OBJECTIVE: To study the feasibility and the generalizability of the Remote fitting models of hearing AIDS from primary hospitals. METHOD: we comparative analyzed the speech recognition scores and satisfaction of 45 cases with traditional hearing AID fitting and with a hearing aid remote test respectively. RESULT: 45 cases were analyzed in each group, including traditional hearing AID fitting model and remote test, and 35 recovered in traditional fitting model group, and the recovery rate was 77.8%; Remote fitting model rehabilitation 42 cases, recovery rate was 93.3%, the difference was statistically significant (P < 0.05). In 6 weekend wear hearing AIDS, traditional fitting model of speech recognition rate increased by 19.40% on average, the average distance fitting model speech recognition rate increases by 27.47%, the average distance fitting model than traditional fitting the speech recognition rate increased significantly more (8.07%). Effect of hearing aid international questionnaire results suggest: 45 cases using traditional model fitting hearing AIDS patients, 33 cases (73.3%) satisfaction, 12 cases (26.7%) patients after use. Remote and 45 cases of using hearing AIDS fitting model, satisfied with 40 cases (88.9%), 5 cases (11.1%) patients after use. CONCLUSION the curative effect and the satisfaction of remote fitting models of hearing AIDS on hearing impairment are better than that in patients with traditional fitting models. Therefore it is more worthy of clinical application especially in basic level hospitals.
Audiometry ; Hearing Aids ; Hearing Loss ; rehabilitation ; Hearing Tests ; Humans ; Patient Satisfaction ; Remote Consultation ; Speech Perception ; Surveys and Questionnaires

Objective To investigate the expression of metallothionein (MT) in 113 specimens of liver transplantation for patients with benign end-stage liver diseases and 10 normal liver specimens,and analyze their clinical significance and prognostic value.Method 113 specimens of liver transplantation for patients with benign end-stage liver diseases and 10 normal liver specimens were included in this study.MT in these specimens was detected by using immunohistochemistry.Cox regression model was used to analyze the multi-factors for the prognosis.Results MT levels were lower in specimens of liver transplantation for patients with benign end-stage liver diseases than in normal liver specimens.MT levels were higher in specimens of HCV-related cirrhosis than in those of autoimmune hepatic (AIH) cirrhosis,but there was no significant difference among all other groups.Conclusion MT expression level in AIH cirrhosis tissue is higher than in HCV-related cirrhosis tissue.MT is the independent influencing factor for survival following liver transplantation in patients with benign end-stage liver diseases.

Objective To investigate the clinical efficiency of Isophane Protamine Biosynthetic Human Insulin Injection (pre‐mixed 30R)(Novolin 30R) combined with insulin pump therapy in patients with diabetes mellitus complicated with pulmonary in‐fection ,and to analyze the detection indexes .Methods From Jan .2010 to Feb .2013 ,90 cases of patients with diabetes mellitus com‐plicated with pulmonary infection were selected and divided into the observation group and control group .The control group re‐ceived Novolin 30R treatment and conventional treatment ,the observation group were given insulin pump therapy based on the treatment of control group .The clinical efficiency and detection indexes were compared and analyzed .Results The cure rate and to‐tal effective rate were 51 .11% and 82 .22% respectively in the control group ,and were 84 .44% and 100 .00% in the observation group respectively .There were significant differences of both cure rate and total effective rate between the two groups (P<0 .05) . There were statistically significant differences of hospitalization time ,the time for reaching target of glucose ,insulin dose ,recovery time of body temperature ,hospital costs ,incidence rate of complications ,serum levels of sodium ,potassium and urea nitrogen ,os‐molality and PH value between the two groups(P<0 .05) .Conclusion The combination of Novolin 30R and insulin pump therapy could provide satisfactory clinical efficiency in patients with diabetes mellitus complicated with pulmonary infection .

Objective To study the value of D‐dimer for early diagnosing ischemic bowel disease(IBD) and to find more econom‐ic and more effective detection means for its diagnosis and control .Methods Ninety‐five patients with suspected acute IBD in our hospital from October 2014 to October 2015 were selected as the observation group ,and contemporaneous 74 individuals undergoing routine physical examination were selected as the control group .The differences in D‐dimer levels were compared between the con‐trol group and the patients with definitely diagnosed IBD in the observation group on 1 ,7 ,14 d after admission .At the same time the differences in initial WBC level and fecal occult blood were compared between the two groups .The sensitivity and specificity of plas‐ma D‐dimer level for early diagnosing IBD were calculated and their clinical application value was summarized .Results (1) Accord‐ing to plasma D‐dimer results ,the 74 cases of acute IBD were diagnosed and 21 cases were negative ,while 80 positive cases and 15 negative cases were diagnosed by adopting the CT inferior mesenteric arterial angiography and multislice spiral CT ,the sensitivity of plasma D‐dimer detection was 88 .75% and specificity was 80 .0% .(2) The D‐dimer level ,WBC count and fecal occult blood on 1 d after admission in the observation group were (5 480 .12 ± 876 .32)μg/L ,(17 .37 ± 2 .21) × 109/L and 81 .3% respectively ,which were far higher than those in the healthy control group ,the differences were statistically significant (P<0 .05) .(3)The D‐dimer levels on 1 ,7 ,14 d after admission in the observation group were significantly higher than those in the control group (P<0 .05) , while with the treatment duration extension ,the plasma D‐dimer level was gradually decreased .Conclusion The D‐dimer detection has a relatively higher sensitivity and specificity in the early diagnosis of acute IBD and has better clinical application value .

Objective To evaluate the outcomes of liver transplant recipients who received liver grafts from HBsAg positive donors in patients with hepatocellular carcinoma beyond UCSF (University of California,San Francisco) Criteria.Method The medical records of patients who underwent HBsAg-positive donor liver transplantation for hepatocellular carcinoma beyond UCSF Criteria from October 2008 to December 2012 at our hospital were analyzed retrospectively,including the existence status of HBV,graft function,tumor recurrence,and the survival after transplantation.Result A total of 20 patients were enrolled in the study.One patient lost follow-up while the remaining 19 patients had complete follow-up data.All the patients were followed up until June 2013,with a median follow-up duration of 12 months (range 2-57 months).One patient died from postoperative abdominal bleeding and multiple organ failure at post-transplantative day 21.Five patients survived up to now,including 4 cases with disease-free survival,who has been surviving for 57,35,26 and 12 months respectively.The remaining all 14 patients died from tumor recurrence at different time points after transplantation.Entecavir was used alone in 19 patients and Entecavir combined with Adefovir dipivoxilalone were used as anti-HBV therapy in the recipients.At posttransplant day 45,all the recipients were positive for serum HBsAg and negative for serum HBVDNA,and the liver enzymatic criteria,coagulation criteria and the serum bilirubin restored to normal levels or within twice the upper limit of normal levels.Throughout the follow-up period,recipients were all positive for serum HBsAg,but there was no recurrence of hepatitis B.The 1-,2-,3-and 4-year cumulative survival rate was 48.0％,35.0％,18.7％ and 18.7％ respectively.Conclusion The HBsAg positive liver may be used as a donor in liver transplantation and the graft probably works well after the operation.Liver transplantation may prolong the survival and improve the quality of life,even achieve long-term disease-free survival in patients with hepatocellular carcinoma beyond UCSF Criteria.The use of nucleotide analogue only,instead of combination with hepatitis B immune globulin,can also bring HBV well under control in liver transplant recipients with HBsAg positive donors.

Objective To compare the impact of the sirolimus and tacrolimus on the tumor recurrence after liver transplantation due to HCC beyond Milan criteria.Method Sixty-one liver transplantation recipients due to HCC beyond Milan criteria,between Jan.2008 and Apri.2012,were randomized,with the informed consent,into two different immunosuppression groups: sirolimus group (n=30) and tacrolimus group (n=31).In tacrolimus group,tacrolimus was used as the basic immunosuppressant,methylprednisolone was discontinued within one month postoperatively,and mycophenolate mofetil was used within the dosage of 1.5 g/d accordingly.In sirolimus group,the immunosuppresive scheme was the same as that of the tacrolimus group within postoperative one month,and from that,tacrolimus was transferred to sirolimus.No antineoplastic agents were given before tumor recurrence.The tumor recurrence rate and the survival rate of the recipients were compared between the two groups.Result The median follow-up duration was 35.2 months (10.3～ 60.2).The tumor recurrence rate at postoperative year 1,2,3 and 4 in the sirolimus group (13.3％,36.7％,43.3％ and 53.3％) was significantly lower than that in the tacrolimus group (38.7％,67.7％,74.2％ and 77.4％),P ＜ 0.05 for all.The one-year survival rate in the recipients postoperation had no significant difference between sirolimus group and tacrolimus group (90.0％ vs.87.1％,P=0.438).The 2-,3-and 4-year survival rate in the recipients was significantly higher in the sirolimus group (53.3％,33.3％ and 20.0％) than that in the tacrolimus group (41.9％,22.6％ and 9.7％),P ＜ 0.05 for all.The liver function and renal function of the recipients at the postoperative year 1,2,3 and 4 showed no significant difference between the two groups,P＞0.05.Conclusion In comparison with tacrolimus,sirolimus could significantly reduce the tumor recurrence rate and increase the survival rate for the liver transplant recipients due to HCC beyond Milan criteria.

Objective To discuss the application value of contrast-enhanced uhrasound(CEUS)in diagnosis of hepatic artery thrombosis(HAT)after liver transplantation.Methods Four hundred and seventy-five liver transplantation patients were performed routine exam by color Doppler uhrasound,11patients suspected of HAT were examined by CEUS.Results All cases were confirmed bv DSA or CTA.Of them,6 cases were thrombotic by CEUS,and 3 cases out of the 6 cases HAT were founded infarction.The other 5 cases were nonthrombotic,but the diameter of hepatic artery showed narrow,3 Datients were accompanied by severe fatty liver. Conclusions CEUS is equally effective as DSA or CTA in diagnosing HAT after liver transplantation.

Objective In order to understand the children's blood lead load and presence status of blood lead levels,provide the first-hand information on further preventive intervention in high lead hyperlipidemia.Methods This study routinely collected 5 to 9-year-old children's blood,a total of 1963 cases.Peripheral blood lead levels was detected by atomic absorption spectrometry.Results Blood lead ≥ 100μg/L is 45 cases in 1963 cases of children, the rate is 2.3%, the highest is 439μg/L,only one.Other 44 persons' blood lead level is 100 ~ 200μg/L,average 149.2μg/L.Conclusion The children's blood lead levels in Beilun district of Ningbo city is in normal state in general,not high blood lead load.

OBJECTIVE To investigate the clinical feature,diagnosis and treatment of tuberculosis in post-solid organ transplantation patients.METHODS The clinical data of 11 patients with tuberculosis post-solid organ transplantation were analyzed retrospectively,in which eight cases were the patients with post-liver transplantation,two cases were the patients with post-kidney transplantation and one patient with post-liver and kidney transplantation.The diaghosis were based on the case history,pathogenic,image and the consequence of diagnostic therapy against tuberculosis were observed.RESULTS Infection rate of tuberculosis after liver transplantation,kidney transplantation and combined liver and kidney transplantation were 0.92%,1.10% and 7.14%,respectively.The three cases suffered from acute miliary tuberculosis.One case suffered from exudative pulmonary tuberculosis.One case suffered from tuberculosis pleuritis.One case suffered from lymph node tuberculosis.One case suffered from tuberculosis of lumber spine complicating exudative pulmonary tuberculosis.Four cases were not found lesion in their body.Each patient was adopted with individual treatment.The following up were 83 day to 1080 day.One case was died.Ten cases were cured.CONCLUSIONS Tuberculosis patients with post-solid organ transplantation had atypical clinical symptom under immunosuppressive agents.Part of the patients are lacked of evidences from image,bacteriology or immunology.Diagnostic errors are made sometimes.Diagnostic therapy against tuberculosis should be put into practice for the patients with suspicious tuberculosis.

Objective To report the results of aesthetic reconstruction of distal finger or middle-distal finger segment with transplant harvested from 2nd, 3rd or 4th toe. Methods In a series of 108 cases of distal finger or middle-distal finger segment defect, 141 fingers were reconstructed with transplants harvested from 2nd, 3rd or 4th toe according to the outward appearance of donor toe. The blood-supply was restored by anastomosis of digital artery and vein. In first-stage reconstruction, refinement of outward appearance was applied in doner toe if the toe pulp is bulky or middle part of toe was relatively thinner. Results One hundred and forty fingers survived. The successful rate was 99.3%. Among them, 81 patients had been followed up from 1 to 10 years (mean 3.5years) postoperatively. 61 cases were graded to be excellent and 16 eases good as assessed with Criterion of Functional Evaluation on Finger Reconstruction issued by Chinese Society of Hand Surgery. Conclusion For aesthetic reconstruction of distal finger or middle-distal finger segment, the 2nd toe is usually considered to be donor of first choice. In case the outward appearance of 2nd toe was inferior to that of 3rd or 4th toe, the 3rd or 4th toe should be chosen for better result. In some cases, revisional aesthetic surgery were necessary to refine the outward appearance in first-stage reconstruction.