OBJECTIVE: To investigate the characteristics of tinnitus in patients with auditory neuropathy spec- trum disorder (ANSD). METHOD: This study recruited 14 ANSD patients with tinnitus. All the ANSD patients un- derwent detailed history taking, audiological examinations and assessments of tinnitus. This study analyzed the correlation of tinnitus status and hearing loss, and discussed the effects of sex, age, and the course of disease on tinnitus in ANSD patients. RESULT: (1) In the ANSD patients, tinnitus often occurred in 3 years after the onset of hearing loss; (2) Tinnitus was highly prevalent in ANSD patients, and the severity of tinnitus was mostly from mild to moderate; (3) There was no obvious correlation between the subjective grading of tinnitus and hearing loss de- gree, and the impact of curve patterns of hearing loss on the level of tinnitus need much more evidence-based proof; (4) Along with the course extension, the impact of tinnitus on the quality of life was much more obvious; (5) Some risk factors such as noise exposure could be the reasons of aggravating the degree of tinnitus. CONCLUSION Tinnitus in ANSD patients has its unique clinical features. The study of Tinnitus in ANSD patients can provide clinical basis for further research in ANSD.
Hearing Loss ; Hearing Loss, Central ; complications ; diagnosis ; Humans ; Prevalence ; Quality of Life ; Tinnitus ; complications ; diagnosis

Objective To investigate the current status of nursing undergraduate students′ self-differentiation and career adaptability and analyze the correlation of the two, so as to provide a reference for nursing educators to offer employment guidance. Methods The Undergraduate Self-Differentiation Scale and The College Students′Career Adaptability Questionnaire were used to investigate 341 nursing undergraduates. Results The mean scores of the self-differentiation and the career adaptability were (3.70±0.60) points and (3.60±0.42) points, respectively. It showed that the total score of self-differentiation and its each dimension were positively correlated with career adaptability, the Pearson correlation coefficients were career adjustment 0.26, career interpersonal 0.38, career curiosity 0.32, career confidence 0.39, career concerns 0.27, career control 0.46, and the coefficients between two total scales were 0.46 (all P<0.05). Conclusions The self-differentiation level of nursing undergraduates could affect their career adaptation level, and clinical nursing educators can take corresponding measures to improve their career adaptability based on the characteristics of nursing students′self-differentiation.

BACKGROUND: Some researches suggest that improvement of motor function is closely related to cognitive function. The better the cognitive status is, the better the recovery of motor function is. Early evaluation of cognitive function can predict prognosis of motor function and improve generalized ability, social communication abilities and quality of life (QOL).OBJECTIVE: To observe the correlation of cognitive function in hemiplegia and aphasia and analyze the prognostic factor of early cognitive dysfunction in patients with acute stroke.DESIGN: Contrast study.SETTING: Department of Neurology, Taian Central Hospital; Department of Neurology, Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: Fifty patients with acute stroke were enrolled from Neurological Department of Taian Central Hospital and Neurological Department of the Affiliated Hospital of Medical College of Qingdao University from January 2002 to May 2005. They were 32 males and 18 females aged 34-78 years. All patients were coincidence with the Diagnostic Criteria of Acute Stroke established by the Fourth National Cerebrovascular Diseases Meeting and diagnosed with CT or MRI. Patients were told about the evaluation in details. Among them, 44 patients had hemiplegia, including 30 males and 14 females aged 34-78 years; 30 had aphasia, including 17 males and 13 females aged 34-78 years; 20 had non-aphasia, including 14 males and 6 females aged 38-70 years.METHODS: ① Aphasia was tested with Western Aphasia Battery (WAB).Aphasic quotient of ＜ 93.8 was regarded as aphasia; otherwise, it was regarded as non-aphasia. ② Motor function was evaluated with Fugl-Meyer (FMA).Motor function of upper and lower limbs was scored as 100 in total. The higher the points were, the better the motor function was. ③ Cognitive function was evaluated with Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), which contained 4 items (orientation, perceptibility, visual-motor organization and thinking ability) and 22 subtests in total. The higher the points were, the better the cognitive function was. Functional evaluation started at half-month treatment onset. Intergroup comparison of their mean value was tested using Student's test and one-way analysis of variance.MAIN OUTCOME MEASURES: ① Correlation between cognitive function and hemiplegia; ② correlation between cognitive function and aphasia.RESULTS: Fifty patients with acute stroke were all involved in the final analysis. ① Correlation between cognitive function and hemiplegia: Scores of orientation, perception, visual-motor organization and cognitive function of 44 patients with hemiplegia were positive positively correlated with FMA scores of motor function (r=0.534, 0.598, 0.500, 0.548, P ＜ 0.01); however,scores of thinking ability was not correlated with FMA scores of motor function (r=0.310, P ＞ 0.05). ② Correlation between cognitive function and aphasia: Scores of orientation, perception, visual-motor organization, thinking operation and cognitive function of patients with aphasia were (4.60±2.37), (15.10±6.02), (14.00±6.93), (12.33±6.77), (1.83±1.09) points,which were lower than those of patients with non-aphasia (7.30±1.08),(23.20±1.11), (24.25±4.08), (24.20±5.43), (3.50±0.76) points (t=5.44 to7.197, P ＜ 0.05).CONCLUSION: The more severe the cognitive dysfunction is, the more severe the hemiplegia is. Cognitive function in stroke patients with aphasia is significantly reduced.

Objective To develop a new scoring system,Daping orthopedics operation risk scoring system for senile patient(DORSSSP),for preoperative evaluation of operative risks in the elderly patients with hip fractures based on acute physiology and chronic health evaluation(APACHE)Ⅱ scoring system and physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM)and compare the new scoring system with APACHE Ⅱ and POSSUM in assessing surgical risks and predicting postoperative complications and mortalities.Methods A total of 260 patients with hip fractures treated in our department in recent five years were retrospectively and respectively evaluated with DORSSSP,POSSUM,progressed POSSUM(P-POSSUM)and APACHE Ⅱ scoring system to compare the value of three scoring systems in preoperative evaluation of operative risks and prediction of postoperative mortality and complications.Results POSSUM and DORSSSP predicted complications in 119 and 92 patients respectively,while the actual complication occurred in 84 patients.The prediction value of POSSUM was significantly higher than the actual value,while the prediction value of DORSSSP showed no statistical difference compared with the actual value.POSSUM,P-POSSUM and APACHEⅡ scoring systems predicted 16,10 and 12 deaths respectively,but there were six deaths in fact,with prediction value obviously higher than the actual value.DORSSSP predicted nine deaths,the closest value to the actual.Conclusions DORSSSP has good correlation with postoperative complications and mortalities.Compared with POSSUM and APACHE Ⅱ scoring system,more simple and practicable DORSSSP can more accurately evaluate the preoperative risks and predict the postoperative complications and mortalities in the elderly patients with hip fractures.

To investigate and analysis the multiple medical adverse events about disposable umbilical cord clamp during clinical using in Zhejiang province, and put forward some opinions some suggestions to improve the processing technology, to strengthen the professional training of medical staff in medical institutions of umbilical cord clamp using, and to take precautions against more adverse events.
Disposable Equipment ; Humans ; Product Surveillance, Postmarketing ; Umbilical Cord

This article reviews recent advances in apoptosis on the pathway inducing cancer cell to death, including Bcl-2 family pathway, NF-kappa B pathway, P13K/Akt pathway, Rb gene and p53 gene, especially the targets of anticancer drug in these pathways. It could be useful for the anticancer drug design and estimate. Furthermore, those cancer/testis antigen gene products are potential targets for antigen-specific immunotherapy of carcinoma.
Antigens, Neoplasm ; drug effects ; metabolism ; Antineoplastic Agents ; pharmacology ; Drug Delivery Systems ; Drug Design ; Humans ; Male ; NF-kappa B ; drug effects ; metabolism ; Phosphatidylinositol 3-Kinases ; drug effects ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; drug effects ; metabolism ; Retinoblastoma Protein ; drug effects ; metabolism ; Testis ; drug effects ; metabolism

OBJECTIVE: To investigate the pure tone audiometry characteristics and curative effect in sudden hearing loss patients with hypertension. METHOD: One hundred and fifty-seven inpatients (168 ears) with hypertension suffered from sudden hearing loss were included in this study. We retrospectively analyzed the audiological index of these patients by comparing the pure tone audiometry (PTA) among patients in the aspects of gender, age, affected side, duration of hypertension, with or without inducement, concomitant symptoms and other combined diseases. The hearing threshold at different frequency was also compared, as well as the curative effect among patients with diverse audiological characteristics. RESULT: Of the contemporaneous sudden hearing loss patients (874 cases), the prevalence of hypertension was 17.96%, where the male ones accounted for. 28.69% (103/359) and the female ones accounted for 19.42% (54/278) respectively with statistically significant difference between genders (P < 0.01). The prevalence of hypertension in 34-44 years old group, 45-49 years old group, 60-69 years old group and over 70 years old group was 12.69% (25/197), 22.51% (70/311), 47.62% (40/84), 48.89% (22/45) respectively, which were statistically different (P < 0.01). The number of impaired ears with audiogram configuration characterized by rise type, downslope type, flat type and completely deafness type was 18 (10.71%), 61 (36.31%), 41 (24.40%), and 48 (28.57%), respectively. The decrease of hearing threshold in PTA were increasingly severe as the increasing impaired-frequency, and the difference of the degree of hearing impairment among these three types of frequencies was statistically significant (P < 0.01). The hearing threshold means of each frequency had no significant difference among patients with various gender, age and Cardiovascular Risk Stratification (P > 0.05). The hearing threshold means of each frequency of unilateral hearing loss patients was significantly higher than that of bilateral hearing loss patients (P < 0.05). The hearing threshold means at 125 Hz, 250 Hz, 500 Hz and 1 kHz showed significant difference among patients with different duration of hypertension (P < 0.05). The total effective rate of sudden hearing loss in patients with hypertension was significantly lower than that in the sudden hearing loss patients without hypertension (19.64%, 61.57% respectively, P < 0.01). The total effective rate presented significant difference among patients with different duration of hypertension and different Cardiovascular Risk Stratification (P < 0.05). CONCLUSION The prevalence of sudden hearing loss in hypertension patients was higher in male than in female, which rose with age and combined disease. The hearing threshold means at mid-frequency and high-frequency were higher than that at low-frequency. The total effective rate of sudden hearing loss was relatively low in patients with hypertension. The longer the duration of hypertension and the higher the Cardiovascular Risk Stratification, the lower the total effective rate. Comprehensive understanding of audiological characteristics and hypertension condition plays a crucial role in type-specific treatment of sudden hearing loss.
Adult ; Aged ; Audiometry, Pure-Tone ; Deafness ; Female ; Hearing Loss, Bilateral ; Hearing Loss, Sudden ; complications ; Hearing Loss, Unilateral ; Hearing Tests ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

Objective With the purpose of further improving blood safety and providing the reference basis for a strategy suitable for large-scale routine screening of irregular antibodies in blood service,the irregular antibodies in blood samples from donors in Shanghai area were investigated.Method Irregular blood antibodies were screened in 824 072 blood donors through combined method of saline medium and microplate papain.Result 1 246 samples of blood donors were detected with irregular antibodies among the total 824 072 samples which indicate the positive rate of 1.51‰.Conclusion Screening of irregular antibodies in blood samples from donors can effectively reduce or avoid hemolytic transfusion reactions.The combined method of saline medium and microplate papain is an effective method for large-scale routine screening of irregular antibodies in blood service.

Objective To investigate the role of hemoglobin (Hb),red blood cell count (RBC) and hematocrit (HCT) during the first trimester in predicting the occurrence of gestational diabetes mellitus (GDM) in the third trimester in nonanemic women in Kunming.Methods A prospective study was carried out.Routine blood tests were performed in 1189 nondiabetic singleton pregnant Chinese women at their initial prenatal healthcare before 14 gestational weeks in the First Affiliated Hospital of Kunming Medical University from January 1,2008 to December 31,2009.They were divided into four groups by quartiles of Hb,RBC and HCT levels respectively.Differences of GDM incidence at the third trimester were compared among groups.Kollmogorov Smirnov test was used to detect normal distribution of Hb,RBC and HCT results.Differences between rates of groups were detected by Chi-square test.Independent risk factors of GDM were screened by Logistic regression analysis.Results The incidence of GDM at the third trimester increased as quartile categories of Hb,RBC and HCT ascended.The GDM incidence (13.1 ％,34/259) of ≥75th Hb group was higher than that of ＜ 25th group (5.9 ％,18/304,x2 =8.53,P＜ 0.0 1),25th ～ group (9.2 ％,30/326,x2=4.18,P＜0.05) and 50th～ group (9.3％,28/300,x2=3.96,P＜0.05).The GDM incidence (11.7 ％,34/290) of 50th～ RBC group (RBC≥4.44 × 1012/L) was higher than that of ＜25th group (6.3％,19/304,x2=5.30,P＜0.05),25th～ group (7.0％,21/298,x2 =3.93,P＜0.05); and the GDM incidence (12.1％,36/297) of ≥75th group was also higher than that of ＜25th group (6.3％,19/304,x2 =6.49,P＜0.05),25th～ group (7.0％,21/298,x2=3.85,P＜0.05).The GDM incidence of ＜25th HCT group (5.3％,16/303) was lower than that of 25th～ group (9.3％,29/311,x2=7.04,P＜0.01),50th～ group (10.8％,31/287,x2=3.93,P＜0.05) and ≥75th group (11.8％,34/288,x2=6.49,P＜0.05).Logistic regression analysis showed that Hb (OR=1.031,95％ CI:1.010-1.052),RBC (OR=2.286,95％CI:1.318-3.963) and HCT (OR=1.106,95％ CI:1.037-1.179) were independent risk factors of GDM (all P＜0.05).Conclusions High maternal Hb,RBC and HCT levels in the first trimester could be used in predicting GDM in pregnant women in Kunming area.

Objective To evaluate the feasibility of modified lateral approach to sciatic nerve block guided by ultrasound and nerve stimulator for foot surgery.Methods Sixty-two patients of both sexes,aged 18-60 yr,with body mass index ＜ 30 kg/m2,of ASA physical status Ⅰ-Ⅲ,scheduled for elective foot surgery,were included in the study.Anesthesia was induced with iv propofol 2-4 mg/kg and sufentanil 0.2-0.4 μg/kg.The laryngeal mask airway was inserted and the patients were mechanically ventilated.Sevoflurane was inhaled continuously.Modified lateral approach to sciatic nerve block was performed with 0.3 ％ ropivacaine 30 ml under the guidance of the ultrasound combined with nerve stimulator.Rocuronium 0.6 mg/kg and propofol 1-2 mg· kg-1 · h-1 were administered after completion of sciatic nerve block.Additional sufentanil 0.10-0.15 μg/kg was intravenously injected immediately after skin incision and rocuronium 0.15 mg/kg was injected intravenously at 1 h intervals.The depth of puncture and time for puncture and success rate of puncture were recorded.Sensory block was assessed after the patients regained consciousness completely.Nerve injury,hematoma at the puncture site and infection within 72 h after surgery were recorded.Results The time for puncture was (40 ± 17) s.The depth of puncture was (5.8 ± 0.7) cm.The success rate of puncture at first attempt was 77 ％.The rate of complete sensory block was 100％.The post-operative follow-up showed that no patients developed nerve injury,hematoma or infection.Conclusion Modified lateral approach to sciatic nerve block guided by ultrasound and nerve stimulator is safe and effective for foot surgery.