Objective:To explore the influence of mindfulness on perceived stress in psychiatric nurses and the mediating effect of resilience.Methods:A total of 427 psychiatric nurses from a psychiatric hospital in Beijing were selected.Five-facet mindfulness questionnaire(FFMQ), Chinese-version perceived stress scale (CPSS) and Connor-Davidson resilience scale (CD-RISC) were used in this survey.Pearson correlation analysis and multiple stepwise regression analysis were performed using SPSS 24.0.And mediating effect was performed using AMOS 24.0.Results:The total score of psychiatric nurses' perceived stress was (37.89±7.16). Among all psychiatric nurses, 66.74% were under high pressure and 20.84% were under great pressure.The perceived stress was negatively correlated with mindfulness(123.69±10.82, r=-0.65, P<0.01) and resilience(85.40±17.87, r=-0.67, P<0.01), and mindfulness was positively correlated with resilience ( r=0.50, P<0.01). The direct effect of mindfulness on perceived stress was -0.15, the indirect effect was -0.34, and the total effect was -0.49. Conclusion:Resilience plays a partial mediating role between mindfulness and perceived stress psychiatric nurses.

Objective To investigate the changes of follicular regulatory T cells ( Tfr cells) and follicular T helper cells ( Tfh cells) in peripheral blood of children with myasthenia gravis ( MG) . Methods We recruited 28 MG patients and 20 healthy subjects in this study. The percentages of Tfh and Tfr cells in peripheral blood samples were measured by flow cytometry. Real-time PCR was performed to detect the ex-pression of transcription factors and regulatory factors of Bcl-6, c-MAF, Blimp-1 and PD-1 at mRNA level. ELISA was used to detect the levels of IL-2, IL-6, IL-10 and IL-21 in plasma samples and the titers of Ach-Rab and PsMab. Results Compared with the healthy subjects, the MG patients showed higher percentages of Tfh cells and lower percentages of Tfr cells before receiving treatment. The expression of Bcl-6 and c-MAF on CD4+T lymphocytes cells at transcriptional level were significantly enhanced, while the expression of Blimp-1 on CD4+T cells and the expression of PD-1 on Treg cells at transcriptional level were inhibited in the MG patients in comparison with those in healthy subjects. Moreover, decreased levels of IL-2 and increased levels of IL-21 were found in plasma samples collected from the MG patients. Conclusion The decreased percentages of Tfr cells and increased percentages of Tfh cells in patients with MG resulted in abnormal ratios of Tfr/Tfh cells, which might be involved in the immunological pathogenesis of MG. Several changes in the patients with MG might be responsible for the imbalanced ratio of Tfr/Tfh cells, which included changes of IL-2 and IL-21 in microenvironment, enhanced expression of Bcl-6 and c-MAF at mRNA level and inhibited expression of Blimp-1 at mRNA level on CD4+T cells as well as over-expression of PD-1 at mRNA level on Treg cells.

Objective To investigate the quality of life (QOL) and its influential factors in the aged patients with ulcerative colitis (UC).Methods A cross-sectional survey of the UC patients was conducted by Chinese version of inflammatory bowel disease questionnaire (C-IBDQ).The influential factors for QOL in elderly patients with UC were evaluated and analyzed by correlation analysis and multiple linear regression analysis.Results A total of 90 aged UC patients finished the questionnaire study.The overall score of QOL in the aged UC patients was (175.7±37.6),and the score of each item was decreased,especially in the aspect of economic burden,emotional function and systemic symptoms.Multiple linear regression analysis indicated that the influential factors for QOL were sex,disease severity,duration,disease activity and the payment.The scores of bowel symptoms were higher in men than in women [(53.9±12.1) vs.(49.1±10.5),P=0.049].The QOL scores were lower in patients with the duration less than one year than over one year (P＜ 0.05).The QOL scores were lower in severe patients than in mild patients (P＜ 0.05).The QOL scores were lower in patients during active period than during remission period [(149.7 ± 35.1) vs.(193.9 ± 27.3),t=6.731,P=0.000].The QOL scores of patients whose medical cost was mainly paid by themselves were lower than those paid by insurance.And there were significant differences in systemic symptom,social function and economic burden (all P＜ 0.05).Conclusions The QOL of the aged UC patients is impaired in varying degree.The influential factors for QOL are sex,disease severity,duration,disease activity and the payment.The QOL in UC patients is obviously affected by economic burden.

Objective:We probe more direct operation pathways in sphenoidal sinus and saddle area, and take proper measures for correlated diseases which surpass scope of sphenoidal sinus by combining image data, which could prevent serious complication.Method:Under nasal endoscope, the operation approaches we adopted included trans-anterior ethmoid sinus-posterior ethmoid sinus-sphenoidal sinus pathway, trans-meatus nasi superior-posterior ethmoid sinus-sphenoidal sinus pathway, trans nasal septum-sphenoidal sinus pathway and trans-natural opening of sphenoid sinus anterior into sphenoid sinus pathway by taking upper edge of posterior naris as a consistent surgical landmark. Forty-six cases who had sphenoidal sinus mass with bone erosion recieved surgical treatment.Result:Twenty-one cases with cyst and pus cyst of sphenoidal sinus had been healed by trans-meatus nasi superior pathway;1 case with hematoma and organization in sphenoidal sinus had been cleared by trans-meatus nasi superior pathway;3 cases had hematoma and organization in sphenoidal sinus and pseudoaneurysm in internal carotid artery,one of them suffered fatal hemorrhage in surgical exploration, and cured by endovascular embolization, the other two only underwent nasal endoscopic examination,the diagnosis was established by DSA and they received interventional therapy;4 cases with papilloma in sphenoidal sinus had been treated by trans-natural opening of sphenoid sinus approach,and 3 cases were cured,1 case had only partial mass resection as the papilloma offended the outer wall of sphenoidal sinus diffusely;2 cases with cholesteatoma of sphenoid sinus have been removed completely by trans-meatus nasi superior approach;1 case with encephalomeningocele of sphenoidal sinus underwent sphenoidotomy by trans-natural opening of anterior of sphenoidal sinus, and intraoperative puncture showed characteristic cerebrospinal fluid,the exposed meninges were then repaird surgically;1 case with mycosis of sphenoidal sinus had been cured by thorough clearing of the leision in sphenoidal sinus combined with antifungal therapy;3 cases with malignancy of sphenoidal sinus had received major mass resection of sphenoidal sinus by trans-anterior ethmoid sinus-posterior ethmoid sinus approach, and followed with radio therapy and chemotheraphy;5 cases with NPC in-volving sphenoidal sinus had been treated by radio therapy and chemotherapy after pathological examinacation;5 cases with post-operative cerebrospinal rhinorrhea and granulation hyperplasia of sphenoidal sinus had been repaired successfully by trans-meatus nasi superior approach or tans-nasal septum approach.Conclusion:There are various surgical pathways to deal with sphenoidal sinus and correlated diseases under nasal endoscope.The operation will be direct, safe and minimal invasive if we choose the pathway properly. Thin slice CT scan and 3D reconstruction of sella, and DSA or angiography of brain before operation is one of effective means to prevent surgical complications for leisions beyond scope of sphenoidal sinus.

Objective To explore the effective method for preserving laryngeal function in the treatment of laryngeal cancer of T3 lesions. Methods Utilizing unilateral pedicled muscle-periosteal flap, 32 cases with laryngeal carcinoma of T3 lesions underwent extended vertical partial laryngectomy for laryngeal cavity structure after one-stage reconstruction. Results With 1-3 years postoperative follow-up, the patients had good pronunciation, unobstructed respiration and no tumor recurrence, with extubation rate of 100%. Conclusion It showed that treating patients with laryngeal carcinoma of T3 lesions with extended vertical partial laryngectomy using unilateral pedicled muscle-periosteal flap reconstruction for laryngeal cavity structure can remove tumor effectively and obtain the satisfactory respiratory pronunciation function. The method has a good clinical application prospect.

Objective:In order to prevent misdiagnosis and degrade death rate, we explored the early diagnosis and correct treatment methods of traumatic pseudoaneurysm of internal carotid artery in sphenoid sinus,. Method: The clinic data of 6 cases who had traumatic pseudoaneurysm of internal carotid artery in sphenoid sinus and were admited in our hospital were analyzed retrospectively. Large numbers of literature about the disease were re-viewed. Some early diagnosis methods and optimal treatment schemes were proposed. Result: All patients had a history of cranium trauma and recurrent attacks nasal hemorrhage. There are two patients with a complication of sight loss in single eye. In the six cases, one case was treated with unilateral common carotid artery ligation, three cases were treated with aneurysm and internal carotid artery embolism by using sacculus proprius which is able to shedding , one case was treated with internal carotid artery embolism by using tiny circlip ring . These five pa-tients were crued with no severe complication. One patient death of hemorrhea. His nasal cavity was tamponaded repeatly because repeat nasal hemorrhage. However, he had never treated with internal carotid artery embolism. Conclusion:The patients who have traumatic pseudoaneurysm of internal carotid artery usually die of unmanageable hemorrhea. The patients may be cured if they could obtain an early diagnosis and correct treatment.

Objective To explore the sensitivity of using NT,combined with serum biochemical markers (Free-βhCG,PAPP-A) for Down's Syndrome screening in early stage of pregnancy.Methods Collect pregnant women aged 17-45 years old voluntary antenatal screening in our hospital from March 2009to October 2010,a total of 11882 cases.Serum Free-βhCG and PAPP-A were measured NT value was determined by ultrasound at 11-13w+64 of gestation.Calculating combined screening (NT,Free-βhCG,PAPP-A),and serum integrated screening (Free-beta hCG,PAPP-A) risk,respectively,using the risk calculation software for the same person.Results Early pregnancy screening was performed in 11 882patients,18 had a fetus with Down's syndrome,a rate of 0.15％.The detection rates of Down's syndrome in combined screening and serum integrated screening were 83.3％ and 72.2％ respectively.The specificities were 98.4％ and 97.3％ and detection efficiency were 7.18％,3.90％ respectively.Areas under the curve (AUCs) of fhst-trimester combined screening and serum integrated screening were 0.975 (95％ CI:0.943,1.007),0.901 (95％ CI:0.789,1.013) respectively.Conclusion In early stage of pregnancy,combined screening for Down's syndrome has higher sensitivity and specificity than serological screening,has higher detection rate in the same false-positive rate case,which can effectively reduce the pregnant women to receive invasive puncture.

Objective:To explore more reliable standards for identifying vestibular hair cells of saccule and utricle prepared in studies with patch clamp technique under inverted phase contrast microscope. Method:The length and width of two types hair cells were measured besides the length of cilia,and all datas were analyzed statistically.Result:The width and length of cilia of two types hair cells in saccule and utricle from guinea pig were similar. The length of type Ⅰ was longer than that of type Ⅱ,SO the ratio between length and width was larger and the ratio of the length between cilia and cell body was small.Conclnsion:Two type'S hair cells of saccule and utricle from guinea pig may be distinguished through the ratio of cell body's length and width even the ratio of the length between cilia and cell body,besides the standards before.

To investigate the effect of CDR1/CDR2 or MDR1 genes overexpression on oxidative stress in Candida albicans,we evaluated the effect of H2O2 on cell viability in C.albicans overexpressing genes CDR1 /CDR2 or MDR1 and their parent strains.After establishing an oxidative stress model with H2O2,we detected reactive oxygen species (ROS),mitochondrial membrane potential (Δψm) and the expression of oxidative stress response-related genes (CAP1 and GRP2) and ROS clearance related-genes (SOD2 and SOD5).The results showed that C.albicans growth were inhibited by 100％ after the treatment of 5 mmol/L H2O2.HeO2 caused more ROS accumulation and Δψm reduction in parent strains than in CDR1/CDR2 or MDR1 genes overexpressed strains (P＜0.05).Compared to parent strains,the up-regulated expression of CAP1 and GRP2 were relatively less in CDR1/CDR2 or MDR1 genes overexpressed strains,moreover,the down-regulated expression of SOD2 and SOD5 were also relatively less in CDR1/CDR2 or MDR1 genes overexpressed strains (P＜0.05).In conclusion,the overexpression of CDR1/CDR2 and MDR1 genes could reduce the oxidative stress response and enhance the adaptability of C.albicans to oxidative stress.

Objective To investigate the presences of regulatory T cells (Treg) and natural killer T cell (NKT)-like T cells in the peripheral blood of healthy subjects and patients with newly diagnosed cancer. Methods Patients were enrolled into four groups: healthy subjects (Group A), patients without cancer (Group B), patients with newly diagnosed stage Ⅰ~Ⅱ cancer (Group C), and patients with newly diagnosed stage Ⅲ~Ⅳ cancer (Group D). Flow cytometry was performed to detect the percentage of CD4+ CD25high CD127low cells in CD4+ T lymphocytes (Treg) and the percentage of CD3+ CD56+ cells in CD3+ T lymphocytes (NKT-like). Results The percentage of Treg cells in CD4+T lymphocytes was(6.72 ± 3.16)%, (6.49 ± 2.83)%,(6.80 ± 3.07)%and (7.63 3.47)% in Group A, B, C and D, respectively, with no significant differences among these groups (P>0.05). However, the percentage of CD3+CD56+T cells in CD3+T lymphocytes was (3.13 ± 1.66)%, (2.56 ± 1.27)%,(7.22 ± 2.70)% and (7.72 ± 3.10)% in Group A, B, C and D, respectively, with marked increases in Group C and D compared to those in Group A and B (P < 0.05). Conclusion Patients with newly diagnosed cancer demonstrated increasing trends in the percentage of peripheral NKT-like cells.