Objective To probe into the treating method for 8 patients with amniotic fluid embolism and summarize the cognition and experience.Methods A retrospective analysis was made on the treatment of 8 patients with amniotic fluid embolism and the prognosis clinical material of mother and baby.Results All of them had the drop of blood pressure and shock.7 cases had premonitory symptom.7 cases had survived and 1 case had been dead.Conclusion It is very important for the successful rescuing that the symptom is found out in early period, diagnosis is correctly made, adrenocortical hormones and heparin are used in time, amount of blood and fibrinogen level were supplied quickly, pathogenic factors are removed and subtotal hysterectomy can be carried out early, which has absolutely clinical value for the successful rescuing patients with amniotic fluid embolism.

Background:Gastroesophageal reflux disease(GERD)is a common disease,its incidence is related to geographic environment and race. Studies reported on epidemiology of GERD in minority groups are rare. Aims:To investigate the prevalence and related risk factors of GERD in She population in Ningde. Methods:Three natural villages of She population in Ningde were selected for undergoing the cluster random sampling method. GERD was diagnosed by gastroesophageal reflux disease questionnaire(GerdQ)with score ≥8,and questionnaire was used to detect the prevalence and risk factors of GERD. Results:A total of 936 residents completed the questionnaire,and 89 were diagnosed as GERD, the prevalence was 9. 50% . Univariate analysis showed that the risk of GERD was significantly increased in She population with body mass index(BMI)≥24 kg/ m2 ,intake of strong tea or oily diet(P all < 0. 01). Multivariate analysis showed that BMI ≥24 kg/ m2(OR = 3. 022,95% CI:1. 917-4. 765),intake of strong tea(OR = 2. 145,95% CI:1. 338-3. 438) and oily diet(OR = 2. 016,95% CI:1. 208-3. 318)were the risk factors of GERD. Conclusions:The prevalence of GERD is high in She population in Fujian Province,and the etiology may be related to overweight and diet habit.

Objective To analysis the re-hearing expectations and the need for auditory training and the time of adaptation exchanges after cochlear implantation .Methods Sixteen cases of adult postlingual deafness, which were selected, from 2002 to 2011, were treated by cochlear implantation .9 cases participated in speech training right after cochlear implantation , and 7 cases didn ’ t participate in speech training .In the initial stage, the patients were given the tone and input hearing test with voice frequency in the natural environment.The auditory training was for 2 hours a day, which included single and combined training .The training method was comprehensive , including auditory speech perception , writing and verbal expression .The training focused on the coherence and clarity of oral Reading .One training course was 3 -10 weeks .The efficacy of the training with the combination of sound and the ability to adapt to society was analyzed . Results In 10 cases joining the training , 4 cases instantly began to auditory training after cochlear implantation and lasted for more than 5 weeks.1 case discontinuously trained for 4 weeks, and other 5 cases trained transiently ( less than 3 ~4 days ) .6 cases refused to participate in the training process after cochlear implantation .Assessed by the “the lowest auditory function test vocabulary”, the distinguish rate of 5 patients was 90.3%after training for more than 4 weeks, who gradually adapted to working and learning environment after 5-7 months, and gained normal communication after 1.5-2.0 years.The distinguish rate of 5 patients was 36.0%after training for several days , and 2 patients cannot accomplish the test .Besides, the 6 patients without participation the training program cannot finish the assessment for over 2 years after cochlear implantation.Conclusions Cochlear implantation provides patients with the possibility of re-hearing, and the postoperative training can help patients in communicating in social life .A variety of factors can affect the efficacy of re-hearing adult patients with post-lingual hearing after cochlear implantation .

Objective To explore the methods of auditory enlightenment and whole ability training in severe hearing impaired children with inner ear malformations and growth retardation .Methods Eleven severe hearing impaired children with inner ear malformations were chosen , and received the methods of multiple stimuli including auditory, vision, tactile sensation, large and fine motor and so on in order to train their skills including the response and discrimination of sounds , language , and cognition and so on .Results The abilities of hearing and sense were gradually establishment in children 3 months after the training .Seven children could perceive clearly sound , and finish the hearing examination after training 6-13 months so as to lay the foundation for behavioral responses after the cochlear implantation surgery .Two children finished the hearing assessment after the hearing compensation through the audiphone .Conclusions The methods of multiple stimuli in the different sense at the same time can promote the formation of auditory consciousness and auditory nerve loop in infants with inner ear malformations .

Objective To explore children with audition symptom as normal but heterophthongia impacting on the process of their growth , and try to find out the symptom of abnormal speech and hearing to prevent and cure early .Methods Fifty six children were selected at the age of 6 months to 8 years old whose development of audition and speech had not reached the normal norm and known their information relative growth factors such as medical history , present illness , family medical history and environment of growth inside out .We assessed the speech and audition of all cases by clinical objective and subjective audition test and they shown different level of audition damage .We provided different methods to prevent and cure disorders according to inducing factors .Results The characteristic of children , whose right and/or left ear had different damage ( earshot:35 -120 dB ) , usually could not arouse attention especially at early linguistic stage because of inapparent hearing and speech disorders .The delayed diagnosed audition problem already leaded that sixteen children from 4 -8 years old acquired the problems of inappropriate response to voice , simple and vague language and restricted study and twenty cases obtained no response to voice , delayed development of audition comparing with peers , and expressed their demand by body language until 2 to 4 years old until they sought medical advice .Neonatal audition had not passed first and second screen and the level of audition damage were at range of 20-90 dB; however , parents believed neonate could develop naturally when neonate grown up so that they attended training without consistency and worn hearing aid incontinuity .These kind of behavior leaded that neonate acquired medical treatment until 1.5 to 2 years and some reflections had been built up or delayed . Conclusions Children with a similar audition as normal children but heterophthongia are unapparent at early stage, but it will slight show out when they grow up .Parent should comprehend the children ’ s process of hearing and language development and try to find out language and hearing problem as earlier as possible .Early detection could decrease growth gab between children with audition problems and normal children .

Objective:To investigate the prognostic significance of high sensitivity-C reactive protein (Hs-CRP) in patients with peripher-al T-cell lymphoma (PTCL). Methods:A total of 234 newly diagnosed PTCL patients with a median age of 48 years were analyzed retro-spectively. Serum Hs-CRP levels and other factors, including tumor stage and international prognostic index (IPI), were determined. Af-ter a median follow-up of 23 months, the relationship between Hs-CRP and overall survival (OS) was observed. Results:Serum Hs-CRP level positively correlated with IPI score (r=0.132, P<0.001), tumor stage (r=0.183, P=0.005), B symptoms (r=0.225, P=0.001), and lactic dehydrogenase (r=0.169, P=0.009), but negatively correlated with plasma albumin levels (r=?0.343, P<0.001), hemoglobin concentra-tion (r=?0.239, P<0.001), and platelet count (r=0.131, P=0.045), and is uncorrelated with age (P>0.05), gender (P>0.05), fitness score (P>0.05), and leukocyte count (P>0.05). Patients with serum Hs-CRP levels≤10 mg/L had better OS than patients with serum Hs-CRP levels>10 mg/L. Univariate and multivariate Cox regression models showed that platelet count, Hs-CRP, albumin levels, and IPI score were independent adverse prognostic factors. Conclusion:The baseline Hs-CRP level can serve as a major indicator of prognosis in PT-CL patients.

OBJECTIVETo observe the short- term effects of hemogram in donors after peripheral blood stem cell（PBSC）collection and donors' tolerance.

METHODSA total of 166 related allogeneic donors were selected from The First Affiliated Hospital of Medical School of Zhejiang University between January 2013 and December 2014, including 86 male and 80 female. All donors accepted granulocytecolony- stimulating factor（G-CSF）5-10 μg·kg⁻¹·d⁻¹ until collection finished and were measured by blood cells count before and after PBSC collection.

RESULTSAfter PBSC collection, the hemoglobin level decreased from 145（94-181）g/L to 138（93-167）g/L, and the platelet counts decreased in all donors from 231（105- 490）× 10⁹/L to 95（39- 210）× 10⁹/L. The amount of hemoglobin contamination in collection products was weak correlated with the decreased hemoglobin in peripheral blood（r=0.297, P=0.017）, and the platelet contamination was high correlated with that decreased in peripheral blood（r=0.719, P<0.001）. The decline of hemoglobin level after twice PBSC collection was of no significant difference between four groups in different ages（P≥0.05）. The decline of platelet counts was out of a significant difference（P> 0.05）. In addition, the decline of hemoglobin level after once and twice PBSC collection was of a significant difference between four groups in different body mass index（BMI）（P=0.003 and P<0.001）, especially in thinner group with obvious decrease. But the decline of platelet counts was out of a significant difference （P>0.05）.

CONCLUSIONThe hemoglobin level decreased mildly in healthy allogeneic hematopoietic stem cell donors after PBSC collection and it is better to adjust parameters every time to ensure their safety for thinner donors. However, it will increase the risk of platelet decline, which is unrelated with ages and BMI and can be tolerated.

Blood Donors ; Blood Platelets ; Female ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cells ; cytology ; Hemoglobins ; analysis ; Humans ; Male ; Platelet Count

Objective: To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7⁺ in AML patients with wild-type (WT) or mutant-type (MT) CEBPA. Methods: The clinical data of 298 newly diagnosed non-M₃ AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7⁺ and CD7^- patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7⁺ group by Kaplan-Meier method. Results: In CD7⁺ group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7^- group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7⁺ group comparing to those of CD7^- group in AML patients with wild type CEBPA. There were no statistical difference between CD7⁺ group and CD7^- group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7⁺ group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7⁺-CEBPA MT group, CD7^- and CD7⁺-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) . Conclusion The CEBPA mutation rate was higher in CD7⁺ AML patients then that of CD7^- patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.