Objective To investigate and compare the perception of communication difficulties by mainstreaming students with hearing impairment and that of their peers.Methods The children’s version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to measure perceived communication difficulty in various daily situations.Results There was significant difference between the perception of mainstreaming students and that of their peers for the background noise(BN) subscale questions.Conclusion In order to improve the communication ability of the students with hearing impairment, it is critical to educate one of their important communication partners—their peers, about the hearing loss and its effect on communication, especially under the situation of background noise.

Objective To investigate the correlation between ankle-brachial index and ultrasonography in lower ex- tremities vascular in type 2 diabetic patients.Methods 218 type 2 diabetic patients were enrolled,and ankle-brachial index(ABI)measurements and uhrasonography in lower extremities vascular were performed in all patients.Lower extremi- ties vascular disease(LEVD)were divided into six species according to the uhrasonography results and scored in accord- ante with its serious degree,then investigate the correlation between ABI and uhrasonography results score.All patients were divided into deferent groups according to uhrasonography results and ABI range,and then compared their deference. Results The lower the ABI,the more serious of the LEVD showed by ultrasonography.ABI and ultrasonic inspection score was significantly negatively correlated(r=-0.65,P

Objective To evaluate the role of β-arrestin-1 in penehyclidine hydrochloride (PHC)-induced inhibition of lipopolysaccharide (LPS)-caused increase in pulmonary microvascular permeability in human pulmonary microvascular endothelial cells (PMVECs).Methods Human PMVECs were seeded in 6-well plates (2 ml/well) or in culture flasks (4 ml/flask) at the density of 1 × 105 cells/ml and divided into 5 groups (n=15 each) using a random number table:empty plasmid transfection group (group C),LPS plus empty plasmid transfection group (LPS group),PHC plus LPS plus empty plasmid transfection group (P+LPS group),LPS plus β-arrestin-1 short hairpin RNA (shRNA) transfection group (LPS+shRNA group) and PHC plus LPS plus β-arrestin-1 shRNA transfection group (P+LPS+shRNA group).In LPS and LPS+shRNA groups,the cells were transfected with empty plasmid 1.5 μg or with plasmid containing 15 nmol/L β-arrestin-1 shRNA,LPS with the final concentration of 0.1 μg/ml was added at 24 h of incubation,and the cells were then incubated for 1 h.In P+LPS and P+LPS+shRNA groups,the cells were transfected with empty plasmid 1.5 μg or with plasmid containing 15 nmol/L β-arrestin-1 shRNA,PHC with the final concentration of 2 μg/ml was added at 24 h of incubation,LPS with the final concentration of 0.1 μg/ml was added at 1 h of incubation,and the cells were then incubated for 1 h.The cell permeability was measured using Transwell chambers.The expression of heat shock protein (HSP27) was detected by immunofluorescence.The expression of β-arrestin-1,p38 mitogen-activated protein kinase (p38MAPK) and phosphorylated p38MAPK (p-p38MAPK) was detected by Western blot.The ratio of pp38MAPK/p38MAPK was calculated.Results Compared with group C,the cell permeability was significantly increased,the expression of HSP27 was up-regulated,p-p38MAPK/p38MAPK ratio was increased,and the expression of β-arrestin-1 was down-regulated in LPS,LPS + shRNA and P + LPS + shRNA groups (P＜0.05),and no significant change was found in the parameters mentioned above in group P+LPS (P＞ 0.05).Compared with group LPS,the cell permeability was significantly decreased,the expression of HSP27 was down-regulated,p-p38MAPK/p38MAPK ratio was decreased,and the expression of β-arrestin1 was up-regulated in group P +LPS,and p-p38MAPK/p38MAPK ratio was significantly increased (P＜0.05),and no significant change was found in the other parameters in group P+LPS+shRNA (P＞0.05).Compared with group P+LPS,the cell permeability was significantly increased,the expression of HSP27 was up-regulated,p-p38MAPK/p38MAPK ratio was increased,and the expression of β-arrestin-1 was down-regulated in group P+LPS+shRNA (P＜0.05).Conclusion The mechanism by which PHC inhibits LPS-induced increase in pulmonary microvascular permeability is totally related to β-arrestin-1 in human PMVECs.

Objective Clinical effect analysis of low dose dopamine(LDD)and dobutamine (DOB)subsidiary in the treatment of 86 cases of Children serious pneumonia.Methods From July 2011 to July 2013,86 CSP patients who were diagnosed with CSP in People's Hospital of Wenzhou were selected.Patientas were randomly divided into observation group(n=43)and control group(n=43)according to the random number method.Both groups were treated with routine treatment,then observation group on the basis with LDD and DOB subsidiary,then compared efficacy of two groups at 1 week after treatment,as well as the time of symptoms and signs which had improvements,and changes of levels of Interleukin-6(IL-6),Interleukin-8(IL-8), C-reactive protein(CRP)and Tumor necrosis factor-α(TNF-α)before and after treatment. Results The efficacy in observation group was significantly better than that of control group(P<0.05 ).And time of symptoms and signs which had improvement in the observation group was significantly less than control group(P<0.05).After treatment,IL-6,IL-8,CRP and TNF-αlevels were lower than before,but the observation group had a greater degree of reducing(P<0.05).Conclusion Routine treatment combined with LDD and DOB for CSP patients,can significantly improve the therapeutic effect,and relieve the clinical symptoms.

Objective To investigate the effects of human leptin ( hLEP) gene transfection on rat bone marrow stro-mal cells ( rBMSCs) .Methods rBMSCs were cultured and transfected with adenoviruses encoding hLEP ( Ad5-hLEP-EGFP) in vitro as experimental group while rBMSCs transfected with Ad 5-EGFP and non-transfected were control groups.The proliferation was detected by MTT and the expression of collagen type Ⅰ(Col-Ⅰ) and alkaline phosphatase ( ALP) were assessed by real-time PCR.The ability of mineralized nodule forming was also examined by Alizarin red staining .The combination of transfected rBMSCs and β-tricalcium phosphate (β-TCP ) was con-structed and the osteogenic ability of the construction was evaluated in nude mice .Results hLEP could be trans-fected into rBMSCs successfully by adenovirous .After transfection , the proliferation was not affected while Col-Ⅰand ALP expressions were more pronounced in rBMSCs transfected with Ad 5-hLEP-EGFP ( P<0.05 ) .Alizarin red staining showed the ability of mineralized nodule forming was also up-regulated in Ad5-hLEP-EGFP group (P<0.05).In addition, the transfected rBMSCs adhered to β-TCP and survived well and the combination showed more new bone like tissue formation in nude mice compared to control groups .Conclusions rBMSCs transfected with hLEP might be potently used in bone or periodontal tissue regeneration .

Objective To investigate the potential relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei.Methods A random cluster sampling method was used to identify study population among 60 -70 years old residence in Renqiu region, Hebei.In the face of health questionnaire survey,neck vascular ultrasound examination,a total of 4 413 cases,inclu-ding 1 876 males and 2 537 females,the occurrence of carotid artery plaque and stenosis were detected by ultrasound. Carotid ultrasound was used to identify the characteristic of atherosclerotic plaque of bilateral carotid arteries,which were categorized as with and without plaque,single and multiple plaque,homogenous and heterogeneous plaque,and with and without stenosis.Cardiovascular events were defined as composite events of myocardial infarction,cardiovas-cular death,fatal or non -fatal stroke during the subsequent 2 years follow -up after initial evaluation.Multiple Logis-tic regression was performed to identify the association between the characteristics of bilateral carotid arteries and cardiovascular events.Results A total of 4 413 case enrolled in the study.With carotid ultrasound,2 438 cases (55.2%)were found to be with atherosclerotic plaque formation and 235(5.3%)were with carotid artery stenosis. The proportion of single,multiple,homogeneous and heterogeneous plaques were 1 024cases(23.2%),1 114cases (32.0%),1 106cases(25.1%)and 1 333cases(30.2%),respectively.Among them,the single plaque and new cardiovascular and cerebrovascular events occured in 83 cases(P =0.168),the multiple plaques and new cardiovascular and cerebrovascular events occured in 161 cases(P <0.001 ),the homogeneous patch and new cerebral vascular events occured in 98 cases(P =0.032),the non -homogeneous patch and new cerebral vascular events occured in 146 cases(P <0.001),the stenosis and cerebral vascular events occured in 42 cases(P <0.001).Taken the new onset cardiovascular and cerebrovascular events as dependent variable,the single factor analysis showed that the carotid plaques(χ2 =14.969,P <0.001 ),and the multiple plaque(χ2 =22.509,P <0.001 ),the carotid artery stenosis (χ2 =27.561,P <0.001),the homogeneous plaque(χ2 =4.606,P <0.050),the non -homogeneous plaque(χ2 =18.301,P <0.001),the history of hypertension(χ2 =33.709,P <0.001),the high blood fat disease(χ2 =11.262, P <0.001),and the history of diabetes(χ2 =5.525,P <0.050),the coronary heart disease history(χ2 =10.440, P <0.001),the gender(χ2 =5.606,P <0.050),the smoking(χ2 =4.823,P <0.050)and the systolic blood pressure value,were all associated with the new cardio cerebral vascular events.Multivariate analysis showed that,the heterogeneous plaque(β=0.371,P <0.050),the carotid artery stenosis(β=0.621,P <0.050),the history of hypertension(β=0.517,P <0.001)and smoking(β=0.264,P <0.050)were shown to be significantly associates with new onset cardiovascular events.Conclusion The characteristics of atherosclerotic plaque of carotid artery were significantly associated with the subsequent cardiovascular events among 60 -70 years old residence in Renqiu region,Hebei.Routine carotid ultrasound screening might be useful for identify those people with high risk of develo-ping cardiovascular events.

Objective To explore the etiology,clinical characteristics,diagnosis and treatment of the bile duct perforation in children.Methods The clinical data of 7 children with the bile duct perforation were retrospectively summarized in Wuhan Children's Hospital from April of 2009 to April of 2014.Results There were 7 cases of the children with perforation of the bile duct,1 male and 6 female,the average age was 2.05 years.The most common presenting symptoms were abdominal distension in 7 cases(100.0％),nausea and vomiting in 6 cases(85.7％),abdominal pain in 5 cases(71.4％),jaundice in 1 case(14.3％) and diarrhea in 1 case(14.3％).Six cases experienced preoperative abdominal paracentesis,which all gained bilious ascites.Both abdominal ultrasound and computed tomography(CT) showed ascites in 5 cases.On exploration,sites of perforation were seen in 3 cases(42.8％) at the junction of the common hepatic duct and cystic duct,1 case(14.3％) at common hepatic duct,and 1 case(14.3％) at common bile duct,while sites of perforation in other 2 cases(28.6％) were not localized.In the cases(case 1,2,5 and 7) whose site of perforation was large,the T-tube drainage and peritoneal drainage through laparotomy or laparoscopic surgery was performed.In case 4 whose site of perforation was very small,and case 3 and 6 whose site of perforation was not localized,the cholysystostomy and peritoneal drainage was performed through laparotomy or laparoscopic surgery.Simple closure of the perforation was performed in case 4.Case 4 and 5 showed recurrent abdominal pain after operation and abdominal CT revealed biliary tract dilatation,and then biliary reconstruction was performed.Both of the patients recovered well postoperatively.The other 5 children recovered well and had an uneventful postoperative period from the 7 months to 5 years follow-up.Conclusions Early diagnosis of perforation of the bile duct can be made based on clinical manifestations,abdominal ultrasound and CT and abdominal paracentesis.Active surgical treatment should be performed once diagnosis was made.Depending on the size of perforation of the bile duct,appropriate surgical drainage scheme is made.The children with recurrent abdominal pain and biliary tract dilatation should receive biliary reconstruction.

Objective To investigate the incidence of heterotopic ossification in cervical artificial disc replacement in Chinese mainland population by meta-analysis.Methods The related literatures published between 1997 and June 2012 were collected from both English databases,including Pubmed,Ovid,Cochrane library and Embase,and Chinese databases including Chinese Biomedical Literature Database,China National Knowledge Infrastructure,VIP database and Wanfang database.Literatures were selected in strict accordance with the inclusion and exclusion criteria.Studies providing data of prevalence of heterotopic ossification after cervical artificial disc replacement in Chinese mainland population were included.The information of literatures was extracted by excerpts questionnaire,and recorded by two independent researchers.I2 was calculated to test heterogeneity among studies.A random effects model was used if I2 ≥25％.Subgroup analysis was done according to the number of levels of disc replacement,brands of implants and duration of follow-up.Sensitivity analysis was done according to the sample size.The Meta-Analyst software was used for statistical analysis.Results A total of forty studies (1822 cases) were included in this study.The pooled incidence of heterotopic ossification was 7.3％ (95％CI:4.7％ to 11.0％).For single and mixed level disc replacement,the incidence was 11.6％ and 5.8％,respectively.For single and mixed level disc replacement using Bryan disc,the incidence was 13.8％ and 5.4％,respectively,and the total incidence was 7.2％.No matter the single or mixed level disc replacement,the incidence of heterotopic ossification increased with follow-up.Conclusion The incidence of heterotopic ossification in cervical artificial disc replacement is high in Chinese mainland population,while it is lower than in foreigners.However,it is necessary to monitor its long-term incidence due to its increase with follow-up.

Objective:To compare the effect of Cable-Pin system (CPS) and tension-band wiring (TBW) in surgery of patellar fractures by using meta-analysis of randomized controlled trials (RCTs).Methods:Seven RCTs were reviewed in this study.Odds ratio (OR) and 95％ confidence interval (CI) were calculated for dichotomous data and weighted mean difference (WMD) and 95％CI were applied for continuous variables.Results:It was shown that there was no significant difference in surgery time and intraoperative blood loss between two groups.The length of incision,fracture healing time,complications and hospital for special surgery knee score after surgery were significantly different between two groups (P＜0.05).Conclusions:Compared with TBW,CPS is better and safer in treatment of patellar fractures,with better improvement on knee function.

Objective To explore the associations between fasting serum lipids and high-sensitivity C-reactive protein ( hsCRP).Methods Serum triglyceride ( TG),high-density lipoprotein cholesterol (HDL-C) and hsCRP were measured in residents of Chengdu,China.Subjects with potential factors which might influence lipids and hsCRP were excluded,580 subjects [ mean age ( 62.3 ± 6.6 ) years ; male:58.7％ ] were finally recruited by random sampling methods.Results There was a weak positive relationship between TG and hsCRP ( r =0.108,P =0.01 ) and a weak negative relationship between HDLC and hsCRP (r =- 0.197,P ＜ 0.001 ),this was also true in the sub-group with BMI ＜ 24 kg/m2 ( r =0.236,-0.140 respectively,all P ＜0.001 ).In subjects with BMI ＜24 kg/m2,the hsCRP concentration was significantly higher in subjects with higher TG or lower HDL-C ( all P ＜ 0.05 ).hsCRP increased in proportion with the degree of dyslipidemia.After adjusting for gender,age,TC,LDL-C,fasting blood glucose,systolic blood pressure,diastolic blood pressure,history of hypertension and diabetes,smoking and alcohol drinking,logistic regression analysis showed that the odds ratio for increased hsCRP was 1.970 in subjects with either increased TG or lower HDL-C (P =0.105) and 9.098 in subjects with both higher TG or lower HDL-C levels (P =0.031 ).However,the observed relationship between TG,HDL-C and hsCRP in subjects with BMI ＜ 24 kg/m2 could not be observed in subjects with subjects with BMI ＞ 24 kg/m2despite significant more cardiovascular risk factors in these subjects.Conclusions A weak positive correlation between TG and hsCRP as well as a weak negative correlation between HDL-C and hsCRP was evidenced in the whole cohort suggesting dyslipidemia might be related to enhanced inflammatory status.However,this relationship is not observed in subjects with BMI ＞ 24 kg/m2 despite existence of more cardiovascular risk factors in these subjects.