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 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.

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 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 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 evaluate the effect of dexmedetomidine on acute lung injury induced by scalds in rats.Methods Seventy-five male Sprague-Dawley rats,weighing 200-220 g,were randomly divided into 5 groups (n =15 each) using a random number table:control group (group C),scald group (group S),dexmedetomidine group (group D),α-bungarotoxin (α-BGT) group,and dexmedetomidine+ α-BGT group (group D+α-BGT).About 30％ of the total body surface was shaved and then exposed to 98 ℃ water for 12 s in S,D,α-BGT and D+α-BGT groups.The back of rats was exposed to 37 ℃ water for 12 s in group C.Rats were resuscitated with lactated Ringer's solution injected intraperitoneally according to Parkland formula within 24 h after establishment of the model.In D,α-BGT,and D+α-BGT groups,dexrnedetomidine 40 μg/kg,α7 nicotinic acetylcholine receptor antagonist α-BGT 1 μg/kg,and α-BGT 1 μg/kg plus dexmedetomidine 40 μg/kg were injected intraperitoneally,respectively,at 15 min before establishnent of the model.At 24 h after establishment of the model,the rats were sacrificed,and lungs were removed for examination of the pathological changes and for determination of myeloperoxidase (MPO) activity,in terleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNF-α),and IL-6 contents (by enzyme-linked immunosorbent assay),and nucleoprotein factor kappa B (NF-κB) (by Western blot).The lung water content [(wet weight-dry weight)÷wet weight× 100％] was calculated.Results Compared with group C,the lung water content,MPO activities,and contents of IL-1β,TNF-α and IL-6 were significantly increased,and the expression of NF-κB was up-regulated in S,α-BGT and D groups (P＜0.05).Compared with group S,the lung water content,MPO activities,and contents of IL-1β,TNF-α and IL-6 were significantly decreased,and the expression of NF-κB was down-regulated in D and D+α-BGT groups (P＜0.05),and no significant change was found in the parameters mentioned above (P＞0.05),and the pathological changes were significantly attenuated in group α-BGT.Compared with group D,the lung water content,MPO activities,and contents of IL-1β,TNF-α and IL-6 were significantly increased,the expression of NF-κB was up-regulated (P＜0.05),and the pathological changes were aggravated in group D + α-BGT.Conclusion Dexmedetomidine can mitigate scalds-induced acute lung injury in rats.

Objective To investigate the effect of ultrasound-guided paravertebral nerve block on stress reaction in patients undergoing esophageal resection. Methods Eighty patients scheduled to do the operation of esophageal resection were randomly divided into two groups with 40 cases in each group. The patients in group A were given the general anesthesia combined with ultrasound-guided paravertebral block, and the patients in group B were given the general anesthesia only. Both of two groups received postoperative patient controlled intravenous analgesia (PCIA). The amount of propofol and remifen-tanil used were recorded. The data of blood pressure, heart rate (HR) and pulseoxygen saturation (SpO2) before anesthesia (T1), before induction (T2), after intubation (T3), in 2 h of surgery (T4), after surgery (T5), 1 h after surgery (T6), 8 h after surgery (T7), 24 h after surgery (T8), 48 h after surgery (T9)were recorded. The analgesic effect was measured by VAS scores and Ramsay sedation scores were also recorded at T6-T10. The levels of blood glucose, epinephrine (E), norcpincphrinc (NE) and dopamine (DA) were also detected at T1, T4, T5, T9. Results The amount of propofol and remifentanil used in group A were lower than those in group B: (960.0 ± 216.9) mg vs. (1 242.5 ± 200.2) mg, (1.5 ± 0.4) mg vs. (2.3 ± 0.4) mg, P<0.05. The patients in two groups successfully completed surgery, and intraoperative vital signs was stable. The quiet and active VAS scores at T6-T9 in group A were significantly lower than those in group B (P<0.05). The Ramsay sedation scores at each time point in two groups had no significant differences (P>0.05). The levels of blood glucose and NE at T9 were significantly higher than those at T1, T4 or T5 of same group, P<0.05.The level of E at T4 and T5 was significantly lower than that at T1 and T9 of same group, P<0.05. The level of DA at T9 was significantly higher than that at T1, T4 and T5 in group B (P<0.05). The levels of blood glucose, NE, E and DA at T9 in group B were significantly higher than those in group A (P<0.05). Conclusions General anesthesia combined with ultrasound-guided paravertebral nerve block could offer favorable anaesthesia effect. It could decrease stress reaction and anesthetics requirements in patients undergoing esophageal resection.

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.