Objective　To study the relationship between the quality of sleep and the mental health of elder people in community.Method　 41 social elderly people were studied by using Self-rating Scale of Sleep (SRSS) and Symptom Checklist 90 (SCL-90).Results　There was a significant difference in the mean of total score of SRSS and obsessive-compulsive, depression, anxiety, hostility, total score of SCL-90 ; the response of insomnia and depression, anxiety, hostility, paranoid ideation, total score of SCL-90; inability to sleep soundly and wake early, obsessive-compulsive, depression; medicine and depression, anxiety, total score of SCL-90; frightening dream and anxiety Conclusion　 The results suggested depression and sleep disorder affeced each other in elderly people. We would treat sleep disorder with depression and anxiety using antidepressants,anti-anxiety drugs and cognitive therapy. Improving sleep states would have a beneficial effect on the mental health of the elder, and improving mental health would be benefit for sleep.

Objective: To investigate the influence of Taoist education on subjective well-being of elderly Method: 105 elderly participated the Taoist education for 3 months were assessed with PGC (Philadelphia geriatric confidence) and SCL-90 before and after the education Other information, such as status of marriage, family relationship, self-reported health state, were also collected Results: The average scores of anxiety, phobia, somatization and depression in SCL-90 were higher in elderly than Chinese norm (P

Objective To improve the clinical prognosis of patients by reviewing ten years epidemiology data of acute poisoning inpatients.Methods The epidemiology data of the acute poisoning inpatients from 2006-2015 were retrospectively analyzed.The indexes including age,gender,nationality,geographical distribution,substance of poison,seasons,diagnosis and fee-for-service were collected.Results There were 1 083 patients with acute poisoning in total,624 cases (57.6％) for gas poisoning,213 cases (19.7％) for pesticide poisoning,136 cases (12.6％) for drug poisoning,74 cases (6.8％) for food poisoning and 36 cases for others.The ration of male to female was 0.94:1.The age of 31 to 45 range accounted for the highest proportion.The incidence of poisoning in 2011-2015 was significantly higher than that in 2006-2010 (P ＜0.05).The geographical distribution was also significantly different (P ＜0.05),most of the cases were in Shihezi city,then were Manasi and Sawan counties.Among the 1 083 patients,59％ cases were cured,33.6％ cases were improved after treatment,and the mortality rate was 2.6％.Feefor-service was also significantly increased in the older patients or males,and substance of poisoning dependent.The highest treatment cost was carbon monoxide poisoning,then were pesticide,drugs and food.Conclusions The common causes of poisoning in Shihezi city were carbon monoxide,organophosphorus pesticide,botulism and drugs,more emergency medical service should prevent poisoning and treat these patients.

ObjectiveTo investigate the incidence, types and risk factors of neurological complications in the early post-operation of renal transplantation. MethodsThe clinical course of 3169 cases of renal transplantation were reviewed, the clinical data of 102 patients with neurological complications were analyzed retrospectively.ResultsThe total incidence of neurological complications was 3.2%, which including: encephalopathy 35 (1.1%), seizure 24 (0.76%), acute stroke 15 (0.47% ), peripheral nerve disease 15 (0.47%), headache 12 (0.38%), central nervous system infection 1 (0.03%). ConclusionThere were varied of neurological complications of renal transplantation in early post-operation, in which encephalopathy and seizure were more common. Some of the complications may be related to immunosuppressive agents.

Objective In order to optimize the Fontan circulation,a technique for direct total cavopulmonary connection was devised.To evaluate its surgical feasibility as well as surgical outcomes,our clinical experience was retrospectively reviewed.Methods From August 2005 to March 2012,23 consecutive patients underwent modified extracardiac Fontan operation with direct total cavopulmonary connection.Clinical profile of the patients,and procedural variables were examined and analyzed.Results All patients had adequately developed main and branch pulmonary arteries.Inferior caval vein was contralateral to the pulmonary trunk main pulmonary artery in 7 cases,ipsilateral in 8,and others in 8.There was 1 hospital death.The other 22 patients remained hemodynamically stable postoperatively.Prolonged effusions (n =13,62％) was a challenging problem.No obvious stenosis was found at the direct cavopulmonary anastomosis.Conclusion we are convinced that a direct total cavopulmonary connection is feasible in select subset of patients.This modified Fontan procedure retains the advantage of extracardiac connections together with the avoidance of prosthetic materials.

Objective The aim of this article is to review and analyze the timing and surgical management of mediate and severe atrioventricular valve regurgitation(AVVR) in single-ventricle patients.Methods Between June 2006 and October 2011,twenty-three cases of single-ventricle patients accompanied with AVVR underwent atrioventricular valve plasty or replacement.There were 17 males and 6 females.Their ages ranged from 2.1 to 22.0 years,and their weight from 12.5 to 59.0 kg.There were 3 cases of A type of single ventricle,17 of B type,2 of C type,and 1 of D type.All cases had one atrioventricular valve except one of D type with 2 groups of atrioventricular valves.There were 18 patients with sever AVVR and 5 with the moderate.Before the management of AVVR,12 patients had undergone the first stage palliation,including B-D Glenn procedure 11 cases and A-P shunt 1 case.The periods between the two stages operations were 7-96 months.Among the all,there were 7 cases of atrioventricular valve replacement ; 3 cases of atrioventricular valve replacement and TCPC ; 5 cases of atrioventricular valve replacement and B-D Glenn procedure ; 2 cases of atrioventricular valve repair and TCPC ; 4 cases of atrioventricula repair and B-D Glenn procedure; 1 case of atrioventricular valve repair,B-D Glenn procedure and TAPVC repair; 1 case of atrioventricular valve repair,B-D Glenn procedure,PA Banding and TAPVC repair.Results In this group,there were 65.2％ patients who underwent atrioventricular valve replacement.The ones with moderate regurgitation underwent atrioventricular valve repair.Only 3 of the 18 cases with severe regurgitation could underwent atrioventricular valve repair(P =0.002).Three cases died.The mortality was 13％.All cases undergone atrioventricular valve repair were alive.The mortality of atrioventricular valve replacement was 20％.All the post-operative alive were followed up.Their follow-up period were between 0.8-6.3 years,withoud a dead case.Conclusion The regurgitation with single ventricle should be managed before the image of myocardium occurred.It is the best time to manage the atrioventricular valve when the regurgitation was moderate.The atrioventricular valve replacement is effective to the cases of single ventricle with severe AVVR.

Objective To investigate the clinical characteristics of invasive pneumococcal disease (IPD) and its drug resistance among children under the age of 5 years.Methods Clinical characteristics of 45 children of IPD admitted to the Shengjing Hospital of China Medical University from 2009 to 2010 and antimicrobial non-susceptibility results were analyzed retrospectively.Results Forty-five cases of IPD were confirmed by positive culture of sterile body site,most of which occurred between April and June.Most of the IPD children were below the age of 2 years,which accounted for 66.7％ (30/45).The disease spectrum included bacteremia in 32 cases (71.1％),encephalitis in 9 cases (20.0％),empyema in 23 cases (51.1％),necrotizing pneumonia in 10 cases (22.2％).Pneumococcal non-susceptibility to erythromycin were found to be 100％,to clindamycin were 95％,to tetracycline were 95.12 ％,to trimethoprim-sulfamethoxaole were 80.49％,to chloramphenicol were 18.18％,while pneumococcal resisitanse to rifampicin,quinolones and vancomycin were 0.Eight of eleven and 18/24 were found to be pneumoccal resistance to penicillin and cephalosporin respectively and their minimum inhibitory concentrations were high.Twenty five cases were cured (55.6％).Fifteen cases were improved (33.3％).Four cases died (8.9％).One cases was retreated.All cases of death were under the age of 2 years.Conclusion IPD is more common with a high mortality rate among those under the ages of 2 years.Poor outcome is associated with Streptococcus pneumoniae resistance to antibiotics.

Objective Retrospectively analyze primary experences of surgical correction of complicated aortic arch anomaly with autologous palmonary artery.Methods Between July 2010 and December 2012,13 cases of complicated aortic arch anomaly underwent reconstruction of aortic arch with autologous pulmonary artery.Classifications of aortic arch anomaly were interrupted aortic arch with ventricular septal defect in 4 patients,ventricular septal defect associated with coarctation in nine patients.There were 7 males and 6 females.Their age at surgeries ranged from 1 month to 16 years,and the body weight were from 3.5 kg to 52.0 kg with median weight of 12.6 kg.Cardiopulmonary bapass was estabished with dual arterial cannulations in patients with interrupted aortic arch.During cooling to deep hypothermia(rectal temperature was 18 ℃),intracardiac defects were totally corrected.Arch anomaly was reconstructed under deep hypothermia,including deep hypothermic cardiac arrest(DHCA) in 9 patients,deep hypothermia with regional perfusion in 4 patients.Anterior wall of pulmonary artery was excised in all of 13 patients.In 4 cases,the excised wall of anterior wall of pulmonary artery was sutured to form a conduit with different diameters according to the patient's bady surface area.Two ends of the conduit were anastomosed the aortic arch and desceding aorta respectively.In another 9 patients,aortic arch was augmented with tailored pulmonary artery patch in oval shape.The defect of pulmonary artery was repaired with autologous pericardial patch.Results There was only 1 death due tomutiple organ failure postoperatively.Another 12 patients survived without neurologic complications.Differences of arterial pressures between upper and lower extremeties were not monitored in all cases.During follow-up,routine echocardiogram showed satisfactory results with unobstructive blood flow at the aortic arch.Conclusion Autologous pulmonary artery can be used to relieved complicated aortic arch anomaly completely without any tension of anastomosis site and compression of left main bronchea postoperatively.More patients with long-term follow-up are necessary to draw an accurate conclusion of this technique.

Objective The aim of this study is to retrospectively analyze surgical management of absent pulmonary valve syndrome(APVS).Methods Between January 2005 and January 2012,totally 11 children with APVS underwent primary surgical correction.There were 7 boys and 4 girls.Age at surgeries range from 1 to 5 years,and wcight from 10.2-17.5 kg,with average (12.3 ± 3.4) kg.Surgical procedures include VSD repair,pulmonary arteries reconstruction and RVOT reconstruction with monocusp valve.5 cases chose Lecompte maneuver as an option to release compression to bronchus,5 cases underwent fibroscopy inspection and airway secretion suction,and 4 cases adapted deep hypothermic circulatory arrest (DHCA)during correction procedures.All survivors are routinely followed-up with echocardiogram.Results All 11 cases survived,2 of them suffered from frequent lungs infections during the first year post surgery.No case exists bronchus or pulmonary arteries compression.Conclusion APVS is a rare congenital heart defect,which may challenge perioperative managements and operations.Ideal surgical correctiou includes RVOT reconstruction,decompression of bilateral bronchus,and airway inspection with fibroscopy.However,compression of intrapulmonary bronchi by abnormally branching pulmonary arteries may expose patients to a relative long time of medication therapy after surgical correction.A large number of patients with long-term follow-up are needed to draw definitive conclusions on this strategy' s effectiveness.

Objective To compare the results of transcatheter intervention (TI) and surgical operation (SO) in the pri-mary treatment for pulmonary atrcsia with intact ventricular septum (PA/IVS). Methods From January 2006 to May 2009, 25 patients (20 male,5 female) with PA/IVS were treated. The age at treatment was from 2 days to 8 months. The body weight was from 2.1 kg to 6.7 kg. All patients had mild to moderate hypoplasia of the right ventricle (the Z-valvue of the tricuspid valve: from -2 to 1.5) with tripatite right ventricle and without coronary artery-right ventricular fistula. Eight patients under-went TI and 17 patients underwent SO. Results The primary procedure was successful in 7 patients (88%) in TI group and in 16 patients (94%) in SO group. There were 2 deaths (1 in each group). There was no significant difference regarding re-sidual pulmonary stenosis between two groups. The ventilation time and the days of hospital stay were shorter in TI group than in SO group. All the survivors were followed up for 3-36 months. One patient required repeat balloon dilation in TI group. While in SO group, one required reoperation and one required balloon dilation for PS, and 2 patients were waiting for balloon dilation. Twenty-one patients have achieved complete biventricular circulation. Two patients were scheduled for Glenn shunt operation later (1 in each group). Conclusion For PA/IVS patients with mild or moderate right ventricle hypoplasia, tran-scatheter intervention is a better alternative than surgical operation in the primary treatment.