To investigate the changes in CAP and CM recorded from the cochlear round window when glutamate solution in different concentrations(10mmol/L, 5mmol/L, 1mmol/L) was instilled into whole cochlea perilymph. The results demonstrated that there was a dependent correlation between CAP threshold shift and glutamate concentration. CAP threshold shift and amplitude could be markedly influenced by glutamate instillation. However, amplitude of CM was not obviously affected, and the I/O function of CM amplitude always maintained a nonlinear characteristic. The results suggest that glutamate has selective effects between inner hair cells and outer hair cells. High concentration glutamate might cause an increase in intracellular calcium, even as high as to induce toxicity. It could be induced by glutamate when it acts on IHC′s presynaptic autoreceptor in positive feedback manner, or on the afferent neurons, so that the synapsis is directly damaged by glutamate concentration overload in synaptic cleft.

Objective To observe the effect of Cyclosporine A on the brain immunoligical reject reaction of transgenic cellular transplant in rats with experimental brain hemorrhage.Methods We established the brain hemorrhagic models of rats and the models were divided into group A (treated with Cyclosporin A) and group B (without treatment) randomly after transplanting brain cells modified by NGF gene. The levels of CD~+_4, CD~+_8T cells subsets in peripheral blood were examined by using flow cytometry at 15 d after transplantation. The expressions of MHC-classⅡantigens and infiltration of CD~+_4, CD~+_8T lymphocyte subsets were examined by SP immunocytochemical stain.Results The count of CD~+_4, CD~+_8T lymphocyte and CD~+_4/CD~+_8 in peripheral blood were 29.20?3.97, 20.65?2.02 and 1.41?0.86 in group A, and were 47.39?3.01, 28.30? 2.36 and 1.68?0.69 in group B, respectively.There were significant differences between the two groups (all P

Adult ; Aneurysm, Dissecting ; complications ; pathology ; Anterior Wall Myocardial Infarction ; etiology ; Aortic Aneurysm, Thoracic ; complications ; Humans ; Male

Objective:To explore the optimal postpartum nursing intervention method of elderly second-birth parturient based on the best evidence and evaluate its effect so as to improve the quality of clinical nursing.Methods:Based on the best evidence obtained from the previous study, the optimal nursing examination index of the elderly second parturient was established, and the evidence of best practice was obtained by using the evidence-based nursing method, and the 2017 revised version (the third edition of) Johns Hopkins evidence-based nursing practice model) was used to guide nurses to apply the evidence to clinical practice. During the period from March to May 2019, the baseline review was completed, including 82 pregnant women and 43 nurses. The evidence was incorporated into clinical practice in June 2019. From July to October 2019, the same indicators and inclusion and exclusion criteria were used to evaluate the effectiveness of evidence application in 43 nurses (including midwives) and 85 elderly second-child parturients in obstetric wards (including baby-friendly areas). The anxiety, depression, maternal satisfaction and nurses' correct implementation rate of the best evidence were compared before and after the application of evidence.Results:After the use of evidence-based intervention, the implementation rate of nurses was above 80%. The anxiety score of parturient decreased from 55.29±10.11 to 41.74±10.35, the difference was statistically significant ( t value was 8.55, P<0.001), and the depression score decreased from 57.77 ±8.32 to 47.86 ±9.33, the difference was statistically significant ( t value was 7.23, P<0.001). Maternal satisfaction increased from 92.68% (76/82) to 98.82% (84/85), the difference was statistically significant ( χ2 value was 3.92, P< 0.05). Conclusion:The result of practice shows that through evidence-based nursing intervention, we can further standardize the postpartum optimal nursing paradigm of elderly second-child parturients in China. Reduce postpartum anxiety and depression and improve maternal satisfaction. And quality review still needs to be continuously promoted and implemented in clinical practice in order to continuously improve the quality of nursing and ensure sustainability.

Objective: To investigate the metabolic effects of two different formula of amino acids on postoperative patients . Methods: According to prospective ,randomized , single blind and controlled rule, 120 patients after abdominal operation were randomized to receive parenteral nutrition with either amino acid enriched BCAA or balanced amino acid (18 F).From the second day after operation, total parenteral nutrition was infused to the patients with equal calorie and equal nitrogen by central or peripheral vein for 6 days. Meanwhile, every day nitrogen balance was monitored by collecting urine in 24 hours .The indices were investigated such as amino acids patterns, and serum levels of total protein, albumin, prealbumin, thansferrin and fibronectin. Results: Nitrogen balance of patients in study group on day5 was higher than those of control group. The decreased serum levels of albumin in study group were lower than the control group. Concentrations of valine increased more significantly in study group than that of the control group. Conclusions: The formula of amino acid enriched BCAA may be more suitable and effective for the postoperative traumatic patients on protein metabolism.

Objective To explore the clinical value of indocyanine green near-infrared fluorescence imaging with methylene blue for the sentinel lymph node biopsy (SLNB) in early breast cancer.Methods SLNB was performed in forty patients by fluorescence navigation with methylene blue.Frozen section was performed,followed by conventional histopathology.Results The identification rate of SLN was 100％.100％ of SLNs were fluorescent,with the average number being 2.88.92.5％ of SLNs were stained blue,with the average number being 1.75.The presence of lymph node metastasis was observed in intraoperative biopsy in 7 patients,and a total dissection of the axillary lymph nodes was performed immediately.Metastatic lesions were not found in the identified lymph nodes by intraoperative biopsy and permanent pathological diagnosis in the other 33 patients.Conclusions Sentinel lymph nodes biopsy by fluorescence navigation with methylene blue was a feasible minimally invasive technology with high detection rate.

Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma) and its correlation with proximal colon carcinoma.Methods From January 2003 to December 2013,the clinical features of 963 hospitalized patients with rectal polyps were retrospectively analyzed.According to whether the patient with colon carcinoma,the clinical data of rectal polyps patients were divided into pure polyps group (n=855) and sentinel polyps group (n 108).The characteristics under endoscopy,clinical pathological features,treatment and prognosis of the two groups were observed.Chi square test was performed for differences comparison between groups.Results The length of stay in hospital of 963 patients was from four to 33 days,the average age was (49.7 ± 9.4) years,and the majority of the patients were male (n=610,63.3％).A total of 785 patients (81.5％) had non-specific abdominal symptoms,such as frequency or habit change of defecation,hematochezia,abdominal pain,abdominal distension.The relatives within three generation of 78 patients (8.1 ％) were diagnosed with tumor and some relatives of the patients diagnosed with familial adenomatous polyposis (2.2％,21/963).The positive rate of tumor marker of sentinel polyps group was higher (69.4％,75/ 108) than that of pure polyps group (6.8％,58/855; x2 =316.285,P＜0.01).The proximal colon carcinoma of patients with sentinel polyps appeared as neoplasma with circumferential growth,there was no specific appearance between distal rectal polyps and proximal colon carcinoma.When compared with pure polyps group,most polyps of sentinel polyps group were in maximum diameter over 1 cm (61.1％ (66/108) vs 46.9％ (401/855)),multi polyps (n＞5,38.9％ (42/108) vs 11.8％ (101/855)) and adenomatous polyp (83.3％ (90/108) vs 35.6％(304/855),x2=7.752,55.595 and 90.544,all P＜ 0.01).Majority of the proximal colon carcinoma with rectal polyps was papillary adenocarcinoma and tubular adenocarcinoma which was account for 75.9％ (82/108).Some were mucinous carcinoma and signet ring cell carcinoma.Most of the proximal colon carcinoma with rectal polys did not penetrate the serosa layer (Duk A-+Duk B,59.3％,64/108) and with little distant metastasis (Duke D,17.6％,19/ 108).Ninty-five point six percent (817/855) of patients with pure polyps underwent endoscopic treatment and all of them were cured and discharged.Forty-one point seven percent (45/108) of patients of sentinel polyps group accepted the radical operation and 19.4％ (21/108) received endoscopic submucosal dissection.Conclusions If multiple,maximum diameter over 1 cm and adenomatous rectal polyps were detected under colon endoscope,the possibility of carcinogenesis of the polyps or the proximal colon should be awared.If the endoscope is difficult to go further or the patient can not tolerate the whole colon examination,the patient should be followed up in short-term and complete the whole colon examination.

Objective To investigate the long-term effects and risk factors of arterial polyvinyl alcohol resin (PVA) embolization for ⅢB and IV non-small cell lung cancer(NSCLC) patient.Methods 126 patients with 1 B or V NSCLC were performed the perfusion with 5-FU,THP,DDP by PVA grain embolization under fluoroscopic control.All patients were followed up.Kaplan-Meier was used to calculate the survival rate and the median survival time,and Cox regression model was adopted to analyze related risk factors which affected curative effect.Results The median survival time was( 11.78 ± 3.24) months and 1 -,2-year survival rate was 39.1 ％,25.59％ in 126 patients with NSCLC.Cox model analysis showed that of the tumor staging,tumor size,location and combination chemotherapy were all independent risk factors of prognosis (all P ＜ 0.01 ).Conclusion Arterial embolization of PVA for treatment of NSCLC is effective.Tumor size,stage,location and combination chemotherapy are associated with prognosis of NSCLC.

Objective To provide valuable references for ultrasonic diagnosis of pelvic organ prolapsed (POP) by finding an eas ily detecting referential line based on MRI.Methods Data of 107 patients who underwent pelvic MRI were retrospectively analyzed.All the patients were divided into 6 groups according to age:Group 1 (20 29 years old),group 2 (30-39 years old),group 3 (40-49 years old),group 4 (50-59 years old),group 5 (60-69 years old) and group 6 (≥70 years old group).Four reference lines were set basing on the median sagittal view of T2WI:PS-PS line (the line connecting the two endpoint of the pubic symphysis),PIAS line (the line connecting the inferior margin of pubic symphysis and the bottom of sphincter internal anal sphincter),PPC line (the line connecting of the inferior margin of pubic symphysis and the point of the pubococcygeous attached on the rectum) and PM line (the line connecting of the inferior margin of pubic symphysis and the M point [the midpoint of the line from the crosspoint of PPC line and the front wall of the rectum mucosa to the bottom of sphincter internal anal sphincter]).The angles between the horizontal line and PS-PS line,PIAS line,PM line,PPC line (angle 1,angle 2,angle 3,angle 4) were measured,respectively.The differences of the angle among various age-groups were compared.The consistency between the two observes were evaluated.Results PM line was the closest line to the horizontal line.There was no statistical differences of angle 1,angle 2 and angle 3 among the 6 groups (all P＞0.05).The difference of angle 4 among the 6 groups were significant (F=3.42,P=0.01).Intergroup pairwise comparisons showed that significant differences were found between group 1 and group 4,group 5,group 6,between group 2 and group 4,group 5,group 6,between group 3 and group 4,group 5,group 6,respectively (all P＜0.05).And no significant difference was found in the other comparisons.The consistency of the two observers in meaning angle 1,angle 3 and angle 4 were good,but the consistency of angle 2 was poor.Conclusion Of all the referential lines,PM is the closest to the horizontal line and is less influenced by the patient's age.However,the feasibility of using PM lines as the ultrasound referential line is still unclear.

BACKGROUND: A stable and exact animal model is the necessary tool and basis for studying hemorrhagic cerebrovascular diseases.OBJECTIVE: To establish and evaluate the intracerebral capsular hemorrhage models in rats.DESIGN: A randomized and controlled animal experiment.SETTING: Second Hospital Affiliated to Xuzhou Medical College; First Hospital Affiliated to Nanjing Medical University.MATERIALS: This experiment was carried out in the animal experimental center of Nanjing Medical University during May to November 2002.Totally 35 SD rats were randomized into two groups: experimental group (n=30) and sham-operation group (n=5).METHODS: ① Autoblood was injected into the intracerebral capsule of rats to create intracerebral capsule hemorrhage models with stereotaxy in the experiment group. ②Scoring was conducted according to 5-point neurological scoring criteria from ZeaLonga, somatic sensation and motor function of rats were observed. ③Somatosensory evoked potential(SEP) of rats was detected pre- and post-operation under anesthetic state. ④ After determination of SEP, the rats were sacrificed under anesthetic state. Brains were taken out to made slices, then sections were stained with haematoxylin and eosin. Changes in haematoma and histomorphology were observed at the largest focus under optical microscope.MAIN OUTCOME MEASURES: ①Nerve function scoring; ②Latent period of various waves of SEP; ③ Observation of brain tissue morphology.RESULTS: Totally 35 rats entered the stage of result analysis. ①Appearance of obvious paralysis of the rats suggested the modeling was successful. The successful rate of this experiment was 93.3%(28/30). Significant difference existed in neurological scoring between experimental group [(2.74±0.46)points] and sham-operation group (0 point)(P＜0.05). ②SEP showed that the latent periods of various waves of experimental group after operation were significantly delayed than those before operation and those of sham-operation group [P1: (15.72±0.78) ms, (10.69±0.52) ms, (10.73±0.48) ms;Nl: (17.95±1.27) ms,(13.21±1.31) ms, (13.34±1.27) ms;N2:(21.16±1.62) ms, (15.42±1.46) ms,(15.58±1.44) ms;N3:(24.86±1.58) ms, (18.72±1.76) ms, (18.99±1.67) ms,P＜0.05]. ③In the shamoperation group, a few red blood cells were scattered in the peripheral area of needle channel were found, but hemorrhagic focus was not; In the experimental group, irregular or oval blood clots presented in the left internal capsule area. In about a low-fold visual field, brain tissue in the surrounding of hemorrhagic focus was loosened and swelled, and pathological changes were obviously severer than those in the sham-operation group.CONCLUSION: Intracerebral capsular hemorrhage induced by injection of autoblood with stereotaxy is more close to clinical situation, and it is easy to operate and has good reproducibility.