Objective To investigate the characteristic changes of the auditory brainstem response (ABR) of normal hearing newborn and infants .Methods One hundred and forty -five cases (290 ears) normal hearing new-born and infants were enrolled for ABR test .Before that they passed the distortion product otoacoustic emissions and acoustic immitance test previously .According to age ,13 (26 ears) of 145 were included in the 1~7 days age group ,17 (34 ears) was in the 30~59 days age group ,20 (40 ears) in the 2~4 months age group ,19 (38 ears) in the 5~7 months age group ,17 (34 ears) in the 8~10 months age group ,18 (36 ears) in the 11~13 months age group ,12 (24 ears) in the 14~16 months age group ,13 (26 ears) in the 17~19 months age group ,16 (32 ears) in the more than 20~24 months age group .The control group was 20 (40 ears) normal hearing young persons (18~25 years old) .The variation of the peak latency and interpeak latency of waves were observed ,and compared with the normal young people .Results In 70 dB nHL click sound stimulus ,the peak latency and interpeak latency ofⅠ ,Ⅲ ,Ⅴ waves of normal hearing neonates and infants progressively shortened as they grew older .As they ap-proach 18 months or more old age ,their peak latency and interpeak latency of Ⅰ ,Ⅲ ,Ⅴ waves may be same as nor-mal young people .Conclusion With the growth of the age ,the peak latency and interpeak latency of Ⅰ ,Ⅲ ,Ⅴwaves of normal hearing newborn and infants gradually shortened .The reason may be related to the maturity of the auditory system .

Objective:To observe the clinical effects of dexmedetomidine(DDM)under monitored anesthesia care(MAC)in oral and maxillofacial patients undergoing percutaneous dilatational tracheostomy(PDT).Methods:38 patients with oral and maxillofa-cial tumor undergoing PDT before surgery were randomly assigned into 2 groups(n =19).Patients in group D received a single-dose DDMof 0.5 μg/kg infused for 10 min;those in group Mreceived 2 mg of midazolam and 1 μg/kg of fentanil.Then all patients were given local anesthesia followed by PDT.MAP,HR and SpO2 were monitored before (T0 )and after drug administration (T1 ),at T2 (skin incision)and T3 (insert dilation catheter).Ramsay scorce,bucking,respiration depression and adverse cardiovascular reaction were recorded.All patients were followed up 24 h postoperatively for the observation of adverse recall of PDT.Results:Compared with T0 ,at T1 ,T2 MAP and HR in group D were lower,but MAP and HR at T3 in group Mwere higher(P <0.05).At T1 ,T2 and T3 ,MAP and HR in group D were significantly lower than those in group M(P <0.05).During operation,the incidence of bucking and respiration depression in group D was lower than that in group M(P <0.05).Conclusion:During PDT operation under MAC,a single-dose dexmedetomidine is effective in stablizing hemodynamics,reducing bucking and respiration depression.

Objective To investigate the relationship of the activation of nuclear factor kappa B(NF-kB) with myocardial neutrophil infiltration and injury in human open heart surgery,and to observe the inhibiting effect on the activation of NF-kB and protecting effect on myocardium of the coenzyme Q10,a scavenger of oxygen free radicals.Methods Forty-seven adult patients undergoing open heart surgery were randomly divided into two groups,the control and the treatment.CoenzymeQ10 tablets were given to the treatment group 5 days before operation.Biopsy of right atrium for myocardial pathology,activated NF-kB detection and ultrastructure observation were done prior to cardiopulmonary bypass,45 minutes of ischemia and 45 minutes of reperfusion.The dynamic indexes,vasomotor drug dosage,and outcomes were observed postoperatively.Results Upon 45 minutes of ischemia and 45 minutes of reperfusion,in control group there were neutrophil accumulation and adhesion of vascular endothelium,ultrastructural damages,and positive expression of NF-kB both in nuclei and cytoplasm,in myocardium.In treatment group,there were only mild neutrophil infiltration and ultrastructural damages,and weak positive expression of NF-kB both in nuclei and cytoplasm.However,the dynamic indexes,vasomotor drug dosage,and outcomes of two groups were not significantly different.Conclusion NF-kB plays an important role in pathophysiological process of myocardial ischemia and reperfusion in open heart surgery.CoenzymeQ10 has obvious inhibiting effect on activation of NF-kB and protecting effect on myocardium.

Purpose:The value of color doppler ultrasonography( CDUS) in monitoring hemodynamic changes was investigated in patients with hyperdynamic circulatory state before and during 730 days after orthotopic liver transplantation.Materials and Methods:83 cases of orthotopic liver transplantation (OLT) were examined by CDUS to assess the hemodynamic changes of portal vein,hepatic artery,splenic artery and longitudinal diameter of the spleen ( LDS).Results:(1) Portal flow velocity ( PFV) was significantly lower in pre-OLT but higher than controls (P < 0.05 ) during 730 days after OLT.Resistance index of the hepatic artery ( HARI) in pre-OLT and within 7 days- after OLT was significantly higher (P<0.05).(2) Resistance index of splenic artery ( SARI) was also significantly higher in pre-OLT (P < 0.05 ).LDS was significantly higher after OLT than in both pre-OLT phase and controls(P<0.05).Conclusions: In early stage after OLT,HARI changed from high to low value and so did PFV,which kept the stability of hepatic blood flow.In late stage,high PFV and large spleen improved,but could not back to normal.

Objective To investigate the clinical efficacy of different treatment in 35 chronic lymphocytic leukemia (CLL) patients. Methods Patients were treated with different regimen according to Binet stage. Patients at stage A were subcutaneously injected with interferon (3-6) MU/day, consecutive for 5 days every week. The dosage could be reduced to 2-3 times a week in long term maintenance phase after the 6 months loading treatment if there was no disease progression. Those at stage B or C were initially treated with chemotherapy regimen of FC/FC -R or CHOP/COP, and interferon were administered during chemotherapy interval, after complete remission (CR) or partially remission (PR) as maintenance therapy.Results Twenty patients were at stage A and treated with interferon, with 5 patients(25%) achieving partial remission (PR), 14 patients at stable status while no patients acquiring CR. Three of the 5 patients who achieved PR collapsed after 36.3 months at average. Eight of the 14 patients at stable status deteriorated to stage B and received chemotherapy after mean 74 months interferon maintenance treatment. In total, 27 patients in the current observation were finally included at stage B or C. Patients at stage B or C in FC/FC-R chemotherapy regimen achieved CR at 38.9% and total effective rate 77.8%, which were superior to that of CHOP/COP prescription (CR 11.1 %). The mean survival time for patients at stage A, B and C were 155.2,97.5 and 82.9 months, respectively and were statistically significant via Kaplan-Meier analysis method (P =0.032). Ten patients died in this observation, 2 at stage A, 4 at stage B and C, respectively, among whom 9died of infection and 1 for gastric cancer bleeding. The side effects of interferon were generally mild during the long term treatment. Conclusion Patients with CLL need to be individually treated with different regimen by considering disease stage and other prognosis criteria. Interferon could be applied at early phase of CLL and may reduce occurrence of infection after long term treatment.

Objective To investigate the relationship between self-efficacy and positive degree in patients with cervical spondylosis.Method A questionnaire survey was conducted among 98 patients with cervical spondylosis.Results The self-efficacy score was 6.30±1.56,the score on the positive degree was 53.76 ±12.53.The self-efficacy and positive degrees were positively correlated (r=0.531,P＜0.001).Conclusions The patient's self-efficacy and positive degree are at medium level.Nursing staff should take corresponding measures to improve self-efficacy of cervical spondylosis patients,in order to improve its positive degree and achieve the purpose of effective self-management and health promotion.

Objective To observe effect of scalp acupuncture combined with cognitive rehabilitation training in ameliorating cognitive dysfunction in stroke patients. Methods Eighty-four stroke patients with cognitive dysfunction were randomly divided into a treatment group ( n = 42) and a control group (n = 42 ) . All of the patients in both groups received routine therapy including cognitive rehabilitation training by professional therapists aimed at improving their orientation, perception, attention and thinking. The patients in the treatment group also received prolonged scalp acupuncture, in which the acupuncture needle remained in the scalp for 6 hours. All cases were evaluated using Loewenstein's occupational therapy cognition assessment (LOTCA) before and 10 weeks after treatment. Results The LOTCA scores were significantly different before and after treatment in both groups. The effect in the treatment group was significantly better than in the control group. Conclusions Prolonged scalp acupuncture combined with cognitive rehabilitation training can significantly improve the cognitive ability of stroke patients.

Adenocarcinoma ; genetics ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; methods ; Bronchoscopy ; Carcinoma, Large Cell ; genetics ; pathology ; surgery ; Carcinoma, Non-Small-Cell Lung ; genetics ; pathology ; surgery ; Carcinoma, Squamous Cell ; genetics ; pathology ; surgery ; Female ; Gene Amplification ; Humans ; Lung Neoplasms ; genetics ; pathology ; surgery ; Male ; Middle Aged ; Polyploidy ; Receptor, Epidermal Growth Factor ; genetics ; Young Adult

OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

OBJECTIVETo investigate the effects of exercise (EX), low-fat diet (LFD) and their combination intervention on the tumor necrosis factor-alpha (TNF-alpha) expression of insulin resistance in rats.

METHODSOne hundred and thirty male rats randomly assigned to 2 groups: Control (CON)-10 rats consuming a low-fat diet; HFD-120 rats consuming a high-fat diet (HFD). The dietary regimen was sustained for 8 wk, at which point the 40 HFD group rats gaining the most weight were referred to as the obese rats. Glucose tolerance was assessed by an oral glucose tolerance test (OGTT). During the procedure of OGTT, the blood was drawn for insulin assay (insulin release test). The whole body insulin resistance was assessed by glucose-insulin index. The obese HFD group rats were randomized into one of four intervention groups: HFD-sedentary (HFD-SED), HFD-exercise(HFD-EX), low fat diet-SED (LFD-SED), LFD-EX. Ex rats performed 8-wk exercise training on a motorized treadmill. The CON group had access to low-fat diet for another 8 wk. After 8 wk of exercise and low-fat diet intervention, the OGTT and insulin release test were performed again. To use ELISA technique for detecting TNF-alpha in soleus muscle and adipose tissue.

RESULTSAfter being fed high-fat diet for 8 wk, glucose-insulin index in the HFD group were significantly greater than that in CON group (P < 0.01). After 8-week exercise and low-fat diet intervention, glucose-insulin index in HFD-SED group was significantly greater than that in CON group (P < 0.01). The index in three intervention groups was significantly less than that in HFD-SED group (P < 0.01) . TNF-alpha content in adipose tissue and the soleus muscle for HFD-SED group was significantly greater than that in CON group (P < 0.01). Three intervention groups were significantly less than HFD-SED group (P < 0.01).

CONCLUSIONExercise and low-fat diet interventions can decrease the TNF-alpha expression in insulin resistance rat.

Animals ; Diet, Fat-Restricted ; Insulin Resistance ; Male ; Obesity ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism