Cysts ; Humans ; Laryngeal Diseases ; Male ; Middle Aged

Neovascular age-related macular degeneration(nAMD)and polypoidal choroidal vasculopathy (PCV)are leading causes of blindness and visual impairment in older population.They are both with a hemorrhagic and exudative macular disorder.PCV has been proposed to be a sub-type of nAMD,hut this is a matter of controversy.Although several genes are found to be associated with PCV and nAMD(CFH,ARMS2/HTRA1),but more genes show no common association with the two diseases.such as BF/C2,Elastin,PEDF,SERPlNG1,VEGF,APOE genes.All these Results might imply that PCV and nAMD have different pathogenesis.But in the current state of our knowledge for PCV and nAMD.we still could not conclude if they are the same diseases.The purpose of these review is to discuss the recent progress in the molecular biology of PCV and nAMD.

Objective To find out the clinical effect of integrative therapy for pregnant women with viral myocarditis(VMC).Methods The experimental group 60 VMC maternal cases were treated by integrative therapy,while the control group 43 patients were treated by simple western medicine,the efficacy of two treatments were compared,and left ventricular function,myocardial enzymes and other indicators were compared.Results Markedly effective rate of control group was 48.84％,and total effcctive rate was 72.09％ ; markedly effective rate of experimental group was 65.00％,and total effective rate was 91.67％.Markedly effective rate and total effective rate of experimental group were significantly higher(P ＜0.05).After treatment,stroke volume,ejection fraction and cardiac output index of experimental group were significantly higher than before treatment (P ＜ 0.05 ); After treatment,the indexes of experimental group and control group were significantly different ( P ＜ 0.05 ).After treatment,creatine kinase,creatine kinase myocardial isoenzyme,aspartate aminotransferase and lactate dehydrogenase index of experimental group were significantly lower than before treatment ( P ＜ 0.05 ) ; After treatment,the indicators of experirnental group were lower than control group( P ＜ 0.05 ).Conclusion This prescription is used to treat pregnant women with valid prescriptions of VMC,the clinical efficacy of integrative medicine is significant,the cardiac contractile function can he improved,and a strong application advantages is shown compared to conventional therapy with simple western medicine.

Objective To explore the feasibility of various compensation approaches and their combination after canceling the drug addition at municipal public hospitals in Anshan city.Methods 2008~201 1 medical services,balance of payments of Anshan municipal public hospitals during 2008~201 1 were analyzed,to calculate the balance of profit and loss of the hospitals with the drug addition canceled,as well as the effects of various compensation models and their combinations on hospitals’balance,government financial burden,costs of health insurance and patients’out-of-packet costs.Results Without drug addition,hospitals are found with surplus drop,and doubled number of years in deficit.Losses incurred by the canceling can be covered partly by pricing adjustment of medical services or collection of pharmaceutical service surcharge,with complete compensation by collection of medical service surcharge;government financial subsidies for large equipment depreciation or medical services offer part of the compensation,which is affordable by government finance.Such deficits cannot be covered completely by any single approach,yet they can be greatly eased by a combination of the approaches mentioned above.With impacts on all stakeholders in consideration,the optimal solution is the combination of the scheme with adjusted services price plus collection of pharmaceutical service surcharge and medical services compensation.Conclusion With the drug addition policy canceled,the establishment and perfection of the compensation mechanism calls for a synergy of pricing,health insurance and government finance.

Objecfive To compare the clinical effectiveness of three different fixation methods for peripherally inserted central catheter(PICC).Methods Totally 120 patients requiting PICCs were randomized into suture securement group(group A),tape securement group(group B),and sutureless adhesive-hacked device (StatIock)securement group(group C),with 40 patients in each group.Patients were followed up throughout their entire catheter course,and the securement effectiveness,catheter-related complications,risk of skin injury,and patients'satisfaction were observed.Results The rate of catheter migration without function loss in group B (57.5%)was significantly higherthan in group A(12.5%,P=0.000)and in group C(7.5%,P=0.000).Catheter dislodgment rate in group B(15.0%)was also significantly higher than group A(0,P=0.034)and group C(0,JP=0.034).Phlebitis documented during their catheter course in group B(25.0%)were more than in group A(7.5%,P=0.034)and in group C(5.0%,P=0.012).In addition,the rate of cellulitis in group A was significantly higher than group C(20.0%vs.2.5%,P=0.034).The rate of skin injury in group A 0.005).Nearly half of patients in group A (52.5%)complained irritation and/or pain at the sucure site,which was significantly higher than in other two groups ( both P = 0.000 ).The patients' satisfaction rate was significantly lower in group A (12.0% ) than in the other two groups ( both P = 0.000), documented highest in group C (90.0%) (group C vs.group B, P = 0.004).Conclusions The availability of sutureless adhesive-backed de vice StatLock provides an alternative for securement of PICCs.It performs as well as suture securement in catheterfixing.Meanwhile, it can prevent catheter-related complications such as migration and dislodgment Furthermore, it avoids skin injuries during catheter fixation or securement.

Objective To explore the anxiety and depression in caregivers of patients in persist vegetative state and minimally conscious state, and discuss the related factors. Methods From January, 2010 to December, 2014, 60 caregivers of 60 patients in persist vegetative state and minimally conscious state were assessed with Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). The sex, ed-ucation level, relation to the patients and family income of the caregivers, and the age of the patients and number of the families of the pa-tients were recorded, and analyzed with Logistic regression. Results 55％caregivers were found in anxiety, and 48.4％in depression. The fe-male caregivers (OR>6.870, P<0.05), the number of the family of the patients (OR<0.233, P<0.05) and age of the patients (OR<0.294, P<0.05) were independent factors associated with anxiety and depression. Conclusion The caregivers of patients in persist vegetative state and minimally conscious state are troubled in anxiety and depression, especially the female, while age and the number of the families of patient may be important factors for it.

Objective To investigate the predictive value of umbilical cord blood bilirubin for pathological jaundice in healthy term newborns. Methods Two ml navel string vein blood of baby were collected after giving birth in the normal newborn, and the hemobilirubin was detected by accidentally oxidation method. After birth, the infant's bilirubin level was tested on the forehead by the transcutaneous bilirubinometer at 8:00 -9:00 every morning until discharging from hospital. The ration of pathological jaundice of newborn and its treatment were analyzed in different levels of cord blood hemobilirubin. Results Fifty-nine cases ( 22.96% ) with pathological jaundice were diagnosed in 257 newboms.The concentration of cord blood hemobilirubin in baby with pathological jaundice [(39.68 ±8.10) μmol/L] was significantly higher than that of the normal newborn [(30.05 ±5.51) μmol/L](P＜0.01). As the concentration of cord blood hemobilirubin was increased, the incidence of pathological jaundice was raised (P＜ 0.01), and the cases that needed to intervention treatment was increased(P＜ 0.01). Conclusion The detection of the level of cord blood hemobilirubin is not only very worthy to estimate the occurrence of pathological jaundice of newborn, but also offer reliable evidence for clinical early diagnosis and treatment.

ObjectiveTo investigate the effect of immunoglobulin G (IgG) extravasated from blood circulation on the expression of toll-like receptor 4 (TLR4) induced by peripheral lipopolysaccharide (LPS) in rat brain. Methods The rats were divided into four groups in random, 5 rats in each. Group one received LPS 100μg/kg by intraperitoneal administration, normal saline was given by intravenous injection 6 hours later; group two was injected with adrenalin (AD) 15μg/kg intravenously; group three was treated with LPS intraperitoneally, AD was injected 6 hours later; group four was injected normal saline intravenously as control. For all groups, the animals were sacrificed 30 min after the last injection, and the brains were taken for investigation of the TLR4 expressions by immunofluorescence staining and RT-PCR. Result Immunofluorescence staining showed that IgG immunoreactive product was patch-like, distributed in the brain parenchyma in all the animals that received AD. In the LPS+normal saline group, IgG was found merely around the blood vessels. Meanwhile, in LPS+AD animals, TLR4 immunoreactive product coexisted with microglia marker Iba-1 within the IgG extravasated area. The double-labeled cells dispersed in the brain parenchyma and near to the cerebral vessels. In the LPS+saline group, TLR4 positive cells were endothelial-like. RT-PCR results indicated that the expression level of TLR4 in the LPS+AD group were significantly higher than that in the LPS+saline group or AD group or the saline control (P<0.01). Conclusion Extravasated circulating IgG may enhance the TLR4 expression in the rat brain induced by peripheral LPS.

Objective:To establish a new method of designing and fabricating a facial simulation model of infant cleft lip for lip repair simulation and surgery teaching. Methods: Using latest three-dimensional scanning, reversed engineering and rapid prototyping techniques to fulfill the individual design and rapid auto-manufacture for the facial model of the cleft lip infants. With the new chromatosis technique and special silicone material of Maxillofacial Prosthetics the simulative face of infant cleft lip were fabricated. The new simulation model was used for lip repair surgery teaching. Results: The vivid faical data was successfully acquired by scanner and then designed by software. The solid plastic partern of patient's face was fabricated by machine, which was eventually replaced by maxillofaical silicon. The surgeon applied it for pre-surgery simulation and surgery teaching. Conclusion: This study successfully designed and fabricated the new simulation model of cleft lip infant's face, which can be a ideal training model for lip repair surgery teaching.

Objective To explore the significance and important measure of integrative treatment of multiple trauma patients with severe craniocerebral injury in emergency center. Methods One hundred and forty-eight multiple trauma patients with severe craniocerebral injury in emergency center from November 2002 to February 2006 were analysed retrospectively. Result In total 148 cases, 72 were cured and 26 dead, 7 were in status of plant man, 17 experienced severe deformity, and 26 did mild deformity. Conclusion Multiple trauma patients with severe craniocerebral injury usually experience a serious situation and rapid development. Therefore emergency doctors are required for organizing salvage of such patients, at the same time treatment and diagnosis are implemented. Firstly the most important key to successful salvage is appropriate disposal of fatal injury and early elimination of shock. Proper surgical choice, especially at the first time, inspection and protection of visceral functions, and attention to nutritional support are other vital methods to gain more successful salvage. ICU is also emphasized for its essentiality.