Objective To investigate the auditory brainstem response (ABR) of newborns in the neonatal intensive care unit (NICU) after hear screening failure.Methods To test ABR of 833 healthy newborns with no perinatal diseases at the clinic,and 425 newborns born in NICU who failed the hearing screening of monaural or both-ear from March 2014 to May 2015.Results 49.6% of children′s wave V response thresholds were ≥30 dB in the NICU group and 36.1% children′s wave V response thresholds were ≥30 dB in healthy group.The hearing abnormality rate of the NICU group was significantly higher than that of the healthy group(P<0.05);The average auditory thresholds healthy of the group[(19.76±6.59)dB] was significantly lower than those of the NICU group[(41.52±20.35)dB](P<0.05);both ear latency for waves Ⅰ,Ⅲ and Ⅴ and interpeak latency for waves Ⅰ-Ⅴ in healthy group were significantly shorter than those in NICU group (P<0.05).Conclusion The hearing loss extent of the NICU group is greater than that of the healthy group.The ABR abnormality reflects auditory pathway is abnormal.

Objective To investigate the role of M3 receptor in the effect of penehyclidine hydrochloride(PHC) upregulating β-arrestin-1 expression in lipopolysaccharide(LPS)-induced human pulmonary microvascular endothelial cell(HPMVEC) injury.Methods.M3 shRNA transfected HPMVEC and normal HPMVEC cells were randomly divided into LPS group(A),LPS+pHC group(B),LPS+ M3 shRNA transfection group(C) and PHC+ LPS+ M3 shRNA transfection group(D).The cytoskeleton change was observed by laser scanning confocal.The LDH level in cellular supernate was detected.The VCAM 1 protein expression was examined by immunofluorescence chemistry.β-arrestin-1 protein expression was determined by Western blot and β-arrestin-1mRNA expression was measured by real-time PCR.Results Compared with the group A or C,F-actin cytoskeleton arrangement in the group B or D was neat,the LDH level and VCAM-1 protein expression were decreased,and β-arrestin-1 expression was increased;compared with group A or B,F-actin cytoskeleton arrangement in the group C or D was neat,the LDH level and VCAM-1 protein expression were decreased,while the β-arrestin-1 expression had no obvious change.Conclusion Silence M3 receptor is conducive to reduce LPS-induced HPMVEC injury.But the role of PHC up-regulating β-arrestin-1 expression has no necessary connection with M3 receptor.

OBJECTIVETo compare the clinical efficacy difference between encircling needling combined with physical factor therapy and simple physical factor therapy for severe pressure sore, and to explore the optimal method for severe pressure sores.

METHODSThirty-four patients with IV-grade pressure sore were randomly divided into an observation group and a control group, 17 cases in each one. Patients in the control group were treated with conventional nursing, ultrasonic wave and short-wave ultraviolet therapy; additionally, the encircling needling was applied in the observation group. All the treatment was given once a day, 5 times a week, and 4-week treatment constituted one session. Totally, two sessions of treatment were performed. Three indices, including the area of pressure sore, 24-h volume of exudates and wound-bed tissue type, were compared between the two groups before and after treatment; the clinical efficacy was evaluated in the two groups.

RESULTSAfter treatment of one session and two sessions, the area of pressure sore, 24-h volume of exudates and wound-bed tissue type were significantly reduced in the two groups (P < 0.01, P < 0.05), which was more obvious in the observation group (all P < 0.05). The total effective rate in the observation group was 76.5% (13/17) after 1 session and 94.1% (16/17) after 2 sessions, which were superior to 35.3% (6/17) after 1 session and 64.7% (11/17) after 2 sessions in the control group (both P < 0.05).

CONCLUSIONEncircling needling combined with physical factor therapy can obviously reduce the pressure sore area and 24-h volume of exudates and improve wound-bed tissue type, which is superior to simple physical factor therapy.

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Pressure Ulcer ; therapy ; Short-Wave Therapy ; Ultrasonic Therapy ; Ultrasonic Waves

Objective To investigate the clinical efficacy of postoperative three-dimensional conformal radiotherapy concurrent with paclitaxel +TS-1 chemotherapy in the treatment of advanced gastric carcinoma.Methods A total of 60 patients with advanced gastric carcinoma were randomly divided into treatment group and control group.In treatment group,30 patients received simultaneous three-dimensional conformal radiations therapy combined with paclitaxel +TS-1 chemotherapy.In control group,30 patients received paclitaxel +TS-1 chemotherapy.The long term survival rate,local recurrence rate and side reactions were observed in two groups.Results The 1,2-year survival rate in treatment group [93.1％ (27/29),75.9 ％ (22/29)] and control group [72.4 ％ (21/29),48.3 ％ (14/29)] had significant difference (P ＜ 0.05).The 1,2-year local recurrence rate in treatment group [6.9％ (2/29),13.8％ (4/29)] and control group [31.0％ (9/29),44.8 ％ (13/29)] had significant difference (P ＜ 0.05 or ＜ 0.01).The side reactions in two groups were mainly manifested as leukopenia,thrombocytopenia,anemia,nausea,vomiting,liver function damage and oral mucositis.The incidence rate of nausea,vomiting in treatment group was significantly higher than that in control group [83.3％ (25/30) vs.53.3％ (16/30)] (P =0.012).Conclusions Postoperative threedimensional conformal radiotherapy concurrent with paclitaxel +TS-1 chemotherapy in the treatment of advanced gastric carcinoma may improve the long-term survival rate,lower local recurrence rate.But the adverse reactions are increased.

BACKGROUND:Cervical decompression and fusion internal fixation wil accelerate adjacent segment disc degeneration, and it is not clear whether single segment instaibility can increase the adjacent segment disc degeneration. OBJECTIVE:To study the changes of morphology, proteoglycan and col agen type Ⅱ in the adjacent intervertebral disc of the cervical instability models. METHODS:Sixteen New Zealand white rabbits were divided into two groups randomly, with eight rabbits in the control group and eight rabbits in the model group. The animal cervical instability models were made by destroyed partly annulus fibrosus and absorbed C 5/6 nucleus pulposus through anterior cervical puncture. After 12 weeks, the animal models were tested by X-ray film. Al rabbits were sacrificed and 10 mg nucleus pulposus of the intervertebral discs of C 4/5 cut from sagittal plane were harvested and stored under 0 ℃. The content of proteoglycan in nucleus pulposus was tested with phloroglucinol method. Then, the paraffin sections of intervertebral disc tissues were taken for hematoxylin-eosin staining and SABC immunohistochemical staining. RESULTS AND CONCLUSION:The notochord cells of C4/5 intervertebral discs in the experimental group was decreased, and being replaced by fibroblast-like cells. Round chondrocytes could be seen occasional y and intervertebral discs annulus fibrosus became rough and arranged disorderly, the hyaline degeneration and pigmentation were observed as wel as the fibrochondrocytes, and there was a gap between inner and outer annulus fibrosus. The content of proteoglycan was decreased in the nucleus pulposus, and there was significant difference between two groups. The col agen type Ⅱ in the degenerative disc nucleus pulposus and annulus fibrosus of the experimental group was lower than that of the control group. Cervical instability can lead to adjacent intervertebral disc degeneration with the morphological changes and decreased content of proteoglycan and col agen type Ⅱ.

Objective To investigate genotypes and antibiotic resistance of Escherichia coli producing plasmid-mediated AmpC ?-lactamase in Anhui province.Methods A total of 407 clinical isolates of nonrepeated Escherichia coli were collected from different cities in Anhui province.AmpC ?-lactamase producing isolates were identified by cefoxitin three-dimensional test and antibiotic susceptibility was identified by agar dilution test.Plasmid extraction,PCR amplication of corresponding group was performed, followed by sequencing.Results The positive rate of cefoxitin three-dimensional test was 8.1% (33/407), and the prevalence of plasmid-mediated AmpC ?-lactamase was 3.0% (12/407).bla_(CMY-2) gene,bla_(DHA-1) gene and bla_(ACT-2) gene were identified by PCR amplification and confirmed by sequencing in 5 strains,4 strains and 2 strains,respectively.A new CMY genotype was identified,with its sequence revealed 97% identity to the deduced amino acid sequence with previous CMY-2.This is also the first report on ACT-2 genotype in China.The susceptibility test showed that all strains were resistant to cephamycins and piperacillin,and susceptible to imipenem.Two strains of Escherichia coli producing DHA-1 were resistant to fourth-generation cephalosporin.Conclusions CMY-2,DHA-1 and ACT-2 are the most common genotypes in plasmid-mediated AmpC ?-lactamase produced by clinical Escherichia coli isolates in Anhui province. Carbapenems could be the first choice for the treatment of infection caused by AmpC ?-lactamase producers.

Objective To evaluate the application of Herniamesh in repairing adult umbilical hernia.Methods The data of 12 aduh patients with umbilical hernia were treated with Hemiamesh from January 2007 to March 2009 was analyzed retrospectively,included characteristics,methods and effects of Hemiamesh Oval Patch 0812 on the repair of hernia.Results All cases were cured.The average stay in hospital was (5±2)d.No postoperative complication,no recurrence follow-up visited 1 to 25 months.Conclusion Repairing umbilical hernia in adult with Hemiamesh Oval Patch 0812 is a kind of simple,safe,effective operation and the ring of hernia no more than 4cm.

Objective To discuss the diagnosis and treatment of renal tuberculosis.Methods A retrospective study was made on 96 cases.Results Frequency (51.8%), urgency (37.2%),odynuria (33.4%),lumbodynia (41.0%),and hematuria(48.1%)were the most common symptoms. The diagnostic accuracy of IVU, B-type ultrasonography, CT and biopsy of mucous membrane of urinary bladder were 69.1%,12.5 %,37.5% and 33.3% respectively. 96 cases were given medicine (INH+RFP+PZA or PIA for 6-8 months).38 cases(39.6%)have been cured, while symptoms of 43 cases (44.8%) have been improved. Operation was performed on 15 cases that were ineffective treated by chemical therapy. Conclusions Urine routine, IVP, cystoscopy+biopsy of mucous membrane of urinary bladder provide important information for the diagnosis of renal tuberculosis. INH, REP and EMB or PIA combination therapy yields satisfactory outcome for early cases.

Objective To evaluate the effects of conscious sedation analgesia during superficial bladder tumor resection for elderly patients. Methods Forty elderly patients who needed 2 μm laser resection for bladder tumors were treated with target controlled infusion (TCI) remifentanil and propofol. The initial target concentration of remifentanil was 2.5 ng/mL and that of propofol was 1 μg/mL. The target concentration of those two agents was adjusted until loss of painfulness to the operative stimulus. The MAP, HR, SpO2, RR and PetCO2, BIS and scores by OAA/S were compared between pre-and post-surgery at different time points (time before anesthesia, T0; time before analgesia, T1; time when the resection began, T2; 5 minutes after the resection began, T3;10 minutes after the resection began, T4; 15 minutes after the resection began, T5; the end of operation, T6;5 minutes after operation). Results All patients lived through the surgery under a conscious sedation. After the anesthesia, blood pressure, heart rate and breathing rate were declined, while oxygen saturation was unchanged. Conclusion TCI with remifentanil and propofol provides better hemodynamic stability, satisfactory sedation analgesia and faster recovery of surgery.

Objective:The clinical factors of single-port video-assisted thoracoscopic surgery (SP-VATS) were compared with those of multi-port video-assisted thoracoscopic surgery (MP-VATS). The differences between the two surgical methods and their respective postoperative recoveries were also discussed. Methods:A total of 522 patients who underwent surgical treatment for lung cancer in Tianjin Medical University Cancer Institate and Hospital from January, 2014 to December, 2015 were retrospectively reviewed. Of these cases, 83 underwent SP-VATS and 439 underwent MP-VATS. The two surgical methods were then compared in terms of opera-tive time, operative bleeding, number of lymph node and lymph node cleaning station, pain degree, 24 h postoperative chest drain-age, and in-hospital time after operation. Results:The differences between the patients who underwent SP-VATs and those who under-went MP-VATS in term of gender, age, smoking, tumor diameter, TNM stage, pathological type, and tumor location were not statistical-ly significant. The operative time in SP-VATS group was longer than that in the MP-VATS group (P<0.01), whereas in-hospital time after operation in the former group was shorter than that in the latter (P=0.011). Furthermore, pain degree in the SP-VATS group is lower than that in the MP-VATS group (P=0.041). The differences between the two groups in terms of operative bleeding, number of lymph node and lymph node cleaning station, and 24 h postoperative chest drainage were not statistically significant. Conclusion:SP-VATS can achieve a surgical effect similar to that of MP-VATS but has a prolonged operation time. SP-VATS is beneficial to postoperative re-covery and reduces the degree of pain. Thus, it has great potential for development.