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.

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.

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.

Objective To investigate the clinical and laboratory characteristics of hematological malignancies with t(1 1;19)(q23;p13.1).Methods Chromosome specimens of bone marrow cell from a patient with hematological malignancy were collected.After short-term culture,and chromosome karyotype analysis was carried out by R banding technique.Results The chromosome karyotype of the patient diagnosed with AML M4+ was t (11;19)(q23;p13.1).The patient did not obtain complete remission after application of MA regimen chemotherapy.Conclusions t(11;19)(q23;p13.1) translocation is a rare and recurring chromosome abnormality,which is related with a specific type of AML.The prognosis of the AML patients with this chromosome abnormality is poor.

Objective To establish a whole-body dynamic inhalation exposure system for toxicological studies on highly toxic chemicals, and to evaluate the safety and applicability of the system.Methods The safety and standardization of the laboratory were ensured after positive and negative pressure protection and airtight protection were finished.By modifying and optimizing the key technological units of the exposure chamber, the relationships between aerosol concentrations in the chamber and the push rate, exposure time and different monitoring points were investigated.Results and Conclusion Multi-protection was achieved, including the independent exposure chamber, negative pressure experiment and positive pressure protection under working conditions.The laboratory meets the demands of safety and specifications.The exposure aerosol concentrations in the chamber are uniform, stable and controllable while the air is dynamically flowing.The whole-body dynamic inhalation exposure system can meet the need for toxicological studies on highly toxic chemicals.

Objective To analyze the clinical characteristic s of an infant with congenital lipoid adrenal hyperplasia (CLAH),and to sequence the acute regulatory protein (steroid acute regulatory,StAR) gene of the infant patient and her pedigree.Methods Physical examination,laboratory tests,and imaging examination of the 11-month-old patient with CLAH were collected.DNA was extracted from blood samples of the patient and her parents.The 7 exons of StAR gene were amplified by PCR and then sequenced.Results Dark skin,girl vulva,and one each 1.0 cm×1.0 cm palpable lump in inguinal area bilaterally were observed.The adrenocorticotropic hormone (ACTH) was 253 pg/ml,cortisol was 27.6 nmol/L at 8 am,17-hydroxyprogesterone was 3 nmol/L.Uhrasound showed that sign of testicular ultrasonography existed in bilateral inguinal regions.Karyotype analysis showed 46,XY.Sequencing of PCR amplified fragments showed that there were two heterozygous mutations c.229C ＞ T,p (Gln77X) and C.659A＞G,p (His220Arg) of StAR gene in this patient.By rectifying the disturbance of electrolyte,and treating with hydrocortisone and 9α fludrocortisone,etc,the patient has been stable so far.Conclusion The patient presents typical clinical manifestations.Two heterozygous mutations including c.229C ＞T,p (Gln77X) from maternal and C.659A＞G,p (His220Arg) from paternal of StAR gene were detected.Wherein the c.659A＞G,p.(His220Arg) as a novel point mutation of StAR gene,has not been reported so far.

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.

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.

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.