Objective To study the relationship between arousal and sleep apnea in old people with sleep apnea syndrome(SAS). Methods Sixty-two aged patients were diagnosed of SAS after polysomnography (PSG). Records included total sleep time, apnea-hypopnea index(AHI),total arousal number(TAN), arousal index(AI), total respiratory-related arousal number(TRAN), total number of arousal lasted over 15 seconds (T15AN) and the severity of hypoxemia (desaturation). Sixty-four non-aged patients were included in control group. Ten aged patients were intervened with nasal continuous positive airway pressure (nCPAP) treatment. Data were compared with that before treatment. Results The results for the above parameters of the aged and the non-aged SAS patients were( 35.1?23.2)/h and (39.1?27.2)/h respectively for AHI, (15.8?11.4)/h and (20.4?13.0)/h for AI, 44.1% and 51.3% for the ratio of TRAN/TAN, only 6.1% and 6.7% for ratio of T15AN/TAN. 50% of 62 aged and 64 non- aged SAS patients were in severe desaturation. The AI and TRAN of the aged patients were significantly lower than that of non-aged patients (P

Objective To approach the reasons and influence factors about sudden deafness of nurs-es in the operating room. Methods We investigated the psychologic status and etiological factors of nurs-es in operating room through questionnaires designed by ourselves about general work pressure and sudden deafness correlative reasons. Results The total score of pressure was 21.486,among which rush work and check and examination,worrying about mistakes and accidents, pricking wound were the main reasons re-suiting in sudden deafness for the operating room nurses. Conclusions Enhancement of psychological nursing, health education and working environment improvement can lessen the anxiety emotion of nurses who have sudden deafness and has considerable effect to promote recovery.

Objective To determine the value of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natri-uretic peptide and homocysteine in the risk stratification of patients with unstable angina pectoris;thus to provide an assessment for the condition of patients in clinic.Methods 135 patients with unstable angina were included in the disease group and subjected to risk stratification according to GRACE risk score software,70 cases of low-risk group,60 cases in the middle-risk group and 5 cases in the high-risk group.Another 145 healthy people were in the control group.The levels of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine were detected and compared.Results Between the control group and the disease group,significant difference of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocys-teine was found (P <0.05),but the difference of ischemia modified albumin was not statistically significant(P >0.05).In the dis-ease group,the levels of ischemia modified albumin,heart-type fatty acid-binding protein and homocysteine in each risk stratification showed no significant difference(P >0.05).The level of B-type natriuretic peptide in high-risk group was higher than that in the low-risk group and in the middle-risk group and the difference was statistically significant (P <0.05),while there was no statisti-cally significant difference between the low-risk group and the middle-risk group(P >0.05 ).Conclusion The detection of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine possesses certain meaning in diagnosing unstable angi-na,and the level of B-type natriuretic peptide indicates the risk degree of the disease.

Objective To evaluate the value of diffusion tensor imaging (DTI)in diagnosing MCI.Methods DTI and conventional MRI were performed in 26 patients with MCI and 26 age-matched normal control subjects (NC).FA were measured in the 10 select-ed white matter regions,included bilateral frontal lobe,temporal lobe,parietal lobe,parahippocampal gyrus and cingulate gyrus,in the patients with MCI (n=26)and NC (n=26).FA of each ROI (region of interest)between the patients and controls were com-pared by using independent sample t-test.The correlation between the FA values and the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)scores was analyzed by using Spearman correlation analysis.Results Compared with NC,the FA values of the right frontal lobe,temporal lobe white matter and bilateral cingulate gyrus in the patients were significant-ly reduced (P <0.05).FA values of the left temporal lobe,right frontal lobe and bilateral parahippocampal gyrus were significant correlated with MoCA scores,and FA values of the bilateral parahippocampal gyrus were significant correlated with MMSE scores (P <0.05).Conclusion DTI can be used as a diagnosis index of MCI.It has important value in early intervention and improving the quality of life of patients to early diagnosing MCI.

Objective To summarize the key point of application of acellular dermal matrix(ADM)in operative cooperation of pharyngeal tissue repair.Methods In order to rebuild the air-tight cavity,ADM was sewn to the anterior vertebrae fascia in 7 patients with pharyngeal malignant tumor undergoing total laryngectomy or pharyngolaryngectomy to rebuild the posterior wall of the laryngopharynx.Meanwhile the muscular flap of the pectoralis major Was used to rebuild the anterior and lateral walls of the laryngopharynx.Results There was no reject reaction or pharyngeal fistula in these 7 cases and the wound surface were all mucous membranized.All the incisions reached the primary healing.Conclusions ADM is easy to get and possesses good histocompatibility and compatible thickness.It is easy to be managed during operation and can modify the peripharyngeal defect with the combination of muscular flap of the pectoralis major or any other neck tissue.Strict nursing preparation before operation and perfect cooperation during operation are key steps to complete the surgery successfully.

This paper described the measures taken by Sir Run Run Shaw Hospital of Zhejiang University School of Medicine in development of general medicine,and differential care of acute and chronic diseases. Rational allocation of medical resources and leveraging of tertiary hospital′s advantages in medicine and education effectively improved the utilization ratio of medical resources for better health of the people.

Objective To detect the expression of beta 2 adrenergic receptor in the infantile hemangiomas (IH) tissue and to explore its role in the pathological evolution of infantile hemangiomas as well.Methods 48 cases of infantile hemangioma were divided into two groups.29 cases were in the proliferating period,while the other 19 cases were in non-proliferating period.By using immunofluorescence technology,the endothelial nuclei and beta 2 adrenergic receptor of the IH tissue were marked by fluorescent tags,respectively,in two groups.The location of fluorescent labeling was shown in photos.By using the Image-Pro Plus 6.0 software,we analyzed and compared the average fluorescence intensity of endothelial cell nucleus and beta 2 adrenergic receptors in these two groups.Results Beta 2 adrenergic receptors were widely expressed in IH tissue,especially in endothelial cell nucleus shown in fluorescent images.The average fluorescence intensity of endothelial cell core in proliferating IH group was 0.031 ±0.002,which was much higher than that of fading period IH group (0.022±0.002).There was significant statistical different (P＜0.05).The average fluorescence intensity of beta 2 adrenergic receptor in proliferating IH group was 0.035± 0.003,which was much higher than that of fading period IH group (0.028± 0.002).There was significantly statistical different between the two groups (P＜0.05).Conclusions Beta 2 receptors are widely expressed in the endothelial cells of infantile hemangioma.

Objective To explore risk factors of unintentional injury among left-behind children in a rural poverty county and to provide evidence for injury intervention.Methods 2 909 students,including 1 630 left-behind children,were recruited from a poor counties of five schools by Multi-stage stratified cluster random sampling method,and were surveyed applying designed questionnaire,interview method and observation method to collect the data of the injury accidents and related factors in the last one year.Results The incidence of unintentional injury among the left-behind children in rural area was 34.0％,higher than the rate of 27.7％ among non-left-behind children and the difference was statistically significant (c2 =13.541,P＜0.05);in the top five injury type were falling injury (14.0％),burus (5.6％) and sharp instrument injury (3.6％),bite (3.0％),parts (1.6％) among left-behind children.Low age,often miss my mother,fighting in school,outdoor activities,road and traffic state were risk factors for injury of left-behind children.Corcltsion The unintentional injury of left-behind children has become a social problem that can not be ignored,and targeted intervention should be carried out.

0.05).CONCLUSIONS The effects of the four sterilization methods are uniform.Plasma hydrogen peroxide is a highly effective,safe and with environmental protection method.Soak for 30 minutes with 2% alkaline glutaraldehyde is a supplementary method when using high pressure or ethylene oxide methods.

Sixty-eight cases undergoing living related renal transplantation in First Hospital of Sun Yat-sen University between April 2004 and August 2007 were selected.The informed consent was obtained from the donors and recipients.The clinical data about operation assistance were retrospectively analyzed,including the pre-operation air sterilization in operation room,preparation of apparatus,one-off utensils and medicine,donor position fixation,assistance in kidney perfusion and preparation,management and usage of medicines,and steps of assistance during operation by instrument nurse.The results show the operational apparatus and utensils were prepared well,and the nurses knew well operation process and worked in harmony with the surgeons.For the 68 donor kidneys,the warm ischemic time was 1-6 minutes,and cold ischemic time was 10-118 minutes.The operations for both donors and recipients ran smoothly and lasted for 2.5-4 hours.Blood loss was less than 200 mL.Vital signs were stable during operation,and no complications happened.Good pre-operative preparation,strict management of personnel participating in operation,and training of assistant techniques are the preconditions for operation assistance.Rigorous aseptic management and correct preservation of organs are the keys for assistance for living donor kidney transplantation.Short warm and cold ischemic time of the donor kidneys are of great importance for the success of operation and the long-term survival of transplanted patients.