Although young anesthetists demonstrate the excellent characteristics of agile thought , strong manipulative ability and are ready to receive challenge, they are short of teamwork cooperation spir-it. Clinical anesthesia knowledge and skill can be improved and teamwork cooperation spirit can be culti-vated through correcting attitude , modest learning , implementing tutor system among young doctors , strengthening the understanding of team spirit , cultivating interpersonal communication ability and orga-nizing regular learning discussions.

Objective To study butylphthalide on acute cerebral infarction with leukoaraiosis patients cognitive function. Methods 80 patients with acute cerebral infarction combined with leukoaraiosis in Yuncheng Central Hospital from June 2014 to June 2015 were selected, all patients had cognitive dysfunction, and randomly divided into study group and control group with 40 cases in each group. The two groups were given conventional treatment of cerebral infarction, the study group was given the butylphthalide soft capsules two tablets, three times once day orally for three months, we used MMSE and MoCA scale to assess the cognitive status of the patients in the two groups at four, eight, and 12 weeks after treatment. The changes of liver function during treatment were analyzed. Results In the treatment, the two groups of patients with MMSE were improved, in four weeks of treatment, the MMSE scores of the study group was higher than the control group, but there was no significant difference between the two groups, eight weeks and 12 weeks, the MMSE scores of the study group was significantly higher than the control group, and the difference between the two groups was statistically significant (P<0.05), the MOCA score of patients in the study group gradually become normal, and significantly higher than the control group, after treatment for four weeks, eight weeks and 12 weeks the difference was statistically significant (P<0.05), the study group patients first had abnormal liver function in the treatment, recovered after stopping the medication. Conclusion Butylphthalide can improve the cognitive function of patients with acute cerebral infarction combined with leukoaraiosis, the increase of transaminase caused by treatment has no significant effect on clinical medication, which is worthy of further popularization and application.

Tumors are believed to consist of a heterogeneous population of tumor cells originating from rare cancer stem cells (CSCs). However, emerging evidence suggests that tumor may also originate from non-CSCs. To support this viewpoint, we are here to present definitive evidence indicating that the number of tumorigenic tumor cells is greater than that of CSCs in tumor, and tumor can also derive from non-CSCs. To achieve this, an idealized mathematical model was employed in the present study and theoretical calculation revealed that non-CSCs could initiate the occurrence of tumor if their proliferation potential was adequate. Further, experimental studies demonstrated that 17.7%, 38.6% and 5.2% of tumor cells in murine B16 solid melanoma, H22 hepatoma and Lewis lung carcinoma, respectively, were potentially tumorigenic. Thus, based on the aforementioned findings, we propose that the scarce CSCs, if exist, are not the sole source of a tumor.

Objective To explore the relationship between osteoporosis and chronic vascular complications in elderly male patients with type 2 diabetes and to evaluate its related risk factors.Methods A retrospective study was conducted in 428 elderly type 2 diabetic patients.The bone mineral density (BMD) of lumbar spines (L2 ～L4),femoral neck,Ward's triangle were measured by dual X-ray absorptiometry,and chronic vascular complications in patients were tested.The correlation between BMD and chronic vascular complications was analyzed.Results Diabetic course was longer in osteoporosis group than in non-osteoporosis group (P＜0.05).Levels of fasting blood glucose (FBG) and postprandial blood glucose (PBG) were significantly higher in osteoporosis group than in non-osteoporosis group (P＜ 0.05).The incidences of diabetic nephropathy,diabetic retinopathy,diabetic neuropathy and hypertension were higher in osteoporosis group than in non-osteoporosis group (59.8％ vs.12.0％,41.8％ vs.22.3％,33.6％ vs.24.5％,and 35.7％ vs.26.1％,respectively,all P＜0.05).Logistic analysis showed that diabetic course,FBG and diabetic nephropathy were correlated with diabetic osteoporosis (OR =1.055,1.168,7.401,95％ CI:1.015-1.096,1.073-1.273,4.303-12.727,P=0.007,0.001,0.001).Conclusions Osteoporosis has a close relationship with diabetic microvascular complications in elderly diabetic patients.Diabetic nephropathy plays an important role in the development of diabetic osteoporosis.It is helpful for osteoporosis prevention to early monitor and intervene on microvascular complications index such as urinary albumin in elderly patients with type 2 diabetes.

Wingless type protein (Wnt protein) is a group of protein which plays an important role in the process of animal growth and hemopoiesis,the signaling pathway they conducted was called Wnt signaling pathway,and its abnormal activation can lead to many tumors,include lung caner.As a tumor suppressor gene,WIF-1 can restrain the activation of Wnt signaling pathway,which can avoid lung cancer.WIF-l's methylation can downregulate the expression of WIF-1,which can activate Wnt signaling pathway and cause lung cancer.So the detection of WIF-1's methylation may contribute to clinical diagnose of lung cancer,and therapy of WIF-1 's methylation may be one of the treatment metheds of lung cancer.

Objective To understand the nurses' evaluation of current grading nursing system.Methods Self-questionnaire was designed and used to investigate 141 clinical nurses coming from three general hospitals sampled conveniently.Results (1)Clinical nurses lacked in-depth study of grading nursing instruction principle;(2)Doctors and nurses lacked the cooperation during the process of identifying the level of care;(3)Level of care was not consistent with the patients' condition and self-care ability;(4)Disease inspection and primary care were not consistent with patients' level of care;(5)Health guidance and mental nursing couldn't meet the actual needs of patients;(6)Senior nurses' evaluation of the implementation of grading nursing was lower than Junior nurses; (7)Clinical nurses held positive attitudes to nurses and patients participating in grading nursing.Conclusions Nurses thought poorly of grading nursing system in operation,it was necessary to improve the content of principles about grading nursing manner,health instruction and psychological nursing,and implement grading nursing system correctly.It was also important to take patients' willingness of participating in care into account.

Objective To explore whether childhood abuse experiences predict higher levels of depression and lower levels of self-esteem for graduate students and examine the mediating role of social support between childhood abuse and mental health.Methods A sample of 907 graduate students were investigated with the Childhood Trauma Questionnaire (CTQ-SF),Perceived Social Support Scale (PSSS),Self-esteem Scale (SES) and Center for Epidemiological Survey Scale (CESD).Results The scores of childhood abuse,social support,self-esteem,and depression of graduate students were (33.88±9.35),(68.31±12.01),(36.62±4.80) and (35.85± 9.20).Childhood abuse was negatively correlated with self-esteem (r=-0.32,P＜0.01),but positively correlated with depression (r=0.28,P＜0.01),and negatively correlated with social support (r=-0.44,P＜0.01).Social support was positively correlated with self-esteem (r=0.39,P＜0.01),and negatively correlated with depression (r=-0.41,P ＜0.01).Examining the mediation model indicated that social support had a partial mediation effects(42％) on the relationship between childhood abuse and self-esteem,and social support had a partial mediation effects(54％) on the relationship between childhood abuse and depression.Conclusions The childhood abuse not only affects the graduate student's self-esteem and depression directly,but also can take the same effect by social support indirectly.

Objective To establish practical cell model of HCV infection, and investigate the susceptibility of a human liver cell line HepG2 to hepatitis C virus in vitro. Methods A human liver cell line HepG2 was incubated with serum from a chronic hepatitis C patient for 6～8 hours. Both the plus and minus strands of HCV RNA in infected cells or supernatant were examined by reverse transcription polymerase chain reaction (RT PCR). The HCV NS 3,NS 5 antigens in infected cells were respectively detected with the monoclonal antibodies to antigens of their own by immunohistochemical assay. The minus strand of HCV RNA in infected cells were localized by in situ hybridization. Results The intracellular plus or minus stands of HCV RNA were first detected on day 3 post incubation and then could be intermittently detected until day 35 post incubation in cells or supernatant. The positive signals of NS 3,NS 5 antigens could be expressed within cytoplasm of infected cells. The minus strand of HCV RNA was located within cytoplasm by in situ hybridization. Conclustions These results show that a human liver cell line HepG2 is not only susceptible to HCV but also able to support its long time replication in vitro.

Objective To study the influence of colon hydrotherapy on premature infants with jaundice.Methods Based on intravenously infusing yinzhihuang and albumin and enzyme inducer,the warmed normal saline was poured into colon by 10 mL/kg per 8 hours in 40 preterm infants,and compared with 44 cases of control group.Serum bilirubin of all patients were measured at 24,72,120,168,216 hours,respectively.The days of meconiumbeing eliminated completely were recorded.Results The bilirubinemia level in trial group were lower in trial group than that in control group at every time and the rate of hyperbilirubinemia of the test group was lower(?~2=4.073 P

Objective: To apply the NRS2002 to screen the nutritional status of preoperative patients and investigate the nutrition support in the perioperation and clinical outcomes. Methods: 127 selective operational cases(including general surgery,thoracic surgery,gynecology and orthopedic) were recruited to adopte the NRS2002 which issued by CESPN in 2006,and the nutrition support,energy and nutriment in the perioperation,complications,length of stay and drug costs were investigated. Result: 30.7% patients needed nutrition support,with general surgery(28.3%) being higher than thoracic surgery(2.4 %),gynecology(0%) and orthopedic(0%).The nutritional risk in elderly,carcinoma,abdominal operation patients were 18.1%,19.7% and 18.1% seperately,which was higher than others(P