Objective To evaluate the effect of different sevoflurane postconditioning on myocardial injury in patients undergoing coronary artery bypass grafting (CABG ) with cardiopulmonary bypass (CPB ) .Methods Seventy-five NYHA class Ⅰ or Ⅱ patients ,aged 46-72 yr ,weighing 57-90 kg ,scheduled for elective CABG with CPB ,were randomly divided into 5 groups ( n=15 each) using a random number table :control group (groupⅠ) , postconditioning with continuous administration of 1.7% sevoflurane group (groupⅡ a ) , postconditioning with continuous administration of 3.4% sevoflurane group (group Ⅲa) ,postconditioning with interrupted administration of 1.7% sevoflurane group (Ⅱb) and postconditioning with interrupted administration of 3.4% sevoflurane group (group Ⅲb) .Sevoflurane was not given in group Ⅰ .In Ⅱa group ,after the anastomotic stomas of the internal mammary artery to anterior descending artery were released ,the patients continuously inhaled 1.7% sevoflurane for 15 min .In Ⅱb group ,after the anastomotic stomas were released .In Ⅲa group ,after the anastomotic stomas were released , the patients continuously inhaled 3.4% sevoflurane for 15 min , the patients inhaled 1.7%sevoflurane for 5 min first ,inhalation was interrupted for 5 min ,and then inhalation was recovered lasting for 5 min ,and it was 15 min in total .In Ⅲb group ,after the anastomotic stomas were released ,the patients inhaled 3.4% sevoflurane for 5 min first ,inhalation was interrupted for 5 min ,and then inhalation was recovered lasting for 5 min ,and it was 15 min in total .Venous blood samples were taken for determination of the plasma creatine kinase ,creatine kinase isoenzyme-MB , lactic dehydrogenase , and cardiac troponin I concentrations before CPB and at 6 and 24 h after operation .Myocardial specimens were obtained from the right auricle before CPB and after termination of CPB for microscopic examination of the ultrastructure .Results Compared with group Ⅰ , the concentration of cardiac troponin Ⅰ was significantly decreased at 6 and 24 h after operation ( P<0.05) ,and no significant changes were found in the other parameters in Ⅱb group ( P>0.05 ) .The pathological changes were significantly attenuated in sevoflurane postconditioning groups as compared with group Ⅰ ,especially in Ⅱb group . Conclusion Postconditioning with continuous administration of 3.4% sevoflurane for 15 min can attenuate myocardial damage in patients undergoing CABG with CPB .

Objective To develop a Chinese military psychosomatic health scale(CMPHS) and examine its reliability and validity. Methods Based upon the previous researches, the Scale was compiled according to open-ended inventory survey. The data was collected from 1050 subjects chosen by random cluster sampling. 60 of them were tested with the CPSHS at the same time, while 61 of them were retested with the CMPHS after two weeks. The reliability and validity were examined by exploratory factor analysis ( EFA) and correlation analysis. Results According to the factor analysis results, 11 factors were extracted, namely espiratory apparatus, alimentary system,skeletal and musculature,integument,regeneration and endocrine,nervous system, anxiety, depression, psy-choticism and family history. There were 91 items in the formal scale when one lie subscale was added. The correlation between subscales were 0. 103 ～ 0. 778 (P < 0. 01) , the correlation between subscales and total scale were 0.600 ～0.859(P<0.01). The test-retest correlation coefficients of total scale and subscales were 0.427 ～0.901 (P < 0.01); the Cronbach (α) coefficients were 0. 643 ～ 0. 935 (P < 0. 01) ; and the split-half correlation coefficients were 0. 349 ～ 0. 855 (P < 0. 01 ). The correlation coefficients were 0. 425 ～ 0. 979 (P < 0. 05 or 0. 01 ). Conclusion The Chinese military psychosomatic health scale has acceptable psychometrics properties on reliability and validity.

0.05).Conclusion Certain changes have been found in mental health of Chinese standby peacekeepers,such as expectancy anxiety,depression,neurasthenia,interpersonal sensitivity etc.

Objective To investigate the relationship between the anti-earthquake military rescuers' psychosomatic health and social support, and observe the effect of intervention to the army men who suffered troubles.Methods By cluster random sampling, 152 military rescuers and 139 army men not taking part in the rescues were investigated by Facility Psychosomatic Health Scale and Social Support Rating Scale. Mental intervention or medication was performed to those produced psychosomatic health. Results The scores of somatic symptoms,mental status,psychosomatic health and social support of military rescuers and the control group were (4.09±4.70) ,(2.18 ±3.16) ,(6.27 ±7.08) ,(6.14 ±4.20) and (2.11 ±4.16) ,(1.37 ±3.09),(3.47 ±6.55),(4.57 ± 4.17 )respectively, the difference was significant(P＜0.05). The somatic symptoms had significantly positive correlation with mental status in military rescuers (r=0.17～0.52, P＜ 0.05 or 0.01 ). Failure of social support had positive correlation with mental disorders (r=0.18～0.40, P＜0.05 or 0.01). The degree of social support was the main factor which had affected on the psychosomatic health of military rescuers. The somatic symptoms of military rescuers were apparently higher than their mental symptoms. Mental and pharmaceutical intervention showed good effect on them. Conclusion There is an apparent effect for military rescuers injured seriously psychosomatic health through medication or mental intervention.

Objective To explore the correlation between mental health and social support of the seven countries peacekeeping soldiers,and provide theoretical guidance for the peacekeeping soldiers to improve the mental health status.Methods Through random cluster sampling,1143 peacekeeping soldiers were investigated with Chinese Military Mental Health Scale (CMMHS) and Social Support Scale (SSS).Results The total score of CMMHS and depression factor((61.06 ± 3.99),(10.11 ± 1.67)) of the suicidal ideation peacekeeping soldiers were significantly higher than the no-suicidal ideation peacekeeping soldiers ((59.97 ± 3.73),(8.97 ± 1.81))(P ＜ 0.05),CMMHS total score and each factors of the seven countries peacekeeping soldiers were significantly higher than the Chinese soldiers norms (P ＜ 0.05),and the total scores ((28.50 ± 1.69)) of the social support of the suicide idea peacekeeping soldiers was lower than the no-suicidal ideation peacekeeping soldiers ((28.92 ±1.78)) (P＜0.05).The obsessive-compulsive factor,anxiety factor,depression factor,phobic anxiety factor,somatization factor,neurastheria factor and interpersonal sensitivity factor of CMMHS were the risk factors arise the mental diseases of the peacekeeping soldiers,especially the depression factor(OR =27.00,x2 =439.46,P ＜ 0.05).The CMMHS total score and each factors had obvious negative correlation with social support scores(r =-0.199 ～0.434,P ＜ 0.05).Analysis of multiple stepwise back displayed that the age,gender,education and social support were main factors of influencing mental health of the seven-country peacekeeping soldiers (age:t =2.428,educational level:t =-3.310,social support:t =1.990,P =0.047 ～ 0.01).Conclusion The suicidal ideation has close relationship with peacekeeping soldiers' psychological disease,and the mental health of the peacekeeping soldiers is influenced by the age,gender,education level,and especially by social support.

Objective To investigate the effects of sevoflurane postconditioning on myocardial ischemiareperfusion(I/R)injury in patients undergoing coronary artery bypass grafting(CABG)with cardiopulmonary bypass(CPB).Methods Forty NYHA Ⅰ -Ⅲ patients of both sexes,aged 55-64 yr,with BMI ＜ 30 kg/m2,scheduled for CABG under CPB,were randomly divided into 2 groups(n = 20): control group(group C)and sevoflurane postconditioning group(group S).Anesthesia was induced with midazolam and/or etomidate,fentanyl and rocuronium.Patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propefol and intermittent iv injection of fentanyl and pipecuronium.In group S,2% sevoflurane was inhaled continuously for 15 min immediately after aortic unclamping.After anesthesia induction,before CPB,10 min after the end of CPB,at the end of operation,and 6 and 24 h after operation,MAP,HR,CVP,mean pulmonary arterial pressure,pulmonary arterial wedge pressure,CO and S(v)O2 were recorded,and CI,SVI,systemic vascular resistance index and pulmonary vascular resistance index were calculated.Blood samples were taken from central vein before aortic clamping,at 6 h of reperfusion and 24 h after operation for determination of plasma creatine kinase(CK),creatine kinase isoenzyme(CK- M B)and lactate dehydrogenase(LDH)activities and tropenin I(TnI)concentrations.Myocardial tissues were obtained from right auricle before aortic clamping and at the end of CPB for observation of the ultrastructure and the severity of myocardial injury was assessed.Results There was no significant difference in hemodynamics and parameters of cardiac function between the two groups(P ＞ 0.05).Compared with group C,plasma CK-MB and LDH activities at 6 h of reperfusion and plasma CK activity and TnI concentrations at 24 h after operation were significantly decreased and the myocardial injury was significantly reduced after the end of CPB in group S(P ＜ 0.05).Conclusion Sevoflurane postconditioning can protect myocardium against I/R injury induced by CPB in patients undergoing CABG.

Objective To explore correlation between alexithymia and resilience in military personnel.Methods 2802 subjects were chosen by random cluster sampling to outline the military personnel resilience scale and military alexithymia scale.The data were analyzed by t-test,chi-square test,ANOVA,correlation analysis and multiple linear regressions analysis.Results The prevalence rate of alexithymia was 6.85％,while resilience was 6.60％.Compared to sea force (45.62 ± 11.25 ) and air force (45.32 ± 9.98 ) subjects,land force (47.92 ± 9.92)had significantly higher total score in alexithymia(P＜ 0.05 ).Compared to sea force (87.35 ± 12.15 ) and air force ( 88.58 ± 10.39 ) subjects,land force ( 85.73 ± 10.70) had significantly lower total score in resilience(P ＜ 0.05 ).The total score and every factor score of subjects with alexithymia were significant lower than those of control group in resilience(P ＜ 0.05 ).Every factor of Resilience Scale were mild negative correlation with every factor of Alexithymia Scale (P＜0.01).Problem solving,volition,optimism and family supports were the main factors which had affected on the alexithymia.Conclusion The prevalence rate of alexithymia in military personnel is lower than ordinary people,but there are still issues in alexithymia and resilience,particularly in land force.The research show mild correlation between alexithymia and resilience in military personnel.

Objective:To assess the implementation of injection-related risk management based on WeChat platform for type 2 diabetic patients with the insulin self-injection.Methods:A total of 124 diabetic patients, who would receive insulin therapy by self-injection at home after discharge from the PLA 903 hospital during April 2017 to July 2018, were divided into the control group( n=62)and the study group( n=62). All patients were given routine education on insulin injection during the hospitalization,while the study group( n=62)received additional video and text education based on WeChat platform after discharge. The skill of self-injection and the status of blood glucose control were evaluated in both groups 4 weeks and 8 weeks after discharge, respectively. Results:The insulin injection skill, including skin disinfection [36(58%) vs. 11(18%),χ 2=21.42, P<0.01], exhaust before injection [62(100%) vs. 51(82%),χ 2=12.07, P<0.01], stay 10s after injection [60 (97%) vs. 47(76%),χ 2=11.52, P<0.01], disposal of used needle[49(79%) vs. 18(29%),χ 2=31.20, P<0.01], rotation of injection site [48(77%) vs. 35(56%),χ 2=6.16, P=0.01], insulin storage [62(100%) vs. 57(92%),χ 2=5.21, P=0.02], and the ability of correctly dealing with hypoglycemia [52(84%) vs. 38(61%),χ 2=7.94, P=0.01] in the study group were significantly better than those in the control group after 4 weeks of injection-related risk management. The fasting plasma glucose [(6.41±0.76) vs.(7.19±0.81)mmol/L, t=5.61, P<0.01], glycosylated hemoglobin A1c [(6.71±0.64)% vs. (7.37±0.78)%, t=5.18, P<0.01], incidence of hypoglycemia [6(10%) vs. 15(24%),χ 2=4.64, P=0.03] in the study group were significantly lower than those in the control group after 12 weeks of the management. Conclusion:The risk management based on WeChat platform can improve insulin self-injection skill and the ability of dealing with hypoglycemia,also promote effective blood glucose control for diabetes patients.

Objectives To explore the decade-feature of military personnel' s psychosomatic health and Its Influence factors.Methods By random cluster sampling,a total of 11362 military personnel ( including army,navy and air-force) were tested by Chinese Psychosomatic Health Scale (CPSHS) from 80' ( n=1100),90' ( n=8000),2000' ( n =2262)then employing SPSS statistic 17.0 program for data analysis by using ANOVA,LSD multiple-comparison,and stepwise regression analysis.Results The factor of eye-ear( 80s' ( 1.17 ± 1.68),90s'( 1.19 ± 1.64 ),2000s' ( 1.12 ± 1.48 ) ) had no significant difference in three decades (P ＞ 0.05 ) ; military personnel' s respiratory system,cardiovascular system,alimentary system,bone-muscle,skin,reproductive-endocrine system,nervous system,anxiety,depression,psychotic traits,family history,mental heath,physical health,and total psychosomatic health psychosomatic health had significant differences in the three decades (P＜ 0.05 ～0.01 ).The stepwise regression analysis revealed that decade,length of military service,urban-rural,marital state had significant effect on total psychosomatic health( decade:t =- 12.452,length of military service:t =-0.024,urban-rural:t=-0.066,marital status:t=0.119,P＜0.012 ～0.000).Conclusions The level of military personnel's psychosomatic health is improved from 80' s,90' s of last century to the year of 2000; the influenced factors of military personnels' psychosomatic health are including decade,length of military service,rural-urban,and marital status.

ObjectiveTo explore the decade-feature of military personnel' mental maladjustment and its influenced factors.MethodsBy random cluster sampling,a total of 10883 military personnel( including army,navy and air-force) were tested by military mental maladjustment scale (MMMS) in three decades (80s' 90s',2000),then employing SPSS 17.0 for data analysis by using ANOVA,LSD multiple-comparison,and stepwise regression analysis.ResultsThe single scores for behavioral disorders( (2.79 ±2.96),(3.42 ± 2.98 ) vs (2.85± 2.93 ) ),affective disorders ( ( 1.50 ± 1.47 ),( 1.76 ± 1.50 ) vs ( 1.51 ± 1.47 ) ),interpersonal relationship( ( 1.78 ± 1.93 ),( 2.44 ± 2.14) vs (2.30 ± 2.18 ) ),environmental adjustment( (0.63 ± 0.94 ),( 0.89 ± 1.02 )vs ( 1.02 ± 1.18) ),and total score ( ( 6.71 ± 6.01 ),( 8.50 ± 6.20) vs ( 7.69 ± 6.89 ) ) had significant differences in the three decades (P ＜ 0.01 ).The changing disposition of behavior,emotion,interpersonal relationship and total mental maladjustment seemed as reversed V in three decades,but environmental adjustment revealed linear increase; stepwise regression analysis revealed that total scores of mental maladjustment had significant decadeeffect after introducing other four independent variables( t =5.96,P =0.000 ) ; the educational level,urban-rural also had significant influence on military mental maladjustment( t =- 3.15,- 9.02,P =0.002 ～ 0.000 ).ConclusionThe mental maladjustment of military personnel reveale a decreasing disposition from 80s',90s' of last century to the year of 2000 ; the influencing factors are decade,educational level and rural-urban.