OBJECTIVE To investigate the advantages of nicardipine induced hypotension in endoscopic sinus surgery.METHODS Eighty patients underwent endoscopic sinus surgery under general anesthesia were randomly assigned into two groups(n=40 each):Group A(Enflurane Group), Group B (Nicardipine Group).The effect of controlled hypotension was compared between the two groups.The changes of MAP, HR were recorded during induced hypotension, the time of induction, maintenance and recovery in induced hypotension were recorded.RESULTS 1.The induced hypotension induction time in group A was significant shorter than that in group B, BP recovery time in group A was obviously longer than that in group B (P

Objective To establish a model of immune-mediated inner ear disease(IMIED) and to compare the efficacy of dexamethasone between systemic application and round window adminstration. Methods The guinea pigs were injected with keyhole limpet hemocyanin(KLH) mixed with complete Freund's adjuvant subcutaneouly in the back,and were boosted with KLH mixed with incomplete Freund's adjuvant two weeks later.Meanwhile,a small piece of gelatin sponge full of KLH was delivered on the round window through operation.Thus established a model of IMIED.Micro-osmotic pumps were used to deliver dexamethasone through the round window(PBS control group also set),and systemic application was implemented by intraperitoneal injection.The efficacy was compared by recording auditory brain-stem response(ABR) before and after the treatment. Results None of the 6 guinea pigs in the control group experienced significant hearing loss,while 22 of the 39 guinea pigs in the experiment group suffered from hearing loss beyond 10 dB.Seventeen guinea pigs with hearing loss no less than 15 dB were divided into three groups randomly and were given different treatment.Those(n=6) treated by local application through the round window enjoyed the efficacy and the mean ABR threshold decreased 13.3 dB.Four out of the 6 treated by systemic application enjoyed the efficacy and the mean ABR threshold decreased 13.7 dB.No efficacy was observed in the PBS group. Conclusion The model of IMIED can be successfully induce by KLH through the round window,and dexamethasone administered through the round window is as efficacious as systemic application.

Adult ; Arrhythmogenic Right Ventricular Dysplasia ; physiopathology ; Electrocardiography ; Humans ; Male ; Middle Aged

12E7 Antigen ; Antigens, CD ; metabolism ; CD57 Antigens ; metabolism ; Cell Adhesion Molecules ; metabolism ; Female ; Humans ; Immunohistochemistry ; Neuroectodermal Tumors, Primitive, Peripheral ; metabolism ; pathology ; therapy ; Pancreas ; chemistry ; pathology ; surgery ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; metabolism ; pathology ; surgery ; Phosphopyruvate Hydratase ; metabolism ; Young Adult

Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; pathology ; physiopathology ; Pituitary Gland ; pathology ; Pituitary Neoplasms ; pathology

BACKGROUND: Child neglect is one of the most important aspects of child abuse and has become a serious problem influencing children's development all over the world. Therefore, it is necessary to nderstand the current conditions and influential factors of child neglect and establish effective evaluation methods in China.OBJECTIVE: To investigate the current conditions and influential factors of urban child neglect in Suzhou city.DESIGN: A comparative analysis of sampling survey.SETTING: Department of Children's Health Care, Soochow University Affiliated Children's Hospital.PARTICIPANTS: This study was conducted in one public kindergarten and two private kindergartens of urban areas in Suzhou city between March and October 2003. Totally 370 children (196 boys and 174 girls) aged between 4 to 6 years old without obvious physical and mental diseases were voluntarily investigated, and they had been living with the person that answered the questionnaire regarding to child neglect in China in the recent 1 year. METHODS: Questionnaire regarding to child neglect in China was sent to each volunteer.he questionnaire evaluates the current conditions of child neglect by 20 items of 5 aspects including physical care (buy fruit for child, consider the nutritional need of child, care about the body height and body mass of child), emotional care (chat with child, play and tour with child, encourage child to do the things whatever they can, listen to what the child feels, introduce the child to the guests when they come to your home, let him or her stop immediately when child cries, care about the activities in kindergarten), education care (buy books for child, tell stories to child, recognize and correct the bad behavior of child, answer the questions asked by child seriously), safety care (protections against fire and electricity at home, warn child against matches, knives and other sharp things, teach child how to cross the road) and health care (prepare the common medicine for child at home, urge child to brush teeth, correct the bad posture). The volunteers were asked to answer each question objectively according to the conditions of child within the recent 1 year, and each question should be answered by selecting only one choice (never, occasionally, usually, always), and anyone should not be omitted. Meanwhile,the educational background and occupation of the parents were also investigated.MAIN OUTCOME MEASURES: The general status of child neglect and the effects of different family educational background and occupation of parents on child neglect were observed. RESULTS: Totally 370 questionnaires were sent out, and 370 qualified ones were recollected, the effective rate was 100%. ① In Suzhou city, the children were given better regards and good care in the aspects of education, medicine and safety, but neglects on children's physical and mental care still exists in a few families. ② Families of different educational background could think highly of the medical care, safety and psychical care of children, but neglects on education and emotional development more commonly existed in the families with the educational background under university. ③ All the families with different occupation could think highly of the medical care, safety and physical care of the children, but education and emotional development were better in the cadre families than in the ordinary families.CONCLUSION: In Suzhou city, the children are given better regards and good care in the aspects of education, medicine and safety, but some bad manifestations of child neglect exist in education and emotion, which are associated with the educational background and occupation of the parents.Further studies about the evaluation, prevention and intervention are needed for child neglect in China.

Objective To observe the effect of treatment of the diabetide foot with the fresh skin of the bufo bufo gargarizans cantor. Methods 42 diabetic foot patients were randomized into the control group and the treatment group with 21 patients in each. In the control group the patients were treated with disinfection routinely and dressing changing. In the treatment group the patients were treated with the fresh skin of the bufo bufo gargarizans cantor covering the infected feet after routine disinfection treatment. The treatment effect, the healing time and the length of antibiotics treatment course were compared between the two groups. Results The treatment effect of the treatment group was 100.00%, significantly higher than 80.95% of the control group. The healing time of the treatment group was (9.05 ±4.09) days, shorter than (17.41±4.20)days of the control group. The length of the antibiotics treatment course of the treatment group was(9.33±4.73)days, shorter than (17.10±4.83) days of the control group. Conclusions The fresh skin of the bufo bufo gargarizans cantor can improve the recovery rate, shorten the healing time and the length of the antibiotics treatment course by covering the infected feet.

Objeetive To explore the effectiveness of early warning assessment and management for maternity on perinatal outcomes.Methods From January 1,2013,a cohort prospective study was conducted on 49 261 pregnant women who registered initially at 6-13 gestational weeks and were followed up at 246 community health centers from 17 districts or counties of Shanghai.The first screening was conducted in community health centers for gestational age verification,medical history collection and physical examination.The pregnant women would be marked as green alert if all of the above three indices were normal.A woman would be transferred to level two or above hospitals if the first screening results were abnormal and the early warning signs were divided into five categories,including green alert (normal),red alert (complicated with sever mobility and complications during pregnancy),orange alert (complicated with sever mobility and complications during pregnancy,but not as severe as that of red alert),purple alert (concomitant communicable diseases during pregnancy),yellow alert (complicated with milder mobility and complications during pregnancy compared with that of red alert).The low risk pregnancy referred to yellow alert,and the high risk ones referred to orange,red or purple alert.We offered corresponding management and follow-up program for women with different warning signs,and analyzed the in-process indices such as screening-transport time,transport-diagnosis time,diagnosis-feedback time,feedback-initial-follow-up time,times of follow-up and regular or irregular follow-up.The association between in-process indices and perinatal outcomes (women with severe diseases during pregnancy and delivery,maternal mortality,preterm and low birth weight children and neonatal mortality) in both low and high risk pregnant women were analyzed using logistic regression model.Results Out of the 49 261 pregnant women,10 485(21.28％) were positive in the first screening and 38 776 (78.72％) were negative.For early warning classification,36 250(73.59％) were classified as green alert,12 277(24.92％) as yellow alert,625(1.27％) as orange alert,8(0.02％) as red alert,and 101(0.21％) as purple alert.The regular follow-up rate for low risk pregnant women was 82.7％(10 153/12 277),and that of high risk women was 74.1％(544/734).Prolonged feedback-initial-follow-up time increased the risk of maternal mortality (OR=1.051,95％CI:1.015-1.088,P=0.008) among low and high risk pregnant women.The increased times of follow-up for risk pregnancies decreased the occurrence of critical illed complications (OR=0.851,95％CI:0.725-0.999,P=0.049) and maternal mortality (OR=0.534,95％CI:0.307 0.930,P=0.014).Prolonged diagnosis-feedback time increased the risk of preterm birth (OR=l.009,95％CI:1.004-1.015,P=0.000).Prolonged feedback-initial-follow-up time increased the risk of neonatal mortality (OR=1.019,95％CI:1.001-1.038,P=0.045).However,the increase of followup times decreased the risk of preterm birth (OR=0.803,95％CI:0.762-0.847,P＜0.001),low-birth weight (OR=0.882,95％ CI:0.775-0.873,P＜0.001) and neonatal mortality (OR=0.653,95％CI:0.543-0.785,P＜0.001),so did regular follow-up (OR=0.432,95％CI:0.353-0.528;OR=0.494,95％CI:0.392-0.621;OR=0.226,95％CI:0.117-0.435;all P＜0.001).Conclusions The system of early warning assessment and management for pregnancy is effective on perinatal outcomes to some in both low and high risk gravidas extend and is worthwhile to be generalized and to form long-term mechanism.

Objective To explore surgical methods of removing polyacrylamide hydrogel (PAHG) and the right time of repairing the deformity of breast after removing PAHG.Methods We operated with endoscopy to remove PAHG through the lower mammary areolar incision.According to injection influence,we made the dicision whether to put the silicon gel prosthesis (hereafter referred to as prosthesis) simultaneously,and to fix the porsthesis,and to rebuild the imframammary fold of breast using biological repair membrane (hereafter referred to as membrane).Results In all 46 patients,39 patients' injection and their envelope were removed entirely.7 patients left part of the envelope because of its thin and wide characters.14 of them accepted prosthesis augmentation mammaplasty simultaneously and 5 of these accepted membrane repair.4 patients received prosthesis augmentation in stage Ⅱ.All patients' incision were primary healing.The incision scars were not obvious.1 patient with breast cancer suffered breast excision; 1 patient who received prosthesis and membrane simultaneously appeared prosthesis displacement after 3 months and fixed again.1 patient who received membrane appeared hydrops in residual cavity,and the membrane was removed finally.Conclusions This method with endoscopy through mammary areolae is necessary for cleaning PAHG entirely.We can use prosthesis to repair the deformity of breast after removing PAHG,and if necessary use membrane to fix the implant and rebuild the inframammary fold of the breast.

Objective:To explore the effect of fortified human milk feeding on growth and complica-tions of infants with extremely and very low birth weight (ELBW/VLBW)during hospital stay by a pro-spective,random and controlled study.Methods:In the study,1 22 ELBW/VLBW infants were enrolled and divided into two groups.The infants fed with human breast milk,combined with human milk fortifi-cation (HMF)during hospital stay were named HMF group (n=62),and those fed exclusively with pre-mature formula were named premature formula feeding group (PF group,n=60 ).The data of the in-fants’growth (the velocity of increase on the weight,length,head circumference and upper arm circum-ference),the time of rebounding to birth weight,the time of needing intravenous nutrition,the time of hospitalizing,the proportion of extrauterine growth retardation (EUGR)during hospital stay,the level of hemoglobin,bone metabolism and incidence of complications were compared between the two groups. Results:Among the 1 22 infants included,(1 )the length increment in HMF group was higher than PF group [(0.89 ±0.23)cm/week vs.(0.79 ±0.34)cm/week,P=0.04];there were no significant differences in the weight gain,head circumference increment and upper arm circumference increment (P>0.05);(2)the age of rebounding to birth weight [(1 0.1 3 ±4.03)d vs.(8.03 ±3.28)d,P=0.002]and the duration of intravenous nutrition [(1 6.77 ±6.63)d vs.(1 4.23 ±4.1 5)d,P=0.01 ] in HMF group were longer than that in PF group,there were no significant differences between the two groups in the hospital stay and age achieved feeding;(3 )there were no significant differences between the two groups in the incidence rate of EUGR during hospital stay (P>0.05);(4)the level of calcium at birth in HMF group was lower than that in PF group [(2.1 9 ±0.22)mmol/L vs.(2.32 ±0.27) mmol/L,P=0.005 ],and the level of alkaline phosphatase (AKP)in HMF group at discharge was higher than in PF group [(363.98 ±1 22.49)mmol/L vs.(299.73 ±1 1 7.39)mmol/L,P=0.004];(5)the incidence of the feeding intolerance (6.5% vs.1 8.3%,P=0.04)and sepsis (4.8% vs. 1 6.7%,P=0.03)in HMF group were less than in PF group,there were no significant differences be-tween the two groups on the morbidity of necrotizing enterocditis,retinopathy of prematurity (ROP),and bronchopulmonary dysplasia (BPD)(P>0.05).Conclusion:HMF for premature infants may ensure the same growth pattern as those fed by premature formula,promote the calcium absorption,decrease the inci-dence of sepsis and feeding intolerance,and does not increase the incidence of necrotizing enterocolitis.