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 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.

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 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 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 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.

Objective To observe the influence of congenital heart disease(atrial septal defect,ASD)to intervene closure on the right structure of children(<1 5 years)and adults(1 5-65 years)and to make the safety assessment.Methods Totally 1 1 1 un-derwent interventional treatment of complications in patients with ASD in our hospital from 2010 to 2013 were retrospective ana-lyzed.Closure on changing of right heart structure of child and adult were measured by ultrasonic cardiogram.Closure falls off,shut valve insufficiency,arrhythmia,residual shunt were recorded by ultrasonic cardiogram and electrocardiogram.making statistical a-nalysis.Results The inner diameter of the right atrium(RAD),right ventricle diameter(RVD),pulmonary artery diameter(PA) and right ventricular outflow tract(RVOT)were decreased compared with pre-operation(P < 0.05 ),during the follow-up 1,3,6 month,they was continue decreased in the aged between1 5-65 group(P <0.05),but was stable in less than 1 5 years old age group (P >0.05 ).The complication rate of children and adults were 25.0% and 21.3% respectively,and there were no significantly difference(P >0.05),and was no serious complications.Conclusion Congenital heart disease intervention of atria septal defects can improve heart right structure,which can benefit both children and adult,there is no difference in complication rates.All of these have less serious complications,high safety,curative effect affirmation.

Objective To discuss the influence of framing information and time window information upon risk decision making about thrombolysis therapy in patients with cerebral infarction or their relatives in the scenarios of thrombolytic therapy for acute cerebral infarction.Methods Inpatients and outpatients with cerebral infarction or their relatives(n=327) were randomly divided into positive framing group(n=187) and negative framing group(n=140).Every participant underwent risky messages about thrombolytic treatment in three different time windows:0-90 minutes,91-180 minutes and 181-270 minutes.Results In any thrombolytic time window condition,there was no significant difference in thrombolytic tendency of participants between the positive framing group and the negative framing group (0-90 min:x2=1.24,P＞ 0.05;91-180 minutes:x2 =0.35,P＞0.05;181-270 minutes:x2 =0.07,P＞ 0.05).In a negative framework conditions,compared with the participants receiving thrombolytic information in 181-270 minutes time window,subjects receiving thrombolytic information in 0-90 minutes window were more tolerant of thrombolytic treatment (69.3 ％ vs 51.5 ％,P＜ 0.0125).Conclusion There are mutual effects of time window and framing information upon participants' preferences for thrombolysis.Different thrombolytic information are presented according to their corresponding time windows.

Objective To investigate postoperative psychological experiences of patients underwent kidney transplant donated by his/her parent,and to discover mental signs and psychological journey in individual growth.Methods Semi-structured in-depth interviews were conducted among 17 patients underwent kidney transplant donated by his/her parent,and Giorgi analysis method was used to analyze data.Results The postoperative psychological experiences of patients mainly contained 4 aspects:posttraumatic growth,rebuilding meaning of life,being grateful for experience,coexisting of hope and challenge.Conclusion The patients have complex psychological experiences,having positive aspects derived from rehabilitation and improved quality of life,as well as negative aspects derived from concerning health of the donor,fear for complication and rejection,and lack of sound supporting system.Medical staff should guide patients to adjust cognitive and behavioral patterns and face life events directly,integrate medical/social support resources and enhance patients' psychological capital to face future life.