Objective To summarize anesthetic management for 56 patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods Recorded and analyzed the hemodynamie changes of 56 patients undergoing OPCABG including heart rate (HR),rate-pressure product (RPP), mean arterial pressure(MAP), mean pulmonary artery pressure(MPAP), central venous pressure (CVP), cardiac output (CO) and mixed venous oxygen saturation when left anterior descending (LAD), right coronary artery (RCA), diagonal (DiAG) and left circumflex coronary artery (LCX) was anastmosed. Results The patients undergoing OPCABG had hemodynamic fluctuation during vascular anastomosis, mainly showing MAP and CO decreased, CVP increased. The change was especially significant when the LCX or RCX was anastmosed. The based value, when LAD and RCA anastmosed of MAP were (82.0±11.7) mm Hg(1 mm Hg = 0.133 kPa), (60.1±11.5) mm Hg and (58.4±12.1) mm Hg, CO were (4.2±1.2) L/min, (3.1±0.7) L/min and (3.2±0.6) L/min, CVP were (5.6±2.6) cm H2O (1 cm H2O=0.098 kPa), (9.6±4.4) cm H2O and (9.2±3.6) cm H2O. Conclusion The hemodynamie changes during OPCABG,especially in LCX and RCA anastmesed are transient and well tolerated under suitable anesthetic management.

Objective To explore influence of norm-setting three-stage rehabilitation training on hemiplegic stroke patients with movement and cognitive dysfunction. Methods A prospective randomized controlled study and stepwise linear regression analysis was carried out to investigate the early variation factors, which affected the integrated functional recovery of stroke patients. According to variation factors we established our norm-setting three-stage rehabilitation training program. 200 patients were randomly selected, according to the cerebral infarction and cerebral hemorrhage classification, and then randomly divided into the rehabilitation group and the control group with 100 patients in each group. All patients accepted general neurology routine nursing. The rehabilitation group was given an extra norm-setting three-stage rehabilitation training. The improvement of motor and cognitive function were observed. Results The early variation factors of integrated functional outcome were treatment programs, CNFD score, age, diabetes, SFMA score, smoking and the intensity of labor within six months since stroke onset. Movement and cognitive function of the rehabilitation group significantly improved than the control group as well as upon admission on the first, 3rd and 6th months since stroke onset. Conclusions The norm-setting three-stage rehabilitation training obviously promotes the improvement of motor and cognitive function at all stages.

Objective To observe the clinical efficacy of glucocorticoidcombined with the eradication of helicobactepylori (HP) in the treatmenof idiopathithrombocytopenipurpura(ITP) and itinfluence on platelecounand cell subset.MethodNinety-foucaseof ITP were randomly divided into two group.The control group(47 cases) wagiven prednisone treatmen, while the observation group(47 cases) wagiven prednisone combined with HP eradication treatmen.The clinical effecand recur-rence rate within 1 yeawere observed ,and the changeof platelecounand cell subsetwere tested .ResultThe total effective rate of the observation group wa89 .36% ,which wasignificantly highethan 70 .21% in the control group ;the 1-yearecurrence rate in the observation group wa36 .17% ,which wasignificantly lowethan 72 .34% in the control group ,the differencebetween the two grouphad statistical significance (P＜0 .05) .The platelecounaftetreatmenin the two groupwere significantly in-creased ,platelet-associated antibody(PAIgG) level wasignificantly decreased ,buthe improvemenin the observation group wamore significant(P＜0 .05) .The percentage of CD3+CD4+ % increased significantly ,the percentage of CD3+CD8+ % wadecreased significantly ,buthe improvemenin the observation group wamore obviou(P＜0 .05) .Conclusion Glucocorticoidcombined with HP eradication treatmenin treating ITP hadefinitely clinical efficacy ,can increase the platelecoun,improve cell subsetimbalance ,and iworthy to be clinically promoted .

Objective To detect the inhibiting effects of ionizing radiation combined with inhibitors or inducer of autophagy and apoptosis on MCF7 cell line,and to provide the evidence for human breast cancer therapy radiation.Methods MCF7 cells were exposed to X-rays and randomly divided into 4 groups,including 0 Gy,4 Gy,4 Gy+rapamycin,4 Gy+3-MA,and 4 Gy+z-VAD-fmk groups,including 0 Gy,4 Gy,4 Gy+rapamycin,4 Gy+3-MA,and 4 Gy+z-VAD-fmk groups,respectively.The growth doubling time was calculated by MTT method.The specific protein expressions of LC3 autophagy and beclinl were detected by using Western blot and the difference of Drotein contents wasLC3 autophagy and beclinl were detected by using Western blot and the difference of Drotein contents was compared.The percentage of apoptosis of MCF7 cells was measured by flow cytometry (FCM).Resuits The growth doubling time of MCF7 cells in 4 Gy group wag longer than that in O Gy group(t=4.41,P

Objective The purpose of this study was to investigate the effect of a dietary modification intervention model applied by ward nurse on change of dietary behavior among patients with type 2 diabetes mellitus (T2DM).Methods A total of 80 participants were divided into intervention patients (n=40) and control subjects (n=40) by random number table.Except lecture-based diabetes educational which was applied for control subjects,a dietary modification intervention model was conducted in intervention patients for a period of two weeks.The intervention program consisted of evaluating an individual's stage of change after being provided dietary information regarding kind of food and portions,discussion with a role model,and keeping a food diary record.Body mass index (BMI),waist-hip ratio (WHR),fasting plasma glucose (FPG),postprandial 2-h plasma glucose (2hPG),glycosylated hemoglobin (HbAlc) and score of healthy eating behavior were measured at initial and six months later.Results Compared with control group,BMI,WHR,FPG,2hPG,HbA1c in intervention group were significantly decreased,P ＜ 0.01 or 0.05.After six months intervention,FPG,2hPG and HbA1c in both groups were significantly decreased compared with baseline levels,P＜ 0.01.Compared with control group,the scores of healthy eating behavior in intervention group were significantly decreased,P＜ 0.05.After six months intervention,the scores of healthy eating behavior in both groups were significantly elevated,P ＜ 0.01,compared with baseline levels.Conclusions This study yielded evidence for the benefits of using the dietary modification intervention model as a framework in healthy eating behavior among patients with T2DM.

OBJECTIVETo investigate the quality of life of cleft lip and/or palate children's parents and discuss the factors to provide the oretical basis for improving the quality of life of these parents and promoting the healthy growth of children with cleft lip and/or palate.

METHODSA total of 115 parents whose children had cleft lip and/or palate surgery treatment were selected as the experiment group, and another 198 parents (with healthy children having a similar age with those in the experiment group) as the control group. The experiment group was divided into three subgroups according to different types of cleft lip and/or palate: cleft Lip (CL), cleft palate (CP), cleft lip and palate (CLP). The experiment group and the control group were both divided into four subgroups according to age: 0-1, 1-3, 3-6 years old, and more than 6 years old. The experiment group and the control group were both divided into three subgroups according to education: junior middle school and the following, high school and technical secondary school, junior college degree or above. The GQOLI-74 scale was selected to assess the experiment group and the control group. SPSS 16.0 software was used to analyze data.

RESULTS1) The experiment group had no significant difference with the control group in terms of the overall score and the scores of various children ages. 2) The scores of every item had no significant difference in CL, CP, CLP subgroup (P > 0.05). 3) The quality of life scores and scores of psychological function dimension and social function dimension of parents with 3-6 years old patients were obviously lower than those of parents with more than 6 years old patients (P<0.05). The scores of social function dimension of parents with 0-1, 1-3, 3-6 years old patients were obviously lower than those of parents with more than 6 years old patients (P < 0.05). The other items had no significant difference. 4) The scores of material life dimension and social function dimension of parents with junior college degree or above were higher than those of parents with junior middle school degree and the following (P < 0.05). The scores of social function dimension of parents with high school and technical secondary school degree were higher than those of parents with junior middle school degree and the following (P < 0.05).

CONCLUSIONNo difference was observed in the quality of life between cleft lip and/or palate children's parents and normal group. The parents with the low age children with cleft lip and/or palate and low-levels of education need more help and support to improve quality of life.

Child ; Child, Preschool ; Cleft Lip ; psychology ; Cleft Palate ; psychology ; Humans ; Infant ; Quality of Life ; Social Adjustment ; Software

Objective To explore otolaryngology nurses' knowledge of pain and attitude toward pain management and to provide reference for pain management.Methods A total of 102 otolaryngology nurses who participated in 2014 in Chongqing of Otolaryngology Head and Neck Surgery Symposium were surveyed by the nurses' general condition and current management situation and attitude survey regarding Chinese Knowledge and Attitude Survey Regarding Pain(KASRP).Results Average correct response rateon the KASRP from otolaryngology nurses was 45.9％,the interquartile range was 38.9％-51.0％,nurses' knowledge was relate to continuing education,P＜0.05,while irrelevant to age,work experience,education,job title,school education,clinical application of pain assessment tools,etc,P＞0.05.The proportion of nurses who accept the education of pain knowledge was 69.6％ (71/102),there was 74.5％ (76/102) nurses assess the patient by pain assessment tools in their daily work.Nurses first want to get the information of pain assessment,followed by pain medication,operational knowledge of analgesia pump and non-drug interventions for pain.Conclusions Nurses lack knowledge of pain,need to strengthen pain management training by continuing education and get knowledge of pain from academic journals,to provide reference for pain management.

Objective Summarize the experiences of treating after-operation ventricular electrical storm (VES) with extra-corporeal membrane oxygenation (ECMO) .Methods Examine the clinical data of seven cases of treating after-operation VES with ECMO from January 2013 to April 2014 and analyze the basic pre-operation conditions of the patients ,diagnoses ,causes of VES ,ai-ding processes with ECMO ,and prognoses .Results Seven patients all were successfully separated from the machine after the treat -ment ,one patient infected seriously after being separated from the machine ,having multiple organ failure one week later and dis-charged voluntarily ;one patient having cerebral hemorrhage two days later after being separated from the machine and discharged voluntarily ;the remaining five patients cured and discharged with no complications .Conclusion ECMO can provide effective circu-lar support to patients suffering VES after heart operation ,maintaining coronary blood supply ,avoiding further myocardial damage , stabilizing electrolytes and the internal environment ,and gain time for restoration of heart rhythm and treatment according to the causes and triggers .

Objective To evaluate the effect of standardized training and management of prenatal ultrasound screening on birth defects. Methods According to the degree of standardized training and management of prenatal ultrasound screening, the period from March 2004 to December 2009 were divided into three different management stages. Detection rate was applied to describe the prenatal ultrasound screening of 5199 birth defects cases delivered during the three different management stages. Accuracy rate was used to describe the ultrasonographic diagnosis made by staffs in 2009. SPSS 11.5 software was used to analyze the information of 707 staffs participated in the training and assessment activities from October 2007 to September 2009. Related factors of prenatal ultrasound operating skills of staffs were analyzed by comparing the distributing discrepancy of the different variables between qualified and unqualified group with Chi-square test. Results The detection rate of prenatal ultrasonographic screening on birth defects increased with the improvement of training and assessment methods, which was 32. 43% from March 2004 to September 2005,44.81% from October 2005 to September 2007 and 60. 71% from October 2007 to December 2009respectively. In 2009, 187 doctors were tested on abnormal ultrasound photographs identification. The accurate rates were 80. 0% for gastroschisis, 78. 8% for cleft clip, 75.8% for omphalocele, 71.8%for neural tube defects, 50. 0% for severe congenital heart diseases, 31.0% for acromicria, which were in similar sequence as the diagnostic rate identified by prenatal ultrasound in 2009. Among the staffs attending the prenatal ultrasound screening assessment, more had education background at least university level (52.8% vs 47.2%), more performed ≥50 ultrasound screenings per month (50. 5%vs 49.5 % ), more had been working on obstetric ultrasound over 3 yrs (52.5 % vs 47.5 %) and more had been trained in higher level of hospitals focused on prenatal diagnosis (64.7% vs 35.3%) in the qualified group than in the unqualified group. Conclusions Standardized training and management of prenatal ultrasonographic screening could effectively improve the diagnosis rate of birth defects.The quality of prenatal ultrasound screening is related to the staff's education background and whether they are engaged in the position.

Objective To investigate the voxel-based correlation of mini-mental state examination(MMSE) score with apparent diffusion coefficients(ADC) and fractional anisotropy (FA) derived from diffusion tensor imaging(DTI) in the patients with Alzheimer disease. Methods 12 patients aged (70.0± 10.5) years and 16 normal control aged (66.5±6.7) years were enrolled in this study.DTI was performed based on sequence and 32-channel head coils.ADC and FA images were calculated and normalized to the same space and smoothed with 8 mm Gaussian Kernel. With statistical parameter mapping software SPM5 package,the independent two sample t-test with general linear model were performed to detect ADC and FA differences between AD patients and normal control.Correlation analysis was performed between MMSE score and FA or ADC. Results AD patients showed elevated ADC value and decreased FA value in bilateral temporal lobe and anterior cingulate,which was more pronounced in the left than in the right.There was elevation of ADC value but no FA decrease in bilateral posterior cingulate.The abnormal ADC area was larger than that of FA.There was negative correlation between MMSE score and ADC of the right hippocampus(r=-0.9474,P=0.0232) and a tendency towards positive correlation between MMSE score and FA of the right hippocampus(r=0.5414,P=0.5853). Conclusions ADC value may be more sensitive than FA value in DTI. Right temporal lobe microstructure involvement is less severe,but has a stronger relationship with neuropsyehological abnormality.