Objective To survey the current status of job stressor and exhaustion among nursing staff in the catheter room of grade Ⅲ-A general hospitals and to look for regularities.Methods 178 nursing staff coming from catheter room,operating room,and outpatient department of Shenzhou Hospital and Fengtian Hospital accepted questionnaires of Chinese Nursing Stressor Scale and Exhaustion Scale in Spring 2010.Results Chinese Nursing Stressor Scale indicated that scores of subitem and total score of job stressor in the catheter room were significantly higher than those in the outpatient department; however,there were no significant differences in scores of subitem and total score of job stressor between catheter room and operating room.On the other hand,Exhaustion Scale showed that scores of emotional exhaustion and job unconcerned feeling in the catheter room were significantly higher than those in the outpatient department,but scores of job achieved feeling in the catheter room were significantly lower than those in the outpatient department.There were no significant differences in Exhaustion Scale between catheter room and operating room nurses.Conclusions Job stressor and exhaustion were serious among nursing staff in the catheter room of grade Ⅲ-A general hospitals,which should cause the attention of management department.

Objectives To observe the clinical significance and application value of autologous blood transfusion in neurosurgery of primary hospital. Methods Four hundred and fourteen patients who underwent the neurosurgery operation and were subjected to intraoperative blood transfusion were selected, among whom 97 patients were subjected to autologous blood transfusion (observation group), and 317 patients were subjected to heterogenous blood transfusion (control group). The condition of intraoperative blood transfusion, changes of hemoglobin and hematocrit, blood transfusion related cost were compared between 2 groups. Results There were no statistical differences in operation time, infusion volume, rate of transfusion related complications and postoperation hemoglobin, hematocrit between observation group and control group (P>0.05). The patients in control group were infused with 189 000 ml, and the transfusion liquid volume proportion of total blood transfusion was 79.22%(189 000/238 580);13 patients in observation group were used the heterogenous blood transfusion with 5 400 ml, and the transfusion liquid volume proportion of total blood transfusion was 10.30%(5 400/52 430). Eighty-six patients (88.66%, 86/97) in observation group performed autologous blood collection and transfusion, the volume of autologous collection was 80 650 ml, and the volume of transfusion was 47 020 ml. Eleven patients in observation group did not perform autologous blood transfusion, among whom 6 patients was because of operational and mechanical reasons, and 5 patients performed collection but did not transfuse. The cost of heterogenous concentrated suspension red blood cell over 6 U was significantly higher than the cost of disposable material and injection of autologous blood:(2 287.06 ± 243.52) yuan vs. (1 595.08 ± 133.95) yuan, and there was statistical difference (P<0.05). The rate of heterogenous concentrated suspension red blood cell 6 U in control group was 14.83%(47/317), and the rate of over 6 U was 6.62%(21/317). Conclusions The autologous blood transfusion is safe and effective, and it is worth popularizing in neurosurgery of primary hospital. But in the process of its application, it is necessary to strengthen the user′s operating skills and ensure the quality of autologous blood transfusion.

To investigate and analyze the epidemiology of serious corneal ulcer.
● METHODS: A total of 133 serious corneal ulcercases from June 2010 to December 2013 in Xiangya Hospital Affiliated to Central South University were retrospectively reviewed for risk factors, demographic characteristics and diagnosis.
●RESULTS: There were 91 male patients (68. 4%) in the 133 patients. A peak incidence age was from 41 to 60 years old (82 cases, 44. 4%). Most of patients were peasant (77 cases, 57. 9%) and the percentage of the low schooling patients was 85. 0% (113 cases). The number of patients who had been sick was 73 before hospitalization (54. 9%) in all cases. The peak incidence season was January (34. 6%). Average length of stay was 9. 84d. The number of emergency cases was 44 (33. 1%). Most of patient were not only corneal ulcer cases but the hypopyon (92 cases, 69. 2%). The figure of inpatients who received operations was 102 cases ( 76. 7%). And the most of operations was amniotic membrane transplantation (31 cases, 39. 2%). Additionally, this data was classified regard to gender differences.
● CONCLUSlON: The peasant of the middle age and elderly represents a distinct clinical group in the serious corneal ulcer in hospital. Severity, ocular trauma in agriculture and health awareness are the major predisposing factors.

AIM: To test the ability of multifocal visual evoked potential (mfVEP) in the detecting of glaucoma by comparing the mfVEP recorded from normal subjects and glaucoma patients.METHODS: The mfVEP of 32 normal eyes (n =21) and of 58 eyes (n =37) with primary glaucoma were recorded with the Vision Monitor electrophysical apparatus by the second kernel analysis and to determine the correlation of the topographic location between them.RESULTS: There were significant variability (the coefficient of variation was 43.05%) in mfVEP RMS amplitude in the normal subjects; The RMS amplitude of eyes with glaucoma were smaller than that of the normal eyes and significantly statistical difference were found in the relatively center (namely the 0° -10° ring zone) and in superior nasal quadrant (P＜0.05) while there were no significantly statistical differences of the latency time between them.CONCLUSION: The normal subjects have large individual variability of mfVEP responses. The RMS amplitude of the mfVEP of glaucomatous eyes descends, especially in center zone and superior nasal quadrant.

A chiral LC-MS/MS method for the simultaneous analysis of desvenlafaxine (DVS) enantiomers in human plasma was developed and applied to a pharmacokinetic study on 12 Chinese healthy volunteers. d6-Desvenlafaxine was used as internal standard (IS). Chromatographic separation was performed on the Astec Chirobiotic V chiral column (150 mm x 4.6 mm, 5 μm). The assay was linear over the concentration range of 0.500-150 ng x mL(-1) for both enantiomers (r2 > 0.99). The method was successfully applied to a stereoselective pharmacokinetic study of 100 mg desvenlafaxine sustained release tablets on 12 Chinese healthy volunteers under fasting conditions. The results showed that the pharmacokinetic parameters were similar to both enantiomers in Chinese healthy volunteers. The AUC(0-t), and C(max) of the two enantiomers were about 1.5 times higher than those of blacks and whites reported in the literature.
Administration, Oral ; Area Under Curve ; Asian Continental Ancestry Group ; Chromatography, Liquid ; Cyclohexanols ; blood ; pharmacokinetics ; Delayed-Action Preparations ; Desvenlafaxine Succinate ; Dose-Response Relationship, Drug ; Healthy Volunteers ; Humans ; Male ; Plasma ; chemistry ; Stereoisomerism ; Tablets ; Tandem Mass Spectrometry

To study the chemical constituents from the bark of Myrica rubra, fourteen compounds were isolated from the methanolic extract using various chromatographic techniques, including silica gel, Sephadex LH-20 and preparative HPLC. Their structures were identified on the basis of chemical properties and spectroscopic data, as 3, 5-dimethoxy-4-hydroxymyricanol (1), myricanol (2), myricanone (3), myricanol 11-sulfate (4), myricitrin (5), quercetin (6), quercetin-3-rhamnoside (7), tamarixol (8), uvaol (9), ursolic acid (10), taraxerol (11), myricadiol (12), β-sitosterol (13) and β-daucosterol (14). Among them, compound 1 is a new compound, named as 3, 5-dimethoxy-4-hydroxymyricanol, compounds 8, 9 were isolated from the genus Myrica for the first time.
Diarylheptanoids ; chemistry ; isolation & purification ; Myrica ; chemistry ; Phytochemicals ; chemistry ; isolation & purification ; Plant Bark ; chemistry

Objective To explore the relationship between the anastomotic plane and gastric esophageal reflux by analysizing three different anastomotic plan pressure and esophageal 24 h dynamic pH.Methods From June 2011 to March 2012, 45 patients with esophageal cancer had undergone radical surgery.According to the different locations of esophageal carcinoma, we divided patients into three groups(cervical esophagogastrostomy group, above aortic arches for esophagogastrostomy group, low aortic arches for esophagogastrostomy group).we monitored the LESP, esophageal wet swallowing peristalsis amplitude and 24 h dynamic pH value two days before surgery, and monitored the anastomotic plane pressure, residual esophageal wet swallowing peristalsis amplitude and 24 h dynamic pH value 1 month and 2 months after surgery in the same way.Results Three groups' difference of LESP, esophageal wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜4in preoperative was not statistically significant.The difference of esophagogastrostomy plane pressure in postoperative was not statistically significant, but the wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜ 4 in postoperative was statistically significant.Three groups' difference of LESP(compared with esophagogastrostomy plane pressure), wet swallowing peristalsis amplitude and percentage of total time of 24 h dynamic pH ＜ 4 between preoperative and postoperative was also statistically significant.Conclusion For patients with esophageal neoplasms, we should completely resection the tumor, and remain esophagus as much as possible.

Objective To investigate the perioperative characteristics and changing trends of gastric electrical activity of thoracic (tube) stomach in patients with esophageal cancer.Methods The clinical data of 30 patients with esophageal cancer who were admitted to the Sichuan Cancer Hospital between March 2013 and November 2013 were prospectively analyzed.All the eligible patients underwent esophageal cancer resection by Ivor-Lewis according to the inclusion criteria.The electrogastrograms of patients were recorded at preoperative day 1 and at postoperative day 3,7, 11 and 30.The electrogastrograms of patients at preoperative day 1 were used as the control.The parameters of electrogastrogram were analyzed including main frequency, coefficient of dominant frequency instablility, main power, postprandial/preprandial power ratio, percentage of normal gastric slow wave,percentage of slow gastric slow wave and percentage of tachycardia gastric slow wave.Measurement data with normal distritution were presented as x ± s, and measurement data with skew distritution were presented as M (Qn).The postoperative time and pre-and post-prandial electrogastrograms were compared by the repeated measures two-way ANOVA.The comparison between groups were evaluated with the LSD test and analysis of variance.Results Thirty patients were screened for eligibility with a mean age of 62 years (range, 49-75 years), including 26 males and 4 females.The pre-and post-prandial main frequencies were changed from 2.83 ± 0.13 and 3.01 ± 0.17 before operation to 2.66 ± 0.10 and 2.82 ± 0.10 at postoperative day 30 with coherent changing trend.The main frequencies at postoperative each time points were significantly lower than those before operation while postprandial above indicators were higher than preprandial those, showing a significant increasing trend with the passage of postoperative time (F =285.62, P ＜ 0.05).There was no interaction between the time and meal (F =0.22, P ＞ 0.05).The pre-and post-prandial coefficients of dominant frequency instablility were changed from 0.133 ±0.031 and 0.045 ±0.019 before operation to 0.150 ±0.043 and 0.115 ±0.010 at postoperative day 30 with coherent changing trend, and coefficients of dominant frequency instablility at postoperative each time points were significantly higher than those before operation while postprandial above indicators were lower than preprandial those, showing a significant reducing trend with the passage of postoperative time (F =16.51, P ＜ 0.05).The pre-and post-prandial main powers were changed from (85 ± 15) μV and (149 ± 23) μV before operation to (74 ± 9) μμV and (98 ± 10) μV at postoperative day 30, and main powers at postoperative each time points were significantly lower than those before operation, showing a significant increasing trend with the passage of postoperative time (F =48.45, P ＜ 0.05).There was interaction between the time and meal (F =7.39, P ＜ 0.05).The postprandial/preprandial power ratio was changed from 3.00 ± 0.35 before operation to 2.52 ± 0.25 at postoperative day 30, and postprandial/preprandial power ratios at postoperative each time points were significantly lower than those before operation, showing a significant increasing trend with the passage of postoperative time (F =26.66, P ＜ 0.05).The pre-and post-prandial percentages of normal gastric slow wave were changed from 81％ ± 6％ and 94％ ± 5％ before operation to 57％ ± 5％ and 70％ ± 5％ at postoperative day 30 with coherent changing trend, and percentages of normal gastric slow wave at postoperative each time points were significantly lower than those before operation while postprandial above indicators was lower than preprandial those, showing a significant increasing trend with the passage of postoperative time (F =49.36,P ＜0.05).There was no interaction between the time and meal (F =0.24, P ＞ 0.05).The pre-and postprandial percentages of slow gastric slow wave were changed from 17％ ± 7％ and 4％ ± 4％ before operation to 32％±4％ and 21％±4％ at postoperative day 30 with coherent changing trend, and percentages of slow gastric slow wave at postoperative each time points were significantly higher than those before operation while preprandial above indicators were higher than postprandial those, showing a significant reducing trend with the passage of postoperative time (F =46.54, P ＜ 0.05).There was interaction between the time and meal (F =18.12, P ＜ 0.05).The pre-and post-prandial tachycardia gastric slow wave percentages were changed from 1.55％ (1.04％,2.21％) and 1.95％ (1.74％, 4.22％) before operation to 8.97％ (5.76％, 12.02％) and 12.41％ (8.04％,16.85％) at postoperative day 30 without completely coherent changing trend, and percentages of tachycardia gastric slow wave at postoperative each time points were significantly higher than those before operation while postprandial above indicators were higher than preprandial those, showing a significant difference between before operation and postoperative day 3 (Z =11.47, 13.28, P ＜ 0.05) and no significant difference among the postoperative day 7, 11, 30 (Z =1.88, 0.31, 0.03, P ＞ 0.05).There was no interaction between the time and meal (F=0.85, P＜0.05).Conclusions After the esophagectomy, gastric electrical activity of thoracic (tube) stomach is also retained before and after the meal.There are significant differences among the main frequency, main power, coefficients of dominant frequency instablility, postprandial/preprandial power ratio,percentage of normal gastric slow wave, percentage of slow gastric slow wave, percentage of tachycardia gastric slow wave of thoracis (tube) stomach, they have changed dynamically in the perioperative period.

Objective Pathophysiology has high comprehensiveness and practical characteristics. Developing analytical capacity is a major teaching aim of Pathophysiology. This study was aimed to build up the basic knowledge of pathophysiology and develop a critical approach through comparative case learning in medical students. Methods A pair of related cases were chosen in this study. Comparative case learning was performed in our lecture. Case analysis was tested before and after comparative case learning,and a self-evaluation was accessed after comparative case learning. The scores of case-analyzing test and self-evaluation assessment were statistically analyzed. Results Using“comparative case learning”in pathophysiology could improve medical students' case-analyzing score,especially in clinical syndrome analyzing examination questions(difficult examination questions). There was a significant correlation between high score of clinical syndrome analyzing examination and students' self-evaluation. ConclusionComparative case learning could improve the analytical,data searching and comprehensive abilities,thereby enhancing a case-analyzing ability in medical students.

Objective To evaluate the effect of dexmedetomidine on spinal purinergic receptor 2X-4 (P2X4)/nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) pathway in a rat model of diabetic neuropathic pain (DNP).Methods Twenty-four pathogenfree adult male Sprague-Dawley rats,weighing 200-220 g,aged 8 weeks,were allocated into 3 groups (n =8 each) using a random number table:control group (C group),DNP group and DNP plus dexmedetomidine group (DNP+D group).Diabetes mellitus was induced by intraperitoneal 1％ streptozotocin 60 mg/kg and confirmed by blood glucose ≥ 16.7 mmol/L 3 days later.In group DNP+D,dexmedetomidine 50 μg/kg was intraperitoneally injected once a day for 6 consecutive weeks starting from 3 days after the model was successfully established.The mechanical paw withdrawal threshold (MWT) and sciatic nerve conduction velocity (SNCV) were measured at 2,4 and 6 weeks after injection of dexmedetomidine.The rats were sacrificed at 6 weeks after injection of dexmedetomidine,and the L4-6 segments of the spinal cord were removed for examination of the pathological changes (with a light microscope) and for determination of P2X4,NLRP3 and interleukin-lbeta (IL-1β3) expression (by Western blot).The sural nerve was obtained for examination of the ultrastructure by electron microscopy.Results Compared with group C,the MWT was significantly decreased at 2,4 and 6 weeks after injection of dexmedetomidine,the SNCV was decreased at 6 weeks after injection of dexmedetomidine,the expression of P2X4,NLRP3 and IL-1β in the spinal cord was up-regulated (P＜0.05),and the pathological changes of the spinal cord and sural nerve were marked in DNP and DNP+D groups.Compared with group DNP,the MWT was significantly increased at 2,4 and 6 weeks after injection of dexmedetomidine,the SNCV was increased at 6 weeks after injection of dexmedetomidine,the expression of P2X4,NLRP3 and IL-1β in the spinal cord was down-regulated (P＜0.05),and the pathological changes of the spinal cord and sural nerve were significantly attenuated in group DNP+D.Conclusion The mechanism by which dexmedetomidine mitigates DNP is probably related to inhibition of P2X4/NLRP3 pathway in rats.