Objective To investigate the correlation between the degree of pathogenetic condition and cogni-tive impairment in young OSAHS patients. Methods Sixty-three patients (18～44 years old) were divided into 3 groups according to the assessment criteria regarding the degrees of pathogenetic conditions of hypoxemia and its persistence time: mild group(the lowest SaO2 ≥ 85 %, n = 20 ), moderate group (the lowest SaO2 : 65 ～ 84 %, n =24), and severe group (the lowest SAO2<65%, n= 19). Twenty-five healthy young adults were selected as the control group. All the subjects were tested with event-related potential, namely P300, the polysomnogram and the mini-mental state examination scale(MMSE). Results P300 latency in patients of three OSAHS groups was sig-nificantly prolonged as 326.1±12.7, 346.9±19.1, and 34.9±18.3 ms, as compared with those of control group: 311.9±18.3 ms (P< 0.05, respectively). In severe group, P300 latency was markedly increased compared with mild and moderate groups(P<0.01, P<0.05, respectively). No obvious differences were observed between mild and moderate groups(P=0. 095). The difference of hypoxemia lasting time could influence the P300 latency, such as when the hypoxemia lasting time was 4～60 seconds, the latency was 338. 12±13.7 ms, and when the hypoxemia lasting time increased to 60 ～ 140 s, the latency was prolonged to 354.74±16.7 ms(P = 0. 031 ). There was no difference among all groups in the P300 amplitudes. The MMSE scores for all patients were within normal limits andthere were differences between serve and control group(RA -RB=9. 91, P= 0. 003). Conclusion Among patients with OS-AHS, the impairment of cognitive function is con'anon. The degrees of pathogenetic conditions of hypoxemia and its lasting time may be used to evaluate the impairment degree of cognitive function in patients with OSAHS.

Objective To systemically analyze the effect of continuous aspiration of subglottic suction (CASS) on the incidence of ventilator-associated pneumonia (VAP) and other outcomes in mechanical ventilated patients.Methods PubMed,Cochrane Library,Ovid,EBSCOhost,ScienceDirect,Google scholar,CNKI,CBM and Wanfang Database were searched for the RCTs about the effect of CASS on the outcomes of mechanical ventilated patients from July 1994 to July 2014,and the relevant journals were also hand-searched.Data were extracted independently by two reviewers.Meta analysis was conducted using RevMan 5.1 software.Results Data extracted from 7 RCTs with a total of 1 566 patients were analyzed.The risks of developing clinically diagnosed VAP were significantly lower among the patients receiving CASS [RR =0.54,95％ CI(0.43,0.65),P＜0.01],episodes of VAP occurred later in patients receiving CASS [MD=3.52,95％CI(1.98,5.06),P＜0.01],the duration of mechanical ventilation [MD=-2.03,95％CI(-2.23,-1.73),P＜0.01]and length of ICU stay were reduced [MD=-2.99,95％CI(-3.75,-2.23),P＜0.01],while no significant differences were detected between the two groups regarding the mortality rate [RR=0.98,95％CI (0.80,1.20),P＞0.05].Conclusion This study proved that the CASS did have effect in reducing the incidence of VAP,but it is limited by lack of enough RCTs with high quality.Large sample of high quality RCTs is necessary to examine the wider applicability of CASS.

Objective To describe the burden of caregivers of children with asthma,and to provide reference for the development of family care support program.Methods Qualitative research was used to carry out semi-structured interviews with 13 caregivers of children with asthma in the pediatric outpatient of the First Affiliated Hospital of Guangzhou Medical University.The data collected were analyzed with Colaizzi 7-step analysis method.Results The carcgiver burden was classified into 4 themes,including time and energy exhaustion,heavy economic burden,insufficient knowledge of care and negative emotions.Conclusions The burden of caregivers of children with asthma has a relatively great impact on the daily work and life,even the physical and mental health.Care workers should be concerned about the status of caregiver burden and provide targeted interventions,which could help caregiver adapt to their roles,maintain and promote the health of children patients and their families.

The stretched preparation of subcutanous tissue of 120 male rats were observed by means of histochemical methods for separate and consecutive demonstration of norepinephrine and cholinesterase (ChE). In addition to adrenergic nerves, there are acetylcholinesterase (AChE) containing nerves surrounding the small arteries and arterioles. AChE is recongnized as a marker of cholinergic nerves in rat subcutanous tissue. After sympathetic gangliectomy, all adrenergic and most of cholinergic nerves disappeared, we suggested that both of them are terminals of sympathetic postganglionic nerve fibers. Using the method for the consecutive demonstration of norepinephrine (NE) and AChE, it showed a dual innervation at the same site of an arteriole, most of them are superimposed each other, their distribution were just the same; but the other one third were not. The latter is a separate sympathetic cholinergic system. Whether these superimposed terminals were coming from different neurons and travelling in the Schwann cell or they contained two kinds of neurotransmitters in the same neuron terminal were discussed.By the small arteries and arterioles of rat subcutanous tissue, there were many ChE-positive nerves, which were sensitive to iso-OMPA inhibition. Such thin unmyelineted nerve fibers are mainly non-cholinergic. They showed a variety of free nerve endings in the martrix of connective tissue, and they can be traced, in association with the whole course, to the small spinal nerve trunk that travelling in subcutanous tissue. We consider that these ChE-positive nerves and their terminals are sensory components of cerebrospinal fibers. It has been observed that some of free nerve endings are superimposed with adrenergic paravascular plexus by means of consecutive method.

Objective To analyze the clinical manifestations of familial acute necrotizing encephalopathy (ANE)and to improve the recognition of this disease. Methods The clinical data of a 25 - month - old girl with fa-milial and recurrent ANE with evidence of mutation in the RANBP2 gene were collected and analyzed,and the gene examination of their family members was performed. Results A previously healthy girl experienced recurrent ANE epi-sodes at the ages of 8 months,18 months and 25 months,respectively. At each beginning of each episodes the patient presented with lethargy and tremor of limbs following febrile illness of 3 - 4 days,even developed coma and convulsions in the last time. Brain magnetic resonance imaging showed bilateral and high T2 signal changes in thalamus,cerebellum and hippocampus. Abnormal signals also appeared in the brainstem,claustrum,corpus scallosum and cortex(temporal, parietal and cingulate)also appeared abnormal signals. Spinal MRI showed spinal cord involvement. The girl recovered after her first episode;she could speak but could not walk steadily after the second time;after the third episode,al-though she regained consciousness from coma,she could no longer speak or walk. The patient's sister died of encephali-tis at the age of 18 months. Her paternal uncle had suffered from dysnoesia from meningitis at his 17 months of age. The patient and her grandmother,father,uncle and one of her aunts harbored a mutation(c. 1754C ﹥ T)in RANBP2 gene. Conclusions Familial ANE has typical clinical manifestations and characteristic MRI findings. The patient with recur-rent history,especially with positive family history,should have the mutation in RANBP2 gene detected earlier in order to clarify the diagnosis of ANE.

Objective The aim of this study was to compare the basic characters of the speech - evoked audi‐tory brainstem response (speech - ABR) in healthy young women with that in post - menopause women and to get the changes of the probable factors for the auditory brainstem pathway encoding of speech sounds in healthy post -menopause women .Methods Speech - ABR of forty - seven normal hearing subjects including twenty - seven young women and twenty post - menopause women were recorded .The speech syllable /da/ as stimulus sound was trans‐mited to right ear by the insert earphones in speech - ABR test .Results The response waves of speech - ABR in post - menopause women were similar to those in young women ,which containal the onset responses (peak V and A) ,the transition (peak C) ,the frequency following responses (peak D ,E and F) and the offset response (peak O) .Except wave C ,the latency of wave V (6 .99 ± 0 .34ms) ,wave A (8 .32 ± 0 .49 ms) and wave O (48 .86 ± 0 .50 ms) in post - menopause women were evidently longer than those of in young women (the waveV :6 .60 ± 0 .25 ms ,wave A :7 .56 ± 0 .31 ms and wave O :47 .88 ± 0 .31 ms) ,while the amplitude of wave A ( - 0 .16 ± 0 .06 μV ) and O ( - 0 .12 ± 0 .06 μV ) in post - menopause women were obviously lower (modulus) than those of in young women (the wave A : - 0 .27 ± 0 .08 μV and O : - 0 .18 ± 0 .07 μV)(P< 0 .05) .In the FFR of speech - ABR ,the latency of wave D (23 .27 ± 0 .67 ms) ,wave E (31 .88 ± 0 .58 ms) and F (40 .61 ± 1 .22 ms) in post - menopause women were also longer than those of in young women (the wave D :22 .40 ± 0 .44 ms ,wave E :31 .00 ± 0 .43 ms and F :39 .53 ± 0 .61 ms) .Besides ,the amplitudes of wave D ( - 0 .12 ± 0 .04 μV ) and F ( - 0 .08 ± 0 .06 μV ) in post -menopause women were visibly lower (modulus) than those of in young women (the wave D : - 0 .17 ± 0 .08 μV and F : - 0 .16 ± 0 .07 μV)(P< 0 .05) . ④ The V /A slope also showed very significant difference ,the V/A slope in young women was much bigger than that in post - menopause women (P< 0 .05) .Conclusion The synchronism and phase locking of auditory brainstem pathway to processing and encoding capability in healthy post - menopause women is poorer than those of in young women .It may suggest that the growth of the age and the decrease of hor‐mone will weaken the ability to processing of speech sounds in women .

OBJECTIVE:To study the effects of flow components C6 and C7 in n-butyl alcohol extract from the leaves of Ces-trum Nocturnum(CN)on the proliferation and apoptosis of human gastric cancer cell SGC7901. METHODS:C6 and C7 were ob-tained by using different ratio of chloroform and methanol(1:9,1:7)to the gradient elution of CN leaves. After cultured with 0 (blank control),5,10,20,40,80 μg/ml C6 and C7 for 72 h,inhibitory effect of C6 and C7 on the proliferation of SGC7901 was determined by MTT assay. Inhibitory rate and IC50 were calculated. After SGC7901 were cultured with 10 μg/ml C6 and C7 for 72 h,colony formation assay was utilized to detect the effects of C6 and C7 on the cell colony formation,and the rate of colony for-mation was calculated. In addition,Wright/Giemsa and Hoechst33258/PI staining assay were used to observe the change of cytomor-phology. RESULTS:MTT showed that C6 and C7 had inhibitory effect on the proliferation of SGC7901 to different extent;inhibi-tory rates were 22.1%-80.0% and 19.6%-79.7%,and IC50 were 16.4,18.05 μg/ml,respectively. Compared with blank control group,colony formation rate of C6 and C7 group decreased,with statistical significance(P<0.05). The number of apoptotic cells was more in treatment group than in other groups. CONCLUSIONS:Flow components C6 and C7 in n-butyl alcohol extract from the leaves of CN can inhibit the proliferation of SGC7901 cells and induce the apoptosis of them.

OBJECTIVETo investigate the clinical and genetics characteristics of patients with monosomal karyotype acute myeloid leukemia (MK-AML).

METHODSThe karyotypes of 3743 patients with newly-diagnosed de novo AML were analyzed, which had identified 153 cases with MK-AML, for whom the clinical and genetics characteristics were analyzed.

RESULTSThere were 2056 patients (54.9%) among all patients. A total of 153 patients fulfilling the criteria for MK-AML were identified, which comprised 93 males and 60 females, with a median age of 54. The median white blood cell count on presentation was 4.4×10 (9)/L. One hundred and forty-five cases (94.8%) have fulfilled the criteria for complex karyotype (≥ 3 chromosomal abnormalities). Although the monosomy could be found with all autosomes, chromosome 7 has been most frequently involved (38.56%, 59/153).

CONCLUSIONMK-AML is a distinct cytogenetic subtype of AML. Monosomy 7 is frequently detected among MK-AML patients. The monosomal karyotype is common among elder patients with AML.

Adult ; Aged ; Chromosomes, Human, Pair 7 ; genetics ; Female ; Humans ; Karyotype ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Monosomy ; Young Adult

Objective To investigate the status and risk factors of surgical site infection (SSI)in hospitals in Chi-na,so as to provide theoretical basis for the prevention and treatment of SSI.Methods Four types of surgeries (colorectal surgery,abdominal hysterectomy,femoral neck repair surgery,and vascular surgery)in 29 hospitals were monitored prospectively,risk factors for SSI were analyzed.Results A total of 6 309 surgical procedures were investigated,incidence of SSI was 1 .60%.Incidences of SSI in patients receiving colorectal surgery,abdominal hys-terectomy,femoral neck repair surgery,and vascular surgery were 4.47%(74/1 655 ),1 .03%(22/2 139),0.21 %(5/2 372),and 0.00% (0/143 )respectively.The incidences of SSI were different among different regions (χ2 =114.213,P <0.05).The most common SSI was superficial incisional infection,the next was deep incisional infec-tion.The major pathogens causing SSI were Escherichia coli ,Enterococcus spp .,coagulase negative staphylococ-cus ,Staphylococcus aureus ,and Klebsiella pneumoniae .The independent risk factors for SSI were male patients, long duration of surgery,and high NNIS score.Conclusion The risk of SSI is varied with different types of surger-ies.Male,long duration of surgery,and high NNIS score can increase the risk of postoperative SSI.

Objective To explore the incidence of surgical site infection (SSI)and compliance to bundled interven-tion measures,and evaluate the effect of bundled interventions on controlling SSI.Methods From October 2013 to September 2014,three types of surgeries (colorectal surgery,abdominal hysterectomy,and femoral neck repair sur-gery)in 29 hospitals in China were monitored,October 2013 to March 2014 was baseline investigated stage,April 2014 to September 2014 was intervention stage.Results A total of 6 166 episodes of surgeries were monitored,the incidence of SSI was 1 .64%,incidence of SSI following colorectal surgery,abdominal hysterectomy,and femoral neck repair surgery were 4.47%,1 .03%,and 0.21 % respectively.The P 75 time of three types of surgeries were 3,2,and 2 hours respectively.Compared with the baseline stage,the compliance to most intervention measures im-proved after intervention,the largest increase in the compliance to interventions was disinfection with chlorhexidine-containing disinfectant at surgical sites of colorectal surgery (increased by 29.09%),followed by preoperative shower of femoral neck repair surgery (increased by 26.24%),preoperative shower of colorectal surgery(increased by 22.95%),and skin preparation on the day of operation (increased by 20.75%).Incidences of SSI in three types of surgeries were not significantly different before and after intervention(all P >0.05).Conclusion The incidences of SSI are different among different types of surgeries,the compliance to most bundled intervention measures has im-proved to some extent after intervention,but effectiveness of intervention measures needs to be further observed.