Positive psychology focuses on enhancing individual positive emotion and promoting the development of individual positive personality.Introducing positive psychology into the first stage of internal medical resident standardized training will improve the resident ability to solve clinical problems.It's helpful for resident doctors to improve their clinical thinking ability,doctor education innovation ability and lifelong self-education ability.It inspires their creative thinking by motivating their positive emotions It would help them to avoid occupational tiredness.Using the idea of positive psychology could improve the comprehensive quality of residents.

Hip-stressed lower limb specific strength training apparatus is a new kind of training equipment with the combination of specific technical strength training and quantitative evaluating. Base on the mechanism of sports physiology and sports biomechanics, by applying the theory of motor learning and control, the apparatus adopts the training model of the "hip stress loading device" and "hip-feet starting and ending stress point" to simulate the track of working limb in running, jumping and throwing, controls the degrees of body movement freedom reasonably. For the first time, actualizes the heavy load specific strength and sports skill training of leg driving, leg pawing and trunk-backward knees-bend leg driving. The distinctive training pattern of forced track control and the training method of strength & skill coupling" used in this apparatus, makes the action in strength training approach to real sport skill in greatest extent, and shifts the result of strength training to the skill training as much as possible. So it remarkably increase the efficiency of strength training and has an great importance in changing the concept of strength training.

Objective To study the serum levels of PSA, PAP joint detection in diagnosis of prostate cancer and the effect of estrogen on it.Methods60 patients with prostate cancer were selected in Jinyun County People's Hospital department of urology patients, giving diethylstilbestrol 3mg, oral once a day, and give Aspirin Enteric-coated Sustained Release Tablets 100mg oral, once daily, for 2 consecutive months.At the same time, we selected 60 cases of patients with benign prostatic hyperplasia, normal control group of 60 healthy subjects were the same period.Using radioimmunoassay, were observed inprostatic hyperplasia group, normal control group, the prostate cancer group before treatment, the prostate cancer group after treatment, serum PSA, PAP levels, as well as the group before and after treatment in patients with prostate cancer IPSS score index.ResultsThe prostate cancer group, serum PSA, PAP levels were significantly higher than that of benign prostatic hyperplasia group and normal control group, the difference was statistically significant (P<0.05);no significant difference was found between the prostatic hyperplasia group and normal control group, PSA in prostate cancer positive detection rate and the detection sensitivity is 78.33% the specificity was 70%, the index of PAP in prostate cancer, and the positive detection rate and the detection sensitivity was 53.33%, specificity index reached 93.33%;PSA for prostate cancer detection positive rate and sensitivity was higher than that of PAP, but the specificity is less than PAP, the difference is statistically significant (P<0.05) after treatment;the prostate cancer group, serum PSA, PAP levels were improved, compared with that before treatment, serum PSA, PAP levels decreased significantly, the difference was statistically significant (P<0.05);and after the treatment, the prostate cancer group of prostate symptoms have improved, compared with before treatment, IPSS score decreased significantly, the difference was statistically significant (P<0.05).ConclusionThe combined detection of serum PSA, PAP in the diagnosis of prostate cancer can improve the sensitivity and specificity, and can be used for early diagnosis of prostate cancer;estrogen can lower their level, improve the symptoms of prostate cancer, inhibit the progress of the disease.

Objective To investigate the accuracy of end-tidal carbon dioxide (PETCO2) in reflecting arterial carbon dioxide (PaCO2) during mechanical ventilation via laryngeal mask airway (LMA) in children. Methods Fifty-two ASA Ⅰ patients, aged 2-9 yr, weighing 10-30 kg, undergoing orthopaedic surgery under general anesthesia, were randomized into 2 groups (n = 26 each) : LMA group and endotracheal tube (ETT) group. After anesthesia was induced with fentanyl, propofol and succinycholine, LMA or ETT was inserted and the children were mechanically ventilated. After the hemodynamics was stable, arterial blood samples were obtained to detect PaCO2, and PETCO2 was recorded simultaneously. Results There was no significant difference in PaCO2 and PCT CO, between groups LMA and ETT ( P ＞ 0.05) . There was no significant difference between PaCO2 and PETCO2 in LMA group (P ＞ 0.05). Conclusion When mechanical ventilation is performed via LMA in children, PETCO2 can reliably reflect PaCO2 and guide the regulation of ventilatory parameters.

Objective To investigate the effect of propofol on LPS-induced TLR4 expression in rat alveolar type Ⅱ epithelial cells. Methods The primarily cultured alveolar type Ⅱ epithelial cells isolated from male rats were randomly assigned to one of 5 groups: group Ⅰ cells were incubated for 3 h without any additive (control) ; group Ⅱ cells were incubated with LPS 1 μg/ml for 3 h (LPS) ; group Ⅲ , Ⅳ , Ⅴ cells were incubated with LPS 1 μg/ml + propofol 25, 50 and 100 μmol/L respectively for 3 b (P1-3). TLR4 mRNA and TLR4 protein expression was detected by real time PCR and Western blot. TNF-α release amount was measured using ELISA. Results LPS significantly' increased TLR4 mRNA and protein expression in alveolar type Ⅱ epithelial cells as well as TNF-α release amount. Propefol at 50 and 100 μmol/L significantly inhibited LPS-imluced increase in TLR4 mRNA and protein expression and TNF-α release amount. Conclusion Propofol can dose-dependently inhibit LPS-induced inflammation in alveolar type Ⅱ epithelial ceils, through down-regnlation of TLR4 gene and protein expression.

Objective To evaluate the effectiveness and safety of a new designed balloon catheter, the Minirail balloon catheter in coronary intervention Methods Twenty two consecutive patients with coronary artery disease (male 16, female 6, mean age 58 77?8 69 years) were enrolled the study Selective angioplasty was performed for 24 target lesions (17 in LAD, 2 in LCX, and 5 in RCA) Among these target lesions were 5 type C, 14 type B 2, and 5 type B 1 lesions The average extent of narrowing before procedure was 91 18%?5 95% Target lesions were dilated with Minirail balloon catheters Results All of the target lesions were successfully dilated with Minirail balloon catheters The average residual stenosis was 33 18%?25 14% after balloon angioplasty Significant dissection was seen in 3 of the cases, and slow reflow in another one Twenty four stents were implanted in 19 cases The final residual stenosis was 1 82%?5 01% at the end of procedure No death or Q wave myocardial infarction happened No emergency bypass surgery needed Conclusion Minirail balloon catheter is safe, effective, and easy to be used in coronary intervention

Objective To evaluate the efficiency and safety of Percusurge guardwire distal protection system in coronary intervention in patients with acute myocardial infarction. Methods Three male patients with acute myocardial infarction were enrolled in the study. Primary angioplasty was performed for 2 of them, 2 and 7 hours after onset of the infarction symptom, respectively. Selective angioplasty was performed 17 days after infarction for the third case. Percusurge guardwire system was used during the procedure. Results Procedure success was achieved for all of the 3 cases. Lot of thrombus was sucked out. The infarct-related arteries had TIMI 3 flow at the end of the procedures. The patients′ symptoms were resolved soon after the procedure. Minor dissection was seen in one case which did not obstruct the distal flow and was left alone. Conclusion Percusurge guardwire system can be used safely and effectively in coronary intervention in the thrombus-laden arteries such as acute myocardial infarction.

Objective To evaluate the clinical outcome of patients who suffered from acute myocardial infarction with angiographically normal coronary arteries (MINC) Methods Forty patients (mean age: 52 6?12 2 years; range: 30-75 years) admitted with acute myocardial infarction had normal coronary arteries after AMI, defined by normal or insignificant 50% diameter stenosis) The risk factors, clinical data, ventricular functions and the long term outcomes were compared between Group A and Group B Results Hypertension and previous angina were more frequent in Group B Patients in Group A had a lower number of risk factors associated with them than patients in Group B LVEF during hospital was higher in Group A than in Group B The mean follow up period was 67?40 months in Group A and 68?34 months in Group B Incidencs of rehospitalization, repeat intervention therapies, heart failures, and total heart events were fewer in Group A than in Group B Conclusion These data suggest a favorable long term prognosis and fewer risk factors in patients who suffered from acute myocardial infarction with normal or nearly normal coronary arteriogram

Objective To systematically review the influence of propofol orsevoflurane on postoperative cognitive dysfunction(POCD) in elderly patients undergoing non-cardiac surgery.Methods Eight databases including Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Pubmed, CNKI, VIP, CBM and Wanfang Database were searched for randomized controlled trials (RCT) about the influence of propofol orsevoflurane on POCD in elderly patients from the time of database establishment to June, 2016.At the same time, the reference materials of included literature were retrieved manually.All data were selected and evaluated by three independent reviewers according to the inclusion and exclusion criterions.RevMan 5.1 was used for the data analysis.Results A total 14 trials were discovered involving 790 elderly patients undergoing non-cardiac surgery.The results of Meta-analysis showed that the eye opening time and extubation time in the propofol group were significant shorter than sevoflurane group[SMDeye opening=-0.83,95%CI(-1.05,-0.61),P<0.05;SMDextubation=-0.85,95%CI(-1.09,-0.62),P<0.05].The MMSE scores at 1,3 and 6 h respectivelyafter the operation were obviously higher than those of sevoflurane group[SMD1h =0.84,95%CI(0.61,1.08),P<0.05;SMD3 h=1.12,95%CI(0.86,1.38),P<0.05;SMD6h=0.61,95%CI(0.40,0.82),P<0.05].One day after the operation,the difference was not significant[SMD1d=0.14,95%CI(-0.03,0.31),P>0.05].Three days after the operation, the values returned to normal levels, and was still higher in propofol group than in sevoflurane group[SMD3d=-0.32,95%CI(-0.56,-0.07),P<0.05] until 7 d [SMD7d=-0.18,95%CI(-0.51,0.15),P>0.05].The odds ratio of POCD incidence between propofol and sevoflurane groups was 0.35 [95%CI(0.21,0.58),P<0.05].Conclusion Propofol may lead to shorter eye opening time and extubation time compared to sevoflurane in elderly patients undergoing non-cardiac surgery.Both groups may lead to POCD, while propofol is a better choice for elderly patients when choosing general anesthesia.

Objective To summarize the outcomes and clinical experience of orthotopic heart transplantations in Shanghai Zhongshan Hospital.Methods From May 2000 through October 2005,141 patients,101 males and 40 females,diagnosed as having dilated cardiomyopathy in 118,hypertrophic cardiomyopathy in 2,restrictive cardiomyopathy in 2,end-stage ischemic heart disease in 9, primary malignant cardiac tumor in 4,valvular heart disease in 3 and others in 3,underwent orthotopic heart(transplantations) at our center.The operative procedures included 120 bicaval anastomotic cardiac transplantations,19 conventional Stanford orthotopic cardiac transplantations and 2 total heart transplantations.The immunosuppressive therapy strategies included Cyclosporine A or tacrolimus,corticosteroids and mycophenolate mofetil.For the latest 28 patients,induction therapy with Daclizumab was applied.Results There were 3 operative deaths with an operative survival of 97.9 %.During the follow-up from 1 month to 65 months,the actuarial survival rate was 90.8 % after 1 year,84.6 % after 3 year and 81.4 % after 5 year.Acute rejection,infections,graft failure and metastasis of primary cardiac tumor were the main causes of death in the 1st postoperative year,while acute rejection and graft coronary vasculopathy were the leading causes of death thereafter.Postoperative complications included acute rejection,infections,renal dysfunction and graft failure.Conclusions Orthotopic heart transplantation was proved to be a reliable choice for endstage heart disease with excellent outcomes.More attention should be paid to surveillance and management of acute rejection, infections and graft coronary vasculopathy in the long-term follow-up.