Objective To analyze the role of telehealth?based dialysis registration systems in real?time and dynamic reflection of renal anemia in hemodialysis (HD) patients, and discuss the prospect of its application in dialysis registration management. Methods The Red China project was to build up a dialysis registration system based on the WeChat mobile terminal platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, creatinine were recorded in this system. Hemoglobin (Hb) level was monthly recorded. The platform generated Hb statistics report for each HD center monthly, including the detection rate, target rate and the distribution level of Hb, and released it to physicians through the WeChat terminal of mobile phone. After that, physicians could change the treatment of anemia individually on basis of this report. Here the demographic and baseline laboratory parameters, the detection rate, target rate, the average level and the distribution of Hb from June 2015 to October 2017 after the project launched were analyzed. Results From June 2015 to October 2017, 8392 maintenance HD patients from 28 HD centers in Shanghai were enrolled, of whom 5059(60.3％) were male.The average rate age was (60.5 ± 13.7) years old. Baseline average Hb was (108.3±16.0) g/L. Baseline detection rate and target rate were 54.2％and 47.5％, respectively. After 28 months follow?up, the detection rate of Hb increased from 54.2％ to 73.6％ (P<0.001), the target rate of Hb increased from 47.5％ to 56.1％ (P<0.001), and the level of average Hb rose from (108.3±16.0) g/L to (110.7±16.0) g/L. The difference between average Hb in two consecutive months was less than 1.3 g/L. Conclusions The telehealth?based dialysis registration system can timely report the anemia situation of HD patients, which may improve the awareness rate of anemia, the degree of attention and the compliance of anemia monitoring, so as to improve the detection rate and target rate of Hb and reduce the fluctuation of Hb, which helps to maintain the HD patients to correct anemia in a timely, stable and long?term way. The telehealth?based dialysis registration system, as an improved mode of dialysis registration is a promising way for long?term management of renal anemia in dialysis patients.

Objective: To understand the pollution characteristics and assess the pollution health risks of heavy metals in atmospheric PM_2.5 in Lanzhou. Methods: According to the regional characteristics of air pollution and industrial distribution characteristics in Lanzhou, atmospheric PM_2.5 was sampled monthly in Chengguan and Xigu Districts from January, 2015 to December, 2016. Detected the concentration of PM_2.5 and 12 kinds of elements (Sb, Al, As, Be, Cd, Cr, Hg, Pb, Mn, Ni, Se and Tl) by weighing method and inductively coupled plasma mass spectrometry. Enrichment factor and geo-accumulation index were used to describe the pollution characteristics, while health risk assessment was conducted using the recommended United States Environmental Protection Agency (USA EPA) model. The health risks of non-carcinogens were evaluated by non-cancer hazard quotient (HQ), the non-carcinogenic risk was considered to be negligible when HQ<1, HQ>1 meant a health risk. With a single contaminant cancer Risk value to evaluate the health risks of carcinogens, when the Risk value between 10^-6 to10^-4 as an acceptable level. Results: The daily average concentrations of PM_2.5 was 83.0 μg/m³, 77.0 μg/m³ in Chengguan and Xigu Districts, respectively, during the sampling periods, and the concentration of PM_2.5 in winter/spring was higher than summer/fall in both districts. The concentration of Al in PM_2.5 was the highest and other elements in descending order: Pb, Mn, As, Sb/Cd, Tl in both districts. Enrichment factor results showed that Al and Mn were mainly affected by natural factors, the rest of five elements were all typical man-made pollution elements and according to geo-accumulation index pollution level of Cd was the strongest in the winter. The results of health risk assessment showed that Mn had the highest non-cancer risks (HQ>1) and affected the health of the children seriously. HQ reached up to 2.44 and 1.79 in Chengguan and Xigu Districts, respectively. Pb, As, Sb, Cd had slight health impact (HQ<1), could be negligible. The cancer risks range of As, Cr were 6.33×10^-6 to 6.46×10^-5 between the acceptable level of risk (10^-6 to 10^-4), which indicated that As and Cd had potential cancer-risks. Conclusions The pollution level of atmospheric PM_2.5 and the heavy metals in it was still grim;the non-cancer risks caused by multiple metals on children deserved attention. Although the cancer risks of As and Cd were between the acceptable level of risk, the potential cancer risk still shall not be ignored.

Objective: To observe the features of air-conducted sound elicited ocular vestibular-evoked myogenic potential(ACS-oVEMP) and cervical vestibular-evoked myogenic potential(ACS-cVEMP) in patients with Meniere disease (MD). To analyze the relationship between air-conducted sound elicited vestibular-evoked myogenic potentials (ACS-VEMP) responses and clinical stages of disease, as well as its clinical application of cervical and ocular vestibular evoked myogenic potentials in MD. Method: Fifty six patients with MD and 50 normal subjects (100 ears) were recruited for conventional cVEMP and oVEMP examinations. Grades of vestibular function were also collected for patients with MD. The relationship between VEMPs abnormity, grades of vestibular function and clinical stages of MD were analyzed. Results: The abnormal rates of cVEMP and oVEMP in MD patients were 57.1% (32/56) and 64.3% (36/56), which were significantly higher than those in normal subjects respectively (χ²=22.286, P=0.000; χ²=15.217, P=0.000). The abnormal rates of cVEMP and oVEMP in MD patients of stage Ⅰ to stage Ⅳ were 20.0% (1/5) and 40.0% (2/5), 50.0% (9/18) and 50.0% (9/18), 59.3% (16/27) and 70.4% (19/27), and 100.0% (6/6) and 100.0% (6/6) respectively. There was a significant difference in cVEMP abnormity between four stages of MD patients (P=0.046). Significant correlation was found between clinical stages and the grades of vestibular dysfunction (r_s=0.417, P=0.001). Conclusions Dysfunction of vestibular otolithic organs and their input pathways in patients with MD can be detected by cVEMP and oVEMP tests. The abnormal rates of VEMP could show an gradually increasing trend with the development of MD stages. And the extent of vestibular lesions could be detected by cVEMP and oVEMP tests, which may provide a reference for clinical staging of MD.

Objective To evaluate the cosmetic outcomes of nasal aesthetic sub-unit principle. Methods From May 2007 to March 2015,19 patients with traumatic soft tissue defects of nose had a Single-stage reconstruction with suitable reconstructive method. Full-thick-ness skin transplantation was performed in 1 case,forehead nasal flap in 1 case,bilobed flaps in 2 cases,nasolabial flaps in 9 cases,a folded nasolabial flap in 2 cases,free auricular composite flap in 1 case,the temporal flap pedicled with the orbicular oculi muscle in 3 cases. All pa-tients were followed up for 5~27 months,evaluation items were recorded and analyzed. Results Skin transplantation and local flap were all survived. But 1 case with nasolabial flap infected was healing by second intention,the rest were primary healing,free auricular composite flap was gloomy,and it became normal 5 months after operation. The radian and the curve of the folded nasolabial flap to repair the nasal alar area were slightly poor. Condusion Good aesthetic effets come from nasal aesthetic sub-unit principle in Single-stage soft tissue reconstruction of a traumatic nasal defects.

Hearing loss caused by cochlear damage is the main symptom of sudden deafness (SD). Some patients also suffer from vestibular symptoms. In recent years, more attention has been paid to the vestibular dysfunction in patients with SD. The lesions could involve the whole inner ear in SD patients with and without vertigo. Comprehensive evaluation of vestibular function may help us understand the extent of lesions in sudden deafness and analyze the pathogenesis of disease. A less involvement of inner ear lesion may indicate a better hearing recovery.
Cochlea ; injuries ; Hearing Loss, Sudden ; diagnosis ; pathology ; Hearing Tests ; Humans ; Vertigo ; Vestibule, Labyrinth ; physiopathology

Objective To identify the aging effects on air-conducted sound (ACS) elicited ocular vestibular-evoked myogenic potential (oVEMP) and cervical vestibular-evoked myogenic potential (cVEMP) in normal Chinese population.Methods Nighty-seven normal subjects (194 ears) were recruited for conventional ACS-oVEMP and ACS-cVEMP examinations.The candidates'age were 4-83 years old (Ave.± SD,45.7 ± 19.3),41 male and 56 female,divided into 5 groups according to age.500 Hz short tone burst was employed for examinations.Thresholds were identified and the parameters of the responses to 100dB nHL were calculated and compared among groups.SPSS 13.0 software was used to analyze the date.Results As the age growing,the response rate for oVEMP decreased.It was recorded 100％ in both ≤ 10-year-old and 11-30-year-old groups,84.00％ in the 31-50-year-old group,48.15％ in the 51-70-year-old group and 15.00％ in the ＞70-year-old group; while that for cVEMP were 100％ in both-≤10-year-old group and 11-30-year-old group,82.00％ in the 31-50-year-old group,77.78％ in the 51-70-year-old group and 45.00％ in the ＞ 70-year-old group.The thresholds elevated and the amplitudes decreased in both examinations with the age growing.However,latencies and latency-intervals of both oVEMP and cVEMP examinations displayed minor difference among groups except that nI latency of oVEMP prolonged with age growing.Conclusions With the age growing,the otolithic end organ input pathways degenerate in normal subjects,as shown that ACS elicited oVEMP and cVEMP responsed less with higher threshold and smaller amplitude.The extremely low response rates of both VEMPs in the ＞70-year-old group in this study indicates that VEMPs can only provide limited diagnostic information among very old people in clinical practice.

Objective To explore the influence factors and the status of anxiety and depression in main caregivers with cerebral palsy children , improve caregivers psychological health status , and offer references for improving the rehabilitation level of cerebral palsy children .Methods A total of 145 caregivers of cerebral palsy children were selected by cluster sampling to carry on the investigation by using SAS , SDS, WHOQOL-BREF. Results The incidence of anxiety and depression was 42.76%and 53.79%, respectively.The score of anxiety was 47.73 ±10.96, which was higher significantly than domestic routine norm (29.78 ±0.46) with a statistical difference (t =19.730; P <0.01).Anxiety and depression score increased as the life quality score of increased.The single factor analysis results indicated that there was a statistical significance in rate of anxiety among different jobs, education levels,ages,monthly income,and with complications or not (χ2 =11.695, 10.787, 3.919, 5.133, 9.942, respectively; P<0.05), so did the depression among different genders ,and age groups (χ2 =10.393 and 8.919; P<0.05).Multivariate Logistic stepwise regression analysis found the results as following:female caregivers , with complications , and half-paidcombining with New Rural Cooperative Medical System (NRCMS) were easier to have the depressed mood .Workers, peasants, and course of disease above 10 years appeared anxiety easily .Conclusions The caregivers of cerebral palsy children psychological status are relatively poor in hospital , which exists seriously anxious and depression .Medical workers should pay attention to the psychological changes of main caregivers , offering health education and psychological care during the treatment.For there have been mental illness caregivers , it is recommended for them to receive timely psychological treatment , thereby improving the rehabilitation level of cerebral palsy children in an all -round way.

Objective To observe levosimendan-induced hemodynamic improvement of chronic decompensated heart failure patients and adverse effects,and sum up the nursing experience of Levosimendan.Methods Sixty-three patients with decompensated heart failure were treated with Levosimendan,based on optimized conventional treatment for heart failure.Aminoterminal pro-brain natriuretic peptide (NT-proBNP) and left ventricle ejective fraction (LVEF) were measured at baseline and one week after Levosimendan administration.In addition,we summarized the clinical observation,adverse effects and nursing experiences of treatment with Levosimendan in decompensated heart failure patients.Results Levosimendan increased 24-hour urine output in patients at the first day after treatment.This effect of levosimendan persisted for 7 days at least.We observed an improvement in LVEF and a reduction of NT-pro-BNP at 7 days after the initiation of levosimendan treatment.Clinical efficiency of levosimendan in patients was 84.1％ in this study.Twenty two patients(34.9％) experienced different adverse events.Conclusions Levosimendan therapy can improve cardiac function and reduce BNP in patients with decompensated heart failure.The rate of adverse effects of Levosimendan is high.It is important to enhance therapy effect by careful nursing and observing variety state during treatment with Levosimendan.These data will be useful for the nursing care of Levosimendan in clinical practice.

AIM: To observe the changes of morphology, the activity of myeloperoxidase (MPO) and membrane pump activities of spleen tissue in acute renal failure (ARF) rabbits, and to inquire into the role of spleen on pathogenesis of immune function disorders during ARF. METHODS: 42 rabbits were divided into control group, HgCl_2 group and glycerinum group. The ARF model was established by hypodermic injection of 1% HgCl_2 at dose of 1.3 mL/kg in HgCl_2 group, intramuscularly injection of 50% glycerinum at dose of 10 mL/kg in glycerinum group, respectively, and the animals were divided into the 12 h, 24 h, 48 h secondary groups (6 rabbits each group). At different time points, the rabbits were cannulated to facilitate the collection of blood sample to examine the biochemical indexes of renal function. The spleen microscopic sections were prepared for observing the morphology. The spleen homogenate was made for determining the activities of MPO and membrane pumping. RESULTS: Pathological sections of spleen showed that the different degree of congestion was found and spleen trabecula was increased in two model groups at multiple-time points. The MPO activity of spleen homogenate in HgCl_2 group and glycerinum group at all time points were obviously higher than that in control group, and at 24 h, the MPO activitie in two model groups was significantly increased than that in the same group at 12 h and 48 h. The activities of Na~+-K~+-ATPase, Ca~(2+)-ATPase, Mg~(2+)-ATPase, Ca~(2+)-Mg~(2+)-ATPase of spleen homogenate in two model groups at multiple time points were significantly lower than those in control group. Following ARF development, the ATPase activitie in two model groups at 48 h was lower than that at 12 h except the Mg~(2+)-ATPase in glycerinum group. CONCLUSION: Spleen as an immune organ has histological damage, arrest of polymorphonuclear neutrophils and dysfunction of membrane pump during the development of ARF in rabbits, leading to immune disorders.

Objective To evaluate the characteristics of brachyfacial types in adolescents with class Ⅱ~1 division 1 malocclusions by comparing with normal patterns.Methods 32 parameters were evaluated in pretreatment lateral cephalograms of 60 brachyfacial type adolescents,including 30 boys and 30 girls,aged from 11 to 13 years,with class Ⅱ~1 division 1 malocclusions(distal moral relationship,ANB＞5°,Go-Gn-SN＞28°).Results There was a remarkable increase in SNA,ANB,upper incisor inclination (U1-NA),U1-L1/N-Me and Me-L1/N-Me,so was lip protrusion of soft tissue facial profile(NB-Pg'-Ls);the lower sulcus depth(Si-Pg'-Ls)and the lower lip thickness(Li-L1).Mandibular plane(Go-Gn-SN),OP-MP,OP-FH,U1-L1,anterior lower facial height(ANS-Me),anterior lower facial height/anterior facial height(ANS-Me/N-Me),anterior lower facial height/posterior lower facial height (ALFH/PLFH)and mandibular length(B'-J')were significantly decreased.Conslusions Brachyfacial type in adolescents with class Ⅱ'division 1 malocclusions is characterized by decreased anterior lower facial height,increased posterior lower facial height,clockwise rotation of the palatal plane,anticlockwise rotation of the occlusion plane and mandibular plane,deepen overbite,soft tissue protrusive profiles with upper lip protrusion,crimpled lower lip and retracted chin.