Noise‐induced hearing loss (NIHL) seriously affects the life quality of humans and causes huge economic losses to society. To identify novel genetic loci involved in NIHL, we conducted a genome‐wide association study (GWAS) for this symptom in Chinese populations. GWAS scan was performed in 89 NIHL subjects (cases) and 209 subjects with normal hearing who have been exposed to a similar noise environment (controls), followed by a replication study consisting of 53 cases and 360 controls. We identified that four candidate pathways were nominally significantly associated with NIHL, including the Erbb, Wnt, hedgehog and intraflagellar transport pathways. In addition, two novel index single‐nucleotide polymorphisms, rs35075890 in the intron of AUTS2 gene at 7q11.22 (combined P = 1.3 × 10 −6 ) and rs10081191 in the intron of PTPRN2 gene at 7q36.3 (combined P = 2.1 × 10 −6 ), were significantly associated with NIHL. Furthermore, the expression quantitative trait loci analyses revealed that in brain tissues, the genotypes of rs35075890 are significantly associated with the expression levels of AUTS2 , and the genotypes of rs10081191 are significantly associated with the expressions of PTPRN2 and WDR60 . In conclusion, our findings highlight two novel loci at 7q11.22 and 7q36.3 conferring susceptibility to NIHL.

心血管疾病是一种十分常见的疾病,它对于许多人的生命有着极大的危险,也是现在十分普遍而又难以痊愈的一种疾病.对于患病的老年人来说,他们的身边需要家属的陪伴,但是生活当中许多患者他们是无家属陪伴的,因此对于无家属陪伴的患者在进行就诊的过程当中更应该需要有专门的护理和管理.本文就对无家属陪伴心血管病老年患者门诊的护理管理进行简单的研究.

目的 了解参训军人的听力状况,为军事噪声所致听力损伤的防治提供科学依据.方法 对4个独立的部队单位(单位1～4)进行调查,共计821人.将近期未接触军事噪声的单位4的军人作为对照组,将接受礼炮鸣放训练、装甲车训练或手枪射击训练的军人(单位1～3)作为暴露组,分别对各组进行听力测试,比较各组间听力损失和耳鸣发生率的差异.结果 军事噪声暴露的军人听力损失率高于对照组;军事噪声暴露的军人耳鸣发生率高于对照组,但差异均未达到统计学显著水平.军事噪声暴露时间越长,听力损失越严重、耳鸣发生率越高(P<0.05).结论 军事噪声可影响参训军人的听力水平,应采取相应措施,加强防护.

核辐射损伤伤员去污洗消是救援的重要环节.核辐射危重伤员现场救治遵循"先救命后去污、边抢救边去污"的基本原则,待伤员生命体征平稳后,立即对伤口进行精密洗消[1].常规洗消方法容易造成洗消液外溅,扩大污染面积.而污染物的二次污染特别是处置伤口可能造成的污染尤为突出,为了降低二次污染的发生率和严重程度,本文通过平时演练与训练,结合临床外科手术操作技术,总结探讨医用手术膜在核辐射重伤员伤口洗消中的应用.

咽喉部异物是耳鼻喉科常见的急症之一,患者症状明显,一般情况下可在间接喉镜下取出,但如果异物位置隐蔽,患者难以配合,则不易取出.随着医学技术的发展,可采用纤维喉镜检查发现异物并取出.纤维喉镜又称"软式内镜",镜身的屈曲度可达到180 ° ,能观察到咽喉部隐蔽位置,再利用其显示器放大功能,通过医师和护士的配合就能将异物取出.现将护理配合报告如下.

Objective To investigate the curative effect of continuous renal replacement therapy(CRRT) treated senile chronic renal combined with multiple organ dysfunction.Methods A retrospective study was performed on 60 cases of senile chronic renal combined multiple organ dysfunction whose age was more than 65 years old received CRRT treatment from June 2012 to June 2015.The hemodynamics such as heart rate(HR),central venous pressure(CVP),mean arterial pressure(MAP),serum creatinine,blood urea,lactic acid,serum potassium,bicarbonate,hypersensitive c-reactive protein (hs-CRP),oxygenation index,PH value and APACHE 1Ⅱ score changes were observed before and after the treatment.Results After the CRRT treatment,the hemodynamics such as HR,CVP,MAP,serum creatinine,blood urea,lactic acid,serum potassium,bicarbonate,hs-CRP,oxygenation index,PH value and APACHE Ⅱ score were significantly improved compared than those before the treatment(P ＜ 0.05).Conclusion The CRRT treatment in patients with senile chronic renal insufficiency combined with multiple organ dysfunction is effective,and may obviously improve the prognosis of patients.

Objective:To investigate the status of disaster preparedness and relief capability of outpatient department nurses in a military hospital to give an advice on how to prevent and improve the training capacity .Methods:To investigate 34 nurses in a military hospital outpatient department by taking the disaster readiness questionnaire and disaster relief survey. Results:The sample of nurses were short of disaster preparedness. Although all nurses could know well disaster relief classification evacuation and emer-gency rescue position, and 79.4%nurses could formulate self-rescue plans, and 88.3%nurses had taken part in relevant training of di-saster relief, the department had never developed“Three Defense”medical rescue training. The sample of nurses were short of disas-ter nursing knowledge, the correct rate of 11 questions was 64.5%. In the knowledge level of care for the injury assessment, CPR, bleeding, surgical dressings, fixation, handling ,the grasp rates were much better as high as 85%.The correct rates were 64%-77%in classification delivery and defense of infectious diseases.The correct rates were 20%-24%in“Three Defense”medical rescue knowl-edge.Intermediate grade, undergraduate nurses in grasp situation of emergency rescue knowledge was significantly higher than ju-nior ones or college educated nurses, the difference was statistically significant (P<0.05). Conclusion:The low level of disaster re-sponse preparedness and disaster relief capacity needs to be improved, good preparation in peacetime relief work and disaster relief training and exercises needs to be strengthened in order to improve the level of disaster relief for military hospital outpatient depart-ment nurses.

门诊是医院面向社会的窗口，是直接接待患者进行检查、诊断、治疗和开展预防保健、健康教育的场所，是医务人员与患者接触时间最早、人数最多、范围最广泛的部门。门诊以人员数量多、流量大、病情复杂及变化快，患者相对停留时间较短为特点。

目前,对于血管条件差,无法建立动静脉内瘘,老年人心功能差无法耐受手术,不愿行腹膜透析或无法腹膜透析者,长期深静脉留置导管是一种安全有效的血管通路方式,最长寿命可达到10年以上[1].由于导管脱落、导管破损、导管纤维蛋白鞘形成等远期并发症使导管失功,需要重新原位置入导管,保证该侧中心静脉能继续使用,保留对侧血管资源,现就手术方法分析如下.

目的：分析337例确诊的儿童甲型H1N1流感病例，了解其流行病学特点、临床特征及治疗方法。方法：对我院发热门诊确诊的337例患儿的流行病学特点、临床特征及治疗转归统计数据，进行分析。结果：337例患儿中，学龄儿童较为集中，占所有患儿的78％，其发病高峰时间为10月份。初诊时患儿均以发热就诊，伴发症状依次为咽痛（73％）、咳嗽（52％）、流涕（49％）、头痛（45％）、乏力（28％）、肌肉酸痛（22％）、咯痰（15％）、胸痛（11％）、呕吐（2.6％）、腹泻（2.2％）等症状。337例患儿咽拭子均为阳性结果。血常规显示，74例患儿白细胞计数升高，138例患儿中性粒细胞升高，95例C-反应蛋白（CRP）升高。39例胸片提示肺部感染，7例心肌酶增高。337例患儿中仅2例口服奥司他韦，有206例给予抗生素，其中117例给予阿奇霉素，89例给予头孢类抗生素，同时均结合中成药治疗。除了咳嗽、咯痰症状，其他症状在1周左右消失。结论：儿童是甲型H1N1流感的重点防护人群，特别是学龄儿童的防护是重中之重。