Objective To investigate the perception of communication difficulties of children with hearing impairment and their parents.Methods Using the abbreviated profile of hearing aid benefit (APHAB),perception of communication difficulty in daily situations of the children with hearing impairment and their parents was measured,then the scores were compaired.Results There was no significant difference in perception of communication difficulty between the children and their parents.On problems on ease of communication(EC) and aversiveness(AV), there was difference in the perception of communication difficulty between the children who did not wear hearing aids and their parents.Conclusion It's critical to teach the parents knowledge about hearing loss to reduce their communication difficuty.

Objective To compare the clinical value of nerve stimulator-versus ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery.Methods Forty patients,aged 18-60 yr,with body mass index of 18-30 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic surgery,were randomly assigned into 2 groups (n =20 each) using a random number table:nerve stimulator group (group S) and ultrasound group (group U).Epidural anesthesia was performed with 1.73 ％ carbonated lidocaine in both groups.0.2％ ropivacaine 5 ml/h was infused continuously after surgery to perform femoral nerve block for analgesia.VAS score at rest was assessed at 2,6,24 and 48 h after surgery.At 24 and 48 h after surgery,VAS scores during active and passive movement were assessed.The time for catheter placement near the femoral nerve and development of subcutaneous hematoma at the puncture site,local anesthetic intoxication and nausea and vomiting were recorded.The postoperative requirement for analgesics was also recorded.Results There was no significant difference in the VAS scores and puncture for femoral nerve block-and local anesthetics-related adverse events between the two groups.The time for catheter placement near the femoral nerve was 8.0 ± 1.4 and (6.7 ± 0.9) min in S and U groups,respectively,and the time was significantly longer in group S than in group U.No patients required rescue analgesic after surgery in both groups.Conclusion Nerve stimulator-guided continuous femoral nerve block provides higher clinical value than ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery and it is more suitable for clinical application.

Objective To summarize the experiences of ultrasonic liposuction in 204 cases, and to analyze the advantages and disadvantages of this technique. Methods The ultrasonic system (SILBERGEE E.U.A. TM ) and the liposuction equipment (HEROULES TM , American) were applied with the tumescent technique in 204 cases. Results Satisfactory rate was 90.69 %. After operation the highest sucked fat quantity was 6 800 ml, and the fewest quantity 250 ml, with an average of 1 907.6 ml for each case. Average volume of sucked fat in each position was 1 005.5 ml, which exceeded that by the traditional method. Advantages of this technique were larger fat quantity, obvious effect, less bleeding and pain, and safety. Disadvantages and complications were rough and uneven surface, accumulation of the liquid, bilateral asymmetry, slow wound healing, subcutaneous ecchymosis and hardening nodule, and even decreased blood pressure. The corresponding processing technique was recommended after liposuction. Conclusion This method is a simple and convenient, safe and reliable technique. It is suggested that multiple times and less portions of liposuction may be of benefit to patients.

Bone marrow mesenchymal stem cells (MSC) are the non-hematopoietic cellular component in the bone marrow that have multiple differentiation potency. MSC play a key role in the regulation of bone marrow hematopoietic niche and modulation of immune function through various mechanisms. They are currently recognized as a promising cell source in tissue engineering, a vehicle in gene therapy and a powerful tool in the management of graft-versus-host disease after allogeneic stem cell transplantation. In this review some momentous aspects regarding the current status and potential clinical applications of MSC in hematopoietic stem cell transplantation, aplastic anemia and multiple myeloma were summarized.

Objective:To investigate the changes of plasma ghrelin levels and insulin(INS) sensitivity of full-term infants small for gestational age (SGA) and the effects of breast feeding on it.Methods:Full-term SGA hospitalised in the Department of Neonatology, Wuhan Children′s Hospital from October 2014 to April 2019 were re-cruited as the SGA group (120 cases), with full-term infants appropriate for gestational age (AGA) born in the same period as the AGA group (96 cases) in this study with recorded birth weight and length.The levels of fasting blood glucose (FG), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), INS and ghrelin were measured 7 days after birth.Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.The SGA group was subdivided into breast feeding group and formula feeding group.The above indexes were tracked and mea-sured in the 3 rd and 6 th month, respectively, and their growth parameters were recorded. Results:There were no diffe-rences in serum FG, TG, LDL and HDL levels between the SGA and the AGA group (all P>0.05). Compared with the AGA group, the serum INS[(4.21±0.83) mIU/L vs.(3.54±1.10) mIU/L], ghrelin levels[(0.80±0.23) μg/L vs.(0.69±0.19) μg/L] and HOMA-IR (0.85±0.25 vs.0.72±0.25) increased in the SGA group, the differences were statistically significant (all P<0.05). Serum INS, HOMA-IR and ghrelin levels changed with the duration of breast feeding, the differences were statistically significant( F=12.394, 9.810, 5.531, all P<0.05). Conclusions:The serum ghrelin levels of SGA infants increased and INS sensitivity decreased.Breastfeeding can decrease levels of serum INS, HOMA-IR and ghrelin, and can improve INS sensitivity of SGA infants.

The assisted reproductive techniques in China have witnessed rapid development in the past two decades.However,it also brings up issues of ethics and laws,especially the urgent regulation and reinforcement of the procedure of informed consent.This article begins with an explanation of the procedure of informed consent.Then it discusses the decision of the content,major and difficult points of informed consent in assisted reproductive technology services based on the practice in this field.Finally,it discusses the challenges to informed consent.To well enforce an informed consent process,we should first ensure the contents are reasonable and just;second,clinicians should have a scientific understanding of the importance of informed consent and establish normative procedure of informed consent;third,we must work according to relative ethic demands.Last but not least,respecting patients is the key to the principle of ethics.

Objective To investigate the efficacy and adverse reactions of SOX and GP combined with two chemotherapy methods.Methods From January 2014 to September 2016 came to our hospital for treatment of three advanced breast cancer patients with negative 84 cases as the research object of observation,were randomly divided into SOX group and GP group were given chemotherapy measures and clinical observation on the treatment of.Results Two groups of patients with CR,PR,SD,PD,the number of cases and the total effective rate comparison,P values were 0.693,0.637,0649,0.801,0.823; two groups of patients with diarrhea,liver damage,thrombocytopenia,nausea and vomiting,neurotoxicity,anemia,leukopenia,rash,renal toxicity,appetite the incidence rate of decline,P values were 0.374,0.629,0.643,0.374,0.645,0.434,0.450,0.693,0.645,0.815.Conclusion Standard chemotherapy regimens for advanced three negative breast cancer was not uniform,but the SOX and GP regimens are safe and effective,can be used for clinical treatment.

Humans ; Rhinitis, Vasomotor ; physiopathology

OBJECTIVETo analyze the changes of patients with type 2 diabetes in different stages in glucagon (GC) and free fatty acid (FFA) in fasting, OGT and L-Arg experiments, and discusses the role of pancreatic alphabeta cells in diabetes pathogenesis by studying the relations among indexes such as glucagon (GC), free fatty acid (FFA) and blood glucose (BG), insulin, insulin homeostasis model (HOMA) and glucose metabolism hormone secretion curve, in order to provide theoretical basis for the treatment of diabetes.

METHODStudy objects were divided into the T2DM group (45 cases), the IGT group (28 cases) and the NGT group (30 cases) for an OGTT experiment and then an L-Arg experiment on the next day. Under the fasting state, their blood glucose (FBG), insulin (F), glucagon (FGC), free fatty acid (FFA) were detected to calculate HOMA-beta, insulin sensitivity index (ISI) and HOMA-IR of different groups. Meanwhile, efforts were made to calculate different time quantum detected in OGTT and L-Arg experiments and area under the curve AUC(BG), AUC(INS) and AUC(GC).

RESULTObvious overall differences were observed in FFA and FGC of the three groups. FGC of each group was negatively correlated with HOMA-beta and ISI. Among all of the 103 study objects, FGC was positively correlated with FBG and HOMA-IR and negatively correlated with HOMA-beta and ISI, with no correlation with FINS; FFA was positively correlated with FBG, HOMA-IR and negatively correlated with FINS, HOMA-beta, ISI. FGC and FFA were positively correlated in the T2DM group and the IGT group, but with no statistical correlation in the NGT group. The sequence of the three study objects was T2DM > IGR > NGT in AUC(GC) in the OGTT experiment and T2DM > IGR > NGT in in AUC(GC) in the L-Arg experiment, with the significant positive correlation between AUC(GC) and AUC(BG) and significant negative correlation with AUC(INS).

CONCLUSIONGlucagon and free fatty acid of T2DM and IGT patients increased, which was positively correlated with blood glucose and HOMA-IR and negatively correlated with INS, HOMA-beta and ISI. The increase in glucagons of T2DM and IGT patients indicated inappropriate secretion of pancreatic alphabeta cells among patients with type 2 diabetes.

Adult ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; Fatty Acids, Nonesterified ; metabolism ; Female ; Glucagon ; blood ; Humans ; Insulin ; secretion ; Islets of Langerhans ; secretion ; Male ; Middle Aged

This study was aimed to establish the classification method of Chinese herbal medicine based on feature parameters extracted from images of herbal transverse section, in order to explore the feasibility of automatic identi-fication method of herbal medicine. The extracted 26 parameters of 18 herbal medicine images by gray-level co-oc-currence matrix and grayscale gradient matrix were used as the basic data set. And the minimum covariance determi-nant (MCD) was used to delete the outliers. A total of 18 identification models were established using the native Bayes method and BP neural network methods. The results showed that the average correct rates of models were 90%. It was concluded the feasibility of using these models in the establishment of the automatic identification method of herbal medicines. It provided new technologies for the quantitative, scientific and objective identification of Chinese herbal medicine.