Objective: To explore therapeutic effect of individualized cognitive training on improving cognitive function in aged patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).Methods: A total of 92 aged CHD patients after PCI, who were diagnosed and treated in our hospital, were selected.According to random number table, they were randomly and equally divided into routine nursing group (n=46) and cognitive training group (n=46, received active individualized cognitive training based on routine nursing), both groups were observed for three months.Scores of Montreal cognitive assessment (MoCA), self-rating anxiety scale (SAS) and self-rating depression scale (SDS), and left ventricular ejection fraction (LVEF) were compared between two groups before and after nursing.Results: Compared with before nursing, after nursing, there were significant rise in LVEF and MoCA score, and significant reductions in scores of SAS and SDS in both groups (P<0.01);compared with routine nursing group, there were significant rise in LVEF [(51.87±4.89)% vs.(58.29±5.13)%] and MoCA score [(24.44±4.10) scores vs.(29.34±3.14) scores], and significant reductions in scores of SAS [(38.22±5.64) scores vs.(32.09±4.11) scores] and SDS [(37.22±4.98) scores vs.(30.56±5.68) scores] in cognitive training group, P<0.01.Training compliance of cognitive training group was significantly higher than that of routine nursing group (95.7% vs.82.6%, P=0.044).Conclusion: Individualized cognitive training can significantly improve training compliance after PCI, significantly improve cognitive function, relieve anxiety and depression, and enhance cardiac function in aged CHD patients.

Objective To investigate the status of occupational burnout among general practitioners (GPs) and explore the relationship between coping style and burnout. Methods 243 GPs were assessed by Chinese Maslach burnout inventory(CMBI) and simple coping style questionnaire. Results 36.6% of GPs experienced mild burnout, 26.8% moderate burnout, and 3.3% severe burnout; 11.5% of GPs got high scores on emotional exhaustion(EE), 44.9% subjects got high scores on depersonalization(Dp) and 43.6% subjects got high scores on reduced personal accomplishment (RPA). Male GPs experienced greater personal accomplishment than female. Among technical post, subjects with senior technical post scored higher on Dp. The condition of occupational burnout among subjects in north Jiangsu was more serious. GPs with seniority of 5 to 9 years seemed to be more prone to occupational burnout. The coping style of GPs had obvious correlation with occupational burnout. Conclusion The status of occupational burnout among GPs is serious. To prevent and cure occupational burnout, more attention should be paid to female, senior technical post GPs and'persons with seniority of 5 to 9 years. And taking positive coping style can reduce GPs' occupational burnout.

Malnutrition in patients with acute stroke is quite common. It is an independent risk factor affecting stroke prognosis. Early enteral nutrition can improve the nutritional status of the stroke patients, lower infection rate and mortality, promote recovery of neurological function, and improve the quality of life. Therefore, under the premise of the gastrointestinal tolerance, the patients with severe stroke should select early enteral nutrition as early as possible.

Objective To determine the effects of enflurane and isoflurane on the spontaneous neural discharge of central amygdaloid nucleus in rats Methods SD rats (30 60 d) of either sex were decapitated Brain was immediately removed and kept in 4℃ artificial cerebral spinal fluid(ACSF) which was balanced with 95% O 2 and 5% CO 2 gas mixture Braine tissue containing central amyfdaloid nucleus was cut into slices of 300 400?m thick which were immersed in ACSF Enflurane and isoflurane were administered by balancing ACSF with enflurane (1 5%,3 0%,4 5%) or isoflurane (1 1%,2 2%,3 3%) The spontaneous neural discharge of central amygdaloid nucleus was measured before and after enflurane or isoflurane using whole cell patch clamp techniques Results Enflurane and isoflurane inhibited the frequencies of spontaneous neural discharge of central amygdaloid nucleus in a dose dependent manner The spontaneous neural discharge inhibited by enflurane (3 0%) and isoflurane (2 2%) could recover after the slices being washed with normal ACSF for 5 min Conclusions The results indicate that the spontaneous neural discharge of central amygdaloid nucleus can be inhibited reversibly by enflurane and isoflurane Central amygdaloid nucleus may by one of the sites of action of enflurane and isoflurane in central nervous system

Objective To investigate the current situation of occupational burnout of doctors in west China and to explore the relationships among burnout,social support and work-family conflicts.Methods 611 doctors in west China were assessed by Chinese Maslach burnout inventory( CMBI),social support rating scale(SSRS) and work-interference-with-family and family-interference-with-work questionnaire.Results 14.1％ of the doctors in west China got high scores on emotional exhaustion(EE),49.4％ of them high scores on depersonalization(DP) and 33.1％ high scores on reduced personal accomplishment (RPA) ; 27.3％ experienced mild burnout,43.7％ moderate burnout and 3.3％ severe burnout.Doctors who had worked for 5 ～ 10 years and those for 11 ～ 20 years experienced greater EE.Those doctors with bachelor or master degree and intermediate or senior titles got highest level of depersonalization.Doctors in second-class hospitals got highest scores of depersonalization,and those who worked in first-class hospital experienced the highest sense of achievement.Logistic regression analysis showed that social support was a protective factor for burnout,but the conflict between work and family was a risk factor.Conclusion The status of occupational burnout among the doctors in west China is in a grave condition,the balance between family and work,and social supporting is crucial for doctors to resist the occupational burnout.

Objective To explore the relationships among personality,coping style and clinicians' job burnout.Methods 1569 clinicians were investigated with Chinese Maslach Burnout Inventory,Eysenck Personality Questionnaire and Simple Coping Style Questionnaire.The data were performed with regression and path analysis.Results The proportion of burnout was 72.4％,the proportion of slight burnout was 36.5 ％,the proportion of moderate burnout was 31.2％ and the proportion of high burnout was 4.7％.When taking demographic variables into consideration,more introvert and neuroticism indicated increasing tendency of emotional exhaustion.More psychoticism,neuroticism and negative coping style indicated increasing tendency of depersonalization and more introvert and negative coping style indicated increasing of reduced personal accomplishment.Coping style could partly mediate the relationship between personality and job burnout.Conclusion Chinese clinicians suffer from burnout severely,coping styles mediate between the personality factors and the burnout level.

Objective To discuss the application of minimally invasive surgery in the treatment of esophageal leiomyoma. Methods Clinical data of 26 patients with esophageal leiomyoma from September 1996 to October 2002 treated by minimally invasive surgery were reviewed retrospectively. Results Video-assisted thoracoscopic leiomyoma enucleations were performed in 23 patients, and a conversion to mini-thoracotomy was required in 3 of them because of dense pleural adhesion (2 patients) or location failure of tumor (1 patient). The remaining 3 patients underwent transjugular leiomyoma enucleation (2 patients) or esophagoscopic resection of leiomyoma (1 patient), respectively. All the procedures were completed smoothly and the postoperative recovery was uneventful, without mortality or severe complications. All the patients were pathologically diagnosed as leiomyoma after surgery. Follow-up for 2 ～ 73 months (mean,32.3months) found no recurrence. Conclusions Video-assisted thoracoscopic enucleation can be the first choice for the esophageal leiomyomas that derived from lamina propria, while esophagoscopic removal may be considered for those from muscularis mucosa.

Through several years practice of bilingual education,we have established the bilingual teaching model with its own characteristics,which in cludes the selection of materials,the choice of teaching methods,improvement of teaching methods and means on several aspects.We have also made some reflection and study of the existing problems and future improvement of pharmacology bilingual education.

2 67kPa) after MVR were enrolled in the study Parameters in hemodynamics and oxygenation were measured with Swan Ganz technique , 5min before NO inhalation (T 1), 5,15 and 30min following NO 20ppm inhalation (T 2,T 3,T 4), 15min after stopping NO 20ppm inhalation (T 5), 15min and 5h following NO 6ppm inhalation (T 6,T 7) and 15min before and after weaning from mechanical ventilator (T 8,T 9) respectively Results Compared with those at T 1, at T 2 pulmonary artery pressure, pulmonary vascular resistance, alveolar arterial oxygen difference and intrapulmonary shunting significantly decreased, but arterial oxygen partial pressure, oxygen content and oxygen availability index increased significantly (P0 05) Conclusions The persistently inhaled low dose NO is effective and safe for the pulmonary hypertension induced with heart surgery

In order to study the effect of mechanical strain on mesenchymal stem cells (MSCs) differentiation into osteogenic, the cyclic substrate deformation instructment was applicated to MSCs line (D1 cell) in osteogenic media for different strain and times. The cells were cyclically stretched for periods of 1, 2, 3, 5 and 10 min and treated with cytochalasin B(CB) and EGTA. Ca2+, which were loaded with (15 ?l) Fluo-3 AM , were detected by confocal laser scanning microscope(CLSM). The signaling inhibitors, such as SB203580(p38MAPK specific inhibitor), PD98059(MEK-1/2MAPK specific inhibitor), LY294002(PI3Ks specific inhibitor), cytochalasin B(microfilament specific inhibitor), EGTA (Ca2+ specific inhibitor), were used to investigate mechanical signaling pathway by (3% 0.5Hz) Cyclic strain. The results indicated that 3% strain stimulus could induce increasement of [Ca2+] i - dependent fluorescence at 2 min. Its fluorescence intensity were 143.68,which were significantly different compared with 1,3,5,10min groups and 1% and 10% strain groups (P