The most common etiology of neonatal upper airway obstruction is congenital abnormalities,including choanal atresia,Pierre Robin sequence,occupational lesions,laryngomalacia,and so on.Some patients are after birth with dyspnea,severe cases with suffocation,and even death.Due to lack of specific clinical manifestations in early neonatal periode,it is usually misdiagnosed as other respiratory diseases.Therefore,early identification of the etiology,as soon as possible to relieve the obstruction,is particularly critical in the prevention of suffocation for the upper airway obstruction in the neonatal period.

BACKGROUND: Brachial plexus root avulsion is the severest type in brachial plexus injuries. It is preganglionic lesion and its prognosis is very bad. At present, the curative effect of traditional neurotization is not satisfactory. Therefore it is necessary to explore the treatment of brachial plexus root avulsion by tissue-engineered neural transplantation. OBJECTIVE: To explore the role and effect of tissue engineering in nerve injury, so as to provide reference for the clinical treatment of brachial plexus root avulsion using tissue engineered neural transplantation. RETRIEVAL STRATEGY: The relevant articles published between January 2001 and October 2007 were retrieved from PubMed and China Journal Full-text Database using the key English words "brachial plexus avulsion" and Chinese words "brachial plexus injury". 410 literatures were retrieved, including 155 English, and 255 Chinese. Focused articles and literatures in the same field published in the near future or on the authoritative journals were included. Repetitive articles and Meta analysis articles were excluded. Finally 34 articles were selected. LITERATURE EVALUATION: Of 34 articles, one was review article, and the others were clinical and experimental studies. DATA SYNTHESIS: Curative effects of traditional nerve transposition and avulsed never reimplantation are limited. Neurotrophic factor, sialidase, chondroitinase ABC, and N-acetyl cysteine are able to protect and promote injured neuron. Bone marrow stem cells and spinal nerve stem cells can differentiate into neuron at lesion site of spinal cord after transplantation. CONCLUSION: Tissue engineered neural transplantation may be a more effective therapy for brachial plexus root avulsion.

Objective To explore the related factors of school refusal behavior in child and adolescent.Methods Investigated 141 students who had school refusal behavior in the department of psychiatry as the case group. 109 students were chosen randomly from 3 different grades in different schools as the control group. Two experienced psychiatrists made diagnosis according to DSM-Ⅳ criteria, the case group completed the direct factor investigation of School Refusal and the general condition questionnaires. The control group completed the general condition questionnaire only. Results 61 (43.7%) of the case group were diagnosed mental disorder according to DSM-Ⅳ ,17(28.91% ) of them were diagnosed mood disorder, which was the most in all kinds of mental disorder in case group. The results showed that age (P = 0.0003 ), location (P = 0. 035 ) and family income (P ＜ 0. 01 )were the most important factors for school refusal behavior in child and adolescent. The opinions of child and parent on the school refusal factors were quite different (P ＜ 0. 05 ). The former three direct reasons of school refusal were study pressure (6.47%) ,much more examinations and homework( 6.03% ) ,and willing to stay at home only (5.63%). Conclusion Mental disorder is the main causation of school refusal behavior. Age, location and family income are related closely to school refusal behavior. Study pressure, peer difficulty and poor parent-child relationship are direct factors of school refusal behavior.

Objective To detect the serum levels of epidermal growth factor（EGF）in rheumatoid arthritis（RA）patients,and explore the possible role of EGF in RA.Methods The serum level of EGF was measured by enzyme-linked immunosorbent assay（ELISA）in 38 RA patients diagnosed according to dianostic criteria for RA by American Rheumatism Association and 20 healthy controls.Rheumatoid factor（RF）,erythrocyte sedimentation rate（ESR）and C-creative protein（CRP）were also measured in these 38 RA patients.The relation beween the serum level changes of EGF and the corresponding clinical indexes in the two groups was statistically analyzed.Results Compared with the healthy individuals,the serum EGF levels of RA patients increased significantly（P 0.05）.Compared with simple bone rarefaction patients,the serum levels of EGF increased significantly in the bone erosion patients（P 0.05）.The serum levels of EGF in RA patients had no correlation with RF,ESR and CRP levels（P 0.05）.Conclusion The evident increase of serum EGF level in RA patients,especially in bone erosion patients,suggests that EGF may partly play a role in the pathogenesis of RA.

Objective The main purpose of this study was to discuss the current situation of our nursing education from the perspective of educate,and to provide enlightenment for the higher nursing education reform.Methods The current situation of the development of nursing education questionnaire was adopted to conduct the survey.Results Nursing education in our country faced with the problems such as imperfection of the education concept,lack of humanistic curriculum,less practice classes,theory was divorced from practice,single evaluation tools of teaching.Conclusions Our country should carry on the reform of education mode,build international nursing personnel training system,improve the training quality and competition of nursing personnel.

Objective To explore the effect of time management on the on-time rate of implementation of the first selective operation.Methods Five hundred and two selective operations from January to May of 2013 without time management were set as control group, while another five hundred and twenty with time management as experiment group. The two groups were compared in terms of on-time rate of the first selective operation, time for nurse’s extra shift, number of nurses at extra shift, numbers of operations and satisfaction level.Results After time management, the experiment group was significantly better than the control in terms of the on-time rate of operations, time for nurse’s extra shift, number of nurses at extra shift, numbers of operations and satisfaction level (all P<0.01).Conclusion Time management used in the operation room can significantly improve the on-time rate of selective operations and doctors’satisfaction and work efficiency, thus decrease nurses’overworking time.

Objective:To investigate the high flux hemodialysis (HFD) on the application effect of severe renal failure patients the level of inflammatory factors, blood lipid and protein. Methods:In 2012 January to 2013 December was performed in 80 patients with severe renal failure in the treatment of MHD, were randomly divided into two groups, study group 40 cases by high-throughput MHD treatment, 40 cases in the control group using conventional MHD treatment. Results: There was no significant difference in two groups before treatment of various inflammatory factors difference (P>0.05); after the treatment, two groups of patients with TNF- α, IL-6 and hs-CRP levels were significantly lower(t=14.138, t=5.891, t=11.093;P<0.01), and lower levels of TNF-α, IL-6 and hs-CRP levels than the control group after treatment, the study group, with statistical significance correlation between data comparison of difference (t=17.913, P<0.05). Comparison of the plasma protein levels had no significant difference between the two groups before treatment (P>0.05);after the treatment, patients in study group were TP, ALB andβ2-M compared with those before treatment were significantly improved, ALB of control group had obvious improvement than before treatment (P<0.05); improve study group for plasma proteins relevant indexes are the control group was significant (t=2.515, t=59.923, t=3.474, P<0.01). No significant differences between the level of each lipid index (P>0.05);after the treatment, patients in study group TC and TG compared with those before treatment were significantly improved after treatment, and compared with the control group index improved significantly (t=2.963, t=6.914; P<0.01). Conclusion:High throughput MHD therapy based on conventional MHD filtration of small molecular toxin traits on patients with severe renal failure, increase the filtration range, clear promote inflammatory molecules, plasma proteins, blood lipid molecules, such as in large molecules, so as to achieve a better therapeutic effect.

ObjectiveTosurvey obsessive-compulsivesymptomof childrenandadolescents.Methods4335 children and adolescents aged ( 13.88 ± 2.44) year-old (47.7％ male) were measured with leyton obsessional inventory-child version (LOI-CV).ResultsThe frequency of total yes/no score of LOI-CV manifests as normal distribution,while the frequency of total interfering score manifests as J curve.Total yes/no scores of female were higher than that of male ( ( 8.55 ± 3.87 ),(8.21 ± 3.99),t =2.86,P ＜ 0.01 ) ; the difference of country and city were not significant ( ( 8.57 ± 3.86),( 8.35 ± 3.9 ),t =1.32,P ＞ 0.05 ).Primary school ( n =937 ),junior high school ( n =1906 ),senior high school ( n =1492 ) exited significant difference ( (7.86 ± 3.82),( 8.52 ± 3.93 ),( 8.55 ± 3.891 ) respectively,F =11.03,P ＜ 0.01 ).The total interfering scores of male were higher than that of female ( ( 11.35 ± 9.10),( 10.76 ± 8.84),t =2.18,P =0.03 ).The total interfering scores of country were higher than that of city( ( 11.86 ±9.18),( 10.88 ±8.92),t=2.61,P＜0.01 ) ;the difference of primary school,junior high school and senior high school were significant ( ( 10.05 ± 8.76 ),( 11.73 ± 9.17),( 10.77 ± 8.76),F =12.088,P ＜ 0.01 ).The total interfering score from grade four of primary school to grade three of senior high school were( 10.0 ± 8.78),( 10.01 ± 8.64),( 10.19 ± 8.92),( 11.43 ±9.16),(11.40 ±8.67),(12.58 ±9.76),(10.32 ±8.42),(10.19 ±8.38),(12.48 ±9.69) respectively(F=5.90,P＜0.01 ).The two grades of the highest total interfering score were grade three of junior high school and grade three of senior high school.ConclusionObsessive-compulsive symptom are common in children and adolescents.Children and adolescents of male grade three of junior high school or senior high school in the country are more probably interfered by obsessive-compulsive symptom.

Objective To study the immunophenotype and chromosome karyotype of 57 adult patients with newly?diagnostic acute lymphoblastic leukemia(ALL). Methods The immunophenotype and chromosome karyotype of 57 adult patients with newly?diagnostic ALL were determined by using flow cytometer and karyotyping,and then the clinical characteristics and significance were analyzed. Results In patients with B cell acute lymphoblastic leukemia(B?ALL),the expression of CD19 and CD22 were significantly higher than CD10 and CD20(P<0.05). The expression of CD7 and CD3 were much higher in patients with T cell acute lymphoblastic leukemia(T?ALL). As for the early antigen,patients of all subtypes of ALL showed high expression rate of CD34 and CD38. In addition,the HLA?DR was only detected in B?ALL. There was no difference in comparison with clinical characteristics,total rate of CR and rate of relapse between ALL with and without myeloid antigen expression. The expression rate of CD34 and HLA?DR was higher in My+?ALL(P<0.05). The relapse rate was much higher in these patients with abnormal karyotype than other pa?tients(P<0.05). Patients with high?risk karyotype showed higher expression rates of CD20 and CD3 than those with standard?risk. Conclusion The immunophenotypes and chromosome karyotypes show obviously heterogeneous features,and the patients with abnormal karyotypes have higher relapse rate. These above mentioned methods are applicable for the diagnosis and individualized treatment of ALL patients.

Objective To investigate the role of opioid receptors in remifentanil-induced attenuation of renal ischemia/reperfusion (I/R) injury in rats.Methods Seventy-five male Sprague-Dawley rats weighing 250-300 g were randomly divided into 5 groups ( n =15 each):sham operation group (group S),group I/R,remifentanil group (group R),naloxone group (group N),and naloxone + remifentanil group (group NR).Renal ischemia was induced by clamping the bilateral renal arteries for 45 min using an atraumatic clamp followed by reperfusion.In groups R and NR,remifentanil was infused at 1.0 μg· kg-1 · min-1 via the caudal vein starting from 15 min before ischemia until 30 min of reperfusion,while groups S,I/R and N received the equal volume of normal saline instead of remifentanil.In groups N and NR,naloxone 0.3 mg/kg was injected via the caudal vein at 20 min before ischemia and at 35 min after ischemia respectively,while groups S,I/R and R received the equal volume of normal saline instead of naloxone.Blood and urine samples were collected from the femoral vein and urinary bladder respectively at 24 h of reperfusion for determination of the levels of serum creatinine (Cr) and blood urea nitrogen (BUN),urinary N-acetyl-β-D-glucosaminidase (NAG) and γ-glutamyl transpeptidase (γ-GT).The rats were sacrificed at 24 h of reperfusion and the renal tissues were removed for determination of nalondialdehyde (MDA) content and superoxide dismutase (SOD) activity.Pathological changes in renal tissues were observed with light microscope.Results Compared withgroup S,the levels of serum Cr and BUN,urinary NAG and γ-GT,and MDA were significantly increased,while the activity of SOD was significantly decreased in the other 4 groups ( P ＜ 0.05 or 0.01 ) and pathological changes in renal tissues were observed in the other 4 groups.Compared with group I/R,the levels of serum Cr and BUN,urinary NAG and γ-GT levels,and MDA were significantly decreased,while the activity of SOD was significantly increased ( P ＜ 0.01 ),and the pathological changes were reduced in group R,and no significant change was found in the parameters mentioned above in groups N and NR ( P ＞ 0.05).The pathological changes were similar in groups I/R,N and NR.Compured with group R,serum Cr and BUN concentrations,urinary NAG and γ-GT levels and MDA concent were increased,while SOD activity were decreased ( P ＜ 0.05 or 0.01 ).Conclusion Opioid receptors mediate remifentanil-induced attenuation of renal I/R injury in rats.