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To study the characteristics of blood lipids levels' change during pregnancy, and to discuss the relationships between the blood lipid level and the age, gestational hypertension, gestational diabetes and other pregnancy complications.From January to September 2015, we enrolled 2 907 pregnant women admitted to our hospital for regular checks as control group, 190 cases in gestational hypertension group, 258 cases in gestational diabetes mellitus group. The control group was divided into first trimester (≤12 w) second trimester (20 to 26 w) and third trimester (≥28 w) groups; in second trimester group, patients were further divided into the certain age group (35years old) and elderly group (≥35 years old); blood lipid levels including serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) were detected in all groups.(1) Blood lipids levels varied as pregnancy proceeded. TG level increased most significantly, followed by TC, LDL-C level. However, HDL-C level slightly decreased in third trimester comparing with first and second trimester stage, the difference was statistically significant (P0.05); (2) serum TC, TG and LDL-C level in second trimester were significantly higher in the certain age group than in the elder group (P0.05); (3) in gestational diabetes mellitus group, serum TC, TG, LDL-C levels were significantly higher in first and second trimester than those in the control group (P0.05); (4) in gestational hypertension group, serum TC, TG, LDL-C levels were significantly higher in third trimester than those in the control group (P0.05); HDL-C level was lower in the gestational hypertension group than in the control group, and there was statistically significant difference (P0.05).The blood lipid levels in pregnancy increase gradually as the gestational weeks increase, which can be explained as a normal physiological phenomenon. Elder pregnancy, gestational hypertension and gestational diabetes mellitus patients usually have obvious blood lipid disorder, therefore, it is very important to monitor the blood lipid level during pregnancy stages for predicting and early intervention of pregnancy complications such as gestational diabetes mellitus and gestational hypertension.

To evaluate the hemodynamics of maxillary artery (MA), superficial temporal artery (STA) and ophthalmic artery (OA), and evaluate the hemodynamics prediction capability of these arteries formed compensatory arteries into intracranial using Doppler ultrasonography.The evaluation of MA, STA, and OA with transcranial doppler ultrasonography and with cerebral angiography was made in 106 MMD patients (total of 212 hemispheres of the brain), 58 male and 48 female, aged 39.3±12.0 years old. Doppler ultrasonography measured the following blood flow parameters: peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI). DSA evaluate whether MA, STA, OA formed compensatory arteries into intracranial. Based on the compensation situation, the patients were divided into two groups: compensatory group and non-compensatory group. The differences of patient's hemodynamic parameters between compensatory and non-compensatory groups were performed using independent two-sample t-tests with equal or non-equal variance as appropriate. Categorical variables were summarized using frequency and percentage and compared using Chi-square tests. We evaluated the prediction ability of each hemodynamic parameters for each artery (combining left and right side) using Receiver Operating Curve. All the analyses were performed using SAS 9.4 (Cary, NC).Comparing the hemodynamic parameters between the compensatory group and non-compensatory group, all hemodynamic parameters of MA, STA and OA have statistically significant differences between the two groups. Depending on the ROC Curve, EDV (AUC=0.6933±0.0463) for MA, RI (AUC=0.8910±0.0569) for STA, EDV (AUC=0.7863± 0.0330) for OA are better predictors of compensatory growth.Color duplex ultrasonography is a reliable, noninvasive and economic tool to assess hemodynamic changes of MA, STA and OA, and has prediction capability of these arteries formed compensatory arteries into intracranial.

Acute otitis externa(AOE) is defined as diffuse inflammation of the external ear canal skin or subdermis occurred in 3 weeks,which sometimes may also involve the pinna or tympanic membrane.Clinical manifestations include:otalgia,itching,fullness,sometimes with hearing loss.The hallmark sign of AOE is tenderness with movement of the tragus or pinna AOE Often occurs in adults or children older than age of 2,while little morbidity in children under the age of 2.Lifetime incidence is up to 10% in a persons life.Recently,a lot of different versions of the AOE clinical practice guidelines were published abroad.In this review ,the etiology,diagnose,therapy,prevention,are comprehensive described,which on the basis of evidence-based medicine.

To modify the design of the Achilles tendon-scar composite flap into the Z-shape and to apply it into clinic situations to correct the tendon-scar contracture after burn and other injures.According to degree of contracture and strephenopedia, the central limb of Z-shaped design lay in contracture line of posterior ankle area just over the Achilles tendon and extended 8 to 12 cm in length. Lateral limbs extended 5 to 8 cm and usual angles of the Z-shape was 60 degrees. The two tendon-scar composite flaps were made and slipped along the central limb between them. From March 1994 to August 1999, seven patients with Achilles tendon scar contracture were operated with this method.Excellent relieving of the Achilles tendon-scar contractue was achieved. No such complications happened as ischemia and necrosis of the flaps.The Z-shaped tendon-scar composite flap is practical in clinics. It is characterized by abundant blood supply, easily procedure and reliable result.

Acute volume loading produced by autogenous reinfusion of ascitic fluid provides an ideal volume expansion model for studying hormonal regulation and it was carried out in 10 cirrhotic patients with massive ascites. The basal plasma ANP level in the cirrhotic patients with ascites was 1776.00 +/- 160.72 ng/L, which was significantly elevated as compared with the level in normal controls (378.36 +/- 39.58 ng/L, P less than 0.01), PRA was significantly higher in patients with ascites (5.13 +/- 0.18 micrograms/l/h) than in healthy volunteers (1.46 +/- 0.31 micrograms/l/h, P less than 0.01). During reinfusion of ascitic fluid there was a significant natriuresis and diuresis; ANP rose from a basal mean value to a peak value of 2166.00 +/- 195.70 ng/l (P less than 0.05) at periinfusion. Subsequently, ANP dropped at 1 hour after infusion (1819.00 +/- 165.92ng/L, P less than 0.05), PRA dropped progressively from a mean basal level to that of 2.48 +/- 0.58 micrograms/l/h (P less than 0.05) at periinfusion. These data demonstrate that there is no evidence for absolute deficiency of ANP in cirrhosis with ascites. The immediate diuresis and natriuresis were associated with a rise in ANP, but the sustained renal consequences may be possibly connected with suppression of RAAS.

A patient with an infection with the L-form of Staphylococcus aureus occurring in burn wounds is reported. The authors conclude that the infection was attributable to a decrease in the host immunological functions and repeated administration of antibiotics resulting in the development of bacterial L-forms