Objective:To observe the influence of sevoflurane and propofol anesthesia on hemodynamics in laparoscopic cholecys-tectomy. Methods:Totally 98 patients with laparoscopic cholecystectomy were randomly divided into P group and S group. P group was with propofol for anesthesia, and S group was with sevoflurane for anesthesia. Before anesthesia, 2min after intubation, 10 min af-ter intubation, 5min and 30min after pneumoperitoneum, and after the surgery, the levels of blood glucose and cortisol, and hemody-namic changes in the two groups were observed, and the incidence of adverse reactions was also studied. Results:2 min and 10 min af-ter the anesthesia, the blood glucose levels in the two groups were significantly lower than those before the anesthesia(P<0.05 or 0. 01), while 30 min after pneumoperitoneum and after the operation, the blood glucose levels were increased(P<0. 01). The blood glucose levels in S group after the operation were much lower than those in P group (P<0. 01). 2 min after intubation, cortisol was decreased in the two groups (P<0. 05 or 0. 01). 5 min after pneumoperitoneum and after the operation, cortisol levels were higher than those before the anesthesia in P group(P<0. 01), and 5 min and 30 min after pneumoperitoneum and after the operation, cortisol levels in S group were lower than those in P group (P<0. 01). HR and SPO2 showed no significant changes in the two groups during the whole process (P>0. 05). 2 min and 10 min after intubation, SBP in the two groups was decreased (P<0. 01), and 5 min and 30 min after pneumoperitoneum, there was notable difference in SBP between the groups (P<0. 01). 2 min and 10 min after intuba-tion, DBP was decreased in the two groups (P<0. 01), and the difference was significant between the groups (P<0. 01). 5 min and 30 min after pneumoperitoneum, DBP in P group had notable difference with that in S group (P<0. 05). The incidence of adverse re-actions in the two groups showed no significant difference (P>0. 05). Conclusion: Sevoflurane anesthesia in laparoscopic cholecys-tectomy can keep stable hemodynamics in the patients, and the anesthetic effect is better than propofol.

Objective:To study the effect of priming technique combined with time limit on shortening the onset time of cisatra-curium besilate. Methods:Totally 112 adult patients undergoing selective operation with general anesthesia were randomly divided into group A, B and C. Fentanyl with the dose of 4 μg·kg-1 and propofol with the dose of 2 mg·kg-1 were used in the three groups as the inducing agents. Group A was first with intravenous injection of cisatracurium besilate 20 μg·kg-1 , and 3 minutes later, the in-ducing agents and cisatracurium besilate with the dose of 80 μg·kg-1 were respectively injected. Group B was first with intravenous injection of cisatracurium besilate with the dose of l00 μg·kg-1 , and 1. 5 minutes later, the inducing agents were injected. Group C was respectively injected with the inducing drugs and cisatracurium besilate with the dose of l00 μg·kg-1 . The T1 percentage before the induction, the time of 90% and 100% inhibition of muscle twitching, the rating of trachea cannula and adverse drug reactions in the three groups were observed and compared. Results:There was no significant difference in the excellent rate of trachea cannula a-mong the three groups (P>0. 05). Compared with group A and B, group C showed no T1 suppression before the induction, while group B with T1 of (9. 8 ± 2. 6) was higher than group A with T1 of (3. 2 ± 1. 5) (P<0. 01). The time of 90% and 100% inhibition of muscle twitching in group C was the longest (P<0. 01), and the incidence of adverse drug reactions in group C was also the highest (P<0. 05). Conclusion:The application of priming principle and time limit can effectively shorten the onset time of cisatracurium be-silate with significant effect and high safety.

[Objective] To investigate the clinical efficacy of tacalcitol combined Halometasone sequential therapy in the patients of plaque psoriasis. [Methods] 117 cases of plaque psoriasis col ected between 2011.01 and 2013.02 were randomly divided into treatment group and control group. The treatment group were treated with tacalcitol and Halometasone therapy, and required topical use Halometasone(1 time/day) in the morning ,tacalcitol use in the evening(1 time/day) before the first 2 weeks. Continuous two weeks treatment from Monday to Friday with tacalcitol(2 times/day), Saturday and Sunday with Halometasone(2 times/day), final y the transition to be used alone tacalcitol(2 times/day) in the next two weeks of continuous treatment. Control group of pa-tients given alone Halometasone(2 times/day) for 6 consecutive weeks. Observe the adverse reactions PASI scores during and after completion of treatment within the two groups. Al patients were fol owed for three months, observed recurrence. [Results] The PASI score between two groups of patients declined during treatment, especial y at the 4th and 6th week within the treatment group. Both groups had no serious adverse reactions. In treatment group, 54 patients had effective responses, the total effective rate was 90%, significantly better than the control group(41 cases,71.9%). In the fol ow-up of 3 months, the recur-rence rate was 11.1%in the treatment group, significantly lower than the control group(31.6%). The difference of total efficiency and the recurrence rate with-in the two groups was statistical y significant. [Conclusion] Tacalcitol combined Halometasone sequential therapy of plaque psoriasis has significant clinical effi-cacy and low recurrence rate.

Background and purpose:There is an increasing of breast diseases every year. It is important for us to detect the tumor characteristic and to establish the diagnosis of breast diseases through their clinical manifestation and pathology.Methods:A retrospective analysis of 864 cases of breast diseases after surgical operation,was made in our hospital, from 2000 to 2006.Results:85.7% of 864 cases were fibro benign diseases, and most of them were fibro cystic hyperplasia and fibroadenoma of breast.Malignant disease was found 123 cases, and most of them were invasive ductal carcinoma, then medullary carcinoma and early infiltrating carcinoma.It is significant that the youngest age from 30 years old and the incidence rate increased with the age.Conclusions:It is very important to promate the diagnosis rate of breast carcinoma by early prevention and treatment to screen breast diseases and monitor high risk population in time.

Objective To compare the effects of three kinds of dressings (foam dressings,hydrocolloid dressings,homemade gauze dressings)at different periods for preventing nasal and facial pressure ulcers in elderly patients in the intensive care unit with continuous non -invasive ventilation.Methods The study group consisted of 120 patients who were 60 years old in the intensive care unit with continuous non -invasive ventilation.They were randomly divided into A,B,C three groups with random number table.The patients in A group used foam dressings. The patients in B group used hydrocolloid dressings.The patients in C group used homemade gauze dressings.In the first week and the second week,through comparing the incidence of pressure ulcers,we compared the prevention effect of three kinds of dressings on nasal and facial pressure ulcers.Results In the first week,there was no statistical difference about the incidence of pressure ulcers among the three groups(χ2 =2.124,P =0.346).In the second week,the incidence of pressure ulcer of A group was obviously lower than B group and C group(χ2 =5.271,P =0.038).Conclusion When we nurse elderly patients in the intensive care unit with continuous non -invasive ventilation,within 7 days,we can use any one of three kinds of dressings to prevent nasal and facial pressure ulcers. But 7 days later,we should better use foam dressings.

Objective To investigate status quo of illness uncertainty and coping style in family members of patients with severe sepsis of in intensive care unit (ICU),to explore their relationships.Methods A total of 117 family members of patients with severe sepsis of in ICU was chosen by convenient sampling.They were surveyed by the Mishel Uncertainty in Illness Scale-Family version and Simplified Coping Style Questionnaire.Results The uncertainty in illness of family members scored 56 ～ 139 (102.16 ± 14.73).Positive coping style scored 6 ～38 (22.68 ±3.73).Negative coping style scored 4 ～22 (13.08 ±4.12).The total score of uncertainty in illness of family members was negatively correlated with the score of positive coping style,and was positively correlated with the score of negative coping style.Conclusions Illness uncertainty level of patients' families interacts with coping styles.Nurse should take corresponding measures to reduce the patient's family illness uncertainty levels,and help them to take positive coping styles.

Objective To investigate efficacy in Alpmstadil and Shenkang on regulating renal function and lipids in patients with chronic renal failure (CRF).Methods Ninety-eight cases of CRF patients were collected for the study,and 1:1 randomized,double-blind experiment grouping principles were used in the current study.All cases were divided into study group and the control group (49 cases of each group).The two group were given the high quality low protein,low fat low salt diet,inftion control,diuretic swelling,correct acidosis,buck,correction of electrolyte imbalance and other conventional treatment.The patients in study group on the basis of conventional therapy were given 20 g Alprostadil injection + 100 ml saline,intravenous infusion of 1times/d,and 100 ml Shenkang injection +300 ml 5％ glucose the solution,intravenous infusion of 1 times/d.While patients of control grrup on the basis of conventional therapy plus 200 mg Ligustrazine + 250 ml 5％Glucose Injection,intravenous infusion of 1times/d.Two groups were treated for 14 d.Before and after treatment,renal function,lipid metabolism,adverse drug reactions were observed and determined.Results There was no significant difference in term of renal function between two groups before treatment(P ＞ 0.05).After treatment,the levels of serum creatinine,blood urea nitrogen,24 h-Urine protein and creatinine clearance(Ccr) in study group were (313.7 ±66.2) mmol/L,(15.3 ±2.9) mmol/L,(1.24 ±0.45) g/24 h and (35.7 ±5.4) mmol/L respectively,significant different from those in control group ((358.4 ± 53.9) mmol/L,(18.4 ± 3.0) mmol/L,(1.57 ±0.39) g/24 h and (28.4 ±4.3) mmol/L;t =3.754,7.864,5.873,4.312,P ＜0.05).There was no significant difference in term of blood fat between two groups before treatment (P ＞ 0.05).In study group,the levels of glycerin trilaurate,cholesterol total,high density hpoprotein cholesterol,low density lipoprotein cholesterol were significantly different than those in the control group ((2.12 ± 1.26) mmol/L vs.(2.32 ± 1.34) mmol/L,(4.91 ± 1.43) mmol/vs.(5.35 ± 1.31) mmol/L,(1.39 ± 0.43) mmol/L vs.(1.23±0.37) mmol/L,(2.39 ± 0.68) mmol/L vs.(2.73 ± 0.88) mmol/L; t =3.876,4.661,5.387,8.543 ; P ＜ 0.05) after treatment.There were no adverse drug reactions in both groups.Conclusion Combined usage of alprostadil and shenkang injection could significantly improve the patient's renal function,lipid metabolism disorders and shows no significant adverse reactions,suggesting that it is worthy of clinical application and promotion.

Objective:To discuss the effect of transitional care on the quality of life ( QOL) and psychology in acute myocardial infarction patients after PCI. Methods:The acute myocardial infarction patients accepted PCI in our university affiliated hospitals were selected and divided into experimental group and control group randomly. The control group received routine care during the period of hospitalization. The experimental group received transi-tional care including home visits, massed learning, telephone follow-up, and the establishment of WeChat and QQ group. The QOL, anxiety, and depression were investigated pre-intervention and six months post-interven-tion to evaluate the effect of transitional care. Results:After transitional care six months later, the QOL scores in the experimental group were significantly higher than those in the control group, SAS and SDS scores were lower in experimental group than those in the control group ( P<0 . 05 ) . Conclusions:Transitional care for acute myocar-dial infarction patients after PCI could improve their QOL, and relieve their anxiety and depression level in different degrees.

Crisis Intervention ; Disasters ; Humans ; Stress, Psychological ; prevention & control

China ; Humans ; Mental Health ; Public Health Practice