10.3969/j.issn.2095-4344.2013.26.003

Objective To analyse the associativity among serum thyroid hormone level,brain injury and neuroethology in preterm infants by testing the thyroid hormone level and neuro-behaviour assessment.Methods Fifty-two preterm infants were continuously admitted in neonatal department of Shanghai Children's Hospital from Dec 2009 to Apr 2010. Radio-immunity was used to determine the serum level of T3,T4, TSH within 6 h after birth. Each case received cranial ultrasonic examination within 3 d after birth and rechecked every week. Before discharge, every infant received a cranial MRI examination. The 52 cases were devided into three groups according to the result of ultrasound and MRI:no brain damage group (33 cases),intraventricular hemorrhage greup (10 cases) ,and white matter injury group (9 cases). At the corrected gestation age 40±2 weeks,every infant received a neonatal behavioral neurological assessment (NBNA). Results The level of serum TSH in all the three groups of preterm infants were normal, which could reject congenital hypothyroidism. Eight preterm infants(15.4% ,8/52) had normal thyroid hormone level,another 44 preterm infants(84. 6% ,44/52) got lower thyroid functions. The levels of T3 and T4 were higher in the no brain damage group than those in intraventricular hemorrhage group and white matter injury group. And the preterm infants who had white mauer injury got the lowest level of thyroine hormone T3 and T4. Thyroxine hormone levels had significant difference among three groups (P ＜ 0. 05). The preterm infants who had no brain damage got higher scores in capability, passive muscle tonus,initiative muscle tonus and total score than the other two groups. Intraventricular hemorrhage group always got higher scores in NBNA than the white matter injury group (P ＜ 0. 05). The NBNA scores had significant difference among three groups (P ＜ 0. 05). Conclusion Premature infant who has more severe brain injury always has lower levels of thyroxine hormone. Premature infants with brain injury get lower scores in NBNA test than those without brain injury.

Objective:To investigate the effect of hearing on consonant discrimination in postoperative cleft palate patients.Meth-ods:30 subjects after surgery of cleft palate were examined for hearing and evaluated for speech,error frequencies of consonants were counted.According to the Chinese tone frequency and intensity distribution and measurement table of dysarthria in Mandarin,hearing and speech were divided into 3 ranks respectively.Spearman rank correlation analysis was used to determine the relation of consonant discrimination with hearing.Results:Higher error frequency of consonants (form high to low)were [t],[ts],[k],[],[s],[t] and [k'].There was close correlation(P ＜0.05)between hearing and discrimination of consonants including [t],[t'],[k],[k'], [t],[t'],[],[ts],[ts'],[s],[t],[t'],[]and [],while the discrimination of consonants [b],[m],[f]and [n]showed no significant correlation with hearing(P >0.05).Conclusion:The hearing of postoperative cleft palate patients affect the consonant discrimination that mainly in the high frequency region,while low and middle frequency consonant discrimination have no influence. Other feedback channels need to be considered in speech training for high frequency consonants.

Objective To explore the effect of Tracer Methodology on the physical restraint management of the elderly patients. Methods The idea of Tracer Methodology was based on a case study of physical restraint, and then complementary tracking and system tracking. The key problem, which was founded in using Tracer Methodology on the physical restraint management of the elderly patients, could be continuously improved from the regulations, procedures, training, implementation, inspection, feedback, rectification, the implementation and the effectiveness. The normative rate of physical restraint was compared before and after the implementation of this method. Results After using the Tracer Methodology, the rate of physical constraint in the elderly patients was 82% (41/50), which was significantly increased (χ2=5.877,P=0.015) compared with before implementation of this method, which was 60% (30/50). Conclusions Tracer Methodology could improve the normative rate of physical restraint in elderly patients. Meanwhile, it was beneficial for nurses to participate in quality management, and strengthen the team cooperation.

BACKGROUND:Caffeic acid phenethyl ester (CAPE) can inhibit lipid peroxidation after rat brain injury. However, the trend of 5-lipoxygenaseis (5-LOX) and cysteinyl leukotrienes (CysLTs) in model of Parkinson’s disease, and whether CAPE protects against rotenone-induced cel ular injuries by inhibiting the levels of 5-LOX and CysLTs stil need further research.
OBJECTIVE:To investigate the protective effect of CAPE on the rotenone-induced Parkinson-like injury, and to determine whether 5-LOX involved.
METHODS:(1) PC12 cel s in good-growth were col ected and divided into five groups cultured with different concentrations of rotenone (0, 0.01, 0.1, 1, 10μmol/L). 24 and 48 hours later, changes of cel ular morphology and activity were observed to single out the optimum concentration of rotenone;at 24 hours, the levels of 5-LOX and CysLTs were detected by western blotting and ELISA, respectively. (2) PC12 cel s were pretreated with different concentrations of CAPE (0, 0.01, 0.1, 1, 10 μmol/L) for 30 minutes, and 1 μmol/L rotenone was then added. The other cel s received no intervention as blank control group. Subsequently, the cel activity was detected, and the CysLTs production was detected by ELISA at 24 hours.
RESULTS AND CONCLUSION:(1) Rotenone (0.1-10μmol/L) could induce PC12 cel injury with overt morphological and cel activity changes at 24 hours, especial y the 1 μmol/L rotenone. (2) Rotenone also significantly increased the 5-LOX expression and CysLTs production in a concentration-dependant manner. (3) CAPE (1-10μmo/L) significantly attenuated rotenone-induced CysLTs production and cel viability reduction in a concentration-dependant manner. (4) These results suggest that CAPE protects against PC12 cel injuries in the model rat with Parkinson’s disease induced by rotenone involving 5-Lox.

Iatrogenic nerve injury is one of the most severe complications of surgical correction for spinal deformity with different etiologies.The intraoperative neurophysiological monitoring (IONM) has been widely used to detect the nerve injury in spinal correction surgery.The commonly used IONM techniques involve somatosensory evoked potential (SEP),motor evoked potentials (MEP) and electromyography (EMG).All the IONM techniques have both advantages and disadvantages,while combing SEP,MEP and EMG in the spinal correction surgery could maximumly improve the accuracy and reliability of the IONM.The different pathophysiology of patients with spinal deformity due to different etiologies might significantly decrease the success rate,sensitivity,and specificity of IONM,which might further decrease the reliability of IONM.However,the IONM still serves as the most important monitoring method for the iatrogenic nerve injury in patients with different spinal deformity due to different etiologies.For those monitoring changes that cannot be distinguished,the wake-up test is still the gold standard.

Vascular cognitive impairment (VCI) is a main type of syndrome from mild cognitive impairment to dementia,which is caused by cerebrovascular risk factors (eg,hypertension, diabetes,hyperlipemia),obvious (cerebral infarction and hemorrhage) or unobvious cerebrovascular disease (leukoaraiosis and chronic cerebral ischemia).Its incidence is increasing,however,its pathogenesis remains uncertain,and effective therapeutic tools are lacking.Therefore,an increasing attention is being paid to all aspects of studies.This article mainly reviews the recent development in research of neuropsychology,imaging,electrophysiology,biology,and gene.

The anatomical features of the digestive system in 126 new-born cadavers were examined. In the oral cavity, the palatal ridges on the anterior part of the hard palate were very conspicous. The tongue, in most of the cases, was found to protrude out into the vestibule. This condition was contradictory to most of the textbooks, which state the tongue of the new born infant is short. The pharynx showed usual appearance as in the adult. Its lower end, taking the level of the lower border of the larynx as a land-mark, was at the level of the 4th or 5th cervical vertebra. The distance between the lower margin of the soft palate to the above mentioned level was 3—4 cm. The oesophagus showed no distinct constriction throughout its length. The distance between the upper alveolar process to the cardiac orifice of the stomach was 13—16 cm., being 15 cm. in average. In the majority of cases, the stomach assumed a "J" shape, and its general outline was very much like that of the adult. The liver was relatively large, its weight being 3—4% of that of the body. The umbilical vein when coursing in the left longitudinal fissure of the liver showed a dilation, from which 2—3 branches were given out to the left lobe; 1 or 2 branches to the caudate lobe; 1 to the right lobe after anastomosing with the portal vein. From this anastomotic branch, 1 twig was given to the quadrate lobe. The termination of this vein then became the ductus venosus, much diminished in size, before joining the inferior vena cava. The pancreas was 3—5 gms. in weight. Its course was in front of the left suprarenal gland instead of the left kidney. The small intestine appeared lengthy. No measurement was made on account of the embalmed bodies. A second duodenal papilla was found in 86% of the total cases. The caecum assumed a funnel-shape, lying above the iliac crest in most of the cases. In 3 cases the caecum was observed to be high up under the liver. The vermiform appendix was 3—5 cm. in length, and no valve was found at its orifice. A certain quantity of meconium was found in the lumen of the appendix. The position of the appendix was found to be variable. The taeniae coli were visible. In the majority of cases, neither sacculations nor ap- pendices epiploicae were present. The descending and sigmoid colon were largely distended by the meconium. No visible fat deposition was found in the omentum and mesentery in which the blood vessels and lymph nodes were clearly visible. The great omentum was rather short and extended only 2—3 cm. downwards from the great curvature of the stomach.

OBJECTIVE:To observe the clinical efficacy and safety of ambroxol hydrochloride in the treatment of neonatal re-spiratory distress syndrome. METHODS:108 cases of neonatal respiratory distress syndrome were randomly divided into control group and observation group,54 cases in each group. Control group were treated with conventional treatment,such as oxygen inha-lation,anti-infection and nutritional support,observation group was additionally treated with 30 mg/kg Ambroxol hydrochloride in-jection,ivgtt,qd,for continuous treatment of 4-6 d. Clinical efficacy,blood gas indexes [oxygen partial pressure(PaO2),carbon dioxide partial pressure (PaCO2)],12,24 and 48 h after treatment remission time of clinical symptoms,hospitalization time, changes of X-ray film value,tidal volume(VT)and dynamic lung compliance(Cdyn)in 2 groups were compared,and the inci-dence of adverse reactions was observed. RESULTS:The total effective rate in observation group was 94.44%,which was signifi-cantly higher than control group (51.58%),the difference was statistically significant (P<0.05);there was no significant differ-ence in the blood gas indexes in observation group after 12 h(P>0.05),PaO2 was significantly higher than control group and Pa-CO2 was significantly lower than control group 24 and 48 h after treatment,there was significant difference between 2 groups(P<0.05). Remission time of cyanosis,dyspnea,lung moist rales and hospitalization time in observation group were shorter than con-trol group,the difference was statistically significant(P<0.05). X-ray film value,Cdyn and VT levels in observation group were significantly higher than control group,the difference was statistically significant(P<0.05). The incidence of adverse reactions in observation group was 3.70%,which was significantly lower than control group(18.52%),the difference was statistically signifi-cant(P<0.05). CONCLUSIONS:Ambroxol hydrochloride shows obvious efficacy in the treatment of neonatal respiratory distress syndrome,it can improve blood gas indexes and accelerate the recovery from disease,with good safety.

Objective The clinical and endoscopic characteristics of ischemic colitis (IC) were retrospectively reviewed. Methods 23 aged patients with IC were included; their symptoms,signs,laboratory findings and endoscopic appearances analysed. Results IC occurred most frequently in mid-aged and elders with predominant presentations as acute onset of lower abdominal pains and bloody stools.Endoscopic lesions located mainly in left colon with segmental distribution.Mucosal edema,erosion and submucosal bleeding were common pathological features.Most lesions (91％ ) looked to be nongangrenous, transient and reversible.Only 9 percent of cases turned into chronic stage. Conclusion IC should be suspected in all eldly patients with acute onset of lower abdominal pain and bloody stools.Early colonoscopy is of diagnostic significance.