Objective To find the normal range and features for auditory brainstem responses(ABR)of infants within six months,and the basic parameters for identifying the hearing impaired infants.Methods May 2006 to May 2008,60 normal infants and 20 normal adults received the ABR tests.The infants were divided into three groups:group A(6 weeks),group B(3 months)and group C(6 months).Each group consisted of 20 infants(40 ears)and the ABR data were statistically analyzed.Results At 100 dB nHL,the waveⅠ,Ⅲ,Ⅴ latencies of ABR for 6-week infants respectively were 1.49?0.08 ms,4.42?0.16 ms and 6.61?0.25 ms,for 3-month infants,1.47?0.07 ms,4.35?0.20 ms and 6.50?0.25 ms,for 6-month infants,1.45?0.07 ms,4.17?0.15 ms and 6.32?0.22 ms.At 80 dB nHL,the waveⅠ,Ⅲ,Ⅴ latencies of ABR for 6-week infants were 1.63?0.08 ms,4.52?0.17 ms and 6.74?0.26 ms,respectively,for 3-month infants,1.64?0.11 ms,4.44?0.20 ms and 6.67?0.26 ms,for 6-month infants,1.60?0.11 ms,4.27?0.16 ms and 6.43?0.24 ms.As the intensity of stimulating signals decreased,the peak latency of ABR became more delayed.The peak latencies of Ⅲ,Ⅴ waves and interval peak latencies of Ⅰ-Ⅲ and-Ⅴ waves for the infants were more delayed than those for adults,and became shorter with the increase of the infants' ages,but they failed to reach adults' levels even for 6-month infants.However,the length of wave Ⅰ of ABR for infants of different months was close to that for adults.The thresholds of ABR for the infants of different ages were not significantly different,all being close to the values for adults.Conclusion This study has analyzed the ABR wave features for the infants of three ages and this can help to define the reference ranges for the infants and to provide the parameters for early diagnosis of hearing loss among the infants.

BACKGROUND:Clavicular hook plate fixation is a extensively used method in repair of acromioclavicular dislocation in recent years. The metal hook of the clavicular hook plate occupied subacromial space. Some patients affected joint pain. Therefore, it is necessary to find a better fixation material to replace clavicular hook plate. OBJECTIVE:To explore the curative effect of threaded rivets versus clavicular hook plate in treatment of the Tossy III acromioclavicular joint dislocation. METHODS:We retrospectively analyzed clinical data of 51 cases of type Tossy III acromioclavicular joint dislocation. Al fol ow-up data were obtained including 27 cases in the clavicular hook plate fixation group and 24 cases in the threaded rivets group. Imaging results, clinical therapeutic effects and complications were compared and analyzed after fixation in both groups. RESULTS AND CONCLUSION:No significant difference in Japanese Orthopaedic Association scores was detected between the clavicular hook plate fixation group and threaded rivets group (P>0.05). At 3 months after fixation, the incidences of subacromial impingement syndrome and acromial bone erosion were higher in the clavicular hook plate fixation group compared with the threaded rivets group, and the visual analogous scale scores were significantly higher than the threaded rivets group (P<0.05). Results suggested that both two methods can be used to treat type Tossy III acromioclavicular joint dislocation, with similar clinical curative effects, but the threaded rivets have the advantage of preventing the postoperative complications such as acromial bone impact and erosion, subacromial impingement and lysis.

Objective The pathogenesis of intractable epilepsy was explored by examining the expression of the P-gp , GST-Pi as well as MDR1 in peripheral blood of the patients with intractable epilepsy. The potential of the above mentioned three genes as the biomarkers for treatment of intractable epilepsy was investigated. Methods Thirty-one sub?jects with refractory epilepsy, 33 subjects under good circumstances by antiepileptic drugs, and 37 healthy subjects were included in the present study. fluorescence quantitative polymerase chain reaction and flow cytometry were used to detect mRNA levels of MDR1 and GST-Pi and P-gp of MDR1 in the peripheral blood of the patients, respectively. Results The expression levels of MDR1 and GST-Pi were significantly higher in the AEDs intractable group(1.36±0.14,0.585±0.257) than in the treatment group(0.82±0.15,0.309±0.217, P<0.05)The expression levels of MDR1 and GST-Pi were signifi?cantly higher in the AEDs treatment group than in the normal group(0.27±0.07,0.134±0.223,P<0.05). The expression levels of P-gp were significantly higher in the AEDs of the intractable group(0.104±0.084)than in the treatment group (0.063 ± 0.030, P<0.05). The GST-Pi gene expression levels were significantly higher in three(0.535 ± 0.256)or two (0.425±0.254)kinds of antiepileptic drugs combination therapy than in single drug treatment(0.267±0.265, P<0.05). Leucocyte P-gp levels were significantly higher in combination therapy of three kinds of antiepileptic drugs(0.141 ± 0.096)than in combination therapy of two kinds of antiepileptic drugs(0.071±0.020)or in monotherapy(0.050±0.020, P<0.05). Conclusion MDR1 and GST-Pi gene expression levels of peripheral blood can be used as the reference in?dex for treatment of intractable epilepsy and the resistant index of combination treatment for intractable epilepsy.

Objective To investigate the changes of serum and urinary adiponectin (ADPN) levels and insulin resis-tance (IR) states in patients with chronic kidney disease (CKD), and to explore their relationship thereof. Methods A total of 487 patients with CKD stages 2-5 were enrolled in this study, and 30 healthy subjects were served as control group. The se-rum ADPN levels in urine samples were examined by ELISA. The level of fasting insulin (FINS) was detected by radioimmu-noassay. Blood routine test, liver and kidney functions, blood glucose, serum lipids, 24 h urinary protein excretion and endoge-nous creatinine clearance rate (Ccr) and body mass index (BMI) were observed and calculated. The differences of ADPN lev-els in serum and urine samples and homeostasis model assessment for insulin resistance (Homa-IR) were compared between groups. Results The serum and urine ADPN levels and Homa-IR were higher in CKD patients than those of controls (P＜0.05). With the decline in renal function, the ADPN and Homa-IR levels were increased gradually (P＜0.05). The value of se-rum ADPN was significantly higher in patients with CKD stages 3-5 and high Homa-IR. The ADPN levels and Homa-IR were positively related to lipid parameters and 24 h urinary protein, and negatively correlated with hemoglobin and serum al-bumin in patients with CKD (P ＜ 0.05). Conclusion CKD patients had higher ADPN level and more significant IR. The ADPN and IR were correlated with serum lipids, hemoglobin, albumin and urinary protein. Dynamic monitor of ADPN level may have clinical significance in judging metabolic disorders in CKD patients.

Objective To determine 2, 3, 4, 5, 6-pentafluorobenzyl monofluoroacetate (PFB-MFA) as the derivative of monofluoroacetate anion ion by gas chromatography, by which fluoroacetamide, one of the raticides may be analyzed. Methods The calibration curve and limit of detection were obtained by quantification of standardized PFB-MFA using GC/ECD and GC/MS. Results The linear ranges for PFB-MFA were 0.01～0.1ng/?for GC/ECD,1～100ng/?l for GC/MS SCAN and 5?10~(-3)～1 ng/?l for GC/MS SIM. The limit of detections for fluoroacetate anoin were 1.31?10~(-4)ng/?l for GC/ECD, 0.13 ng/?l for GC/MS SCAN, and 1.76?10~(-4) ng/?l for GC/MS SIM. Conclusion The monofluoroacetate anion derivative (MFAPFB) can be deterimined accurately with high sensitivity by GC/ECD and GC/MS SIM, which may be used for analysis of fluoroacetamide in forensic practice.

Objective To explore the relationship of etiopathogenesis,therapy and prognosis in children with chronic arrhythmia.Met-hods Forty cases aged 48 h to 12 years old between Sep.2003 to Oct.2006 were selected.All children had vertigo,syncope,Adam-Stoke syndrome,cardiac shock.Some cases were detected with complete atrioventricular block(CAVB)(33 cases),sinus bradycardia(5 cases) or sick sinus syndrome(2 cases) by electrocardiogram(ECG) at least 2 times,and these symptoms lasted 3 days at least.Congenital CAVB children having no clinical symptom were given no treatment.Cases having sinus bradycardia,sick sinus syndrome resulted from viral myocarditis,the earlier were given antiviral medicine,energy composition,intravenous megavitamin C,isoprenaline,and large dose of adrenocortcal hormone simultaneously.Some were given human ?-globulin.Eight of them were set temporary pacemaker because of unsatisfactory treatment,and 2 of them were set permanent pacemaker.Results Twenty-eight cases were cured,9 cases were improved and 3 cases died.Six out of the cured cases and improved cased were set permanent or temporary pacemaker.Conclusions Early discovery,early diagnosis,and early temporary pacemaker use will lead a better prognosis in regular treatment.On the contrary,the delayed treatment on children with viral myocarditis and CAVB caused by dilated cardiomyopathy will lead a negative prognosis.

OBJECTIVE To explore the risk factors in aged patients with ventilator-associated pneumonia(VAP) and to provide the corresponding clinical prevention strategies. METHODS The ages,underlying diseases,mechanical ventilation method,use of antibiotics,and pathogenic bacteria of the VAP patients were investigated and analyzed. RESULTS Totally 155 VAP of elderly patients had serious underlying diseases,and treated with broad-spectrum antibiotics,tracheal intubation or trachea incision.Most pathogenic bacteria were mutiple-resistant. CONCLUSIONS The prevention of VAP was in priority for control of VAP patients.In order to control the occurrence and spread of VAP,clinicians should cut the time of ventilator,pay more attention to sterilization and isolation,and strengthen the tend of the patients.

OBJECTIVE To study drug resistance status of infected bacteria in abdominal surgical wound for their countermeasures. METHODS The abdominal surgical infection of a hospital was investigated from Jan 2000 to Dec 2004.Bacterial isolation and identification were carried out complying with National Operation Procedure of The Clinical Laboratory.Drug sensitivity test was performed with KB method. RESULTS The infection rate was 4.1%.The species were predominated by Gram-negative bacilli(71.1%),especially Escherichia coli(17.2%),Pseudomonas aeruginosa(16.7%) and Klebsiella pneumoniae(12.7%),and they all beared high antibiotics resistance. CONCLUSIONS Special attention should be paid to abdominal surgical wound infection.

To analyze the correlation between fragmented QRS complexes( fQRS) and inflammation in 136 patients with acute coronary syndromes(ACS). Patients with fQRS had increased hs-CRP levels (P<0.01) in comparison to patients with non-fragmented QRS. The higher hs-CRP levels was,the more the number of leads in the fQRS on ECG was(P<0.01). When we performed multiple logistic regression analysis, fQRS was found to be related to in-creased hs-CRP levels [ OR:1.507 , 95% CI:1.172~1.936 , P<0.01 ] . fQRS was independently related to in-creased hs-CRP. fQRS that may result as an end effect of inflammation at cellular level can represent increased car-diac risk in patients with ACS.

The use of optimal regulatory sequences for simultaneous expression of the transgenes might play a significant role in engineering plants with increased disease and insect resistance.The plant expression vector pOMS-GUS,which contained the GUS gene under the control of a chimeric promoter based upon the mannopine synthase(mas)promoter and the octopine synthase(ocs)enhancer,was constructed.Used as control,another vector pMAS-GUS,carried the GUS gene driven by only the mas promoter.The two vectors were introduced into tobacco plants by Agrobacterium-mediated transformation.Fluorometric assays for GUS activity and reverse transcription-polymerase chain reaction(RT-PCR)analysis revealed that GUS gene expressed weakly with untreated transgenic tobacco while the level of GUS activity increased steadily after 1 h subjected to wounding.The expression of the mas and ocs/mas promoters was induced a further 1.8-fold and 5.7-fold,respectively.SA(1 mmol/L)or MJ(250 ?mol/L)treatment also caused a large induction of the ocs/mas chimeric promoter;And the application of SA in combination with MJ(1 mmol/LSA & 250 ?mol/L MJ)produced an additive effect that exceeded the wounding response.The results showed that the ocs/mas chimeric promoter is a strong inducible promoter that can be activated by various stresses.The chimeric promoter should have utility in development of disease and insect resistant transgenic crops.