Objective:To explore the types and characteristics of the grief reactions of adolescents to friends'death repeatedly,so as to provide reference for effective psychological intervention. Methods:Three college students aged nineteen and twenty years who experienced the death of friends at least twice in adolescence participa-ted in the study by means of an open recruitment in a college. They had friends died at the age of 9 and 12. And then it happened again when they were 15 and 17. Data was collected by semi-structured interviews with the three selected,and analyzed by thematic analysis to classify the grief reactions after the loss of their friends. Results:The common grief reactions of a friend's death in the interview are:shocked,regret and angry,denying,disbelieving, fear of the death,feeling the cruelty of death,crying,searching for support,shirking and recognizing the cruelty of death. The special grief reactions in the interview,especially when they experienced the second death of a friend are:caring for the dead loved ones,having a mental shadow over friend's role,reducing social activities,seeking stimulating and venting,revolting against the school,violence,and working harder. Conclusion:The grief reactions of adolescents to friends'death repeatedly are diversity. It presents the characteristics of the psychological develop-ment of adolescence. And the adolescents need to be given special attention and appropriate psychological interven-tion.

Objective To study the relationship of implicit memory and amnesia effect of oral midazolarn premedication and toobserve its anterograde amnesia, the effect on short-term memory and the onset time and out come of retrograde amnesia. Methods60 patients with ASA I - Ⅱ status undergoing abdomen and limb operations were divided into 3 groups with 20 cases each. Group A:oral midazolam 7.5mg;Group B:oral 15mg;Group C:placebo. The patients received combined spinal-epidural anesthesia after oral midazolam. The parameterns of EEG, SEF 95 %, BISwere collected at the same time and the degree and remark of sedation were dome according to OAA/S. The amnesia and implicit memory were investigated with pictures and muddy identified hearing rate 6 hours after operation. Results (1)Twenty min following drug ad dministration the remarks of sedation of group A and B were significantly loWver than that before and that of group C, Which was not significently different between group A and B. ( 2)The amnesia rates tested six hrs after surgery were significantly higher at 30min in group A, 20min in group B than those before treatment and were kept at 70%-80% levels, which in group C was remained zero. (3)The muddy identified hearing rate was not different significantly, among the three groups. (4) The short-term memory was all 100%during the period of drug action. (5)BIS and SEF 95% Were lower 30min after the treatment and all kept at 80 Hz and 20 Hz, which were not different remarkably between group A and B. ConclnsionOral midazolam 7. 5mg has a good effect on anterograde amnesia 30min after treatment, which may not be improved with increament in dosage. It does not lead to retrograde amnesia. The long-term memory, but not short-term memory, was impaired by midazolam. It only affects the explicit memory. Oral premnedication with midazolam can not prevent the awareness during operation totally.

ObjectiveTo compare the efficacy of 3 internal fixations, locking proximal femoral plate(LPFP), ASIAN IMHS and InterTAN, for intertrochanteric femoral fractures in elderly patients.MethodsA retrospective study was done to analyse 185 elderly patients who had been treated for intertrochanteric femoral fractures from February 2008 to December 2009 in our hospital and fully followed up.They were treated with LPFP (group A, 95 cases), ASIAN IMHS (group B, 52 cases) and InterTAN (group C, 38 cases) . Statistical analyses were conducted to compare the 3 groups in operative time, blood loss,fluoroscopy exposure, hospital charges, intrraoperative complications and functional outcome(Harris hip score).Results The average follow-up was 14. 5 months(from 6 to 28 months). Compared with group A, groups B and C showed significant advantages in operative time, blood 1oss and functional outcome but significant disadvantages in fluoroscopy exposure and hospital charges ( P ＜ 0. 05 ). Compared with group A,groups B and C had significant fewer implant failures ( P ＜ 0. 05).There were no significant differences in all the indexes between groups B and C( P ＞ 0. 05) .Conclusions The ASIAN IMHS and InterTAN appear to be more reliable than LPFP for the treatment of intertrochanteric femoral fractures in the elderly.There appear to be no significant differences between ASIAN IMHS and InterTAN.

Objective To study the dynamic change of high-sensitivity C-reactive protein(hCRP),interleukin-1(IL-1?)interleukin-6(IL-6)in acute traumatic brain injury,and the correlation between the dynamic change and the scale of brain injury and the prognosis of the patients.Methods 192 cases patients were divided into different groups according to the Glasgow Coma Scale(GCS)and the Glasgow outcome Scale(GOS)three months later discharged from hospital respectively.The concentration of serum CRP,IL-1?,IL-6 were detected with immunoturbidimetry and ABC-ELISA 24 with in hours after traumatic brain injury and the concentration of serum after iniwn at ond day,three days and seven days was detected as well.Results Serum hCRP levels were remarkably elevated and reached peak value within 24 hours,and then gradually decreased.There were a negative correlation between hCRP,IL-1?,IL-6 and the patient's GCS groups(r=-0.162,P

Objective The objective of this study was to explore the value of enhanced recovery surgery(ERAS)in perioperative period of laparoscopic assisted colorectal cancer surgery.Methods From November 2015 to July 2016,86 patients with colorectal cancer treated with colorectal surgery were divided into ERAS group and routine treatment group.All patients underwent laparoscopic radical resection of colorectal cancer.The operative situation,postoperative recovery and complications were analyzed in this study.Results There was no difference in the operation time and bleeding volume between the operation group and the conventional treatment group(P>0.05).The postoperative ventilation and defecation time in the ERAS group were earlier than those in the routine treatment group.The postoperative hospital stay and the postoperative pain score were lower than those in the routine treatment group.The rate of postoperative complications was lower than that in the routine treatment group(P<0.05).Conclusion The operation of laparoscopic colorectal cancer under the guidance of ERAS can help patients to recover from hospital,shorten the hospitalization time and reduce the cost of hospitalization.The further application of ERAS should be combined with various disciplines.

Objective To illustrate the chest radiography and MSCT findings of measles pneumonia in adults. Methods One hundred and sixty three measles patients underwent chest radiography, MSCT was performed in 3 of them. Measles pneumonia was confirmed in 10 patients (6.13%). Results Eight of 10 patients had abnormal appearances in initial chest radiography. The characteristic chest radiographic findings were ground-glass opacities (n=6) and bronchial wall thickening (n=2). MSCT showed bilateral multiple ground-glass opacities in 1 patient,unilateral patchy ground-glass opacities with lobular distribution in the right upper lung in 2 patients. Conclusions Familiarizing with radiographic and MSCT appearances of measles pneumonia in adults is very important for the differential diagnosis and appropriate management of measles pneumonia. Normal initial chest radiography cannot exclude the involvement of the lungs.

Based on the plasmon coupling effect in gold nanoparticles core-satellite nanostructures linked by thymine(T)-rich DNA hybridization and the specific Hg2+-mediated T-Hg2+-T base pair, a novel localized surface plasmon resonance (LSPR) optical fiber sensor was proposed and developed for Hg2+ detection in water.The Hg2+-induced conformational change in T-rich DNA sequence inhibited the DNA hybridization reaction, weakened the plasmon coupling effect and leaded to the change of LSPR resonance wavelength.The concentration of Hg2+ was quantitatively determined by the resonance wavelength redshift.The linear range of Hg2+ detection was about 5-150 nmol/L with LOD about 3.4 nmol/L.The specificity of the sensor was proved great by evaluating the response to other heavy metal ions such as Zn2+, Mg2+, Pb2+ and so on.This sensor was applied in environmental water detection by standard addition method,with the RSD less than 4.8% and recoveries of 94.2%-105.4%.

BACKGROUND:There are many methods for evaluating anterior cruciate ligament reconstruction. However, doctors always like to assess the outcome with the objective criteria, such as range of motion and imaging examinations, and patient satisfaction is little considered.OBJECTIVE:To explore the factors that may influence the patient satisfaction after anterior cruciate ligament reconstruction. METHODS:Ninety-eight patients undergoing anterior cruciate ligament reconstruction were enroled, including 58 male and 40 female patients, and the average age was 27.4 years old. All patients were followed up (average 17.5 months) to investigate the patient satisfaction. The factors related to the satisfaction were analyzed, such as age, follow-up time, sex, injured knee, mental health, education, economic situation, postoperative athletic ability, and International Knee Documentation Committee scores. RESULTS AND CONCLUSION:After the follow-up, 72.4% patients said that they were satisfied with the outcome, and 27.6% dissatisfied with the outcome. The mental health, economy situation, postoperative athletic ability, and International Knee Documentation Committee scores were significantly related to the patient satisfaction (P < 0.05). To conclude, improved living and medical standard, intensive communication and psychological counseling, as well as rational postoperative rehabilitation scheme can improve the patient satisfaction after anterior cruciate ligament reconstruction.

OBJECTIVE:To investigate the effect of total saponins of Man medicine Thladiantha dubia root(TSTR)on the ex-pressions of CD3+,CD4+and CD8+ in spleen tissue of rats with type Ⅱ collagen-induced arthritis (CIA),and explore its mecha-nism in the treatment of rheumatoid arthritis(RA). METHODS:8 rats were taken as normal control group(NC group),the others 72 rats were injected mixture of bovine type Ⅱ collagen and Freund's complete adjuvant in tail and back to induce CIA model. The 50 modeled rats were randomly divided into model group(MC group),tripterygium polyglycoside(TG)group(12 mg/kg,posi-tive control),TSTR low-dose,medium-dose,high-dose groups (20,40,80 mg/kg),10 in each group. Rats in medicine groups were intragastrically administrated for 35 d,once a day;rats in NC group and MC group were intragastrically administrated equal volume of distilled water. Ankle swelling degree of rats was determined,arthritis indexes were calculated,HE staining was used to observe the lesions in synovial tissue,and immunohistochemistry was used to detect the expressions of CD3+,CD4+,CD8+ in spleen tissue of rats. RESULTS:After 35 d of administration,ankle swelling degree,arthritis indexes,CD4+ expression in spleen tissue,and CD4+/CD8+ ratio in MC group were significantly higher than NC group (P<0.05 or P<0.01),expressions of CD3+, CD8+were significantly lower than NC group(P<0.05);and there was congestion and massive inflammatory cell infiltration in sy-novial tissue. The ankle swelling degree,arthritis indexes,expression of CD4+ in spleen tissue,and CD4+/CD8+ ratio in administra-tion groups were significantly lower than MC group(P<0.05);the expressions of CD3+,CD8+ in spleen tissue in administration groups were significantly higher than MC group (P<0.05);TG group,TSTR medium-dose and high-dose groups showed mild congestion and a small amount of inflammatory cell infiltration in synovial tissue of rats,and TSTR low-dose group showed no ob-vious congestion or inflammatory cell infiltration. CONCLUSIONS:Up-regulating the expressions of CD3+,CD8+ and down-regu-lating the expression of CD4+ may be one of the mechanisms of TSTR in the treatment of RA;and with best efficacy when the TSTR dose of 20 mg/kg.

AIM:To extract pueraia isoflavone and soyisoflavones with n-butanol by means of inner ebullition from Radix puerariae lobatae.METHODS:A little ethanol was first used to saturate the powder of Radix puerariae lobatae to make the pueraia isoflavone desorbed adequately,and then hot n-Butanol solution was added to make the ethanol inside Radix puerariae lobatae begin to boil and the extraction was intensified.Based on different solubility of pueraia isoflavone and soyisoflavones in n-Butanol,when solvent vaporized,the soyisoflavones were separated and then the pueraia isoflavone by step vaporizeing on centrating crystal.RESULTS:80 mL of 60% ethanol,saturating time 20 min,600 mL n-Butanol including 20% water,at the temperature of 90 ℃,the yield of total isoflavone was 11.3 %.When 90% solvent vaporized,the ratio of quality of the soyisoflavones and pueraia isoflavone was 1∶3.The puerarin and daidzin's purity reached 46.0% and 6.12% by the HPLC respectively.CONCLUSION:The technology of inner ebullition extraction and solvent vaporizing crystal separation are simple,which provide industry production basis for pueraia isoflavone and soyisoflavones.