Objective To evaluate the effects of dexmedetomidine on the development of perioperative cardiovascular events in elderly patients.Methods Forty-eight patients of both sexes,aged 65-85 yr,with body mass index of 19.5-25.3 kg/m2,of American Society Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective abdomninal or lower limb surgery under general anesthesia,were divided into 2 groups (n =24 each) using a random number table:general anesthesia group (group G) and dexmedetomidine plus general anesthesia group (group D).In group D,dexmedetomidine was intravenously infused in a loading dose of 0.25 μg/kg over 10 min and then continuously infused at 0.2 μg · kg-1 · h-1 until 30 min before the end of surgery.The equal volume of normal saline was intravenously infused instead in group G.At 1 day before surgery and 1 and 2 days after surgery,dynamic electrocardiogram was used to monitor heart rate variability including standard deviation of normal-to-normal intervals,standard deviation of the average 5-min normal-to-normal intervals,and root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals.The development of intraoperative cardiovascular events and requirement for vasoactive drugs were recorded,and the development of cardiovascular events within 2 days after surgery was also recorded.Results Compared with group G,standard deviation of normal-to-normal intervals and standard deviation of the average 5-min normal-to-normal intervals at 1 and 2 days after surgery and root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals at 2 days after surgery were significantly increased,the total incidence of intraoperative cardiovascular events and requirement for vasoactive drugs were decreased,and the total incidence of cardiovascular events within 2 days after surgery was decreased in group D (P ＜0.05).Conclusion Dexmedetomidine can reduce the development of perioperative cardiovascular events in elderly patients.

Objective To investigate the characteristics of auditory event-related potentials(AERP) mismatch negativity and P300 in presbycusis patients.Methods Auditory event-related potentials were recorded from 20 presbycusis patients, 20 normal hearing elderly subjects and 20 normal young volunteers(the control group) in the Oddball stimulus paradigm.Mismatch negativity(MMN) was tested under the status of reading.P300 was tested under the status of concentrating.The latencies and amplitudes of 3 groups were compared.Results The latency of MMN in the presbycusis patient group(187.38±29.63ms) was significantly longer than those of the normal hearing older group(160.10±23.21±ms)and the control group(148.22±19.30 ms)(P<0.01).There were statistically significant differences between the normal hearing older group and control group(P<0.05).The amplitude differences were not statistically significant among the 3 groups(P>0.05).The latency of P300 in the presbycusis patient group (369.83±27.09 ms) was significantly longer than those of the normal hearing older group(332.89±25.60 ms)and the control group(318.51±22.32ms)(P<0.01).The amplitude differences were not statistically significant among the 3 groups(P>0.05).Conclusion The presbycusis patients show some central auditory processing dysfunction and cognitive impairment.MMN and P300 might be used as objective methods for evaluating central auditory processing and cognitive function in presbycusis patients.

OBJECTIVE: To investigate the relationship between pure-tone average (PTA), the fractional anisotropy (FA) of the auditory pathway, cognitive cortex and auditory cortex in presbycusis. METHOD: Twenty-five elderly subjects with presbycusis were participated in the study. PTA, speech discrimination abilities were evaluated in each subject. Diffusion tensor imaging (DTI) was applied to access the FA of the IC, the superior frontal gyrus and the Heschl's gyrus. Compare the difference between two sides of the values of FA in the three areas. Bivariate correlation analysis was performed to evaluate the effects of PTA and FA of the inferior colliculus (IC), the superior frontal gyrus and the Heschl's gyrus on speech discrimination abilities. RESULT: There were no significant differences between the left and right side of the inferior colliculus (P > 0.05). Higher FA values were recorded at the left side of the Heschl's gyrus and the superior frontal gyrus (P < 0.05). Both PTA and the FA of the superior frontal gyrus have a negative association with speech discrimination abilities (P < 0.01, P < 0.05), while the FA of the Heschl's gyrus has a positive association with speech discrimination abilities (P < 0.05). CONCLUSION Our findings indicated that the speech discrimination abilities of the elderly is not only related to the peripheral auditory function, but also to the central auditory and cognitive function.
Aged ; Audiometry, Pure-Tone ; Auditory Cortex ; physiopathology ; Auditory Pathways ; Diffusion Tensor Imaging ; Humans ; Inferior Colliculi ; physiopathology ; Presbycusis ; diagnosis ; Speech Perception

OBJECTIVE: To evaluate the characteristics and prognosis of sudden sensorineural hearing loss through vestibular evoked myogenic potentials. METHOD: Fifty patients with unilateral sudden hearing loss underwent an ear test battery, including audiometry, cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential(oVEMP). The cVEMP and oVEMP in patients with sudden sensorineural hearing loss were investigated. Their associations with initial hearing threshold, the type of audiogram, the results of coloric test and hearing recovery were also accessed. RESULT: After one-month treatment, the average threshold declined significantly in affected ears, with normal VEMP rates improved significantly (P < 0.05). Initial hearing threshold and hearing recovery were significantly associated with the results of coloric test and the results of VEMP test (P < 0.05). CONCLUSION Our study indicated that vestibular evoked myogenic potential examination was not only a useful additional diagnostic tool in the neurotological evaluation of patients suffering sudden hearing loss, but also very valuable in the prognosis of sudden sensorineural hearing loss.
Hearing Loss, Sensorineural ; diagnosis ; Hearing Loss, Sudden ; diagnosis ; Hearing Loss, Unilateral ; diagnosis ; Hearing Tests ; Humans ; Otolithic Membrane ; physiopathology ; Prognosis ; Vestibular Evoked Myogenic Potentials

Objective To investigate the distribution characteristics and drug resistance of pathogens isolated from pregnant woman′s urine samples.Methods The urine samples of pregnant women who underwent prenatal examination were collected and cultured.VITEK2 automatic bacterial analyzer was used to identify the bacteria strains,and Escherichia coli ,Streptococcus agalac-tiae were tested for their drug susceptibility.Results The positive rates of urine culture were 4.4%和 3.8% respectively in 2011 and 2012.The top 5 most isolated strains were Escherichia coli ,S .agalactiae ,Enterococcus faecalis ,K .pneumoniae and Propeus vulgaris .In 2011 and 2012,the resistance rates of Escherichia coli to ampicillin and piperacillin was more than 50%,ESBLs-produ-cing rate in Escherichia coli had decreased in 2012 than 2011,the resistance rates of S.agalactiae to erythromycin and clindamycin were more than 30%.Conclusion Escherichia coli accounted for the largest proportion in the strains isolated from urine samples of pregnant women,The pathogen of urinary tract infection in pregnant women are still mainly Gram-negative bacteria(Escherichia co-li),the main pathogens common antibiotics are varying degrees of resistance,pathogens all display common drug resistance of var-ying degrees.

BACKGROUND:It has been found that central nervous system is involved in Guillain-Barre syndrome and Miller-Fisher syndrome, and the involved sites include optic nerve, brain stem and cerebellum. Abnormal signal of MRI can be observed in the brainstem and spinocerebellar tract of patients with Miller-Fisher syndrome. To establish an animal model of encephalitis after infection of Campylobacter jejuni, and investigate the mechanism of formation by means of imaging, immunology and pathology.OBJECTIVE: To construct an animal model of lesion of central nervous system after infection of Campylobacter jejuni Penner 4.DESIGN: A randomized grouping designed, controlled animal experiment.SETTING: Department of Imaging and Department of Neurology, Second Hospital of Hebei Medical University.MATERIALS: The experiment was carried out in the Laboratory of Molecular Imaging, the Second Hospital of Hebei Medical University between August and December 2003. Fifteen healthy flap-eared rabbits were randomly divided into experimental group (n=10) and control group (n=5).METHODS: In the experimental group, Campylobacter jejuni inactivated bacteria liquor was completely emulsified with complete Freund adjuvant (CFA) of the same volume in week 1, and then the rabbits were immunized with subcutaneous injection at multiple points of bilateral axilla, bilateral groins and side of back spine, 1 mL for each site, and 5 mL for each rabbit; The rabbits were further immunized with intraperitoneal injection of simple Campylobacterjejuni inactivated bacteria liquor in the following every two weeks, 5 mL for each time in each rabbit for 5 times. In the control group, the Campylobacter jejuni inactivated bacteria liquor was replaced by saline of the same volume, the injected method and time were all the same as those in the experimental group. Evaluative methods: ①Symptoms and physical signs: their mental status, conditions of diet, urine and excrement, and activities of limbs were observed; ② Serological examination: the contents of anti-Campylobacterjejuni antibody, anti-IgG GM1 antibody and myelin basic protein (MBP) were detected with enzyme-linked immunoadsorbent assay (ELISA); ③ MRI examination was applied to the randomly selected rabbits before every immunization with Toshiba 1.5 T MRI instrument. The scanning sequence included spin-echo T1-weighted image with the scanning parameter of 500/15 ms (TR/TE); rapid spin-echo T2-weighted image, 4 000/108 ms (TR/TE); fluid attented inversion recovery (Flair) sequence, the parameter was 10 000/120 ms (TR/TE), inversion angle was 90°. The thickness of scanning layer was 4.0 mm, and the layer space was 0.8 mm. ④ Histological examination: At 4 weeks after the first immunization, the attacked animals were induced to death by cardiac perfusion, and the skull was opened immediately to remove optic nerve, part white matter, hippocampus, brainstem, cerebellum and spinal cords of neck, chest and waist, which were fixed with formaldehyde solution (40 g/L),and hematoxylin-eosin (HE) staining, fast blue staining and MBP immunohistochemical staining were performed respectively. At 10 weeks after immunization, 5 randomly selected rabbits in the experimental group and the 5 rabbits in the control group were treated with the same methods to obtain the histological samples.MAIN OUTCOME MEASURES: The symptoms and physical signs,contents of anti-Campylobacterjejuni antibody, anti-IgG GM1 antibody and MBP, imaging observation and histological examination were mainly observed.RESULTS: Fifteen animals were enrolled, 14 were involved in the analysis of results, 1 rabbit in the experimental group died at 4 weeks after immunization. ① Mental symptoms and disorder of limb's activity occurred in 1 rabbit in the experimental group at 2 weeks after immunization. ② In the experimental group, titre of anti-Campylobacterjejuni-IgG antibody in serum reach the peak at 2-4 weeks. From week 2, the serum A value was significantly higher in the experimental group than in the control group (1.923±0.403, 0.973±0.633, P ＜ 0.05). The IgG type GM1 (A value) was obviously elevated at week 8, but insignificantly different from that in the control group (0.115±0.042, 0.097±0.039, P ＞ 0.05). The MBP content (Avalue) in serum was significantly elevated at the 8th week (0.134±0.041).③ The imaging examination showed that abnormal MRI signal of different degree occurred at 2-4 weeks after immunization in the experimental group. ④ The histological changes showed that there was swelling of myelin sheath at the sites of brainstem, medulla oblongata, cervical spinal cord, thoracic spinal cord and lumbar spinal cord in the experimental group, no inflammatory cell infiltration and deletion of myelin sheath were observed. No obvious changes at the above site were observed in the contro1 group.CONCLUSION: Campylobacterjejuni Penner 4 can induce lesion of central nervous system.

OBJECTIVE: Three genes including the OTOF, the DFNB59 and the DIAPH3 have been implicated previously in human non-syndromic auditory neuropathy. In this study, we aim to investigate whether DIAPH3 gene or the known deafness loci of 25 cloned autosomal dominant deafness (DFNA) genes contribute to the nonsyndromic hearing loss of a Chinese pedigree with dominantly inherited auditory neuropathy (AN). METHOD: Nine members of the kernal pedigree in this family were selected. Genomic DNA was isolated from the peripheral leukocytes of the subjects using the Puregene DNA Isolation Kits. Firstly, the 5'UTR of DIAPH3 gene was PCR amplified in all subjects. Then, the DNA fragments spanning the entire coding regions of DIAPH3, GJB2 and GJB3 genes, and 50 exons in other 23 cloned DFNA genes were amplified using specific primers. Each fragment was purified and analyzed by direct sequencing. The resultant sequence data were compared with the standard sequence to identify deafness-associated mutations. RESULT: PCR amplifications were successfully conducted. We failed to detect the presence either of c. --172G > A mutation in the 5'UTR that have been reported, or any other deafness-associated mutations in the whole DIAPH3 gene, by sequence analysis. We also did not find any known deafness-causing mutations among the 25 cloned DFNA genes. CONCLUSION The DIAPH3 gene, and the known deafness loci of 25 cloned DFNA genes seem not contribute to the pathogenesis of this Chinese AN family in this study, which suggesting new gene(s) involvement.
Adaptor Proteins, Signal Transducing ; genetics ; Asian Continental Ancestry Group ; China ; Connexins ; DNA Mutational Analysis ; Deafness ; Exons ; Hearing Loss ; Hearing Loss, Central ; genetics ; Hearing Loss, Sensorineural ; genetics ; Humans ; Mutation ; Pedigree ; Polymerase Chain Reaction

Objective To investigate the effects of stellate ganglion block(SGB)on attention and executive function in middle-aged and elderly patients after surgery.Methods Middle-aged and elderly patients aged 55-75 years who underwent hip replacement surgery under lumbar anesthesia were randomized into a control group and an SGB group.Patients in the SGB group received ultrasound-guided stellate ganglion block 30 min before surgery,and patients in the control group were given no additional treatment before surgery.All patients were tested with a modified version of the Trail Making Test-Part A (TMT-A)and a modified version of the Symbol Digit Modalities Test (SDMT)1 day before surgery and 7 days after surgery.The Z-score method was used to diagnose postoperative attention and/or executive function impairment.Results The modified versions of TMT-A and SDMT had good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Age was the main influencing factor for the two tests,and their two parallel versions had good alternate-form reliability.There was no significant difference between the control group and the SGB group in scores of modified TMT-A and SDMT at 7 days after surgery(P＞0.1).However,the incidence of attention and/or executive function impairment was lower in the SGB group than in the control group(19.3％ vs.36.6％,P＜0.05).Conclusions The modified TMT-A and SDMT have good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Preoperative SGB may protect attention and executive function in middle-aged and elderly patients.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with non-syndromic hearing loss (NSHL). METHODS: Commercialized gene chip was applied to detect common mutations associated with congenital deafness. Whole exome sequencing was carried out for patients for whom gene chip yielded a negative result. Candidate variants were verified by Sanger sequencing. RESULTS: Two patients from the pedigree were discovered to carry compound heterozygous variants of the TRIOBP gene, namely c.3299C>A and c.5185-2A>G. Their parents had normal hearing and were both heterozygous carriers of the above variants. Both variants had co-segregated with the disease phenotype in the pedigree and were unreported previously. CONCLUSION Pathogenic variants of the TRIOBP gene comprise an important factor for NSHL. The novel c.5185-2A>G and c.3299C>A variants discovered in this study have enriched the mutational spectrum of the TRIOBP gene and enabled molecular diagnosis and genetic counseling for the family.
Deafness/genetics* ; Hearing Loss, Sensorineural/genetics* ; Heterozygote ; Humans ; Microfilament Proteins/genetics* ; Mutation ; Pedigree ; Whole Exome Sequencing