significance in the diagnosis of HILI awaits more prospective studies.

Objective To investigate the knowledge, attitude status of advance directives in Oncology nurses and analyze the influencing factors. Methods By convenience sampling, from November to December of 2018, 450 Oncology nurses from 14 ClassⅢ hospitals in Hu'nan and Qinghai province were selected as research objects. Nurses' General Information Questionnaire, Advance Directives Questionnaires were used in the study. Results The total score of 450 nurses in Oncology Department was (5.55±2.21). The factors that affected the Oncology nurses' advance directives attitude were:"advance directive can improve patients' autonomy", "everyone should have advance directives in case of emergency", "I don't understand how advance directives works". Conclusions The nurses in oncology department have low scores of advance directives knowledge, but most of them support the quotation of advance directives. We should take relevant measures to improve the awareness of advance directives of nurses in Oncology Department, so as to provide reference for improving the medical and nursing quality of terminal patients.

Objective To investigate the value of strong ion gap (SIG),anion gap (AG),and the anionic gap corrected by albumin (ACAG) and lactate in evaluating the prognosis of severe pneumonia in children. Methods Pediatric patients with severe pneumonia hospitalized in the Affiliated Hospital of North Sichuan Medical College from June 2014 to June 2017 were selected as study subjects. A total of 20 death pa-tients (death group) and 59 survivors (survival group) were analyzed respectively according to their progno-sis. The data of Na + ,K + ,Cl - ,HCO -3 ,Mg2 + ,Ca2 + ,pH,PaCO2 ,P,albumin and lactate were obtained from blood gas analysis and blood biochemistry. Based on these data,ACAG was calculated by the Henderson-hasselbalach formula and SIG was calculated by the Stewart-Figge formula. Results There were significant differences in ACAG,SIG,and lactate levels between death group and survival group(P < 0. 05). The area under the ROC curve of ACAG was 0. 756,and the area under the ROC curve of SIG was 0. 936,which were larger than the area under the diagnostic reference line (P < 0. 05),the results were statistically significant. The sensitivity and specificity of ACAG was 79. 7％ and 70. 0％ respectively,and the cut off was 12. 7. The sensitivity and specificity of SIG was 81. 4％ and 95. 5％ respectively,and the cut off was 2. 7. Conclusion SIG,ACAG and lactate have the guiding value in assessing the prognosis of children with severe pneumonia. Meanwhile,SIG has a greater guiding significance for the assessment of the prognosis of children with severe pneumonia.

Exposure of airborne particulate matter (PM) with an aerodynamic diameter less than 2.5 lm (PM2.5) is epidemiologically associated with lung dysfunction and respiratory symptoms, including pulmonary fibrosis. However, whether epigenetic mechanisms are involved in PM2.5-induced pulmonary fibrosis is currently poorly understood. Herein, using a PM2.5-induced pulmonary fibrosis mouse model, we found that PM2.5 exposure leads to aberrant mRNA 5-methylcytosine (m5C) gain and loss in fibrotic lung tissues. Moreover, we showed the m5C-mediated regulatory map of gene functions in pulmonary fibrosis after PM2.5 exposure. Several genes act as m5C gain-upregulated factors, probably critical for the development of PM2.5-induced fibrosis in mouse lungs. These genes, including Lcn2, Mmp9, Chi3l1, Adipoq, Atp5j2, Atp5l, Atpif1, Ndufb6, Fgr, Slc11a1, and Tyrobp, are highly related to oxidative stress response, inflammatory responses, and immune system processes. Our study illustrates the first epitranscrip-tomic RNA m5C profile in PM2.5-induced pulmonary fibrosis and will be valuable in identifying biomarkers for PM2.5 exposure-related lung pathogenesis with translational potential.