Objective To explore the factors of the Pilots' social avoidance and distress.Methods 458 pilots were evaluated by Social Avoidance and Distress Scale(SAD),Symptom Checklist 90(SCL-90),Cattell's 16 Personality Factors(16-PF),Perceived Social Support Scale(PSSS),Trait Coping Style Questionnaire(TCSQ),Life Event Scale(LES).Data were analyzed with SPSS10.0.Results The results showed there were significant relationship between pilots' social avoidance and distress with mental health,personality,social support,trait coping style,life event;the social avoidance(F=3.09,P＜0.05)and the social distress(F=4.05,P＜0.01)of transports were significantly higher than other aircrafts;the social distress of diseases group was higher than the health group(t=2.74,P＜0.01).It was showed in the multiple correlation regression analysis that excitatory,persistency,boldness and disappearing coping style made the greatest contribution to the social avoidance(standardized coefficients are-0.346,0.230,-0.219,0.209 in turn).Disappearing coping style,excitatory,social support and boldness made the greatest contribution to the social distress(standardized coefficients are 0.591,-0.324,0.185,-0.1 29 in turn).Conclusion Personality,trait coping style,social support,mental health,life events,and other psyehosocial factors affected the pilots' social avoidance and distress.

Objective:To investigate the efficacy and safety of tirofiban on patients with acute myocardial infarction (AMI)during emergency PCI.Method:80 patients with PCI were randomized into a study group(tirofiban+PCI group,n=40)and a controlled group(PCI group n=40).Their angiographic characteristics before and after PCI were collected and studied.The in-hospital cardiovascular events and the bleeding complications were assessed.Result:The patients in the study group were recovered with a higher rate of TIMI 3 grade flow than in the controlled group.There was a lower incidence of the in-hospital cardiac events in the study group than that of the control group(P

Objective To compare the clinical efficacy of different trough concentrations of vancomycin in patients.Methods A retrospective study in patients having at least one trough concentration of vancomycin for enrollment between January 2009 and December 2013 was carried out.The eligibility patients were divided into 3 groups according to the level of trough concentrations namely group A (＜ 10 mg/L),Group B (10 ～ 15 mg/L),and Group C (＞ 15 mg/L).The clinical efficacy,clearance of pathogens and in-hospital mortality were analyzed with the help of SPSS Statistics 17.0.The comparison of dosing days,length of hospital stay and time consumed from initial dosing to the appearance of recovery signs of survivors among the 3 groups.Results There were no significant difference among 3 groups in terms of clinical efficacy (55.6％ vs.33.3％ vs.51.7％),clearance of pathogens (38.9％ vs.25％ vs.24.1％) and in-hospital mortality (44.4％ vs.25％ vs.27.6％).After adjusting by age,the in-hospital mortality decreased along with the trough concentrations vancomycin.Along with increase in the trough concentrations vancomycin,the dosing day (14.90 ± 6.44 vs.18.75 ± 7.23 vs.17.93 ± 9.42) and length of hospitalization [(33.70 ± 18.17) vs.(79 ±45.53) vs.(66.20 ±52.48)] increased,and time required from dosageinitial dosing to the appearance of recovery signs of survivors among the 3 groups [(4.82 ± 2.62) vs.(3.75 ± 0.50) vs.(4.07 ± 3.20)] shortened.Conclusions Improving the trough concentrations of vancomycin could not increase clinical efficacy rate or bacterial clearance rate,but could lower in-hospital mortality.However,it might enhance the financial burden on patients as well.

Objective To evaluate the effects of dexmedetomidine on the expression of neuronal nitric oxide synthase (nNOS) and c-fos in the lcuos cruleus (LC) in a rat model of endotoxic shock.Methods Twentyeight male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 4 groups (n =7 each):control group (group C),endotoxic shock induced by lipopolysaccharide (LPS) group (group L),lowdose dexmedetomidine group (groupLD) and high-dose dexmedetomidine group (group HD).Normal saline 0.5 ml/kg was injected via the tail vein in C and L groups.Dexmedetomidine 0.5 and 4.5μg/kg were injected via the tail vein in group LD and group HD,respectively.Normal saline 0.5 ml/kg was injected via the tail vein 10 min later in C,while LPS 5 mg/kg was injected intravenously 10 min later in the other groups.The rats were sacrificed and their brains were removed for determination of brain water content,the number of nNOS and c-fos positive cells and expression of nNOS and c-fos in the LC by immuno-histochemistry.Results Compared with group C,the brain water content was significantly increased,the number of nNOS and c-fos positive cells in the LC was enlarged,and the expression of nNOS and c-fos in the LC was up-regulated in group L (P ＜ 0.05).The brain water content was significantly lower,the number of nNOS and c-fos positive cells in the LC was smaller,and the expression of nNOS and c-fos in the LC was lower in LD and HD groups than in group L (P ＜ 0.05).The number of nNOS and c-fos positive cells in the LC was significantly smaller,and the expression of nNOS and c-fos in the LC was lower in HD group than in group LD (P ＜ 0.05).Conclusion Dexmedetomidine can down-regulate the expression of nNOS and c-fos in the LC,which may be one of brain-protective mechanisms of dexmedetomidine in a rat model of endotoxic shock.

Objective To evaluate positive p-mTOR expression and its significance in gastric cancer.Methods Original studies published for the correlation between p-mTOR and clinicopathological parameters as well as prognostic significance were enrolled from Cohrane Library,Pubmed,EMbase database and CBM,CNKI.Analyses were performed by software REVMAN 5.0.Age,gender,TNM stage,lymph node metastasis,type were analyzed using pooled odds ratio (OR) with 95％ confidence interval (CI),and OS were analyzed using pooled hazard ratio (HR) with 95％ CI.Results Seven studies including 2 477 gastric cancer patients were enrolled in the meta analysis.p-mTOR expression was positive in 1 089 of the cases.p-mTOR positive expression was correlated with age,OR =0.74,95％ CI:0.62-0.89,dcpth of invasion OR =0.76,95％ CI:0.60-0.97,lymph node metastasis,OR =1.95,95％ CI:1.59-2.39,TNM stage,OR =0.57,95％ CI:0.38-0.84,type,OR =0.64,95％ CI:0.50-0.83,and OS,HR =1.86,95％ CI:1.60-2.16.Gastric cancer patients with p-mTOR positive expression tend to be younger,had a higher risk of lymphatic invasion,later TNM stage and poor prognosis.Its positive expression had no relation with the gender.Conclusion p-mTOR positive expression is a significant predictor for advanced TNM stage,more lymph node metastasis,intestinal type and poorer OS.

Objective To evaluate the quality of clinical trials about acupuncture and moxibustion treatment of vertebrobasilar insufficiency in China.Methods Literature of clinical trials of acupuncture was collected and analyzed,evaluated by the randomized controlled test criteria and the clinical assessing method in Cochrane handbook of international Cochrane cooperation net.Results Sixteen literatures were brought in.87.5% of the included literature had no clear description of random methods,and no allocation concealment,use of blind methods,sample size calculation,intention-to-treat analysis.Among them,62.5% had explicit diagnosis criteria,12.5% with correct randomizing method,62.5% with explicit evaluation criteria,however,31.22% with no words referring to the comparability among the groups.Conclusions Though acupuncture and moxibustion have been widely applied in prevention and treatment of vertebrobasilar insufficiency,it can not provide evidences of higher reliability for clinical treatment due to less clinical randomized controlled tests and lower quality,which severely hinder testing and verifying of clinical therapeutic effects of acupuncture and moxibustion.It is proposed that multiple central and randomized controlled test should be made,so as to search for feasible acupuncture and moxibustion methods with definite therapeutic effect for vertebrobasilar insufficiency,and provide basis for further systematical evaluation.

In order to evaluate the changes in T cell subsets after acute irradiation injury, and investigate the mechanism of deficiency of cellular immunity in acute irradiation syndrome, Balb/c mice were exposed to a single total body irradiation of 5Gy gamma rays from a 60 Co source. On days 10, 28 and 120, the amounts of CD4 + and CD8 + subsets in spleen cells were evaluated by flow cytometry (FCM), and expression of IL 4 gene in ConA stimulated spleen cells was evaluated by reverse transcription linked polymerase chain reaction, in which ?-actin gene was used as an internal control. It was found that after irradiation, the ratio of CD4 + /CD8 + became significantly higher than that of the controls, and then the ratio lowered gradually until day 120. However, it still did not return to the level of the controls. On day 10, expression of IL 4 gene at mRNA level increased significantly. The results indicated that CD8 + subset was more radiosensitive than CD4 + , and the pattern of cytokine seeretion shifted to that of Th2 soon after irradiation.

Objective To compare the effects of butorphanol,midazolam and innovar on relieving appendix traction response during appendectomy. Methods Sixty-eight patients who underwent appendectomy were randomly divided into butorphanol group(n=21),midazolam group(n=23) and innovar group(n=24).Butorphanol,midazolam and innovar were intravenously administered to patients during skin incision.The appendix traction response,sedation score,heart rate(HR),mean arterial pressure(MAP) and pulse oxygen saturation(SpO2) were recorded and compared among groups.Results Compared with those before operation,there was no significant changes in HR,MAP and SpO2 during operation.The effective rates of butorphanol,midazolam and innovar in relieving appendix traction response were 95.2%,65.2% and 50.0%,respectively.Butorphanol surpassed midazolam and innovar in sedation and relieving appendix traction response(P

AlM:To observe clinical effects between the laser in situ keratomileusis ( LASlK ) surgery and the laser subepithelial keratomileusis ( LASEK ) surgery as the second operation after an unsuccessful LASlK surgery.METHODS:Forty-nine patients (98 eyes) with refractive regression after LASlK operation received the second surgery. All patients were divided into two groups:group A and B. Group A (48 eyes of 24 patients) received LASlK surgery and group B ( 50 eyes of 25 patients ) received LASEK surgery. lnspect the main parameters included visual acuity, refraction, corneal curvature, and the total value of high-aberration after 1wk, 1mo and 1a, t-test of groups was used as statistical analysis method.RESULTS: There was statistically significant (P<0. 05) between the two groups in visual acuity after 1wk. There was no statistically significant between the two groups in visual acuity after 1mo, and there was also no statistically significant between the two groups in visual acuity, average spherical equivalent refractive degree, average corneal curvature, and the total value of high-aberration after one year (P>0. 05). There developed one case of epithelium in growth after LASlK surgery, and one case of haze Ⅱ after LASEK surgery.CONCLUSlON: Both LASlK and LASEK surgery can obtain satisfactory therapeutic results after an unsuccessful LASlK surgery.

AIM:To observe the efficacy and safety of ropivacaine supplemented with midazolam for sacral block in pediatric operation.METHODS:40 cases of patients aged 1-6 years old,who were going to be operated in hypogastrium,perineum and lower limb,were randomly and double-blindly divided into four groups with ten cases each:control group(bupivacaine 2.5 mg/kg),low dosage group(ropivacaine 2.5 mg/kg),middle dosage group(ropivacaine 3.5 mg/kg)and high dosage group(ropivacaine 5.0 mg/kg).Sacral block was performed after induction of inhalation anaesthesia with sevoflurane.Sedation was induced by midazolam(0.2 mg/kg)administered through mainline 5 min before the surgical procedure.RESULTS:In a certain dosage range,ropivacaine supplemented with midazolam anesthesia for sacral block showed a slight influence on diastolic blood pressure,mean arterial pressure,heart rate and pulse oxygen saturation.Those parameters remained in the physiological normal range,though they dropped slightly during the operative period.Compared with bupivacaine group,the postoperative analgesic period was similar in the high and middle ropivacaine groups,while it was shorter in low ropivacaine group.There was no significant adverse effect in all groups except for operative stretch reflex and postoperative vomiting in individual patients.CONCLUSION:Ropivacaine supplemented with midazolam anesthesia for sacral block has a slight influence on hemodynamics,prolongs the postoperative analgesic period,and shows less adverse effect.