Objective To explore effective nursing intervention through clinical analysis of middle ear function of children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Tympanogram was obtained from both pre-operation and post-operation in 413 OSAHS cases(the OSAHS group).Audiogram was conducted if the tympanogram was abnormal.There were 279 cases of normal children in the control group.The incidence of middle ear function loss of two groups were compared.Results 288 cases(328 ears) had some degree of middle ear dysfunction,accounting for 69.73％.69 cases had some degree of hearing loss,accounting for 16.71％.The incidences of middle ear dysfunction and degree of hearing loss in the OSAHS group were higher than 7.53％ and 1.43％ of the control group.The hearing ability was gained after operation in both groups.Conclusions The incidence of middle ear dysfunction is higher in children with obstructive sleep apnea hypopnea syndrome.But the bad influence alleviated with age.Therefore,early detection,timely treatment and effective nursing can achieve good effect.

Objective To evaluate the use of the kite flap (als o known as subcutaneous pedicled V-Y advancement flap)for the repair of moderate -sized anterior lamellar skin defects of eyelid. Methods Since 1994, kite flaps have been used to repair anterior lamellar skin defects of eyelids in 14 patients. Six patients were male and eight female, with a mean age of 43 years (range 15-64 years). The diameter of the largest defect reache d 1/3 length of the eyelid. The flaps were designed adjacent to the defects and the incision line corresponding to natural winkle lines on the eyelid. We underm ined the flap under the orbicular muscle, and advanced the flap to cover the def ect. The incisions were closed with 7-0 suture. Results After operation, all flaps survived with primary healing. Follow-up for 3 to 12 months showed that all cases had achieved satisfactory cosmetic effects without secondary deformity. Conclusions It is a simple, safe, an d reliable method to use kite flap for the repair of moderate-sized anterior la mellar eyelid skin defects that are too large to achieve primary approximation. Because kite-flap covers the defect through a direct advancement way without ro tation and twist, there are no dog-ear deformitys present at the pedical area a nd the repaired area looks smoothly. Because of its widely based muscle pedicle which incorporates venous and lymphatic drainage over most of its length, the un desirable pigment deposition is avoided.

Endometriosis ; therapy ; Female ; Humans ; Infertility, Female ; therapy ; Medicine, Chinese Traditional ; Phytotherapy ; methods

A 56-year-old man with 1-year history of palpitation, heat intolerance and sweating, was diagnosed as thyrotropin (TSH) -secreting pituitary adenoma based on the symptoms of hypermetabolism, enlarged thyroid gland, inappropriately increased serum TSH concomitantly elevated plasma thyroid hormones and a pituitary tumor demonstrated on magnetic resonance imaging. Long-acting octreotide formulation was administered at a dose of 20 mg intramuscularly. Tumor volume shrinkage and improvement of thyroid function was achieved after a single drug injection; and the thyroid function returned to normal in 28 days. It is suggested that long-acting octreotide formulation might be used as a routine therapeutic approach prior to pituitary surgery, which may enhance the effectiveness of surgery and postoperative recovery.

Objective Our purpose in this study is to investigate genes involved in the development of diabetes-induced embryonic malformations. Methods Two groups of 70-90 day old Sprague-Dawley rats were employed in our study: group 1 was normal control rats receiving a normal diet (n=3); group 2 consisted of experimentally-induced diabetic rats by intravenous injection of 65mg/kg of streptozotocin(STZ) on pregnancy day 6 with an attempt to reproduce malformations in embryos (n=3). Embryos were examined on day 12 under light microscopy to look for morphological defect of the neural tube (NTD). Yolk sac cells were harvested from each group and RNA was isolated. Genes expression profiles in yolk sac cells were analyzed using a DNA microarray technique. Results Gene expression patterns were compared in a total of 1200 genes between experimentally-induced diabetic rats and normal control rats, and 79 of genes were found to express differently between the two groups. Forty-two of genes were up-regulated in yolk sac cells of diabetic rats, such as apoptosis related genes BAX, bcl-2, heat shock 70kD protein and glucose-transporter 3; 37 of genes were down-regulated, such as phospholipase A2, insulin-like growth factor II receptor. Conclusion Understanding of differently expressed genes should help us disclose the potential molecular mechanisms underlying the developmental process during diabetes-associated embryonic morphogenesis, and it also might provide a useful tool in rapid diagnosis and prevention of malformation in early gestation stage of diabetic subjects.

Objective To investigate the treatment delay in patients with acute cerebrovascular disease in different levels of hospital in Qingdao area and to analyze its influencing factors. Methods A total of 700 patients with acute cerebrovascular disease from the city, county and township hospitals in Qingdao were selected from June 2008 to February 2009. A questionnaire survey was used to investigate and analyze the visiting time in patients with stroke and its possible influencing factors. Results The average visiting rate in patients with acute cerebrovascular disease was 30% within 4.5 hours after the onset in Qingdao area. The average visiting rate of the township hospitals was lowest (26%), of the city hospitals was moderate (28%), and of the county hospitals was highest (36%). For the city hospitals, the male patients usually delayed the visiting. The patients with high school or higher education level, urban medical insurance, 120 transportation, and the National Institutes of Health Stroke Scale (NIHSS) ＜ 3 could usually he treated timely; For the county hospitals, the patients with secondary school or lower education level, 120 transportation, and NIHSS ＜3 could usually be treated timely. For the township hospitals, the patients with NIHSS ＞ 7 and unconsciousness could usually be treated timely. Conclusions The patients with acute cerebrovascular disease in the city, county and township hospitals in Qingdao area had significant treatment delay. Of those, 120 transportation and higher levels of education could decrease the treatment delay of patients. Therefore, perfecting stroke emergency network, raising people's level of education, and strengthening propaganda and education on stroke knowledge in all levels of hospitals are essential for timely treatment of stroke patients.

Objective To investigate the self-regulation of the autonomic nervous system following the cognitive stress tests after heart rate variability (HRV) biofeedback therapy in patients with post-stroke depression (PSD). Methods From May, 2013 to December, 2015, 48 patients with PSD were randomly divided into feedback group (n=25) and control group (n=23). The feedback group received HRV biofeed-back therapy, while the control group only received relaxation therapy without feedback signal. HRV parameters were tracked during the cognitive stress test in quiet baseline state, cognitive stress state, and resting state before and after treatment. Results Under the stress condi-tion, the low frequency of both groups increased during the first cognitive test, and the rate was higher in the control group than in the feed-back group (P=0.02). The heart rates during the second cognitive test decreased in the feedback group, while increased in the control group (P=0.05). After rest, the heart rate of the feedback group decreased below the baseline (P=0.02). Conclusion During the cognitive stress test, HRV biofeedback therapy can achieve a dynamic balance between sympathetic and parasympathetic nerves by reducing sympathetic sensibility, which improved patients' adaptive capacity to cope with their internal physiological environment and external environmental pressures.

Objective To assess the clinical efficacy and safety of transurethral plasmakinetic enucleation of prostate (PKEP) and suprapubic transvesical prostatectomy (SPP) in the treatment of large volume benign prostatic hyperplasia (BPH).Methods A total of eighty patients with large volume BPH were selected in the First People''s Hospital of Xuzhou from March 2014 to December 2016,and they were randomly divided into two groups,the PKEP group and SPP group,with 40 cases in each group.The comparison was made between the two groups in terms of operation indicators,postoperative complications followed up for 6 months after surgery and other related curative effect indexes.Results In the SPP group,the intraoperative blood loss was significantly higher than that of the PKEP group ((215.7±10.4) ml vs.(75.6±9.2) ml,t=6.541,P<0.05).There was no significant difference between the two groups in operation time and excised gland volume (P>0.05).But the catheterization time after operation,bladder irrigation time and length of hospital stay were significantly longer in the PKEP group than in the SPP group ((6.3±1.8) d vs.(2.4±0.6) d,(5.5±1.4) d vs.(1.3±0.6) d,(7.7±2.3) d vs.(3.1±0.7) d,t=4.357,2.542,2.975,P<0.05);in the 6-month follow-ups after operation,IPSS,Qmax,PVR and QOL were all significantly improved in both groups compared with the indexes collected before the operation (P<0.05),while there was no significant difference between the two groups (P>0.05).The rate of complication occurrence in the PKEP group were lower than that of the SPP group (P<0.05).Conclusion PKEP was effective in the treatment of BPH,with less bleeding loss,fewer complications and quick recovery.It can significantly improve the life quality of the patients and will be an ideal treatment for large volume BPH.

Objective This paper reports a modified method for the isolation of rat thoracic aortic vascular smooth muscle cells based on combined enzyme double digestion.Methods An enzyme mixture containing collagenase II, soybean trypsin inhibitor and elastase was prepared and used to remove the aortic tunica intima and tunica adventitia, and then the tunica media was subjected to second digestion using the same enzyme mixture and to isolate vascular smooth muscle cells.Results The isolated VSMCs were cultured in vitro and the growing cells had an elongated spindle-shape, reached confluence within a week, and displaying a typical hill-and-valley pattern.After 1 week, the cells were passaged.Contractile smooth muscle markers(α-SMA, myosin-II and β-tubulin) were highly expressed in the isolated cells.More than 90% of the cells significantly expressed alpha smooth muscle actin and myosin-II.Conclusions Themethod established in this study has advantages of simple and easy to operate, and good reproducibility, with a high activity and purity of the separated cells.It can ensure to obtain a large amount of contraction-type vascular smooth muscle cells within a short time.