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

Health management plays an important role in the control of medical costs and in maintaining people' s health.Since the beginning of health management performance in our country,the major problems were:inadequacy of govement's support;imperfect laws;irregular marketing operation;lack of feasible health management model;controversy over long-term economic benefits;lack of awareness on health in common people and so on.To solve these problems,it is necessary to strengthen government support,and enhance people's health awareness,and explore the health management model consistent with the actual situation in China.

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 evaluate the effect of human milk fortification on short‐term growth of premature infants in NICU and its clinical safety .Methods According to different formulas ,the premature infants were divided into preterm formula group ,human milk group and human milk fortification group (HMF group) .Its growth rate ,blood biochemistry ,adverse event rate and so on were compared .Results There were 147 cases meeting requirements .the weight growth velocity of preterm formula group ,human milk group and HMF group were (19 .44 ± 5 .14) ,(14 .53 ± 5 .86) ,(17 .09 ± 5 .81) g · kg -1 · d-1 respectively with statistical sig‐nificance (P<0 .01);the growth velocity of head circumference of preterm formula group (0 .72 ± 0 .34)cm/w and HMF group (0 .71 ± 0 .29) cm/w were significantly higher than that of human milk group (0 .51 ± 0 .34)cm/w (P<0 .01);the time of regaining or overtopping birth weight of preterm formula group (8 .55 ± 3 .20)d and HMF group (9 .43 ± 4 .53)d was significantly shorter than that of human milk group (10 .93 ± 3 .02)d(P<0 .01);the EUGR occurrence rate of head circumference of preterm formula group and HMF group were significantly lower than that of human milk group(P<0 .01) .The feeding intolerance rate of preterm formula group (15 .52% ) was significantly higher than that of human milk group (2 .13% ) (P<0 .05);there were no significant difference in incidence rate of infection event in each group(P>0 .05) .Conclusion Human milk fortification can control the inci‐dence rate of infection event and feeding intolerance to increase growth velocity of weight and head circumference of premature in‐fants during hospital stay .

Objective:To observe the clinical effect of tuina plus foot bath with Chinese medicine for patients with diabetic foot (DF) in early stage.Methods:A total of 70 patients with early-stage DF were randomly allocated by the random number table into two groups,with 35 cases in each group.Patients in the control group received conventional medication,while patients in the observation group received tuina plus foot bath with Chinese medicine on the basis of conventional medication.The clinical efficacy was compared after 2 courses of treatment.Results:After treatment,intra-group comparisons of ankle-brachial index (ABI) showed statistical significance in both groups (both P＜0.05).The curative rate was 83.3％ in the observation group,with the total effective rate of 96.7％,versus 29.4％ and 76.5％ in the control group,respectively,and the between-group comparisons showed statistical significance (both P＜0.05),indicating a better effect in the observation group.Conclusion:Tuina plus foot bath with Chinese medicine has a good therapeutic effect for DF patients in early stage.

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.