The ability to feed on vertebrate blood has evolved many times in various arthropod clades. Consequently, saliva of blood-feeding arthropods has proven to be a rich source of antihemostatic molecules. A variety of platelet aggregation inhibitors antagonize platelet responses to wound-generated signals, including ADP, thrombin, and collagen. Anticoagulants disrupt elements of both the intrinsic and extrinsic pathways. Vasodilators include nitrophorins (nitric oxide storage and transport heme proteins), a variety of peptides that mimic endogenous vasodilatory neuropeptides, and proteins that catabolize or sequester endogenous vasoconstrictors. Multiple salivary proteins may be directed against each component of hemostasis, resulting in both redundancy and in some cases cooperative interactions between antihemostatic proteins. The complexity and redundancy of saliva ensures an efficient blood meal for the arthropod, but it also provides a diverse array of novel antihemostatic molecules for the pharmacologist.

Objective: To discuss the morphologic diagnosis value of CTA technical on myocardial bridge-wall coronary artery. Methods: Three hundred and seventy seven patients suspected MB-MCA and with CTA and CAG inspection voluntary in cardiology clinic or hospital were analyzed, and the occurrence of type MB-MCA and MCA MB length and degree of stenosis were recorded, the results were analyzed using SPSS17.0 statistical software. Results:103 cases of 377 were diagnosed as final MB-MCA, and there were 110 MB-MCA in total. CTA and CAG checked by means of two kinds of shallow and deep in the model type MB-MCA diagnostic analysis were compared through Kappa analysis, the Kappa value were 0.803 and 1.000. Two methods had a good consistency in the diagnosis of MB-MCA;There were statistically significant in CTA and CAG two kinds of examination methods in the diagnosis of superficial in type (t=-5.149)and deep in the type MB (t=-2.457, P=0.024)(P<0.05). Conclusion:The multi-slice spiral CT angiography CTA technology has good consistency with CAG in MB-MCA diagnosis, can achieve complementary advantages, can combine their respective advantages MB-MCA to improve the diagnostic accuracy for clinical richer diagnostic information.

Objective To analyse the mental health of adolescents with cochlear implants and provide the ref‐erence for programming the personalize rehabilitation schedule of audio - speech -psychological .Methods The mental health test(MHT) was used to evaluate the mental health status of 60 adolescent with cochlear implants ,and compared with those of adolescent with normal hearing .Results The incidence of psychological problems was 3 .33% in adolescent with cochlear implants .The hypersusceptilility scores of the group of cochlear implants (5 .63 ± 2 .22) was higher than that of in normal hearing group(4 .05) in ,which was significantly different(P<0 .01) . The body syndrome scores in the cochlear implants group (4 .03 ± 2 .72) was lower than that of in normal hearing group(4 .99) ,which was significantly different(P<0 .01) .The phobic tendency scores in cochlear implants group (1 .95 ± 2 .01)was significantly lower than that of in normal hearing group (3 .06)(P<0 .01) .Conclusion The over‐all mental health of adolescent with cochlear implants is good .Cochlear implants can help them improve hearing and speech function ,and improve quality of life ,but they still need parents ,teachers and the community to pay more at‐tention and care to help them get through adolescence ,and return to mainstream society .

Objective To investigate the effect of remote ischemic preconditioning (RIPC) on the lung injury during one-lung ventilation (OLV) in the patients undergoing thoracic surgery.Methods Eighty patients scheduled for elective radical operation for esophageal cancer,were randomly divided into 2 groups (n=40 each) using a random number table.control group (group C) and group RIPC.At 0 (T1),30 min (T2),1 h (T3) and 2 h (T4) of OLV,blood samples were obtained from the radial artery for blood gas analysis and determination of plasma concentrations of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1ββ) and IL-10.Oxygenation index(OI),respiratory index(RI) and PaO2/PAO2 were calculated.Exhaled breath condensate was collected and the pH value was measured.Results Compared with group C,Oxygenation index was significantly increased,and respiratory index was decreased at T2-T4,the plasma concentrations of TNF-α and IL-1β were decreased,and the pH value of exhaled breath condensate was increased at T3-T4,and the plasma concentration of IL-10 was increased at T4 in group RIPC.Conclusion RIPC can inhibit inflammatory responses and reduce airway acidification,thus attenuating the lung injury during OLV in the patients undergoing thoracic surgery.

Objective To investigate the effects of different values of PEEP on cardiac index (CI), stroke volume variation (SVV) and oxygen transport index (DO2I) in patients monitored by FloTrac/Vigileo system, and to provide some references for the hemodynamic management and improvement of oxygenation for patients. Methods Sixty patients scheduled for elective television (TV) auxiliary thoracoscope radical operation for esophageal cancer were included in this study. Data of CI, SVV and DO2I were observed by the FloTrac/Vigileo system. Changes of CI, SVV and DO2I were recorded after anesthesia induction and turn left side (T0), artificial pneumothorax with 0 PEEP after 5 minutes (T1), artificial pneumothorax with 5 PEEP after 5 minutes (T2), artificial pneumothorax with 10 PEEP after 5 minutes (T3), and artificial pneumothorax with 15 PEEP after 5 minutes (T4). Results Compared with T0, CI decreased and SVV increased significantly at T1, T2, T3 and T4(P<0.05). Compared with T1, CI decreased and SVV increased at T4. DO2I increased at T2 and T3 compared with that of T1(P<0.05). Conclusion PEEP may have a certain influence on CI and SVV in the process of operation. The values of 5-10 PEEP can significantly improve oxygenation and have a less influence on hemodynamics, which can be appropriately used in clinical care.

OBJECTIVE: A current technology for detecting and controlling transient noise in hearing aids (AntiShock) was evaluated. The objective was to evaluate AntiShock on loudness control and whether results in negative changes in sound quality of speech, transient noise and environmental noise and provide implications for hearing aid fitting. METHOD: Twenty-four subjects with sensorineural hearing loss participated in the study. In a single-blinded paradigm, the subjects were asked to rate loudness of transient noise and distortion of speech, transient noise and environmental noise with the AntiShock in both on and off conditions. RESULT: (1) The percentage of the transient noise rated as soft, comfortable, loud, too loud was 3.0%, 72.7%, 22.9% and 1.4%, respectively. There were significant differences in mean scores of loudness perception among listening conditions and between genders by a Two-Way ANOVA, the P values were 0.009 and 0.001, respectively. (2) The percentage of the speech rated as mild distorted, understandable, clear and very clear was 2.5%, 30.6%, 32.9% and 34.0%, respectively. There were significant differences in mean scores of speech distortion under different listening conditions by an One-Way ANOVA (P < 0.01). (3) The percentage of the transient noise rated as mild distorted, clear and natural was 2.9% and 97.1%, respectively. No significant differences in mean scores of nature of transient noise was found under different listening conditions by an One-Way ANOVA (P > 0.05). (4) The percentage of the environmental noise rated as mild distorted, clear but soft, clear and natural was 0.4%, 0.8% and 98.8%, respectively. No significant differences in mean scores of nature of environmental noise was found between different listening conditions by an Independent-Samples T Test (P > 0.05). CONCLUSION AntiShock showed positive effects on the loudness control of the transient noise. Quality of speech, transient noise and environmental noise were not impacted by AntiShock.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Equipment Design ; Female ; Hearing Aids ; Hearing Loss, Sensorineural ; rehabilitation ; Humans ; Loudness Perception ; Male ; Middle Aged ; Noise ; Quality Control ; Single-Blind Method ; Young Adult

OBJECTIVE: To investigate the law of auditory remodeling by studying the Cortical Auditory Evoked Potential in a group of post-lingually deaf adults in the early stage of the cochlear implant use. METHOD: Ten post-lingually deaf adults implanted with PULSAR ci 100 of Medel device ranged from 19 to 52 years old with duration of deafness from 3 months to 23 years.were involved. Their P1-N1-P2 responses to /ba/ at around 60-70 dB SPi and open-set speech recognition scores of mono-syllabic words were recorded at 1. 3 and 6 months after the switch-on of cochlear implants. RESULT: Six out of 10 typical waveforms of Pl-N1-P2 were obtained. The other I were with atypical waveforms. The group with atypical waveform was characterized by long duration and early onset of deafness. There was no significant difference regarding either the amplitude or the latency of each peak at the 3 data collection time points. There was significant difference among the 3 data collection time points about the speech recognition scores with the highest score at the 6th month of switch on. There was no significant correlation between the peak of the CAEP and speech recognition score. CONCLUSION In the first 6 months of cochlear implant use in the post-lingually deaf adults, the duration and the onset age of deafness played important role in respect of the presence and waveform morphology of the CAEPs. It needs at least 6 months for the central auditory system to make use of the audio input from the cochlear implant.
Adult ; Cochlear Implantation ; Cochlear Implants ; Evoked Potentials, Auditory ; Female ; Hearing Loss, Sensorineural ; physiopathology ; rehabilitation ; Humans ; Middle Aged ; Treatment Outcome ; Young Adult

Objective·To evaluate the relationship between anxiety level,alexithymia degree and quality of life in patients with anxiety disorders.Methods·Anxiety disorder patients admitted to the outpatient department of Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine from October 1,2020 to March 31,2023 were selected as the research subjects,and 438 patients were ultimately included after exclusion.Among them,there were 271 patients with generalized anxiety disorder,101 patients with panic disorder,48 patients with social anxiety disorder,12 patients with agoraphobia,and 6 patients with specific phobia.Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale-17(HAMD-17),the twenty-item Toronto Alexithymia Scale(TAS-20)and World Health Organization Quality of Life Scale-Brief Form Questionnaire(WHOQOL-BREF)were used to assess the patients'anxiety level,depression level,alexithymia degree and quality of life,respectively,and the scale scores of patients with different subtypes of anxiety disorders were evaluated.Spearman correlation coefficient was used to analyze the correlation between anxiety level,depression level,alexithymia degree and quality of life in patients with anxiety disorders.Stepwise regression model was used to analyze the key variables affecting the quality of life in patients with anxiety disorders.Results·There were no significant differences in HAMA score,HAMD-17 score and TAS-20 score among patients with different subtypes of anxiety disorders,but the differences in WHOQOL-BRIEF score were statistically significant(H=10.076,P=0.039).The results of Spearman correlation analysis showed that the WHOQOL-BRIEF score of anxiety disorder patients was negatively correlated with HAMA score,HAMD-17 score and TAS-20 score(r=-0.256,P=0.000;r=-0.311,P=0.000;r=-0.342,P=0.000).The results of stepwise regression analysis showed that age,HAMA score,HAMD-17 score and TAS-20 score had significant impact on the quality of life of patients(all P<0.05).Conclusion·The quality of life in patients with different subtypes of anxiety disorders is different.The anxiety level,depression level and alexithymia degree are the key variables affecting their quality of life.

Objective To investigate the effect of different operation positions on cardiac index (CI) and stroke volume variation (SVV) in the patients monitored by FloTrac/Vigileo system to provide some references for the hemodynamic management and liquid treatment of the patients.Methods Sixty patients scheduled for elective TV auxiliary thoracoscope radical operation of esophageal cancer.The CI and SVV changes were observed by using the FloTrac/Vigileo system.CI,SVV and CVP were recorded at 5 min after anesthesia induction (T0),5 min after converting to the position of head low feet high (T1),5 min after converting to the position of head high feet low (T2).Results Compared with T0,CI at T1 and T2 was decreased(P＜0.05);compared with T0,SVV at T1 was decreased and CVP was increased;SVV at T2 was increased and CVP was decreased(P＜0.05).Conclusion The operation position change may have a significant impact on the patient's CI,SVV and CVP.Focusing on the corresponding change can provide some references for the intraoperative hemodynamic management and liquid treatment.

Literature related to children's adenoid hypertrophy was retrieved to form an expert questionnaire.According to the group standard writing rules of the China Association of Chinese Medicine,the peer consultation,quality evaluation and suitability eval-uation were completed through three rounds of Delphi expert questionnaire surveys and expert discussion meetings,and the Clinical Practice Guidelines for TCM in Children with Adenoidal Hypertrophy was finally formed.The guidelines have been formulated to clarify the scope of application of the guidelines,normative reference documents,terms and definitions,diagnosis,syndrome differentiation,treatment,prevention and care,and to provide an important reference for the clinical practice and diagnosis and treatment norms of tra-ditional Chinese medicine for children with adenoid hypertrophy.