Objective:To study the impact factors of psychological distress in patients with first diag-nosed lung cancer.Methods:The cross-sectional study was applied to newly diagnosed lung cancer pa-tients who received treatments in Cancer Center of West China Hospital of Sichuan University in Chengdu from June 201 3 to March 201 5 by distributed questionnaires.The general information of the patients,the hospital anxiety and depression scale (HADS)and distress management screening measure (DMSM) were included in the questionnaire to evaluate the states of distress,pain and the factors related to the distress of the patients.Results:The survey investigated a total of 390 patients with first diagnosed lung cancer,including 291 male patients and 99 female patients.The proportion of the patients with positive anxiety symptom was 26.7% (1 04 /390),with positive depression symptom was 27.7% (1 08 /390), and with positive distress symptom was 30.0% (1 1 7 /390).On the top five problem list of DMSMwere worry,disease treatment,breathing,pain and sleep.The Spearman correlation analysis showed that an-xiety score,depression score,and the pain intensity were positively correlated with the distress.Multiple linear regression analysis showed that gender (β=-0.209,P =0.003),age (β=-0.098,P =0.042),chronic disease (β=0.378,P <0.001 ),and pain score (β=0.1 00,P =0.029)could affect the distress of the patients.Smoking (β=0.1 1 1 ,P =0.041 )could affect the anxiety of newly diagnosed lung cancer patients.Conclusion:The gender,age,chronic disease and pain score of the patients are the independent factors of the psychological distress of first diagnosed lung cancer patients.Smoking is the predictive factors of the patients with anxiety.Controlling the pain intensity and the clinical process of chronic disease of the patients actively,solving the sleep and breathing problem and helping the patients to quit smoking progressively could alleviate the psychological distress of the patients.

Objective To explore the effect of cognitive behavioral intervention on quality of life and distress of cancer patients. Methods The research was a random control study, and computer randomized grouping, the experimental group and control group contained 64 cases, 66 cases, respectively. The control group only accepted health education, while experimental group accepted cognitive behavioral intervention twice a week. Before and after the research, the patients were investigated with quality of life and distress scale. Results After the study of cognitive behavioral intervention, quality of life of experimental group scored (71.7±17.5) points which showed greater improvement than the control group scored (63.9±18.3) points (t=2.2,P<0.05), the distress score of experimental group was (2.6±0.6) points which was significant lower than the control group scored (3.9 ±0.7) points (t=11.8, P<0.05), and the proportions of distress problems contained anxiety [42.2% (27/64)], pain [29.7% (19/64)], depression [35.9% (23/64)] and sleep [23.4% (15/64)] in the experimental group were all significant lower than the control group [60.6% (40/66), 47.0% (31/66), 53.0% (35/66), 39.4% (26/66)]( X2=4.4, 4.1, 3.9, 4.5, P<0.05). Conclusions Short-term group cognitive behavioral intervention can alleviate the distress and pain, improve their negative emotions and sleep, eventually improve the quality of life of cancer patients.

OBJECTIVE To obser ve the efficacy and safety of rimazo lom for painless gastroscopy sedation in outpatients. METHODS Totally 84 patients who underwent painless gastroscopy were collected from the outpatient department of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from March to June in 2021. By random number table method combined with envelope allocation concealment method ，they were randomly divided into observation group and control group ，with 42 cases in each group. The patients in the observation group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+Rimazole toluenesulfonate for injection 0.2 mg/kg. Patients in the control group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+ Propofol emulsion injection 2 mg/kg. Gastroscopy was performed after the patient ’s consciousness disappeared. The sedative efficiency，sedative onset time ，recovery time and the occurrence of adverse drug reaction were observed in 2 groups. The heart rate（HR），mean arterial pressure （MAP），pulse oxygen saturation （SpO2），modified observer ’s assessment of alertness/sedation （MOAA/S）score and Narcotrend score were recorded in 2 groups after entering the room （T0），after anesthesia induction （T1）， when gastroscope entered the throat （T2），at the end of gastroscope withdrawal （T3），5 min after gastroscopy （T4）. RESULTS There was no significant difference in the effective rate of sedation （100％），the incidence of respiratory depression ， nausea and vomiting between the two groups （P＞0.05）. The qq.com onset time of sedation in the observation group was longer than control group ，and the recovery time and the incidence ofhypotension，hypotension to be tre ated，injection pain and bradycardia in observation group were significantly shorter or lower than control group （P＜0.05）. At T 0，there was no significant difference in HR ，MAP，SpO2，MOAA/S score or Narcotrend score between two groups （P＞0.05）. From T 1 to T 4，the HR of control group was significantly lower than that of the same group at T 0，and significantly lower than observation group at the same time（P＜0.05）. From T 1 to T 3，the MAP of two groups were significantly lower than the same group at T 0（P＜0.05），but there were no significant differences between two groups and between T 4 and T 0（P＞0.05）. There was no significant difference in SpO 2 at different time points between two groups and HR at different time points in observation group （P＞0.05）. From T 1 to T 3，MOAA/S score and Narcotrend score of two groups were significantly lower than the same group at T 0，while the MOAA/S score and Narcotrend score at T 1 and T 3 and Narcotrend score at T 3 of observation group were significantly higher than control group at the same time （P＜0.05），and the Narcotrend score of observation group at T 2 was significantly lower than control group at the same time（P＜0.05）；at T 4，there were no significant differences in MOAA/S score and Narcotrend score between two groups （P＞ 0.05）. CONCLUSIONS Remazolam shows good sedative effect and safety for painless gastroscopy.

OBJECTIVE To investigate the efficacy and safety of ropivacaine combined with oxycodone for the analgesia of iliac fascia nerve block in patients undergoing hip replacement. METHODS Sixty-six patients who underwent hip replacement at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from October 2023 to April 2024 were selected and randomly divided into observation group and control group， with 33 cases in each group. Before induction of anesthesia， ultrasound-guided iliac fascial nerve block was performed. Patients in the observation group were treated with 0.33% ropivacaine+0.1 mg/kg oxycodone injection mixture 30 mL， and patients in the control group were treated with 0.33% ropivacaine injection 30 mL. The time of first postoperative rescue analgesia， 24 h postoperative analgesic drug consumption， sensory block and motor block effective and maintenance time， satisfaction degree， numerical rating scale （NRS） pain score， Ramsay sedation score， muscle strength score， heart rate （HR）， mean arterial pressure （MAP）， oxygen saturation（SpO2）， sleep score， anxiety score， and the occurrence of adverse reactions in the two groups were all recorded. RESULTS Compared with the control group， the first rescue analgesia time after operation was significantly prolonged in the observation group， and 24 h postoperative analgesic drug consumption after operation decreased； the effective time of sensory block was significantly shortened， and the maintenance time of sensory block was significantly prolonged， and the satisfaction score was higher； the NRS pain score after iliac fascia nerve block was lower， HR and MAP were lower， and the anxiety score and sleep score 24 and 48 h after operation were lower （P＜0.05）. In terms of safety， patients in both groups had adverse reactions after operation， such as hypertension， nausea， vomiting， and dizziness， but there was no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS Oxycodone combined with ropivacaine shows good efficacy and safety for iliac fascial nerve block analgesia in patients undergoing hip replacement， can significantly prolong the analgesic time of ropivacaine， reduce postoperative analgesic drug consumption， improve the sleep quality of patients， and promote the rapid recovery of patients.