Therapeutic hypothermia used for clinical purposes has had a long history. With the continuous development in the intensive care and surface cooling techniques, it has made various large hypothermia clinical trials possible. Studies have found that moderate hypothermia (28～35℃) has significant protective effects on important organs such as heart and brain, and it does not have obvious side effects. Recently, mild hypothermia (32～35℃) has been widely used for cardio-pulmonary-cerebral resuscitation, and its effect is satisfactory.

Objective To explore the nursing care for the stiff-man syndrome patient.Methods Retrospective analysis had been performed for the nursing care of a patient with stiff-man syndrome.Results After 4 weeks of careful treatment and nursing care,the patient was discharged from the hospital.Conclusions Suitable nursing according to patients' condition,medication monitoring,psychological care,safety nursing and health guidance can prevent or delay the development of the disease and promote comprehensive rehabilitation for patients.

Substantia nigra is the largest nuclei in midbrain, which is divided into a compact part and a reticular part. Recent studies have shown that the changes of iron content in reticular part of substantia nigra results in the changes of substantia nigra echogenicity. The substantia nigra detected by transcranial Doppler, according to its echo changes, may provide help for the susceptibility of Parkinson's disease, latency and early diagnosis, as well as for the differential diagnosis of multiple system atrophy and vascular parkinsonism.

Objective To explore the factors affecting the quality of life in patients with Parkinson's disease(PD).Methods The quality of life,severity of disease,activities of daily living,motor responses,mental state and the complications of treatment in 71 patients with PD were evaluated by the PD Quality of Life Questionnaire(PDQL),Unified PD Rating Scale(UPDRS),the Hoehn-Yahr scale,the Schwab and England disability scale,the Hamilton Depression Rating Scale for Depression(HRSD),and meanwhile factors such as age,gender,age of onset,the beginning symptom,the location of onset,smoking,doses of L-dopa and fluctuations etc were evaluated by some methods.Results Bivariate analysis showed that the longer course of disease and treatment,the more doses of L-dopa,the higher scores of UPDRS and the Hoehn-Yahr scale,and depression fluctuations with patients,the worse quality of life they had(P

Objective To identify the association between fatigue and depression in Parkinson's disease(PD).Methods 56 PD patients were enrolled in this study.The degree of fatigue was measured by Fatigue Severity Scale (FSS).Hamilton Depression Scale (24 items) was used to evaluate the degree of depression.PD Quality of Life Questionnaire (PDQL) were tested to evaluate the quality of life in PD patients.While other clinical information such as Unified Parkinson's Disease Rating Scale (UPDRS) Ⅲ,Hoehn-Yahr Scale and modified Webster Scale were investigated.Results The incidence of fatigue in this group is 71.4％ (40/56).Score of HAMD and PDQL exhibited a significant correlation to patients' fatigue,coefficient of partial correlation was 0.451 (P ＜ 0.01),-0.346 (P ＜ 0.05).The incidence of fatigue in non-depressive patients was low,27.3 ％.While in depressive patients,the incidence of fatigue is relatively high,for mild depression 75％,moderate depression 100％,severe depression 100％ respectively.Conclusions Fatigue is a prominent symptom of depression in PD patients,sometimes independent of depression also influencing the patients' quality of life.

ObjectiveTo evaluate the accuracy of cerebral state index (CSI) as an indicator of anesthesia depth in the induction of anesthesia with target-controlled infusion (TCI) with propofol and remifentanil patients.Methods Forty-four ASA Ⅰ or Ⅱ patients undergoing elective surgery were anesthetized with TCI with propofol and remifentanil.Anesthesia was induced with TCI with remifentanil and propofol.The target effect-site concentration of remifentanil was 4 ng/ml.The initial effect-site concentration of propofol was 1.5 μ g/ml and was increased by0.5 μ g/ml every 4 min,till 1 min after the level of observer’s assessment of alertness sedation (OAA/S) score was 0 score.Electric tetanic stimulation was given when the level of OAA/S score was 1 score.The CSI,mean arterial pressure (MAP),heart rate (HR),OAA/S score and the effect-site concentration of propofol were recorded.ResultsCSI values declined with the decrease of OAA/S score,CSI was 91 ±5,77 ±7,70 ±7,62 ±6,49 ± 12,36 ± 10 at OAA/S score with 5,4,3,2,1score.CSI values were statistically different between 0 score and 1 score,1 score and 2 scores,3 scores and 4 scores,4 scores and 5 scores of OAA/S score(P ＜0.05).The differences of MAP,HR had no statistical significance between two scores of OAA/S score (P ＞0.05).The Spearman rank correlation coefficients between CSI,MAP,HR and OAA/S score were 0.899,0.342,0.125,respectively.The prediction probabilities to differentiate different OAA/S score for CSI,MAP,and HR were 0.89 ± 0.05,0.62 ± 0.08,0.53 ±:0.11,respectively.There was linear regression relationship between CSI and the effect-site concentration of propofol (the coefficient of determination was 0.812,P ＜ 0.01 ).ConclusionDuring the induction of patients with TCI with propofol and remifentanil,the CSI is accurate as an indicator of awakening and different levels of consciousness after anesthesia,and can reliably predict the anesthesia depth.

Objective To evaluate the effect of pretreatment with butorphanol to prevent injection pain of rocuronium bromide.Methods One hundred and fifty ASA Ⅰ-Ⅱ grade patients,undergoing elective surgery were divided into 3 groups by random digits table with 50 cases each.Butorphanol group received butorphanol 2 mg,fentanyl group received fentanyl 100 μg,and control group received 0.9％sodium chloride when general anesthesia induced.Anesthesia was induced with propofol 2 mg/kg and the test drug was injected over 30 s,120 s after the test drug injection,1％ rocuronium bromide 0.6 mg/kg was injected.Nausea,vomiting,apnea and bucking were recorded after drugs injection.Results The rates of rocuronium bromide injection pain in fentanyl group[10％(5/50)]and butorphanol group[8％(4/50)]were significant lower than that in control group[82％(41/50)](P ＜ 0.01).None of the patients discovered nausea,vomiting,apnea and bucking in 3 groups.Conclusion Pretreatment with 2 mg butorphanol reduced the incidence of rocuronium bromide injection pain,furthermore,there is no untoward reaction such as nausea,vomiting,apnea and bucking.

Objective:To explore whether there will be attentional bias under the condition of fear,disgust and positive emotional arousal. Methods:Totally 96 college students were selected as participants in this study,inclu-ding 60 males and 36 femalesaged 18-22 years. Affective priming videos were adopted to prime participants'emo-tion (dread,disgust,joviality),and then they named the color of the cognitive words (positive words,negative words,neutral words)as quickly and accurately as possible. Reaction time and correctness were recorded. E-prime was adopted to write the experimental program. The reaction time for neutral words was baseline. Results:The aver-age reaction time (RT)of color-naming tasks of negative words were shorter than that of neutral words after fright-ening affective priming[(648 ±118)ms vs. (743 ±124)ms,P<0. 01]. Furthermore,the average RT of color-na-ming tasks of positive words were also shorter than that of neutral after frightening affective priming[(683 ±123) ms vs. (743 ±124)ms,P<0. 05]. The average RT of color-naming tasks of negative words were shorter than that of neutral words after disgusting affective priming[(579 ±86)ms vs. (720 ±101 )ms;P<0. 01 ]. Moreover,the av-erage RT of color-naming tasks of positive words were shorter than that of neutral words after delighted affective priming[(634 ±122)ms vs. (716 ±141)ms;P<0. 01]. Furthermore,the average RT of disgusting priming group-were shorter than the frightening priming grouptowards negative information[(579 ±86)ms vs. (648 ±118)ms,P<0. 05 ]. Conclusion:It suggests that the youth perform more obvious attentional bias towards negative information after disgusting affective priming than the frightening one. Frightening affective priming could evidently induce the attentional bias on positive information.

Objective To study the incidence of depression in essential tremor (ET) and associated factors. Methods Depression in 62 ET patients and 60 healthy subjects as control was evaluated by means of Hamilton Depression Scale ( HAMD ) , as well as Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and Pittsburgh Sleep Quality Index (PSQI). Results Fifty-three point two percent(33/62) of ET patients and 11.7% (7/60) of healthy subjects were found to have at least mildly depression (HAMD score of 8 or higher), 35. 5% (22/62) of ET patients and 8. 3% (5/60) of healthy subjects fell into the mildly-to-mederately depression (HAMD score between 8 and 20 ), 17.7% (11/62) of ET patients and 3.3% (2/60) of healthy subjects were classified into moderately-to-severely depressed range (HAMD score between 21 and 35). There were statistical differences in ET group and healthy subjects group (X2= 23.898, 13.043, 6.649, all P <0.01). Additionally, there were statistical differences in anxiety/ somatization (t=-6.747, P<0.01), cognitive impairment (t=-2.017, P=0.05), block(t= -4.145, P<0.01), sleep disorders (t=-4.500, P<0.01) and despair (t=-3.591, P<0.01) between depression group and non-depression group. There were marked differences in PSQI total score ( t =-3.196, P=0.003 ), subjective sleep ( F1, t=-3.037, P=0.004), quality sleep latency (F2, t= -4.674, P<0.01) and sleep disturbances (F5, t=-2.594, P=0.013 ) between depression disorder group and non-depression disorder group. Meanwhile, the score of TRS, PSQI and sex were closely correlated with HAMD (β=0.589, P=0.000 ;β=0.469,P=0.000 ;β=0.256, P=0.027 ). Conclusions The incidence of depression is high in ET. Manifestation of depression are anxiety, reduced interest in work, sleep disorders, retardneas, inferiority complex, etc. The degree of symptoms relates to the severity of ET, sleep quality and gender.

BACKGROUND:Tranexamic acid is a synthetic anti-fibrinolytic drug, and can effectively control blood loss after total knee arthroplasty through vein. OBJECTIVE:To evaluate the effectiveness and safety of tranexamic acid in reducing blood loss after primary unilateral total knee arthroplasty. METHODS:From 2014 to 2015, 100 patients from the Department of Lower Limb, Sichuan Orthopaedic Hospital underwent primary unilateral total knee arthroplasty, and randomly divided into test group which used tranexamic acid and control group which used tranexamic acid, with 50 cases in each group. 1 g tranexamic acid was infused into the vein at 10 minutes before total knee arthroplasty in the test group, but tranexamic acid was not given in the control group. RESULTS AND CONCLUSION:The amount of total blood loss, postoperative wound drainage in 24 hours, and the amount of blood transfusion were significantly less in the test group than in the control group (P < 0.05). No significant differences in intraoperative blood loss and the number of patients receiving blood transfusion were found between the test and control groups. No significant difference in preoperative hemoglobin levels was detected before surgery, but hemoglobin levels were decreased after surgery between the two groups. Postoperative hemoglobin levels were apparently higher in the test group than in the control group after surgery. At 24 hours after surgery, no significant difference in coagulation was detectable between the two groups. At 6 days, double lower limb vein color Doppler ultrasound examination did not reveal deep vein thrombosis in both groups. These findings verify that treatment with tranexamic acid in the vein before primary unilateral total knee arthroplasty can evidently diminish the amount of perioperative blood loss and blood transfusion, reduce the risk and cost of blood transfusion, which is good for rehabilitation and does not increase the risk of deep vein thrombosis.