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.

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.

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.

To evaluate the mechanism,treatment and prescription acupoint of acupuncture when it was used for osteoporosis.The observation index,effect and outcomes were studied objectively.The characteristics and associated problems of acupuncture were discussed.

To management of syncope in children and adolescents,the primary objectives are etiological diag-nosis and risk stratification.The possible causes for syncope ranging from relatively benign conditions to potentially life -threatening events.The efficient methods of diagnosis and risk stratification are vital important to identify those syncope patients who are at short -term or long -term risk of life -threatening events,avoiding unnecessary hospitali-zation of low -risk patients.In recent years,there came up with a multitude of quantitative methods in diagnosis and risk stratification,according to clinical history and physical exam and 1 2 -lead electrocardiograph.These methods can assit front -line physicians do an optimal decision -making,especially providing valuable guidance to make a well -in-formed choice between hospitalization and outpatient referral.Nevertheless,these existing methods can not replace criti-cal assessment by an experienced physician.

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.

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 .

Objective To explore the effects of isoalantolactone on the proliferation of human chronic myelogenous leukemia drug-resistant cell line K562/A02. Methods K562/A02 cells were treated with 6.25, 12.5, 25, 50 and 100 μmol/L isoalantolactone for 24 and 48 h, cell viability was analyzed with MMT assay. K562/A02 cells were treated with 10, 15, 20 μmol/L isoalantolactone for 24 h. Flow cytometry was used to examine the effect of isoalantolactone on the cell-cycle and apoptosis of K562/A02 cells. The related proteins were analyzed using Western blot. One-way ANOVA was used for statistical analysis. Results Isoalantolactone effectively inhibited the proliferation of K562/A02 cells in a dose-dependent manner (P<0.05) with IC50 value of (15.00 ±1.03) μmol/L at 24 h, respectively; Flow cytometry displayed that isoalantolactone may induce K562/A02 cells apoptosis in a concentration-dependent manner (P<0.05). The apoptotic rate significantly increased from (2.71 ±0.52) % in the control group to (19.10 ±1.55) %, (27.61 ± 2.32)%and (32.01±3.01)%(F=33.901, P<0.05), respectively, after treatment with 10, 15, and 20 μmol/L of isoalantolactone for 24 h. The percentage of cells in the S phase increased from (57.80±2.11) % to (68.62± 2.89)%, (78.41±3.51)%and (80.61±2.90)%, respectively (F=51.328, P<0.05). Western blot indicated that the expression of bcl-2, p-bcr-abl, p-STAT5, CDK2 and cyclin A significantly decreased (P< 0.05), and that of cytochrome C, Bax, and p21 increased with the increasing of isoalantolactone concentration (P< 0.05). Conclusion Isoalantolactone can significantly inhibit the proliferation of K562/A02 cells through bcr-abl-STAT5 signaling pathway.

The necessities and feasibilities of setting up of community nursing specialty for baccalaureate program in nursing college and university are discussed. And the cultivating approach from aspects of training target; training mode, curriculum design and training of community practical abilities is explored.