Humans ; Laryngeal Diseases ; surgery ; Laryngoscopes ; Polyps ; surgery ; Vocal Cords ; surgery

OBJECTIVE To discuss the importance of communication in infection control.METHODS To eliminate the obstacles in infection control,we used different communication skills and manners to gain the aid from the leadership.RESULTS Both the leadership and everyone else in the hospital supported our work in infection prevention and control,for they had known the importance of infection control,especially in hospital.We communicated with them about the knowledge in this aspect in different means.CONCLUSIONS The professional technician should take different ways in communication to solve the problems in every department in the daily work,which can help us to achieve success in infection control.

Objective To discuss the diagnosis value of transrectal ultrasound and transabdominal ultrasound in fat sufferers with bladder tumor.Methods In own control,transabdominal and transrectal ultrasound were used to examine 87 fat patients with suspected bladder tumor.The tumors were confirmed by cystoscope and pathological section.They were divided into 3 groups according to the size:＜10 mm,10-20 mm,and＞20 mm,the detection rates of the tumors and blood flow in tumors,the diagnose accordance rates of the tumor stage of the two methods were analyzed.Results Of the 92 lesions pathologically confirmed to be bladder tumors,the diagnose accordance rate of transabdominal ultrasound was 79.3%,missed diagnosis rate was 1 7.4%,misdiagnosis rate was 3.3%,while the diagnose accordance rate of transrectal ultrasound was 95.6%,misseddiagnosis rate was 4.4%,misdiagnosis rate was 0.There was statistical significance on the detection rate of thetumor and blood flow in tumor of the two methods(P＜0.05).Also there was statistical significance on the diagnosis accordance rate of the tumor staging on Ta,T1,T2(P＜0.05).Conclusions As to detecting bladder tumors in fat sufferers,transreetal ultrasound iS obviously superior to transabdominal ultrasound.

Objective: To explore the value of CYP2C19 genotype polymorphisms for guiding the strategy of anti-platelet therapy in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) with clinical prognosis.
Methods: A total of 326 CAD patients with PCI treatment received CYP2C19 genotype examination. According to CYP2C19 polymorphisms, the patients were divided into 3 groups. The patients with CYP2C19*1/*1, fast metabolism were defined as Routine group, who received clopidogrel 75 mg/day,n=128. The patients with CYP2C19*1/*2, CYP2C19*1/*3, CYP2C19*2/*3, CYP2C19*2/*2, CYP2C19*3/*3, medium and slow metabolism were further divided into 2 groups as High clopidogrel group, who received clopidogrel 150 mg/day,n=99 and Ticagrelor group, who received ticagrelor 90 mg/bid,n=99. The changes of platelet aggregation rate (PAgT) at before and 1, 3, 6 months after PCI were observed, the major adverse cardiac events (MACE) and bleeding condition were compared among different groups at 6 months after PCI.
Results: The PAgT was similar between High clopidogrel group and Routine group at 1, 3, 6 months after PCI, P>0.05;while compared with High clopidogrel group and Routine group, the PAgT decreased in Ticagrelor group at 1, 3, 6 months after PCI,P<0.05. The occurrence of MACE was similar between High clopidogrel group and Routine group at 6 months after PCI,P>0.05; while compared with High clopidogrel group and Routine group, Ticagrelor group had much less MACE occurrence,P<0.05. Ticagrelor group had no more major bleeding events than the other 2 groups,P>0.05.
Conclusion: High dose clopidogrel does not increase MACE occurrence in CAD patients with CYP2C19 medium and slow metabolism after PCI. Ticagrelor may decrease PAgT and MACE occurrence without elevating the major bleeding events.

Objective To summarize perioperative care and effect of surgical treatment of total anomalous pulmonary venous connection (TAPVC) in newborns and babies within 6 months.Methods From September 2001 to May 2013,ninetytwo consecutive patients with TAPVC received surgical correction under cardiopulmonary bypass (CPB) with moderate or deep hypothermia.The anatomic subtype included supracardiac type 48,intracardiac type 36,infracardiac type 6 and mixed type 2.There were 36 newboms.Pathological diagnosis was made by echocardiogram,computerized tomography and operative findings during operation.The option of procedure was determined by findings.Respirator assisted breathing after operation and cardiac function was maintained by a variety of positive inotropic drugs,to prevent the happening of the pulmonary hypertension crisis.Results Severely low cardiac output syndrome occurred in 8 patients and they died within 24 hours after operation.The remaining cases postoperative recover smoothly and receive postoperative follow-up about 1 month to 12 years,3 cases of postoperative pulmonary vein stenosis (PPVS) occurred.Conclusion Total anomalous pulmonary venous connection should be surgical treatment as soon as possible with satisfied effect.The key of perioperative care is maintenance of left heart function,negative balance of liquid,prevention and treatment of pulmonary hypertension.

Objective To study the expression changes of placental insulin-like growth factor Ⅰ and Ⅱ (IGF-Ⅰ and IGF-Ⅰ) between pregnancies following the in vitro fertilization and embryo transfer (IVF-ET) and those conceived spontaneously.Methods The placenta were collected from 49 cases of pregnancies after IVF-ET(case group) and 49 cases of pregnancies who were normal (control group).The expressions of IGF-Ⅰ and IGF-Ⅱ mRNA in placenta were detected by reverse transcription-polymeras chain reaction (RT-PCR).The levels of IGF-Ⅰ and IGF-Ⅱ protein were determined by immunohistochemistry.Results The mRNA levels of the placental IGF-Ⅰ and IGF Ⅱ were 0.30 ±0.13 and 0.28 ±0.04 in the IVF-ET group,and 0.65 ±0.10 and 0.91 ±0.26 in the control group.The protein levels of the placental IGF-Ⅰ and IGF-Ⅱ were 0.26 ±0.04 and 0.29 ± 0.05 in the IVF-ET group,and 0.32 ± 0.07 and 0.34 ± 0.04 in the control group.The mRNA and protein expressions of IGF-Ⅰ and IGF-Ⅱ in human placenta were significantly decreased in IVF-ET group compared to control group (P ＜ 0.05).The incidence rate of low birth weight infant in IVF-ET group was significantly higher than control(P ＞ 0.05).Conclusions Expressions of placental IGF-Ⅰ and IGF-Ⅱ in the IVF-ET group did not affect fetal growth and development.

This paper discussed the interference and noise of medical electronic device and their generation, hazard, depression and application, of which some ones are pointed out for the first time.

Objective To study the effects of exogenous hormones,gibberellin(GA3)and indole-3-acetic acid(IAA),on growth and tanshinones accumulation in the radix of Salvia miltiorrhiza.MethodsThe herb characters and contents of tanshinones(cryptotanshinone,tanshinone Ⅰ,and tanshinone ⅡA)in the radix of S.miltiorrhiza with different hormone treatments were investigated and compared in the combination of trail pot and indoor analysis.Results It promoted aboveground biomass in the radix of S.miltiorrhiza increasing with single GA3.But it inhibited underground biomass increasing.The exogenous addition of low-level and high-level GA3 was benefit for tanshinones accumulation,whereas the middle-level GA3 wasn't.The aboveground and underground biomass in the radix of S.miltiorrhiza increased indistinctively with the increasing of IAA concentration and then decreased.And the IAA solutions also increased plant height and root length indistinctively.in a whole,it was benefit for tanshinones accumulation when applying low-level IAA(0.5 mg/L)singly.With the increasing of IAA concentration,the content of cryptotanshinone increased,but the contents of tanshinone Ⅰ and tanshinone ⅡA decreased.It promoted S.miltiorrhiza radix growth and three tanshinones contents increasing obviously with the combined application of two low-level hormones.Conclusion The applying of GA3 and IAA is benefit for the growth and three tanshinones accumulation in the radix of S.miltiorrhiza.

Objective To investigate the risk factors to acute lung injury based on multiple trauma to provide a theoretical basis for early intervention .Methods The emergency surgical patients with multiple trauma in our hospital from March 2006 to March 2011 were selected .The patients meeting the diagnostic criteria for acute lung injury were taken as the study group and the others as the control group .All patients were enrolled for evaluating the injury severity score (ISS) ,acute physiology and chronic health Ⅱ(APACHE Ⅱ) score and recording smoking ,alcohol abuse ,diabetes mellitus ,number of organ damage ,gastrointestinal bleeding , pulmonary contusion ,diffuse intravascular coagulation (DIC ) ,vomiting ,traumatic shock ,time to correct shock ,blood transfusion . The polymorphism of rs3788853 ,rs13306087 ,rs12709426 of angiotensin-converting enzyme(ACE) gene were analyzed .Results In the study group and the control group ,there were statistical differences in 6 influencing factors of the ISS ,APACHE Ⅱ score ,blood transfusion ,DIC ,traumatic shock ,time to correct shock>6 h(P<0 .05);the gene and genotype frequencies of ACE between the two groups had no statistical difference (P>0 .05);the 6 kinds of influencing factors were risk to acute lung injury based on multi-ple trauma by Logistic regression analysis .Conclusion The ISS ,APACHE Ⅱ score ,blood transfusion ,DIC ,traumatic shock ,long time to correct shock are the risk factors to acute lung injury based on multiple trauma .

Objective To investigate the application of real-time gray-scale contrast enhanced ultrasound (CEUS)imaging in the diagnosis of fallopian tube obstruction.Methods Forty-six females with infertility in the period of 3-7 days after menses were inspected by transvaginal CEUS,and the transmission of contrast agents in the fallopian tubes was observed.Then they were inspected by routine iodic X-ray salpingography.Later the value of real-time gray-scale CEUS in diagnosis of fallopian tube was evaluated.Results The sensitivity of CEUS indiagnosis of fallopian tubal unobstruction,obstruction and open without freely was 92.0%,87.1%,36.4%respectively;the specificity was 85.7%,96.7%,93.7%;the accurate was 89.1%,93.5%,84.7%;the Kappa was 0.78,0.85,0.16 with X-ray salpingography.The concordance was 83.7% between CEUS and X-ray salpingography.Conclusions There were no significant difference between CEUS and X-ray salpingography in diagnosis of fallopian tube unobstruction or obstruction,and the former method is safer and more convenient that is suitable to become an valuable method in inspecting of infertility.