Humans ; Occupational Health ; Stress, Psychological

Burnout, Professional ; Humans

Neuroendocrine neoplasm (NEN)is a group of heterogeneous tumors originated from the peptidergic neurons and neuroendocrine cells. A revised system of classification, nomenclature and grading of NEN was proposed by the fourth edition of“World Health Organization classification of tumours of the digestive system”in 2010. It apparently contributes to unify the method of classification, put an end of the confusion in nomenclature, standardize the grading system and predict the outcomes more accurately. With the combination of the results by immunohistochemical studies, pathologists should be in accordance with the requirements to make a diagnosis of NEN with accurate classification, grading and the pathological parameters essential to staging. Recently, new advances in NEN study put forward a new view in the classification and grading system that will lead to the updates of the diagnostic system after further studies on a large scale of samples.

Objective To explore the effects of combined sevoflurane and remifentanil on shoulder dislocation in elderly patients.Methods A total of 100 elderly patients with shoulder dislocation were randomly divided into the control group and the observation group (n =50,each group).The control group was anaesthetized with remifentanil and the observation group was anaesthetized with sevoflurane and remifentanil.The clinical efficacy of anaesthesia,life quality and the University of California at Los Angeles (UCLA) shoulder rating scale were recorded.Results The excellent rate of anaesthesia was higher in observation group than in control group (92.0％ vs.68.0％,x2 =9.033,P=0.011).There were significant differences in mean arterial pressure (MAP),heart rate (HR) and arterial pulse oxygen saturation (SpO2) between the control and the observation group after anaesthesia [(86.3±3.0) mm Hg vs.(83.1±2.5) mm Hg,(83.2±4.5) times/min vs.(81.1±4.0) times/min,(94.4±5.5)％ vs.(92.0±6.0)％,respectively,t=5.794,2.466,2.085,all P＜0.05].There were significant differences in the onset time of anesthesia,surgery time,recovery time,and hospital stay days between the control and the observation group [(26.6± 6.6)min vs.(5.1±1.3) min,(4.6±2.1) min vs.(2.3±1.2) min,(4.9±2.3) min vs.(2.8±1.1)min,(205.5±121.1) minvs.(121.3±89.3) min,respectively,t=22.600,6.724,5.824,3.957,all P＜0.01].The scores of life quality and UCLA function were significantly higher in observation group than in control group after anesthesia (t =16.873,8.485,both P =0.000).Conclusions The treatment of combined sevoflurane and remifentanil treatment has a good clinical efficacy in elderly patients with shoulder dislocation.It can improve the scores of UCLA and life quality of elderly patients with shoulder dislocation.

Currently, some students place more emphasis on the pursuit of their individual values, but less on their social responsibilities. This can be attributed to the students themselves and the society as well. In order to develop their sense of social responsibilities, the article suggests that we should maintain proper guidance on their values,convert our concept of intellectual fostering and direct college students to participate in social practice.

The clinical data was collected from 26 orthodontics patients at our hospital .All of them received straight wire appliance .The observed teeth were randomly classified into experiment and comparison groups.After the mounting of orthodontic bracket , Duraphat was smeared on the surface of maxillary central incisor, maxillary lateral incisor, maxillary canine, maxillary first premolar and maxillary first premolar in the experiment group while no Duraphat was applied in the comparison group .After wearing orthodontic appliance for 1, 3, 6 and 9 months, enamel demineralization of each tooth was observed .And the enamel decalcification index ( EDI ) of different areas of each tooth at different timepoints was recorded .More demineralization areas existed in the comparison group than the experiment group (P<0.01).In addition, no Ⅲ degree enamel demineralization was observed in the experiment group after Duraphat applying for 1 month.EDI were 0.20, 0.24, 0.21 and 0.16 in the experiment group after Duraphat applying for 1, 3, 6 and 9 months versus 0.37, 0.44, 0.44 and 0.34 in the comparison group during the same time periods.Therefore EDI and demineralization areas were significantly smaller in the experiment group than those in the comparison group (P<0.01).

Objective To Prepare and prefer method for the determination Wan Tong Yan Kang dripping pills. Methods Based on the Orthogonal test,the roundness and dissolution time were regarded as the index,the proportion of PEG4000 and PEG6000,the ratio of drug and matrix and material temperature were investigated. The pill weight pass rate (%)was regarded as the index to prepare dropping pills,the distance,dropping speed and temperature were investigated.Established isofraxidin content assay by HPLC. Results The best preparation method for drugs is:PEG4000 PEG6000 is 72,rugs:standard is1:4;the material temperature is 90 ℃;the cooling liquid temperature is 5 ℃;dropping distance is 10cm,dropping speed is 30 d/min. Isofraxidin regression equation is Y=26842X-835,R2 =0.998. Isofraxidin has good linear relationship in the range of concentrations 0.852-4.26 μg/mL. Conclusion The dripping pill preparation method is simple and feasible. Determination method has high sensitivity and good repeatability. The experiment provides a basis for the preparation of dripping pills and establishment of quality standards.

Aim] To summarize and introduce the clinical experience of Chang Qing in the treatment of refractory asthma. [Method] To analyze the clinical experience and academic views of Chang Qing in the treatment of refractory asthma from the perspective of etiology and pathogenesis; and to discuss his basic prescription compatibility and flexible drug-applying characteristics. [Result] According to Chang Qing's clinical experience, while addressing the symptoms, treating the root is badly needed. He insists that in the period of acute exacerbation the adjustment of traditional Chinese medicine dosage should be used to rapidly bring the asthma under control until the symptoms disappear or obviously ease, then nourishing spleen and kidney to reduce the relapse of asthma. [Conclusion] In the aspect of treating the refractory asthma, Chang Qing has got rich clinical experience and effective. methods to relieve the asthma,his clinical dialectic thinking and the originality of prescription are greatly worth learning.

Objective To study the clinical effect of ischemic heart valve disease combined coronary heart disease with surgical operation in the same period?Methods The clinical data of 31 cases patients of ischemic heart valve disease combined with coronary heart disease in Xinjiang Uygur Autonomous Region People′s Hospital from July 2013 to January 2015 were retrospective analyzed?According to the degree of cardiac function and symptoms,the patients toke the coronary artery bypass grafting treatment,combined with the actual operation of mitral valve replacement, mitral valve replacement, aortic valve replacement, double valve replacement at the same time?Postoperative follow?up for half year,the cardiac function of patients before and after operation were analyzed, the incidence of postoperative complications after the operation were record?Results All patients were treated by coronary artery bypass grafting, combined with the mitral valve replacement,mitral valve replacement, aortic valve replacement, double valve replacement for treatment during this period, the operations were success?There was statistically significant difference about cardiac functional grading before and after surgery ( P=0?000 )?There were 7 cases patients' left ventricular ejection ejection fraction( LVEF) was more than or equal to 40% of patients,24 cases patients'LVEF<40% before operation;21 cases patients'LVEF was more than or equal to 40%,8 cases patients'LVEF<40% after operation,the difference was statistical significance before and after the operation( P=0?000)?Only 2 patients were died because of low cardiac blood?Conclusion Non ischemic heart valve disease combined with coronary heart disease patients to take simultaneous surgical treatment, the difficulty of its operation has increased, but to strengthen myocardial protection during surgery can effectively enhance the clinical curative effect, reduce mortality, provide good protection for the survival of patients with late life.

Objective To improve the content determination of eight-positive particles,and better control drug quality.Methods Gardenin, emodin and chrysophanol of eight-positive particles were determined by HPLC.Revised content determination standards and improved the standards of quality control. Results The revised content determinations of gardenin, emodin and chrysophanol were simple and feasible, and had high sensitivity.Conclusion Unification the quality standards of eight positive granules,the standards provide the basis for standardizing the market of eight-positive particles.