The article aims to investigate the deviated and narrowing understanding on the psychological health problems existing in the medical colleges from the educational perspective,exploring the significance of setting up psychological health courses,and finally propose the constructive suggestions.

PURPOSE In order to correct the wrong point of view which considered the colorectal adenoma with malignant change as early stage of carcinoma or as carcinoma with low grade malignancy and to avoid performing simple operation unreasonably. METHODS 148 cases of colorectal adenoma with malignant change which were treated in our department in 1995-1997 were submitted to a retrospective study. RESULTS We find only 27 cases (18. 8%) whose malignant changes were localized in the layers of mucosa.mucosalmuscle and submucosa,72 cases (50. 0 % , whose malignant changes had penetrated to the layer of serosa, and 43 cases (30. 7 % ) had lymph nodes metastases,18 cases (12. 5%) had blood metastases or implantations. We also find 51 cases (35. 5%) that couldn't get a definite diagnoses of malignant changes although 1-3 times of biopsies had been made before operation. and of them in fact 39 cases (74. 3%)had malignant changes that had penetrated to the layers muscle and serosa ,10 cases (19.6%) had metastases of lymph nodes and 7 cases (13. 7%) and blood metastases or implantations. CONCLUSION The adenoma with malignant change can not be considered as the early stage of carcinoma. We can not say the adenoma whose diagnosis was made by 1 - 3 times of biopsies is a real adenoma and certainly has no malignant change. We can not say the tumor whose original diagnosis was adenoma still belongs to the early stage of carcinoma either. So we suggest to treat the adenoma with malignant change correctly,aviod performing simple operation unreasonably.

Objective To evaluate the feasibility and advantages of gasless endoscopic thyroidectomy via the infraclavicular approach.Methods A single 2-to 4-cm infraclavicular incision was made at the ipsilateral side under local anesthesia.The subplastysmal plane was dissected up to the anterior neck to build a gasless space by mechanical method.Afterwards,by using ultrasonic scalpel,thyroidectomy was performed.Results The procedure was completed in 34 cases with a mean operation time of(120?30) min and mean blood loss of(20?12) ml.After the surgery,3 patients developed subcutaneous fluid and 1 patient had incisional infection,all of the 4 patients were cured by conservative therapy.The 34 cases were followed up for 1 to 30 months with a mean of 18.5 months,during the period,none of them had recurrence.Conclusions Gasless endoscopic thyroidectomy via the infraclavicular approach is a simple and safe method with good cosmetic outcomes.

Objectives To observe the effect of flurbiprofen as preemptive analgesic and it's relative adverse reactions in pa-tients undergoing selective craniotomy .Methods Sixty patients undergoing selective craniotomy were divided into two groups randomly by age,sex,location of craniotomy:observation group (Group-flurbiprofen) and control group (Group-saline).Monitored sonoclot signal and estimate bleeding amount during the operation .Evaluated the quality of emergence after operation .Recorded the VAS pain scores 2 hours,6 hours,12 hours and 24 hours after operation ,and the occurrence of adverse reactions as nausea , vomiting and respiratory de-pression.Results The concentration of prostaglandin E2(PGE2) in the serum of the observation group was lower than that of control group( P <0.05).There were no significant differences in ACT (activated coagulation time) and CR (clot rate) of the two groups( P>0.05),but the PF (platelet function) of observation group was lower than that of control group ( P <0.05).There were no signifi-cant differences in awakening time and extubation time of the two groups ( P >0.05).The 2 hours'pain scores of the two groups was of no significant difference( P >0.05),but the pain scores of observation group were lower than that of control group in 6 hours,12 hours and 24 hours after operation( P <0.05).The occurrence of nausea , vomoting and respiratory depression had no significant differences ( P >0.05) .Conclusions Flurbiprofen as preemptive analgesic can reduce the postoperative pain in patients undergoing cranioto -my,without increasing the occurrence of nausea , vomit and respiratory depression .It can effect the platelet function ,but could not in-crease the amount of bleeding .

Objective:To explore and observe therapeutic effect of nursing exercise rehabilitation on home patients with chronic heart disease (CHF) .Methods :A total of 122 CHF patients ,who performed home‐rehabilitation in community from Jan 2012 to Feb 2015 ,were selected .According to sealed envelope extraction method ,patients were randomly and equally divided into routine nursing group (received routine nursing intervention ) and exercise intervention group (received early exercise intervention based on routine nursing group ) ,the intervention period was eight weeks for both groups .The 6min walking distance (6MWD) ,left ventricular ejection fraction (LVEF) ,scores of Minnesota living with heart failure questionnaire (MLHFQ) and self‐behavior management scale were measured and compared between two groups before and after nursing .Results:Compared with before nursing ,after nursing , there were significant rise in 6MWD ,LVEF and score of self‐behavior management in both groups , P<0.01 all . Compared with routine nursing group after nursing ,there were significant rise in 6MWD [ (482.44 ± 65.29) m vs . (546.24 ± 76.13) m] ,LVEF [ (35.69 ± 7.22)% vs .(38.83 ± 6.92)% ] and score of self‐behavior management [(89.19 ± 25.14) scores vs .(103.49 ± 22.44) scores] ,significant reductions in physical [(62.12 ± 17.97) scores vs . (42.32 ± 17.67) scores] ,emotional [ (67.76 ± 17.17) scores vs .(51.32 ± 16.41) scores] and social dimension score [ (72.43 ± 10.31) scores vs .(62.44 ± 10.45) scores] of MLHFQ in exercise intervention group ,P<0.01 all .Con‐clusion:Nursing exercise can significantly enhance heart function and athletic ability ,improve self‐care capacity , help to improve quality of life in home patients with chronic heart failure .

Fever model was made by intravenously injected leucocytic pyrogen(LP,EP). Chai Ge Jie Ji Tang CGJJT fluid was perfused into rabbits stomach by mouth. 65 New Zealand white rabbits were divided into four groups: (1) control group; (2) LP group; (3) CGJJT fluid group; (4) LP+ CGJJT fluid group. Effects of CGJJT fluid on LP fever and cAMP concentration in cerebrospinal fluid (CSF)were observed. The results obtained from our experiments showed that: (1) The rectal temperature of normal rabbits markedly affected by CGJJT fluid. (2) Febrile response of LP was significantly inhibited by CGJJT fluid (P

0.05). (2) Febrileresponse of LP was significantly inhibited by No.Ⅰ, No.Ⅱ, respectively. Concentrationof cAMP in CSF of LP group, 1 hour after injection of LP, was 140.94?51.74 pmol/ml, while that of the No.Ⅰ+ EP group was (83.48?8.11 pmol/ml) obviously lowerthan that of LP group (P

The dissolution rates of the cephalexin tablets made by five t actories in China were determined with rotating basket method. The dissolution constants Ki were calculated using single exponential method. The analysis of variance was carried out for Ki. The results showed that constants Ki of products from different factories were significantly different (p

Objective To research the efficacy of different dose botulinum toxin A in the treatment of patients with neurogenic detrusor overactivity due to spinal cord injury or multiple sclerosis.Methods The datas of 43 patients with neurogenic detrusor overactivity caused by spinal cord injury or multiple sclerosis which accepted treatment in our hostipal were analyzed.And 38 patients were followed up for 12 weeks,of which 20 cases were treated with 200 U botulinum toxin A,and 18 cases received 100 U botulinum toxin A.The average age of 38 patients was 45.3 years old,and the ratio of famale was higher.The incontinence quality of life(I-QOL)changed from baselin after 6 weeks and 12 weeks was recorded.Resluts The final outcomes showed that the efficacy of botulinum toxin A with 200U was better than that with 100 U according to I-QOL score,and the difference was statistical significance(P <0.05).Conclusion The botulinum toxin A has positive effect on neurogenic detrusor overactivity,and the efficacy of 200 U injection is better than that of 100 U.