Objective Through the investigation of 80 cancer operation patients' families,we would like to investigate further more the effect of their anxiety conditions for the patients' mental state and find out the corresponding strategy.Methods 80 cancer patients' families in our department were chosen to fill the anxiety scales between the 2nd to 5th day after their admission and some corresponding directions were given.Results Compared with the norm,the cancer patints' families' anxiety scores had significant difference(P

Objective To evaluate the effect of remifentanil on mean arterial pressure (MAP), heart rate (HR) and QTc interval during tracheal intubation of general anesthesia patients. Methods Seventy-five ASA Ⅰ -Ⅱ grade patients were selected and allocated to receive either saline (group C), remifentanil 0.50 μg/kg (group R1) or remifentanil 0.75 μg/kg(group R2) by random digits table with 25 cases in each, they were administrated as a bolus intravenous, followed by a continuous infusion at 0.10 μg/ (kg·min), 1 min before laryngoscopy. All patients received fentanyl 3 μg/kg,propofol 1.0 - 1.5 mg/kg and vecuronium 0.1 mg/kg. The ECG.MAP and HR were recorded prior to induction of anesthesia (T0), 2 min following the start of drug intravenous of fentanyl and propofol with vecuronium (T1), 1 min following remifentanil or saline (T2), before laryngoscopy(T3), 30 s (T4), 2 min (T5) and 4 min (T6) after intubation. Results The QTc interval was significantly prolonged immediately following intubation in group C and group R1, but it remained stable in group R2, compared with the QTc interval just before laryngoscopy. In group R2, QTc interval was significantly shorter at T4-T6 compared to group C(P＜ 0.05 or ＜ 0.01). QTc interval significantly increased from baseline at T4 in group R1 and T4-T6 in group C (P＜ 0.05 or ＜ 0.01). The number of patients with QTc interval ＞ 440 ms were significantly greater immediately following tracheal intubation in group C than that in group R2 [44% (11/25) vs. 12% (3/25)] (P ＜ 0.05). Conclusions QTc interval increases following tracheal intubation during induction of anesthesia using fentanyl and propofol. Intravenous of remifentanil attenuates the QTc interval prolongation associated with tracheal intubation. In addition, remifentanil decreases the hemodynamic responses to tracheal intubation.

Objective To evaluate the effectiveness of epidural saline washout on regression of sensory and motor block after epidural anesthesia in elderly patients.Methods A total of 70 males with ASA Ⅰ or Ⅱ who were subjected lumbar epidural anesthesia with 10 ml of 1.73% bicarbonate-lidocaine and fentanyl 50 μg (1 ml).At the end of transurethral surgery,the washout group (35 cases) received an epidural bolus of 20 ml saline while the control group(35 cases) did not,extracted the epidural catheter after 10 minutes.Results Mean times of 3-dermatomal sensory regression for pinpric, 1-grade of motor block, and the rate of 1 h motor block were significantly shorter in the washout group than those in the control group [(24.6 ± 15.9) min vs(32.8 ± 16.7) min, (32.7 ± 13.4) min vs(47.9 ± 22.6) min,5 cases (14.3%) vs 14 cases (40.0%)](P < 0.05 or < 0.01 ).There was no difference in pain-killer utilization, postoperative pain scores no more than 3 scores and side effects between the two groups (P > 0.05).Conclusion It suggests that epidural washout facihtates regression of both sensory and motor block following epidural anesthesia without reducing the postoperative analgesic benefit.

Objective To investigate the impact of overweight and obesity on left atrial (LA) function in healthy subjects with excess body weight.Methods Conventional echocardiography and tissue Doppler imaging were performed in 30 obese subjects (BMI≥28 kg/m2),30 overweight subjects (BMI,24to 28 kg/m2) and 30 age-matched normal subjects (BMI＜24kg/m2).Strain (S),peak systolic strain rate (SSR),peak early diastolic strain rate (ESR) and peak late diastolic strain rate (ASR) values were used to evaluating LA function.Results Compared with controls,mean S,SSR and ESR were decreased in obese subjects,while mean SSR,ESR and ASR were decreased in overweight subjects.Compared with overweight subjects,mean ESR was decreased in obese subjects.Conclusions An impaired LA function is found in overweight and obese subjects who has no other clinically appreciable cause of heart disease by using strain and SR imaging.

Intravenous preparations take more risk than oral preparation and externally applied agent.In phaseⅠtoler- ance trial of intravenous preparations of TCM on human subjects,minimum dose and maximum dose should be decided in light of data derived from preclinical pharmacodynamic and toxicological experiments,combined with practical situation in clinic.Dose-ascending coefficient of the should be reasonable.During the application of intravenous preparations of TCM in tolerance trial,clinical monitoring must be done to ensure the safety of subjects.Overall and integrated observa- tional indices should be designed on the basis of the features of preparation types,administration methods,the nature of medicine,etc.,so as to provide full-scale data for safe dose range,concentration of the preparation,dripping veloci- ty and possible adverse reactions,etc.

Objective To identify risk factors and preventive measures of nosoconial infections in patients with non-Hodgkin lymphoma (NHL). Methods Clinical data of 65 NHL patients admitted from January to December 2007 were retrospectively analyzed. Results According to WHO classification (2001), 58 patients were with B-cell lymphoma, 7 were with T-cell lymphorna. All patients received CHOP regimen as initial chemotherapy and 23 of them were with nosecomial infections. Logistic regression analysis demonstrated that age, length of stay, pathological type, bone marrow involvement, levels of serum lactate dehydrogenase (LDH), beta2-microglobulin and invasive treatment were identified as risk factors of nosocomial infections. Respiratory tract infections and infections with gram-negative microorganisms were the most popular. Conclusion High nosocomial infection rate is found in NHL patients, and control of risk factors may effectively prevent nosocomial infections in NHL patients.

Objective To assess left ventricular synchronicity in patients with metabolic syndrome(MS)by tissue Doppler imaging.Methods Twenty-two patients with MS and left ventricular hypertrophy(LVH)(MS-LVH group),69 patients with MS and non-LVH(MS-NLVH group)and 33 healthy subjects(control group) were included.Left ventricular(LV)systolic and diastolic synchronicity were determined by measuring the maximal difference in time to peak myocardial systolic contraction(Ts-diff)and time to peak myocardial early diastolic relaxation(Te-diff),and the standard deviation of time to peak myocardial systolic contraction(Ts-SD)and early diastolic relaxation(Te-SD)with 6 basal and 6 middle LV segments.Results Compared with control group,patients with MS in MS-NLVH and MS-LVH group showed significantly prolonged Ts-diff,Ts-SD,Te-diff and Te-SD.Furthermore,Te-diff and Te-SD were much more prolonged in MS-LVH group than in MS-NLVH group.Conclusions Patients with MS have impaired L V systolic and diastolic synchronicity.LVH impacts the LV diastolic synchronicity much more obviously than systolic synchronicity in the patients with MS and LVH.

Objective To investigate the clinical,imaging,pathological and molecular biological features of mitochondrial encephalomyopathy with lactic acidosis and stroke -like episodes(MELAS)in children.Methods The clinical,imaging,pathological and molecular biological features of 1 2 children with MELAS diagnosed through muscle biopsy or gene sequencing in the Fifth Affiliated Hospital of Zhengzhou University from January 201 1 to December 201 5 were retrospectively analyzed.Results (1 )Clinical features:the main manifestations included headache and vomiting in 1 1 cases,epileptic seizures in 9 cases,short stature in 8 cases,hairy in 7 cases,intolerance fatigue in 7 cases,cogni-tive decline in 7 cases,visual disturbance in 6 cases,hearing disturbance in 6 cases,and 5 cases had positive family history.In addition,7 cases had the serum lactic acid level increase in a rest for 1 0 min after exercise.(2)Imaging fea-tures:4 cases showed bilateral basal ganglia calcification symmetry in 8 patients who underwent head CT scan.The most frequently involved parts of the lesion were occipital in 1 0 cases,temporal in 9 cases and parietal lobe in 7 cases in stroke -like episodes.The lesions were lamellar necrosis.The abnormal areas by MRI showed low signal intensity on T1 weighted imaging,high signal intensity on T2 weighted imaging and fluid attenuated inversion recovery,high or equal signal intensity on diffusion weighted imaging,high or low signal intensity on apparent diffusion coefficient;the lactate peak significantly increased on magnetic resonance spectroscopy.The distribution was not in accordance with the control region of the cerebral vessels.Dynamic observation revealed that the lesions were reversible and migratory.(3)Myo-pathological features:muscle biopsy was performed in all children,and ragged -red fibers were found in 1 0 cases by im-proved Gomori staining,strongly succinate dehydrogenase -reactive were found in 9 cases,and the lipid droplets slight-ly increased in 8 cases by oil red O staining.Besides,the crystalline inclusion bodies in mitochondria were arranged in a parking lotpattern in 9 cases by electromicroscope.(4)Molecular biological characteristics:the mitochondrial gene mutations were analyzed in peripheral blood of 9 children and their parents,including 8 cases with A3243G muta-tion and 1 case with G13513A mutation.Five mothers had the same A3243G mutation site in 8 cases.Conclusions Children with MELAS have complex and varied clinical manifestations and certain characteristic of neuroimaging.More-over,muscle pathology and gene sequencing have important diagnostic value.Fully understanding the clinical,muscle pathology,imaging and molecular biological characteristics of children with MELAS can be helpful to the early diagnosis and treatment,also reduce misdiagnosis.

Objective To investigate cleanliness of hospital environmental object surfaces and hands of health care workers(HCWs).Methods The adenosine triphosphate (ATP)bioluminescence assay was used to detect object surfaces and hands of HCWs in a hospital,on-the-spot intervention was conducted.Results The qualified rates of hospital environmental object surfaces and ventilator-relevant object surfaces were 58.14% (200/344)and 69.88%(116/166)respectively,the qualified rate of ventilator tracheal intubation site was low (29.17%);the qualified rate of telephone surfaces was the lowest (27.27%).The qualified rates of ventilator-relevant object surfaces used con-tinuously for ≥48h and <48 h were 56.70%(55/97)and 88.41 %(61/69)respectively,there was significant differ-ence between the two(χ2 =19.26,P <0.01).The qualified rates of HCWs’hands before and after intervention were 34.18% and 85.58% respectively,relative light unit (RLU)values were (1 033.46±106.20)and (80.46±10.68) respectively,the qualified rates and RLU before and after intervention were both significantly different (both P <0.01).Conclusion Contamination of object surfaces and hands’of HCWs in hospital dynamic environment is seri-ous,ATP bioluminescence detection and on-the-spot intervention is helpful for improving cleanliness of hospital en-vironment object surfaces and HCWs’compliance to hand hygiene.

Objective To investigate the current status of compliance with hand hygiene among health care work-ers (HCWs)in a comprehensive hospital in Xi’an.Methods Status of hand hygiene among HCWs in 73 clinical de-partments was observed directly.Results 404 moments for hand hygiene of 404 HCWs were observed,255 times of hand hygiene were implemented,181 times of hand hygiene were correct,the total compliance rate was 63.12%, and correct rate was 44.80%.Compliance rate and correct rate of hand hygiene of HCWs in intensive care unit were both higher than general wards (91.89% vs 60.22%,χ2 =14.485,P <0.001;81.08% vs 41.14%,χ2 =5.671,P=0.017).Among HCWs of different occupations,compliance rate and correct rate of hand hygiene of nurses were both the highest (73.76% and 60.18% respectively),while auxiliary persons were both the lowest (40.90% and 10.20% respectively);among five moments for hand hygiene,compliance rate was highest after body fluid and blood exposure (80.00%),correct rate was highest before aseptic procedure (62.96%).Conclusion There is a high compliance rate and low correct rate of hand hygiene among HCWs in this hospital.Compliance rate and correct rate of hand hygiene among HCWs in different departments,different occupations and different hand hygiene moments are varied,compliance with hand hygiene among HCWs should be paid extensive attention.