Objective To study the correlation between the characteristics of tympanic membrane perforation and hearing loss in chronic suppurative otitis media.Methods Ear fibreoptic endoscopic images and complete audio-logical data of 80 patients(104 ears)diagnosed with chronic suppurative otitis media and treated with tympanoplasty type Ⅰ surgery at the Department of Otorhinolaryngology-Head and Neck Surgery of the Second Hospital of Lanzhou University from July 2022 to July 2023 were reviewed.The area of tympanic membrane perforation was measured u-sing ImageJ software.Qualitative variables were professionally assessed by a senior practitioner in otology,inclu-ding whether the perforation involved the quadrant,whether the edge of the perforation was calcified,and whether the extent of the perforation involved the malleus.Results There was a significant positive correlation between the area of tympanic membrane perforation and the mean air-bone conductance difference in patients with tympanic mem-brane perforation due to chronic suppurative otitis media(R2=0.141,P＜0.001).The patients with perforation in-volving the malleus handle had a greater air-bone conductance difference than those without malleus handle involve-ment(P＜0.05).The effect of calcification at the edge of the tympanic membrane perforation and the location of the perforation on hearing loss was minimal and almost negligible.Conclusion Conductive hearing loss due to tympanic membrane perforation is related to the size of the perforation and whether or not the perforation involves the malleus handle,and the patients with larger perforation as well as those with perforations involving the handle of malleus tend to exhibit worse conductive hearing loss.

Heat shock proteins (HSPs) widely exist in all organisms, the structures of which are usually extraordinarily conservative. They are also well-known stress proteins that are involved in response to physical, chemical and biological stresses. HSP70 is an important member of the HSPs family. In order to study the roles of amphibians HSP70 during infection, the cDNA sequence of Rana amurensis hsp70 family genes were cloned by homologous cloning method. The sequence characteristics, three-dimensional structure and genetic relationship of Ra-hsp70s were analyzed by bioinformatics methods. The expression profiles under bacterial infection were also analyzed by real-time quantitative PCR (qRT-PCR). Expression and localization of HSP70 protein were tested by immunohistochemical techniques. The results showed that three conservative tag sequences of HSP70 family, HSPA5, HSPA8 and HSPA13, were found in HSP70. Phylogenetic tree analysis indicated four members are distributed in four different branches, and members with the same subcellular localization motif are distributed in the same branch. The relative expression levels of the mRNA of four members were all significantly upregulated (P < 0.01) upon infection, but the time for up-regulating the expression levels were diverse in different tissues. The immunohistochemical analysis showed that HSP70 was expressed to different degrees in the cytoplasm of liver, kidney, skin and stomach tissue. The four members of Ra-hsp70 family have ability to respond bacterial infection to varying degrees. Therefore, it was proposed that they are involved in biological processes against pathogen and play different biological functions. The study provides a theoretical basis for functional studies of HSP70 gene in amphibians.
Heat-Shock Proteins/genetics* ; Phylogeny ; Amino Acid Sequence ; HSP70 Heat-Shock Proteins/metabolism* ; Stress, Physiological

Extranodal NK/T cell lymphoma, nasal type（ENKTL） is a highly aggressive malignant tumor derived from NK cells. This article reports a case of ENKTL invading the larynx and digestive tract. The clinical clinical manifestations include hoarseness and intranasal masses.
Humans ; Lymphoma, Extranodal NK-T-Cell/pathology* ; Nose/pathology* ; Nose Neoplasms/pathology* ; Larynx/pathology* ; Gastrointestinal Tract/pathology*

Objective:To formulate the Nursing standards of clinical practice of critical care ultrasonography (referred to as the Standards), so as to provide recommendations for the application of ultrasound in intensive care nursing practice. Methods:Based on the experience of intensive care ultrasound nursing practice and literature research, combined with the consensus recommendations of intensive care ultrasound, the critical care ultrasound study group formed the first draft of the Standards. After expert interview, consensus discussion, two rounds of Delphi expert letter consultation and other methods, the content of the Standards was revised and improved, and the final draft of the Standards was formed. Results:The Standards included four parts, such as basic application of intensive care ultrasound, nursing evaluation standard of intensive care ultrasound guidance, nursing operation process guided by ultrasound and intensive care ultrasound training. Conclusions:The establishment of Standards is scientific and practical, which can provide guidance for nursing practice of clinical operation technology of critical care ultrasonography.

Objective:To explore the effectiveness of Caprini risk assessment model in screening deep vein thrombosis (DVT) formation in patients with preoperative hip fractures.Methods:This study was a retrospective cohort study. From January 2017 to December 2018, a total of 242 patients with hip fractures in the orthopedic trauma ward of Peking Union Medical College Hospital were selected as the research subjects by the convenient sampling method. 46 patients diagnosed with DVT by Doppler ultrasonography of lower extremities before surgery were set as the DVT group, while 196 non-DVT patients were set as the non-DVT group. The risk factors of preoperative DVT in patients with hip fractures screened by Caprini risk assessment model were analyzed by binomial logistic regression, and the optimal risk stratification for preoperative DVT in patients with hip fracture was determined based on Caprini score. ROC curve was used to evaluate the clinical predictive efficacy of Caprini risk assessment model.Results:Caprini score of patients in the DVT group was 11.0 (9.8, 12.0) , which was higher than 9.0 (9.0, 11.0) of patients in the non-DVT group, and the difference was statistically significant ( Z=-4.009, P<0.01) . Binomial logistic regression analysis showed that, past or current history of malignant tumors and venous thromboembolism were the main risk factors for preoperative DVT in patients with hip fractures ( OR=3.162, 31.107; P<0.05) . The preoperative risk of DVT in patients with hip fractures assessed by Caprini risk stratification as extremely high-risk (≥12 points) was 6.017 times that of patients with intermediate-risk (7-9 points) , and the difference was statistically significant ( P< 0.01) . The preoperative risk of DVT in patients with hip fractures rated as high-risk risk grade (10-11 points) was 2.836 times that of patients with intermediate-risk risk grade (7-9 points) , and the difference was statistically significant ( P=0.010) . The optimal critical value of Caprini score was 9.5, and the area under the ROC curve was 0.684 (95% CI: 0.597-0.772, P<0.01) . Conclusions:Caprini risk stratification can effectively predict the high-risk population of preoperative DVT in patients with hip fractures. Clinical nurses should focus on the thrombosis prevention and nursing of patients with extremely high-risk and high-risk hip fractures.

Venous thromboembolism (VTE) is one of common complications in hospitalized patients. Hospitalized patient tend to have high risk factors to develop VTE. As an important part of VTE prevention and treatment, it is of great significance for nurses to accurately identify risk factors, to conduct risk assessment of VTE in a timely manner, and to take appropriate preventive measures.

Objective To summarize the reason and nursing experience of one pulmonary embolism patient after total knee arthroplasty easily misdiagnosed coronary heart disease. Methods For the patient to implement risk assessment of venous thromboembolism and develop prevention plan in preoperation, then carry out anticoagulation prevention and physical prophylaxis after operation. Nurse observe the patient changes of clinical symptom and signs,focus on the complain of patient and the changes of laboratory examination results, implement the diagnosis process of pulmonary thromboembolism. Pulmonary thromboembolism patient was definitely diagnosed and got standardized treatment. Results Through the treatment and nursing, the patient finely discharged from hospital. Conclusions To develop the system of VTE risk assessment and implement prevention measures.Nurses need to distinguish the high risk pulmonary thromboembolism patient according to the clinical observation, it is better for the pulmonary thromboembolism patient to be early diagnosed and treated, meanwhile, to implement the effective nursing measures will contribute to the prognosis of pulmonary thromboembolism patient.

Objective To investigate the status on accuracy of estimation in applying Richmond Agitation-Sedation Scale (RASS) by nurses of Intensive Care Unit (ICU) for sedation of critically ill patients and to explore its influencing factors. Methods From November 2016 to January 2017, we selected 206 ICU patients and 38 ICU nurses of a ClassⅢ Grade A hospital in Beijing by convenience sampling. Research group and ICU nurses respectively assessed patients' agitation-sedation state with the RASS and analyzed its differences as well as influencing factors. Results There were 143 patients assessed by ICU nurses with the RASS in accordance with that in research group with 69.4% for the accuracy rate. Logistic regression analysis showed that the influencing factors of accuracy of estimation in RASS included sedative, score of Glasgow and delirium (OR=0.065, 1.424, 0.201;P＜0.05). Conclusions The accuracy of estimation in applying RASS by ICU nurses is at a middle level. We should pay attention to patients with sedative, delirium and the low score of Glasgow during applying RASS for critically ill patients.

Physical prophylaxis, as an important auxiliary means of anticoagulation prevention, cannot be ignored in the prevention of thrombosis. This article reviews the effects of physical prophylaxis alone as well as anticoagulation prevention combined with physical prophylaxis in patients at high risk of deep venous thrombosis to clarify explore the role and value of physical prophylaxis in thrombosis prevention.

Objective By using bibliometric analysis method, the current situation and existing problems of deep venous thrombosis nursing in China were discussed to provide reference for future research in this field. Methods We searched and analyzed the literature about the nursing of deep venous thrombosis in 12 Chinese nursing core journals through Sino-Med, CNKI and Wanfang Datebase from 1st January 2011 to 31st October 2017. We used the bibliometrics to analyze research type, research contents, research object, intervention technique, evaluation indicator and keywords. The data was done with statistical treatment using SPSS 19.0 software. Results Totally 291 articles were included. About 42.3% articles were experimental or quasi-experimental study. The main intervention method was single physical prevention (30.1%), but the comprehensive intervention approaches was just 10.6%. The prevention of deep vein thrombosis was the main research content (55.0%), risk assessment and therapy of thrombosis was both 11.3%. The patients of knee and hip arthroplasty, cancer, lower limb or hip fracture were the main study population. The incidence of thrombosis was the most times as evaluating indexes, the incidence of bleeding was the lowest. Conclusions There were more intervention studies about nursing of deep vein thrombosis in China, however, the intervention method was single, the quality and depth of research still need to be improved, and risk assessment of thrombosis was in the initial stage. In future, nurses should put more comprehensive intervention approaches into clinical research, pay more attention on risk assessment of thrombosis, identify the risk factors of thrombosis, focus on the high risk population of thrombosis, establish the thrombosis management process in high risk department, and implement the model of continuing nursing in therapy of DVT patients.