Objective To discuss the treatment effect of doctor-nurse cooperation in multi-plane operation of obstructive sleep apnea hypopnea syndrome.Methods 73 patients with multi-planar surgery due to OSAHS were divided into the observation group (38 cases) and the control group(35 cases) in our department from January 2008 to December 2012.Health care was strengthened throughout the course of treatment in the observation group and traditional treatment and care were adopted in the control group.Short-term and long-term efficacy,intraoperative and postoperative complications were compared between two groups.Results The operation of short-term effective rate was 100％,and significant differences were found in the long-term efficacy between the two groups.There were significant differences in nasal bleeding during surgery,one-time intubation success rate and the significances were found in postoperative pain,extubation time,lung infection and soft palate regurgitation between two groups.Conclusions The implementation of the multi-plane surgery for patients with OSAHS can effectively improve the short-term efficacy of the patients throughout the course of treatment.Strengthening doctor-nurse cooperation effectively improve the patients' long-term efficacy,reducing the patients' intraoperative and postoperative complications.

Objective To explore the value of peak systolic displacement of mitral annulus in evaluating left ventricular systolic function by speckle tracking imaging(STI).Methods The study population consisted of 96 subjects. The apical four-chamber view and two-chamber view were obtained and the systolic displacements of mitral annulus were measured at lateral, spetum, anterior and inferior mitral annulus (MADlat, MADsep, MADant, MADinf).The systolic displacements of mitral annulus midpoint (MADmid) and its ratio to the length of left ventricle at end-diastole(MADmid%) were calculated.Left ventricular ejection fraction(LVEF) was measured by three-dimensional echocardiography.The correlation of these displacements parameter with LVEF was analyzed.Results ① There was no significant difference among MADsep, MADlat, MADant, MADinf and MADmid(P>0.05).②There was significant correlation between LVEF and these parameters (P <0.01) ,and MADmid and MADmid% showed an excellent correlation with LVEF (r = 0.87 and 0.89 respectively, P<0.01).③The cut-off value of MADmid for LVEF>50% was 8.9 mm with a sensitivity of 95% and a specificity of 80% while the cut off value of MADmid% for LVEF>50% was 10.9% with a sensitivity of 95% and a specificity of 85%.Conclusions Displacement of mitral annulus by STI showed an excellent correlation with LVEF, and it may be a new promising method for routine evaluation of left ventricular systolic function with its high feasibility, simplicity and accuracy.

Objective To investigate the correlation between the serum thyroid-stimulating hormone levels and the outcomes in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke were enrolled prospectively.The general clinical data,vascular risk factors,and biochemical indexes including thyroid hormones were collected.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the severity of baseline neurologic deficit.The modified Rankin Scale (mRS) was used to evaluate the neurological outcomes at day 90 after onset.The mRS 0-2 was defined as good outcome.Multivariate logistic regression analysis was used to identify the independent influencing factors of the poor outcomes in patients with acute ischemic stroke.Results A total of 140 patients with acute ischemic stroke were enrolled,including 95 men (67.86％) and 45 women (32.14％),aged 35-94 years old.Thirteen patients (9.29％)had subclinical hyperthyroidism and 17 (12.14％) had subclinical hypothyroidism.Ninety-eight patients (70.00％) had good outcome and 42 (30.00％) had poor outcome.The proportions of male (x2 =4.717,P =0.047) and small arterial occlusive stroke (x2 =5.564,P =0.018),as well as uric acid (t =2.602,P =0.010),FT3 (t =2.406,P=0.017),and TSH (t =2.302,P =0.023) in the good outcome group were significantly higher than those in the poor group (P =0.001);age (t =-3.489,P=0.001),fasting blood glucose (Z =-2.178,P =0.031),and baseline NIHSS score (t =-8.009,P ＜ 0.001) were significantly lower than those of poor outcome group.The proportion of patients with TSH in the first quartile (＜0.805 mU/L) in the good outcome group was significantly lower than that in the poor outcome group (17.35％ vs.42.86％;x2 =10.204,P =0.003,and that in the fourth quartile (＞ 2.476 mU/L) was significantly higher than the poor outcome group (30.61％ vs.11.90％;x2=5.488,P=0.002).Multivariate logistic regression analysis showed that after adjusting various confounding factors,the higher baseline NIHSS score was an independent risk factor for poor outcome at day 90 after onset (odds ratio,1.690,95％ confilence interval 1.317-2.168;P＜ 0.001),while the higher baseline TSH level was associated with good outcome (odds ratio,0.520,95％ confidence interval 0.408-0.867;P=0.007).Conclusions The higher serum TSH level was independently associated with good neurological outcome at day 90 after onset in patients with acute ischemic stroke.

Gonorrhea is a sexually transmitted disease caused by Neisseria gonorrhoeae,and substantially harms human health and socioeconomic development.Due to inappropriate treatment and the presence of drug resistance genes in patients,antibiotic resistance has emerged in Neisseria gonorrhoeae,such as resistance to penicillin,tetracycline,ciprofloxacin,or other antibiotics.Currently,extended-spectrum cephalosporins (ESCs) are the first-line treatment of gonococcal infection.With the wide use of ESCs,the sensitivity of Neisseria gonorrhoeae to ESCs has been decreasing gradually,and there have been reports on cases of treatment failure in clinical practice.In order to control gonorrhea and deal with drug resistance in Neisseria gonorrhoeae,combined therapy,alternative therapy and new drugs have been developed in clinic.

Two patients with neonatal diabetes tested as V59A and V59M mutations were chosen for the study. Clinical data were analyzed retrospectively. The results showed that the patient with V59A mutation was characteristic of spasm and hyperglycemia at the age of three month, and treated with insulin for a long time as unresponsive to the glibenclamide at the beginning. Myasthenia and delay of development were observed during the follow-up. At the age of two years, glibenclamide was tried for the second time with a high dose and fairly-controlled glucose level. The patient with V59M mutation was diagnosed with diarrhea, hyperglycemia, and ketosis at the age of two month, and was responsive to glibenclamide at a relatively low dose with well-controlled glucose level. These results suggest that KCNJ11 V59M mutation would show some milder clinical manifestations and better glibenclamide efficacy as compared with V59A mutation.

OBJECTIVE To analyze the isolation rate and four consecutive years′(2004-2007) antibiotic-resistance trend of extended-spectrum ?-lactamases(ESBLs) producing Escherichia coli in urinary tract infection and to provide evidence for anti-infection therapy.METHODS The anti-microbial susceptibility test results of E.coli cultured from the midstream urine of outpatients and inpatients of our hospital from 2004 to 2007 were collected.Whonet 5.4 statistical analysis software was used for analysis.RESULTS During four years,no apparent change has been shown about antibiotic resistant rate of ESBLs producing E.coli.The isolation rate of this kind of E.coli increased year by year from 31% to 44% and showed high resistance to third generation cephalosporins and quinolones antibiotics,but was 100% sensitive to imipenem.CONCLUSIONS With the ESBLs-producing E.coli increasing year by year,the antibiotic-resistance rate of E.coli isolated from urinary tract infection is apparently increased and thus screening of antibiotics sensitive to enzyme-producing bacterial is the key point when the empirical therapy especially when the third and fourth generation cephalosporins are ineffective.

Purpose To investigate the expression level and the role of TUSC7 in human cutaneous malignant melanoma (CMM).Methods Quantitative real time-PCR (qRT-PCR) assay was performed to detect the expression of TUSC7 in 60 cases of CMM tissues,20 cases of benign nevus,4 CMM cell lines,and one normal human epidermal melanocytes.Then overexpression of TUSC7 was performed and its role in tumor progression was explored.Results TUSC7 expression was significantly downregulated in primary CMM tissues (n =60) compared to benign nevi (n =20),which were significantly downregulated in all the four melanoma cell lines,especially in A375 cells,compared with the normal melanocytes cells (all P ＜ 0.05).In comparison with the A375 cells transfected with the empty plasmid,those transfected with pcDNA-TUSC7 showed an obvious decrease in the proliferation and colony formation activity,while increase in the apoptosis rate (all P ＜ 0.05).Conclusion Our results suggested that the dysregulation of TUSC7 may play an important role in the CMM progression.

OBJECTIVE To investigate the terminal bacterial pollution of hospital central oxygen supply system and the sanitizing effect of MX-1 disinfector. METHODS Timing many spot samples of terminal oxygen supply equipment (oxygen flowmeter, humid bottle, oxygen pipe) were quantified and cultivated through 24 hours continue supply. RESULTS Five cases of timing many spot samples testified that there were no bacteria oxygen pollution in the pipe oxygen supply in the Department of Respiratory Disease, the Second Affiliated Hospital of Dalian Medical University, and that there were no bacteria pollution in the terminal oxygen supply equipments if they were sterilized strictly, but there would be severe bacteria pollution if they were not sterilized strictly. This test found that lid of humid bottle and lapis were the main source of bacteria pollution. Connection with MX-1 disinfector in the terminal can avoid bacteria pollution. CONCLUSIONS Severe bacteria pollution will happen if the oxygen supply equipments aren't sterilized strictly; connection with MX-1 disinfector in the terminal can avoid bacteria pollution and ensure oxygen for cleanliness and safety.

Objective To observe the effect and toxicity of oxaliplatin plus 5-Fu and CF (FOLFOX) vs irinteean plus 5-Fu and CF (FOLFIRI) in patients with advanced/metastatic colorectal cancer. Methods 67 patients with histologicaly confirmed advanced/metastatic colorectal cancer were non-randomized to enter the study. Patients for FOLFOX: oxaliplatin 85 mg/m2 iv 2 h d1.CF 200 mg/m2 iv 2 h followed by 5-Fu 250 mg iv bolus and 5-Fu 600 mg/m2 iv 22 h d1,2 were given, every 2 weeks as one cycle. FOLFIRI: irinotecan 150 mg/m2 iv d1. CF, 5-Fu do so. Efficacy was evaluated at 4 cycles. Results For 39 patients to FOLFOX and 37 patients to FOLFRI, the objective response rate (CR+PR) was 41.0 % vs 35.1%. The median time to progression was 5.2 months vs. 5.8 months in the FOLFOX and FOLFIRI arm. The median survival time was 13.2 months vs. 14.0 months in the FOLFOX and FOLFIRI arm respectively. The clinical benefit rate was 71.8 % vs 78.4 % in the FOLFOX and FOLFIRI ann respectively. There was no significantly differences between two arms (P>0.05). The most frequently observed toxicity reaction was hematological toxicity nausea/vomiting and neurn-sensory toxicity in FOLFOX arm, and hematological toxicity and diarrhea in FOLFIRI arm. FOLFIRI arm had a remarkably higher incidence rate of grade 3 diarrhea than FOLFOX arm(P<0.025). Conclusion FOLFOX and FOLFIRI arm provid high effective and well tolerable treatment for advanced/ metastatic colorectal cancer.

Objective To study the applied value of diffusion weighted imaging-DWIBS(diffusion weighted imaging with background suppression) in detecting the body tumour.Methods 10 healthy volunteers and 20 patients with histologically proven tumour were examined by diffusion Weighted MR with different techniques of background/fat body signal suppression.STIR-EPI sequence and spin echo-echo planar imaging(SE-EPI) sequence with chemical shift selective(CHESS) pulse were compared in terms of their degree of fat suppression.The diffusion weighted imaging features of control group and patients with tumour were observed and the values of ADC were measured.Results Fat suppression with STIR-EPI sequence in neck,chest,spine and extremity was well and SE-EPI with CHESS pulse in chest,abdomen,pelvic was satisfying.Signal to noise ratio(SNR) wss higher in SE-EPI with CHESS than that in STIR.The glands,spleen,peripheral nerves,lymph nodes and so forth could be showed by DWIBS in control group.85% malignant lesions were well visualized and appeared as high signal intensity and lower signal intensity in similar PET imaging,but the lesions only in 3 patients are not well visualized including pancreas cancer(1 case),rectum cancer(1 case),prostate cancer(1 case).PET scan was performed in 3 patients and well corresponded with diffusion weighted imaging in 2 cases,the other one was not visualized on diffusion weighted imaging.The highest ADC of malignant tumors was(1.58?2.06)?10-3mm2/s,the lowest ADC of malignant tumors was(0.88?0.74)?10-3mm2/s,the mean values of ADC of malignant tumors was(1.34?0.79)?10-3mm2/s.Conclusion DWIBS is a new method of diffusion-weighted MR,it has high spatial resolution,high contrast to noise ratio(CNR) and high SNR. This technique can be used as a powerful screening tool for tumour and evaluating the pathological lesions by measuring the values of ADC.