Objective To investigate the sleep problems and related affecting factors of primary or possibly symptomatic school-aged children with epilepsy.Methods 54 epilepsy children(7 to 12 years old) and the general 54 healthy children whose gender and age were strictly matched with epilepsy group were investigated by using the chinese version of CSHQ.Results ① The total CSHQ score and 6 subscale scores (bedtime resistance, sleep onset delay,sleep anxiety, night wakings, parasomnias, and daytime sleepiness)were significantly higher in the epilepsy group(P<0.05).② In the epilepsy group, different age groups had statistical difference in the total CSHQ score and 4 subscale scores(sleep resistance, sleep onset delay, sleep duration and sleep anxiety) (P<0.05).The seizure controlled group and the uncontrolled group had statistical difference in the total CSHQ score and all subscale scores, except sleep onset delay(P<0.05).There were statistically significant differences in the total CSHQ score and all subscale scores, except sleep-disordered breathing in different seizure frequency groups(P<0.05).Different seizure type groups had statistical difference in the total CSHQ score and 4 subscale scores(sleep resistance, sleep duration, sleep anxiety and daytime sleepiness)(P<0.05).Different seizure time groups had statistical difference in the total CSHQ score and 5 subscale scores(sleep resistance, sleep onset delay, sleep duration, sleep anxiety and night waking)(P<0.05).Monotherapy group and polytherapy group had statistical difference in the total CSHQ score and 4 subscale scores(sleep onset delay, night waking, parasomnias and daytime sleepiness) (P<0.05).③ Multiple linear regression analysis showed that the main influencing factors of the total CSHQ score and some subscale scores were gender, age, control of seizure, frequency of seizure, type of seizure, time of seizure and the number of drug taking.Conclusion Children with epilepsy compared with healthy children are more likely to have sleep problems, and the occurrence of sleep problems may be related to many factors.

Objective To evaluate the safety and efficacy of Voriconazole on invasive fungal infections in very elderly patients.Methods Clinical data of 24 very elderly patients with invasive fungal infections who had sought treatment at the Department of Geriatrics of our hospital from April 2013 to April 2014 were retrospectively investigated.The classifications and quantities of fungi,accompanying symptoms,adverse reactions,blood tests,and liver and kidney function indicators were recorded and analyzed before and after treatment.Results Each of the 24 cases was found to have been infected with one or more of 17 fungal strains belonging to the genus of Candida.The rate of complete fungal elimination after treatment was 70％ (12/17).Of the 24 cases,5 achieved a full recovery(20.8 ％),10 (41.7 ％) had significant improvement,5 (20.8 ％) had some improvement,and 4 cases(16.7％)showed no therapeutic benefits,with a total effectiveness rate of 62.5 ％.There was no significant difference in liver and kidney function before and after treatment(P＞0.05).A transient increase in serum creatinine occurred in 1 case and defective vision in another patient during Voriconazole treatment.Conclusions The incidence of invasive fungal infections is high in very elderly patients,with Candida as the main pathogen.Voriconazole is effective in treating invasive fungal infections in very elderly patients,and close monitoring of liver and kidney function is required during voriconazole treatment.

Objective To explore how to improve the capability of emergency rescue to cope with the explosion of hazardous chemicals through analyzing the rescue process of Tianjin port 8 · 12 explosion hazard.Methods The process of explosion emergency rescue on the hazardous chemicals warehouse of Ruihai company in Tianjin Port on the evening of August 12,2015,were analyzed,summarize the experience and lessons.Results There were some shortcomings on field assessment,safety zoning,EMSS,treatment in hospital,personal protection equipment and public knowledge on hazardous chemicals explosion in Tianjin port 8.12 explosion hazard.we should learn from the lessons,to provide reference for the future similar rescue.Conclusions The ability of emergency rescue team to deal with the major hazardous chemicals explosion should further improve,to protect the safety of society and health of common people.

Objective To explore the decision-making process of medical students who turned the major from the medicine to other majors,and the related factors that hindered them continuing to study the medicine.Methods According to the design of interpretative phenomenon logical analysis,semi-structured in-depth interviews were used to collect the data.Participants were six undergraduate students who had moved from medical major to another major.Interviews were recorded on audio-tape with the students' permission and then transcribed verbatim.The transcribed interviews were analyzed according to six steps of interpretative phenomenological analysis.Results Even if the participants had left the medical major,they still expressed a strong sense of professional identity for the doctor.However,they also admitted that the professional process of medicine students was very hard and tired,and couldn't get the equal return for their payment.They thus were lack of confidence for the future.Some of the participants talked about the fact that they had been curious about the future of medical students.Internet and seniors were the main avenues for obtaining job-related information,but they were often plagued by the negative information.Education about career adaptation should be carried out as soon as possible,to strengthen the professional identity of medical students,and enhance their ability to defend against negative information,which could help to deal with the status of high turnover rate for medical students.Conclusion Based on the students' perspective,exploring the decision-making process of turning major for medical students will contribute to the educators taking effective strategies to improve the students' career identity,stabilize their professional thought,and reduce the loss of the medical students.

Objective To investigate the correlation between meteorological factors and the incidence of acute cardiovascular disease.Methods The number of calls for ambulance in case of cardiovascular disease between 2006 to 2010 was obtained from Beijing 120 emergency center and the data of meteorological factor during for the same period from Beijing Meteorological professional were collected,and then the impact of the weather factors of different seasons of weather factors on the incidence of cardiovascular disease was ere analyzed by time-stratified case-crossover design.Results The average daily incidence cases of cardiovascular disease in four seasons average daily were 5.61,4.55,5.05 and 6.03 respectively.The association between temperature Temperature and the incidence of acute cardiovascular disease was were non-linear relationship changes in spring and autumn seasons.Atmosphere Air pressure and the incidence were negatively correlated in the winter.The relative humidity of airand the incidence were related in the spring,summer,autumn.Wind and the incidence were related in the spring,summer,but negative correlation in the autumn,winter.Conclusions The incidences of acute cardiovascular disease are higher more in winter and spring than in summer and autumn.The incidences of cardiovascular disease are related with temperature,relative humidity,wind speed and other meteorological factors.,The influence of meteorological factors on the incidence of the disease delays to occur after changes in weather.

Objective To evaluate the neurotoxicity induced by multiple exposures to sevoflurane anesthesia in the neonatal rats.Methods Thirty-two healthy SPF Sprague-Dawley rats of both sexes,aged 7 days,weighing 15-20 g,were randomly divided into 2 groups (n=16 each) using a random number table:control group (group C) and multiple exposures to sevoflurane anesthesia group (group Sev).On postnatal day 7,14 and 21,2.6％ sevoflurane was inhaled for 2 h in group Sev,while the mixed gas of oxygen and air was inhaled instead of sevoflurane in group C.Morris water maze test was carried out on postnatal day 32-36 to assess the cognitive function.On postnatal day 21 and 36,8 rats in each group were selected and anesthetized,and the cerebrospinal fluid was collected for determination of the concentrations of amyloid β-protein by enzyme-linked immunosorbent assay.Results Compared with group C,no significant change was found in the escape latency,movement time spent in the effective region of the platform,movement distance,the number of entries into the effective region,percentage of residence time,percentage of movement distance,and percentage of the number of entries (P＞0.05),and the concentrations of amyloid β-protein in the cerebrospinal fluid were significantly increased on postnatal day 36 in group Sev (P＜0.05).Conclusion Multiple exposures to sevoflurane anesthesia can induce central neurotoxicity,but do not induce changes in the cognitive function in the neonatal rats.

Emotional and cognitive disorders (EACD),such as depression and anxiety,have become very common in today′s society,seriously affecting human lives and health. Neural plasticity can reflect the anti-stress ability of the nervous system to the internal and external stimulation,and is capable of dynamic changes in structure or function to adapt to environmental changes,as is often manifested in the process of compensation and repair of nerve injuries. EACD is often accompanied by macroscopic and cellular morphological changes in brain tissues and functions. Thus,studies on the mechanisms of neural plasticity will contribute to the treatment of EACD. In this paper ,the role of neural plasticity in the active components of Chinese herbal medicine(ACCHM) is reviewed. The effects of ACCHM on 5-hydroxytryptamine(5-HT)system,and the antioxidant activities and neurotrophic effects of ACCHM are described. ACCHM can affect neural plasticity,playing a neuroprotective role by improving 5-HT levels,reducing oxidative stress in brain cells,and increasing the expression of brain derived neurotrophic factor(BDNF). In summary,one ACCHM could affect neural plasticity through one or more mechanisms. There are interactions between different mechanisms of the same ACCHM. Different ACCHM can play a synergistic effect on the enhancement of neural plasticity because of their different mechanisms.

Objective To evaluate the effects of psychological nursing process on the quality of life and its related factors in maintenance hemodialysis patients.Methods Ninety maintenance hemodialysis patients from September 2013 to September 2014 were selected as research object,and they were divided into control group 45 cases and observation group 45 cases by random digits table method.The patients in control group received routine psychological intervention,while the patients in observation group received psychological intervention with nursing process.The two groups were evaluated and compared with Short Form 36 Health Survey Questionnaire score (SF-36), Self-Efficacy for Managing Chronic Disease(SEMCD) and Perceived Social Support Scale(PSSS) before and after the intervention at 6th and 12th month.The score changes of each scale were analyzed by repeated-measures analysis of variance and multivariate analysis of variance.Results The number of patients that had completed the whole intervention process was 42 in control group and 44 in observation group.The SF-36 scores of two groups were all increased gradually with the extension of intervention time (time effect, all P＜0.01), but compared with control group, observation group had a trend towards better SF-36 score except for the dimension of physical functioning(interactive effect, all P＜0.01).In all dimensions of SF-36, the scores of physical role,general health,vitality and social function in observation group as a whole were higher than those in control group (group effect, all P＜0.05).Similarly, the SEMCD and PSSS scores of two groups were all increased gradually with the extension of intervention time (time effect, all P＜0.01), but the increasing trend of observation group was more obvious than control group (interactive effect, all P＜0.01).Conclusions The application of psychological nursing process can effectively improve the life quality of maintenance hemodialysis patients, and have a satisfied long-term effect,which may be related to the continuous improvement of psychological nursing process on the self-efficacy and perceived social support of the patients.

Objective To observe the analgesic and sedative effects of oxycodone combined with dexmedetomidine and its effects on respiratory and cardiovascular functions during endotracheal intubation guided by fiberoptic bronchoscope at conscious state.Methods Forty patients with endotra-cheal intubation difficulty were randomly divided into sulfentanil group and oxycodone group.An initial induction dose of 1 μg/kg dexmedetomidine was given followed by an maintaining infusion of 0.2 μg·kg-1 ·h-1 in sulfentanil group,additionally,0.2 μg/kg sulfentanil was given intravenously. Patients in oxycodone group received intravenous infusion of oxycodone 0.08 mg/kg instead.The changes of HR,MAP and SpO 2 were monitored during medication and intubation.The Ramsay scores before intubation, the PET CO 2 and comfort degree after intubation were recorded. Results There were no statistically significant differences in hemodynamic changes,Ramsay scores and comfort level between the two groups during drug-injection and intubation.SpO 2 of patients in oxycodone group was higher than that of sulfentanil group after injection of drugs,but PET CO 2 of oxycodone group after endotracheal intubation was lower.Conclusion The combination of oxycodone and dexmedetomidine can be safely used in awake tracheal intubation,for it shows effective sedation and analgesia,less respiratory depression and other side-effects compared with sufentanil.

Objective To establish a method for determination of imatinib mesylate liposome and related substances. Methods The liquid chromatography was carried out on a Kromasil C18 column. The mobile phase A consisted of methanol-octane sulfonate solution(42:58). The mobile phase B consisted of methanol-octane sulfonate solution(4:96). The flow rate of gradient elution was 1. 2 mL·min-1 . The detection wavelength was 268 nm. The column temperature was room temperature. Results The intermediates and degraded substances could be seperated under the selected chromatographic conditions. Imatinib mesylate showed a good linear relationship within 1-100μg·mL-1,r=0. 999 1(n=5). Conclusion The method is specific, accurate,sensitive,and simple,and can be used for quality control of imatinib mesylate liposome.