Objective To survey the incidence of sleep disorders among patients with industrial injuries and analyze the relevant factors.MethodsA total of 112 depressed patients ( male 106,female 6; aged 22-79 years,course of disease 35 d-25 years) were assessed by a professional psychologist using life satisfaction index A,the type A behavior pattern scale,the Pittsburgh sleep quality index (PSQI) and the Barthel index.ResultsThe incidence of disordered sleep was 40.18％ (45/112),of whom mildly depressed patients were 34.29％,moderately depressed patients 42.86％ and severely depressed patients 85.71％.The incidence of sleep disorders increased with increasing depression severity.The incidence of disordered sleep was significantly higher among the severely depressed patients than among those mildly or moderately depressed,but there was no significant difference in incidence between moderately and mildly depressed patients.PSQI scores among the severely and moderately depressed patients were significantly higher than among those mildly depressed,but there was no statistically significant difference in average PSQI scores between the severely and moderately depressed patients.The sleep disorder group suffered significantly poorer sleep quality and took significantly longer to get to sleep.There were no significant differences in average age,educational level,marital status,social relations,family and social support,gender distribution or course of disease between the two groups.There were,however,significant differences in family income,life satisfaction,character type and disease species between the groups.ConclusionThe incidence of disordered sleep among depressed patients after industrial injury is correlated with the severity of depression,family income,life satisfaction,the type of injury and the patient's character.

By quoting the learning process proposed in The Book of Rites·The Doctrine of the Mean:"studying extensively,enquiring accurately,reflecting carefully,discriminating clearly,practicing earnestly",this paper con-structed the "Five - step" model in the moral and values education of college students,and also applied it to medi-cal students' professional values education. This method can guide students to study extensively and accumulate knowledge,ask in detail and explore carefully,think thoughtfully and accept actively,embed knowledge and judge rationally,devote oneself to practice and make the unity of knowing and doing,so as to achieve the purpose of "em-bedding within the heart and practicing outside the action in line" in the values education during the process of gradual progress and continuous circulation.

Objective To investigate the efficacy and safety of dexmedetomidine intravenous assisted epidural anesthe-sia for labor analgesia. Methods Forty full term puerperant who had a single fetus were randomly divided into two groups, Group C (n=20), a catheter was advanced into epidural space,anesthetic drugs (0.125%ropivacaine with fen-tanyl 1.5μg/mL)of 10 ml was infused,then implement PCEA(bolus 4 mL with 15 min lockout interval,background in-fusion 4mL/h).Group D (n=20)assisted the routine epidural block anesthesia with intravenous injection of dexmedeto-midine,which was infused 0.2 μg/(kg·h). ECG,RR,BP,SpO2,analgesic effect were assessed by VAS,labor process,mode of delivery,Apgar score of neonates and side effects of analgesia were recorded. Results The VAS during the first and second stages of labor in group D were better than group C (P<0.05),there was no significant difference in Apar score between two groups. The second stage of labor in group C had an extended period of time(P<0.05). There was no significant difference in vital signs,fetal heart rate and uterine contraction between two groups. Conclusion Intravenous dexmedetomidine can optimize the traditional labor analgesia mode and reduce the dosage of PCEA.The puerperants can be more comfortable and effective in accouchement.

Objective: To evaluate the efficacy and safety of recombinant human thrombopoietin (rhTPO) treatment for primary immune thrombocytopenia (ITP) patients during the perioperative period. Methods: Adult ITP patients who were refractory to first-line glucocorticoid therapy and underwent selective surgery were enrolled to be treated with rhTPO at the dosage of 1.5×10⁴U/d subcutaneously during the perioperative period. rhTPO treatment would not be terminated until one of the following conditions occurred: ①Platelet counts met the requirement of surgery; ②Platelet counts were ≥100×10⁹/L; ③Completed the 14 days of therapy. End points of the study were surgery rate, rhTPO therapy response rate, rescue therapy rate and adverse responses. Results: 42 patients were enrolled from Jan. 1, 2016 to Jun. 30, 2018. 14 were male and 28 were female. The median age was 60 (25-73) years old. There were no newly diagnosed patients. 5 patients were persistent and 37 were chronic. 27 patients completed selective surgery. The surgery rate was 64.3% (27/42) . Among them, 13 patients were under local anesthesia and 14 under general anesthesia. Of 42 cases receiving rhTPO therapy. 31 patients achieved responses, The overall response rate was of 73.8%. Among them, 24 patients achieved CR. The CR ratio was 77.4% (24/31) . 7 achieved response. The response ratio was 22.6% (7/31) . 11 patients did not respond to rhTPO therapy. The non-response rate was 26.2% (11/42) . The median time to reach CR was 7 (3-16) days. The median time to reach the peak of platelet counts were 10 (3-21) days. rhTPO was used for a median of 7 (3-14) days. The median platelet counts of patients undergoing surgery before rhTPO therapy, before surgery and at day 7 after surgery were 33 (20-89) ×10⁹/L, 125 (78-245) ×10⁹/L and 72 (30-250) ×10⁹/L, respectively. The median peak of platelet counts was 149 (101-466) ×10⁹/L. No infection, bleeding, thromboembolism and therapy-related adverse responses occurred in the patients. Conclusion rhTPO for ITP patients during the perioperative period is safe and effective.