Objective To evaluate the accuracy of auditory evoked potential index (AAI) in monitoring the anesthetic depth during isoflurane anesthesia.Methods Thirty ASA Ⅰ or Ⅱ patients aged 18-55 years and undergoing elective surgery under general anesthesia were enrolled in this study. The patients were unpremedicated. Anesthesia was induced with midazolam 0.05 mg/kg, fentanyl 3 μg/kg and propofol 1 mg/kg. Tracheal intubation was facilitated with recuronium 0.1 mg/kg. The patients were mechanically ventilated (VT:40 mm Hg. Anesthesia was maintained with isoflurane inhalation and intermittent intravenous boluses of vecuronium. Isoflurane was started with high-flow (FGF, 3 L/min) for 12 min followed by low-flow (LGF, 0.5 L/min). The inspired isoflurane concentration was set at 3%. The electrocardiogram (ECG), mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2), end-tidal isoflurane concentration and AAI were continuously monitored during anesthesia and recorded before induction of anesthesia (baseline, To ), immediately after induction (T1), immediately before isoflurane inhalation (T2), at 3 min(T3), 6 min (T4), 9 min (T5) and 12 min (T6) during high-flow wash-in and at the end-tidal isoflurane concentrations of 0.8 MAC (T7), 1.0 MAC (T8) and 1.3 MAC (T9) during low-flow inhalation of isoflurane, respectively.Results AAI decreased gradually while the end-tidal isoflurane concentration increased during high-flow wash-in. And AAI was negatively correlated with the end-tidal isoflurane concentrations ( r = -0.896, P ＜ 0.01 ) during low-flow inhalation of isoflurane anesthesia.

Objective:To investigate the behavior of tobacco use among migrants in construction sites and explore the associated factors .Methods: A total of 652 migrants in 10 construction sites were selected in Xi’ an and Tongchuan .Chi-square and logistic regression were used to analyze the influencing factors of tobacco use.Results:The average age of the migrants in the construction site was (38.23 ± 10.61), and males occupied 82.7%(535/647) of the total.The current smoking rate of the migrants was 55.8%(364/652), with 64.3%(344/535) in males and 14.3%(16/112) in females.82.5%(329/399) smokers wanted to quit smoke , however only 52.7%(210/399) had tried quitting smoking in action, and 8.8%(35/399) quitted smoking successfully .Multivariable regression indicated that the migrants who were at lower age , and sick within 2 weeks, had perceived not difficult to stop smoking and who disagree with the benefits of smoking were more likely to try to quit smoking .Conclusion:Migrants in construction sites show their characteristics of old age , low level of health literacy , male-domination , high smoking rate and high intention of quitting smoking .Tobacco control projects should be implemented in construction sites to promote the translation of smoking quitting intention into action .

Objective To assess the value of S index and FIB-4 for diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB) by comparing with traditional indexes APRI and Forns.Methods A total of 361 patients with confirmed CHB from the First Hospital of Nanjing Medical University and Huashan Hospital Affiliated to Fudan University during January 2006 and December 2011 were enrolled in the study.The clinical,laboratory and pathological data of patients were collected.Four noninvasive score systems APRI,Forns,S index and FIB-4 were computed.With liver biopsy as the gold standard,the area under the ROC curve (AUROC) was used to assess the value of above 4 score systems in diagnosis of liver fibrosis,and Z test was performed to evaluate the effectiveness of above systems.Results The areas under ROC curve (AUCs) of APRI,Forns,S index and FIB-4 for significant fibrosis (≥S2) were (0.737 ±0.027),(0.716 ± 0.028),(0.745 ± 0.026) and (0.781 ± 0.025),respectively.When the cut off value of FIB-4 was set at 1.62,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) for diagnosis of significant fibrosis were 59.3％,85.8％,89.4％ and 51.2％,respectively,which were better than Forn index (Z =3.28,P =0.001).While for S4 (cirrhosis) the AUCs of APRI,Foms,S index and FIB-4 were (0.687 ± 0.035),(0.792 ± 0.028),(0.863 ± 0.024) and (0.832 ± 0.025),respectively.When the cut off value of S index was set at 1.06,the sensitivity,specificity,PPV and NPV for diagnosis of cirrhosis were 77.9％,85.5％,59.4％ and 93.5％,respectively,which were better than APRI and Forns (Z =6.74 and 3.21,P ＜ 0.01).Conclusions APRI,Forns,S index and FIB-4 are simple and accurate methods for assessing liver fibrosis.FIB-4 and S index are better than APRI and Forns in diagnosis of significant fibrosis and cirrhosis,which may replace liver biopsy in certain extend.

Objective To explore the effect of team-based individualized health management on health literacy and health status among hypertensive patients in community. Method This study was a self-controlled quasi-experimental design. A two-stage cluster random sampling method was used. Two neighborhood committees among 23 neighborhood committees in Desheng community were randomly sampled. The name list of hypertensive patients were obtained from the 2 sampled neighborhood committees, getting one from each five, 470 in total before intervention and 444 in total after. The two groups of patients before and after intervention had comparability in the social demographic characteristics as the age (67.16± 9.84, 66.47 ± 10.50 years), the gender (the male accounted for 47.00%and 44.10%), the ethnicity (the Han accounted for 93.80%and 92.30%) and the marital status(the married accounted for 91.30%, 88.90%)(t=1.447 χ2 =0.774, 1.595, 2.555, P>0.05). Since July 2013, Desheng community health service center intervened the hypertensive patients by team-based individualized health management. After one year, we compared the change of their health literacy and health status. Result After health management, the proportion of hypertensive patients with adequate health literacy increased from 38.50% to 53.40%, The average rate of health knowledge awareness among them increased from 65.30% to 75.30%. The average accuracy of health services utilization skills of them increased from 49.10%to 70.90%, lifestyle behaviors in dietary and in exercise the average increase was from 35.55, 17.07 to 37.05, 21.28 respectively, after the intervention the patients did better work in self management behavior, such as self-test of blood pressure, medication compliance and control of salt intake (74.40%, 87.60%, 80.00%) were obviously better than before intervention (61.30%, 68.30%, 62.20%), and the differences were statistically significant (χ2 =16.813, 48.295, 52.058, P<0.05). After health management, the self-report health was better among hypertensive patients. The proportion of them with normalized blood pressure increased from 72.90% to 79.50%, and the difference was statistically significant (P<0.05). Conclusion Team-based individualized health management could increase health literacy of hypertensive patients in community and improve their health status obviously.

Objective To compare the efficacy of different target concentrations of etomidate in combination with midazolam,fentanyl and rocuronium used to induce anesthesia for tracheal intubation.Methods Eighty ASA Ⅰ or Ⅱ and Mallampati Ⅰ or Ⅱ patients of both sexes,aged 25-50 yr,weighing 57-76 kg,scheduled for elective non-cardiac surgery under general anesthesia,were randomly allocated into 4 groups according to the target effect-site concentration of etomidate (n =20 each) ∶ 0.5 μg/ml group (group E0.5),0.7 μg/ml group (group E0.7),0.9μg/ml group (group E0.9) and 1.1 μg/ml group (group E1.1).The patients were unpremedicated.Anesthesia was induced with midazolam 0.05 mg/kg,fentanyl 3 μg/kg,rocuronium 0.6 mg/kg and etomidate given by target-controlled infusion.When the effect-site concentration of etomidate reached 0.5,0.7,0.9 or 1.1 μg/ml,endotracheal intubation was performed.Auditory evoked potential index was recorded before induction of anesthesia (baseline),immediately before intubation,during insertion of the laryngoscope,and at 1,3 and 5 min after intubation.Myoclonus,injection pain,the requirement for vasoactive agents and burst suppression (BS) were recorded during induction of anesthesia.Results Compared with group E0.5,the requirement for urapidil was significantly decreased in group E0.7,the requirement for esmolol and urapidil was significantly decreased and the incidence of BS was increased in group E0.9,the requirement for esmolol and urapidil was significantly decreased,and the requirement for atropine and ephedrine and incidence of BS were increased in group E1.1 (P ＜ 0.05).The incidence of BS was significantly higher in group E0.9,and the requirement for atropine and incidence of BS were significantly higher in group E1.1 than in group E0.7 (P ＜ 0.05).The incidence of BS was significantly higher in group E1.1 than in group E0.9 (P ＜ 0.05).There was no significant difference in auditory evoked potential index and incidences of myoclonus and injection pain among the four groups (P ＞ 0.05).Conclusion The optimum target concentration of etomidate is 0.7μg/ml when combined with midazolam,fentanyl and rocuronium used to induce anesthesia.

Objective To observe clinical efficacy of Qilin Pills combined with Three-Spot Caressing in the treatment of acquired non-consolidated kidney qi premature ejaculation (PE). Methods Totally 129 acquired non-consolidated kidney qi PE patients were randomly divided into TCM group, Fangzhognshu group and combination group. TCM group was given Qilin Pills, 6 g each time, three times a day, orally. Fangzhognshu group was guided to conduct Three-spot Caressing during sexual intercourse, no less than twice a week. Combination group was given Qilin Pills and Three-spot Caressing with the same method as Fangzhognshu group. The treatment course for each group lasted for 8 weeks. Before and after treatment of 4 weeks, 8 weeks and 4 weeks after with drawal, the intravaginal ejaculatory latency time (IELT), Chinese Index of Sexual Function for Premature Ejaculation-5 (PECI-5) scores and TCM syndrome scores (TCMS) were compared. Results Compared with before treatment, IELT increased in three groups at different time points after treatment (P<0.05). In the combination group, IELT was superior to the other two groups (except for TCM group after 4-week treatment), with statistical significance (P<0.05). Compared with before treatment, PECI-5 scores improved in three groups (except for Q6 and Q7 in Fangzhongshu group after 4-week treatment) at different time point after treatment (P<0.05). The improvement of Q5, Q6 and Q7 scores in PECI-5 of combination group was significantly better than that in the other two groups at 8-week treatment and 4-week after treatment (P<0.05). Compared with before treatment, TCMS in TCM group and combination group were improved significantly (P<0.05), PE and loss of libido score improved significantly in Fangzhongshu group (P<0.05);mental malaise and move spontaneous perspiration were significantly improved at 8-week treatment and 4 weeks after treatment (P<0.05). The improvement in TCMS was significantly better in combination group than that in the other two groups at 8-week treatment and 4 weeks after treatment (P<0.05). Conclusion Qilin Pills combined with Three-Spot Caressing has definite and long-term efficay for the treatment of acquired non-consolidated kidney qi PE.

Objective: To investigate the serum levels and clinical significances of microRNA-205 (miR-205) and microRNA-221 (miR-221) in patients with colon cancer. Methods: A total of 172 patients with colon cancer (colon cancer group), 130 patients with benign diseases of colon (benign lesion group) and 70 healthy persons (control group) admitted to Central Hospital of Western Hainan from January 2016 to December 2018 were selected. The serum levels of miR-205 and miR-221 in each group were detected, and their relationships with clinicopathological characteristics of patients with colon cancer were analyzed. The diagnostic values of the serum levels of miR-205 and miR-221 in colon cancer were analyzed by receiver operating characteristic (ROC) curve. Pearson correlation analysis was used to analyze the correlation between the serum levels of miR-205 and miR-221. Results: The serum levels of miR-205 in colon cancer group, benign lesion group and control group were 2.84±0.96, 1.16±0.27 and 1.05±0.23, with a statistically significant diffe-rence (F=10.113, P<0.001). The serum levels of miR-221 in the three groups were 1.95±0.74, 0.37±0.08 and 0.32±0.05, with a statistically significant difference (F=12.416, P<0.001). Further pairwise comparisons found that the serum levels of miR-205 and miR-221 in colon cancer group were significantly higher than those in benign lesion group and control group (all P<0.001). The serum levels of miR-205 and miR-221 in patients with colon cancer were related with TNM stage (t=5.412, P<0.001; t=6.103, P<0.001), degree of tumor differentiation (t=4.573, P=0.028; t=4.805, P=0.013) and with or without lymph node metastasis (t=5.837, P<0.001; t=7.410, P<0.001). ROC curve analysis showed that the optimal cut-off values of the serum levels of miR-205 and miR-221 for the diagnosis of colon cancer were 2.17 and 1.30, respectively. The area under the curve of the two combined diagnostic method for colon cancer was the largest (0.924, 95%CI: 0.865-0.983), with the sensitivity and specificity of 91.3% and 87.4%. The correlation analysis showed that the serum levels of miR-205 and miR-221 were positively correlated in patients with colon cancer (r=0.837, P<0.001). Conclusion The serum levels of miR-205 and miR-221 are significantly increased in patients with colon cancer, and the two combined detection has a high value for the diagnosis of colon cancer.

OBJECTIVETo investigate health literacy and enterprise provided health service utilization among migrants in construction sites and explore the influencing factors of enterprise provided health service utilization.

METHODSAll 652 migrants in 10 construction sites in Xi'an and Tongchuan were selected using stratified cluster sampling method, and health literacy level, occupational health awareness and enterprise provided health service utilization of migrants were investigated in 2013 April to June.Score and pass rate was used to describe status of health literacy and occupational health awareness of migrants. Chi-square was used to analyze the difference of occupational health awareness and enterprise provided health service utilization between migrants of different levels of health literacy. And logistic regression was used to analyze the influencing factors of enterprise provided health service utilization.

RESULTSAverage score of health literacy among migrants in construction site was (3.75 ± 2.17) (9 score totally). Migrants who knew enterprise should provide health training, physical examination, safety training, occupational protection and pay health insurance for workers accounted for 28.2% (174/616), 43.5% (268/616), 52.8% (325/616), 54.9% (338/616) and 37.7% (230/616) respectively, and the percentage of migrants who thought there were noise and dust in their working environment were 46.4% (201/627) and 44.8% (281/627) respectively.61.1% (373/610) received none of health training, occupational training, physical examination and first-aid kit, and only 0.8% (5/610) had utilized all of the above health service in workplace. And logistic regression showed that migrants whose health literacy score was higher than 5 had 1.819 times probability to utilize enterprise provided health service (OR = 1.82, 95%CI:1.13-2.92) , and migrants who were educated for more than 13 years had 3.812 times probability to utilize enterprise provided health service than those who were educated for less than 6 years (OR = 3.81, 95%CI:1.75-8.31) .However, occupational health awareness had no significant influence to the utility of enterprise provided health service utilization in logistic regression (χ(2) = 3.50, P = 0.061).

CONCLUSIONOccupational health awareness and enterprise provided health service utilization were both low among migrants in construction site, level of health literacy and school years were the main factors that influence enterprise provided health service utilization.