OBJECTIVE:To observe therapeutic efficacy and safety of batroxobin in the treatment of senile sudden deafness. METHODS:Totally 102 senile patients with sudden deafness were randomly divided into control group(51 cases)and observation group (51 cases). Control group was given routine treatment as Ginkgo biloba extract injection 105 mg+Dexamethasone sodium phosphate injection 30 mg+Methotrexate tablets 6 mg orally. Based on control group,observation group was additionally given Ba-troxobin injection 10 BU added into 0.9% Sodium chloride injection 100 mL intravenously,running out within 1 h,every 2 days, and then given 5 BU added into 0.9% Sodium chloride injection 100 mL intravenously,running out within 1 h. Both groups were treated for 10 d. Clinical efficacy,hearing recovery time,ear drowsiness disappearance time,dizziness disappearance time and tin-nitus disappearance time of 2 groups were observed. The levels of pure tone threshold,plasma specific viscosity(ns),high shear rate of whole blood viscosity(nbh),low shear rate of whole blood viscosity(nbl),hematocrit(HCT),erythrocyte sedimentation rate (ESR),Fb,endothelin (ET) and nitric oxide (NO) were observed before and after treatment as well as the occurrence of ADR. RESULTS:The total response rate of observation group was significantly higher than that of control group;hearing recovery time,ear drowsiness disappearance time,dizziness disappearance time and tinnitus disappearance time were significantly shorter than control group,with statistical significance(P<0.05 or P<0.01). Before treatment,there was no statistical significance in the levels of pure tone threshold,ns,nbh,nbl,HCT,ESR,Fb,ET and NO between 2 groups(P>0.05). After treatment,the levels of pure tone threshold,ns,nbh,nbl,HCT,ESR,Fb and ET in 2 groups were significantly lower than before;the observation group was significantly lower than the control group. The levels of NO in 2 groups were significantly higher than before;the obser-vation group was significantly higher than the control group,with statistical significance(P<0.01). During treatment,no obvious ADR was found in 2 groups. CONCLUSIONS:Based on routine treatment,batroxobin is effective in the treatment of sudden deaf-ness in the elderly,can effectively relieve the symptoms,improve the recovery of local blood flow and inner ear microcirculation disturbance with good safety.

Objective To study the relationship between juvenile transient synovitis of the hip and enterovirus.Methods EV-IgM antibody was detected with ELISA in blood and arthrocentesis. At same time, sample with coxsackievirus B(CVB) IgM positive was tested by serptype.Results IgM antibody was detected in 38.27% in blood of the patients and in 76.19% in arthrocentesis.CVB-IgM was found positive in 16.05% of blood and in 42.86% of arthrocentesis.AdV-IgM was in 11.73% and in 23.81%,respectively.Most of the CVB-IgM positive individuals were infected with CVB3.Conclusion The results of this study suggest that there may be a significant correlation between juvenile transient synovitis and CVB, especially CVB3.

Objective To explore the clinical nursing methods for the treatment of the skin degloving injury in foot by the combination of free femoral anterolateral skin flap transplantation and vacuum sealing drainage (VSD) technique. Methods From January 2010 to January 2014, 18 cases of the skin degloving injury in foot were treated by debridement and implant skin, negative pressure drainage and irrigation at first period, then the operation to repair the foot wound by transplant femoral anterolateral skin flap were done at second period. Nurses applied the key technology of VSD into postoperative nursing. Nurses should master the observation method and characteristics for the flow of blood to the flap skin, the method for foot position nursing, afford effective analgesic care, and flap local high flow oxygen therapy,improve the local tissue oxygen partial pressure and introduce the foot early functional exercise during postoperative. Results Eighteen cases flaps all survived. Clients were followed-up for 6 to 12 months,the discovery showed that all of the clients had good flap blood supply,the skin was soft and elastic,and the function of foot were recovered well. Conclusions The combination of of free femoral anterolateral skin flap transplantation and VSD technique apply into foot degloving injury repairation postoperative care,by application of high quality nursing, it really can improve the success rate of surgery and reduce the pain for clients.

ObjectiveTo summarize the early postoperation complications and treatments in children with total anomalous pulmonary venous connection (TAPVC).MethodsThirty TAPVC children who were treated with corrective operation and transferred into PICU were collected.Patients were monitored routinely for electrocardiogram,blood pressure and SpO2.The routine treatment measures included mechanical ventilation,sedation,hemostasis,positive inotropic agents,diuresis,vasodilator,antibiotics and symptomatic treatment.Adrenaline or isoproterenol was used when low cardiac output syndrome appeared and temporary pacemaker was employed in the case of bradycardia.Alprostadil and sildenafil were added instantly after corrective operation when severe preoperative pulmonary hypertension or reactive postoperative pulmonary hypertension was present.ResultsThe early postoperation complication was found in 30 cases of TAPVC,which included 13 cases of pneumonia (43.3％ ),8 of arrhythmia (26.7％ ),7 of low cardiac output syndrome (23.3％),6 of respiratory failure (20.0％ ),4 of pulmonary hypertension ( 13.3％ ),3 of pulmonary edema or atelectasis( 10.0％ ) and 1 of pneumorrhagia ( 3.3％ ).Two cases died postoperatively.The interval of stay in PICU was 1 ～ 21 d and the mean time was (5.95 ± 4.94) d.ConclusionOccurrence of respiratory complications is high among early postoperative complications of TAPVC.Therefore,preventing pulmonary infection and maintaining pulmonary function should be viewed as the key points in early postoperative monitoring and managing.In addition,more attention should also be paid on correction of arrhythmia,prophylaxis and treatment of low cardiac output syndrome and pulmonary hypertension crisis,which may improve the postoperative survival rate and care quality of TAPVC.

Objective To investigate the common causes of hypokalemia of inpatients in department of endocrinology.Methods Fifty-nine inpatients with hypokalemia were analyzed retrospectively.Results 84.7％(50/59) of patients with hypokalemia was clearly caused by endocrine diseases,among which 33.9％ (20/59) was diabetes mellitus,25.4％ (15/59) was hyperthyreosis,others were rare endocrine diseases,for example primary hyperaldosteronism and Cushing syndrome,et al.Conclusions Endocrine disease is an important reason of hypokalemia.The doctor should attach importance to the diagnosis and treatment of hypokalemia caused by endocrine disease.

Objective To study the influence of postural intervention on ambulation of patients after video-assisted thoracoscope surgery? Methods One hundred and forty eight patients having undergone chest cardiac surgery were randomly divided into the control group(n = 75)and the observation group(n = 74)? The former received routine nursing intervention and the latter postural intervention besides routine nursing? The two groups were compared in terms of the time for ambulation and the ability in ambulation? Result The ambulation in the observation group was earlier than the control group and the ability in ambulation was better compared to the control group(both P < 0?05)? Conclusion The postural intervention after thoracic surgery is effective in pushing patient’s ambulation and improve their ability?

Fifty-three patients with alopecia areata were treated by plum-blossom needles tapping and mild moxibustion of the focus and 54 cases taking Bozhi tablets orally were considered as a control group. The total effective rates were 96.2% and 70.4 respectively after 3-course's treatment.

Objective: To study the role of auto-antibody in the diagnosis of patients with PBC. Methods: ANA, SMA and AMA in serum of 58 PBC patients were tested by indirect immune fluorescence and Western blot. Such auto-antibodies as Anti-type AMAM2,anti-SLA/LP, anti-LKM-1 and anti-LC-1 were also identified. Results: Auto-antibodies existing in patients with PBC were mainly AMA(96.5%) and AMAM2(93.1%) and the titer was beyond 1∶100. 8 cases of those patients were positive with ANA and SMA simultaneously. One case had positive AMA and SLA/LP in serum and the clinical appearances were the same as those of type Ⅰ and type Ⅲ autoimmune hepatitis. 19 patients with positive AMAM2 in serum had liver-puncture and the results suggested the diagnosis of PBC in 63.7%(12/9). Conclusion: Test of auto-antibodies is clinically significant for the diagnosis of autoimmune hepatitis.

Objective To analyze the clinical value of low molecular heparin calcium combined with early rehabilitation intervention in the prevention of deep vein thrombosis after internal fixation of intertrochanteric fractures.Methods 100 patients with internal fixation for treatment of femoral intertrochanteric fracture from January 2014 and October 2015 were selected and randomly divided into two groups:the control group of 50 cases, treated with low molecular weight heparin low molecular weight heparin by abdominal subcutaneous injection of drug therapy and routine nursing intervention service, observation group of 50 cases, in the control group based on the use of early rehabilitation intervention.The incidence of deep venous thrombosis after operation in two groups was recorded, and the changes of platelet count and coagulation markers were observed before and after intervention in the two groups.Results The observation group of patients with postoperative deep venous thrombosis incidence rate of 4%, significantly lower than the control group 16%, the difference was statistically significant (P<0.05), the two groups after the intervention each time the platelet count was higher than that of before intervention, four weeks after the intervention, the observation group of platelet count (239.51 ±34.62) ×109/L, significantly higher than the control group (235.23 ±28.87) ×109/L, the difference was statistically significant (P<0.05), the two groups before the intervention of each marker concentration, the difference was not statistically significant, patients in the observation group after the intervention, the blood coagulation markers concentrations were significantly lower than before treatment, and were significantly lower than the control group after the intervention.The comparison between the two groups, the difference was statistically significant (P<0.05).There was no chest pain, chest tightness, dyspnea and other symptoms of pulmonary embolism in the two groups , and no adverse reactions were found.Conclusion The application of low molecular weight heparin calcium combined with early rehabilitation intervention can effectively reduce the incidence of deep venous thrombosis after intertrochanteric fracture fixation.

[ ABSTRACT] AIM:To investigate the effect of Ginkgo biloba extract ( GBE) on diabetic retinopathy ( DR) and its possible mechanism in rats .METHODS:Goto-Kakizaki ( GK) rats were used as a DR model, and were treated with different doses of GBE.Normal Wistar rats were used as the control.Blood glucose and retina barrier injury were analyzed, respectively.Ganglion cell apoptosis was detected by TUNEL staining.Moreover, the protein expression of nuclear factor E2-related factor 2( Nrf2) , ERK, Bcl-2 and P53, and ERK phosphorylation were examined by Western blot.RESULTS:GBE reduced blood glucose in the DR rats, attenuated retina barrier injury, and decreased the apoptosis of ganglion cells. Furthermore, the expression of Nrf2 and Bcl-2, and phosphorylation of ERK were increased after GBE treatment, whereas P53 expression was decreased.CONCLUSION:GBE protects ganglion cells against apoptosis in DR rats, which may be through activation of Nrf2/ERK pathway and regulating Bcl-2 and P53 expression.