Objective To investigate the effect of different anesthesia methods on perioperative body temperature. Methods Eighty patients undergoing esophagus cancer resection were randomized into two groups of combined general and epidural anesthesia(GEA, group A,42 cases) and general anesthesia(GA, group B, 38 cases). Epipharynx and peripheral temperatures were recorded at the same time every 30 minutes for 3 hours after induction. Epipharynx temperature was recorded than after when circulating water mattresses and fluid warming were used to rewarming. The incidence of postoperative shivering was recorded. Results The peripheral temperature was gradually decreased after induction in both groups. The core temperature was decreased quickly within the first 1 hour in both groups, which was reduced slowly within the next two hours with a greater magnitude of temperature reduction in group A than that in group B(P<0.05). The incidence of shivering was higher in group A than that in group B during warming up. Conclusion The patients undergoing long procedures such as esophagus cancer recection under GEA is at more risk for hypothermia than those under GA.

Objective To explore the application effect of paclitaxel combined with carboplatin neoadjuvant chemotherapy in patients with advanced cervical carcinoma.Methods Forty patients with stage Ⅱa and above cervical cancer who were treated between August 2015 and August 2016 were selected as the research objectives and all patients were diagnosed by pathological examination.They were divided randomly into experimental group(n=20)and control group(n=20).Patients in the experimental group were treated with intravenous chemotherapy before operation.This scheme included paclitaxel and carboplatin.It included 2 cycles,and the interval between the 2 cycles was 3 weeks.Extensive hysterectomy and pelvic lymphadenectomy were made in 14 days after chemotherapy.The patients in the control group were treated only with extensive hysterectomy and pelvic lymphadenectomy.The efficacy of neoadjuvant chemotherapy was evaluated according to WHO criteria,and observed the operation condition.Adverse drug reactions were evaluated according to WHO anti-cancer drug adverse reaction grade.The quality of life of the two groups was evaluated by the mos item short from health survey(SF-36).Results 20 patients completed chemotherapy,CR5 cases,PR11 cases,SD3 cases,PD1 cases,and the total effective rate(CR+PR)was 80％.At the same time,The paracervical tissue becomed soft in varying degrees,the gap widened,the invasive lesions were controlled in different degrees.Adverse reactions were mild and relieved without special treatment.There was no kidney and heart function damage.All cases were operated successfully after chemotherapy.There were no significant difference in operation time and blood loss between the two groups.The rate of lymph node metastasis,the infiltration rate of uterine tissue and the residual rate of tumor tissue in the vaginal margin were lower than those in the control group(P<0.01).The SF-36 scores of the two groups were higher than those before treatment,but the score of the experimental group was higher significantly than that of the control group,and the difference was statistically significant(P<0.01).Conclusion Paclitaxel combined with carboplatin in neoadjuvant chemotherapy of cervical cancer can reduce the tumor volume,increase the chance of surgery,has less toxic side effects,lower metastatic rate and improve the quality of life of patients.It is worthy of further clinical research and recommendation.

Objective To observe the efficacy of multifactor intensive nursing intervention on chronic heart failure patients with outside hospital treatment,including self-management ability and related clinical indicators.Methods By application of prospective study,a total of 215 patients with chronic heart failure discharged from hospital were randomized into the usual care group (105 cases) and the intensive nursing intervention group (1 10 cases).Patients were followed up for 12 months,and 205 patients completed the follow-up.The usual care group only received conventional outpatient follow-up,the intensive intervention group patients received telephone counseling,more detailed clinical follow-up and regular health education.The intervention effect was compared between two groups.Results Compared with the usual care group,the passing rate of sodium/water limit and daily monitoring of weight was higher in the intensive intervention group.Left ventricular ejection fraction and six-minute walking test were better in the intensive intervention group,while the level of NT-pro-BNP was lower in the intensive intervention group.Compared with the usual care group,re-hospitalization rate and incidence of cardiovascular events were lower in the intensive intervention group.Conclusions Multifactor intensive nursing intervention is helpful on improving self-management ability,alleviate cardiac function,reduce re-hospitalization rate and incidence of cardiovascular events for chronic heart failure patients.

Objective To study the effects of repetitive transcranial magnetic stimulation(rTMS) of the supplementary motor area(SMA)on the cortical excitability in patients with Parkinson's disease(PD).Methods Sixteen patients with PD were included in this study.The motor evoked potentials(MEP)and the N30 component of somatosensory evoked potentials(SEP) were assessed for each patient before and after 1200 pulses of rTMS of the SMA at 5 Hz and an intensity of 100% of relaxed motor threshold (RMT) for the abductor pollicis brevis.Results Ten minutes after the rTMS intervention,the peak-to-peak amplitude of the SEP component P20-N30 increased significantly(P<0.05),with the P/F index decreased simultaneously(P<0.05).The MEP amplitude increased significantly,and reached the highest value at 10min after the rTMS intervention. Conclusion 5 Hz rTMS of the SMA can improve the excitability of the SMA itself temporarily.Meanwhile,it can induce a short-lasting facilitation of the excitability of M1 connected with SMA.

BACKGROUND:Molars are characterized by multi-root, multi-root canal, multi-directional, different geometric shape and distribution. Single-root canal teeth post-core theory was used to guide molar repair in the clinic. It is easy to cause root canal perforation or vertical fracture due to excessive post preparation. Therefore, it is necessary to make further study and investigation in the design of fiber post-resin core for repairing molars. OBJECTIVE: To evaluate the clinical therapeutic effects of fiber post-resin core with different numbers of posts in the repair of molar residual roots and crowns. METHODS: A total of 54 human molar residual roots and crowns with sound root canal filing in 48 patients were selected and restored with fiber post of different numbers and resin core as wel as complete coronal restoration. There were 17 cases (20 samples) restored with single fiber post core, 16 cases (18 samples) restored with double fiber post cores, and 15 cases (16 samples) restored with three fiber post cores. They were folowed up for 24 months and the repair results were compared. RESULTS AND CONCLUSION:After 24 months of folow-up, the success rates were 85%, 94% and 94% in the single fiber post, double fiber post and three fiber post groups, respectively, and no significant difference was detected among the three groups. Five failures were observed among 54 teeth: three cases of fiber post shedding in the single fiber post group, one case of fiber post shedding in the double fiber post group, and one case of fiberpost shedding in the three fiber post group, and no root fracture occurred. Three kinds of fiber post-resin cores for repairing molar residual roots and crowns can get a better short-term clinical result. The repair effects were not different because of the different numbers of fiber posts.

Objective:To investigate the relationship between VitD 3 concentration and glucose and insulin levels of OGTT in patients with CKD 3-5 stages.Methods: We included the patients with CKD 3 and 4 and 5 stages who fulfill the including standard.All patients were recorded the concentrations of [1,25 (OH):D3]concentration of glucose and insulin at fasting ,postprandial 1 h,2 h during OGTT and concentration of glycosylated hemoglobin level ,C peptide concentration.We performed the correlation analysis about [1,25 (OH):D3],glucose and insulin.Results: We totally included 91 patients with 3-5 stages CKD into our study.The D3 concentration of stage 3 were 160.9-261.3 mmol/L[(218.38±8.67)mmol/L] of stage 3,75.2-166.3 mmol/L[(117.01±4.72) mmol/L] of stage 4 and 11.8-96.5 mmol/L[(41.91±12.83)mmol/L] of stage 5 (P<0.05).The average concentrations of serum glucose at fasting,1 h after the meal and 2 h after the meal was(4.74±0.21)mmol/L,(8.31±0.43)mmol/L and(7.36±0.32)mmol/L in 3 stage and (4.92±0.25) mmol/L,(9.14±0.15) mmol/L and (9.14±0.39)mmol/L at 4 stage and (4.81±0.13)mmol/L, (10.72±0.41)mmol/L and (10.72±0.49)mmol/L at 5 stage (P<0.05).The average concentrations of insulin during OGTT at fasting,1 h after the meal and 2 h after the meal was (6.58±0.32) μU/L,(57.78±5.63)U/L and (42.77±8.45)U/L in 3 stage (6.03±0.53)U/L,(55.69±7.35)U/L and (62.52±5.39)U/L in 4 stage and (6.12±0.65)U/L,(62.82±9.73)U/L and (77.34± 8.62)U/L in 5 stage (P<0.05).Correlation analysis shows that the concentration of 1,25 (OH):D3 of different stages of patients with CKD and vitamin D 3 concentration and glucose tolerance test was found to be inversely associated with the insulin levels ( P<0.05 ) . Conclusion:There are obvious differences of concentration of vitamin D 3 between patients with 3-5 stages of chronic kidney disease (CKD).There also showed a negative correlation relationships between glucose and insulin levels ,and vitamin D3 concentration and glucose and insulin levels at OGTT of patients with 3-5 stages CKD.

Objective: To study the air removal efficiency of prevacuum sterilizers.Methods: The results of Bowie-Dick(BD) tests were monitored every day using the 3M disposable BD test pack,which was placed horizontally in the bottom section of the sterilizer rack near the exhaust opening.Results: Of the 1370 BD tests conducted with 3 autoclaves,1366 showed negative results and 4 positive.Conclusion: BD tests can be used to precisely assess the efficiency of prevacuum sterilizers.

Objective To understand the status of comprehensive health function impairment in elderly patients with rheumatoid arthritis, and to explore its influencing factors. Methods A total of 80 elderly patients with rheumatoid arthritis were enrolled in the first Affiliated Hospital of Kunming Medical University from December 2014 to October 2016. The quality of life SF-36 score was used to measure the physical health, mental health, daily activities and social health to assess the overall health status of patients. The factors influencing the comprehensive health function of the patients were analyzed by univariate analysis and multivariate linear regression analysis. Results The univariate and multivariate analysis showed that the low level of education, general occupation, marital misfortune, poor economic condition and self-treatment expense were the risk factors affecting the comprehensive health function in elderly patients with rheumatoid arthritis ( P<0.05). Conclusion Elderly patients with rheumatoid arthritis have problems of the functions of daily life, physical health, mental health and social health. To alleviate the high medical costs, improve the level of medical treatment, improve the people 's health and education level and maintain a good mood are the key to improve the overall health in patients with rheumatoid arthritis.

Objective To explore the characteristics of EEG frequency in recruits and veterans and their relationship with depression scale scores.Methods Fifty-five newly enlisted soldiers formed the recruits group and 68 demobilized soldiers the veterans group.A general information survey,EEGs and the Hamilton depression scale (HAMD) were administered to all of the subjects.According to the HAMD scores,35 of the 123 were designated as the abnormal group,while 88 formed the normal one.Eighteen of the 35 with EEG abnormalities served as a doubleabnormal group to be compared with the remaining 17 cases with abnormal HAMD scores and normal EEGs (the single-abnormal group),and 9 of the 18 with higher HAMD scores as the higher group,and the other 9 cases as the lower group.The EEG frequency spectrum and the power percentages from the δ to γ frequency bands were calculated as δ:0.5-4 Hz,(o):4-8 Hz,α:8-13 Hz,β:13-25 Hz,γ:25-40 Hz.Results Forty-six of the subjects (37.4％) had abnormal EEG results,35 had abnormal HAMD scores,and 18 (51.4％ of the soldiers with abnormal HAMD scores) had both abnormalities.The veterans had lower δ band power percentage in all channels than the recruits,but in the (0) band it was the reverse.In the left channels the veterans had lower α and γ band power percentages than the recruits.Compared with the normal,all channels in the EEGs of subjects with abnormal HAMD scores had significantly higher δ band power percentages.The higher the δ band power percentage a subject had,the higher his HAMD score.Conclusion There is some correlation between changes in EEG power percentages and the possibility and severity of depression.Objective and subjective EEG evaluation can help improve the positive rate of diagnosis,and thus the management of the army.

Objective:To isolate breast cancer stem/progenitor cells from human breast cancer and study their proliferation and differentiation biological characteristics over long-term passages in vitro. Methods:Human breast cancer stem/progenitor cells were enriched in suspension cultures as nonadherent mammospheres(MS). Serial sphere formation assay was performed to determine self-renewal ability of mammosphere-derived cells (MSDC). Differentiation was induced by culturing MSDC in DMEM-F12 supplemented with serum but without growth factors. The ratio of CD44~+/CD24~(-/low) cell population was evaluated by flow cytometry(FCM). Results:The mammospheres were formed after inoculation of primary breast cancer cells into culcutre medium with growth factors but without serum. The mammospheres contained undifferentiated cells similar to stem cells, which had self-renewal and extensive proliferation capabilities. With increasing passages, the cells tended to adhere and differentiate. The number of adhering and differentiating cells increased, and the amount and size of mammospheres decreased. The CD44~+/CD24~(-/low) cell population was enriched in the basal-like molecular subtype of human breast tumors. The biological behaviors of mammospheres varied between different specimens.Conclusion:Cancer cells with stem cell properties of self-renewal, indefinite proliferation and multi-lineage differentiation widely existed in human breast cancer tissues. The biological behaviors varied because of different origin of specimens and changed under the effects of environmental factors.