Burnout, Professional ; Humans

Neuroendocrine neoplasm (NEN)is a group of heterogeneous tumors originated from the peptidergic neurons and neuroendocrine cells. A revised system of classification, nomenclature and grading of NEN was proposed by the fourth edition of“World Health Organization classification of tumours of the digestive system”in 2010. It apparently contributes to unify the method of classification, put an end of the confusion in nomenclature, standardize the grading system and predict the outcomes more accurately. With the combination of the results by immunohistochemical studies, pathologists should be in accordance with the requirements to make a diagnosis of NEN with accurate classification, grading and the pathological parameters essential to staging. Recently, new advances in NEN study put forward a new view in the classification and grading system that will lead to the updates of the diagnostic system after further studies on a large scale of samples.

Objective To explore the effects of combined sevoflurane and remifentanil on shoulder dislocation in elderly patients.Methods A total of 100 elderly patients with shoulder dislocation were randomly divided into the control group and the observation group (n =50,each group).The control group was anaesthetized with remifentanil and the observation group was anaesthetized with sevoflurane and remifentanil.The clinical efficacy of anaesthesia,life quality and the University of California at Los Angeles (UCLA) shoulder rating scale were recorded.Results The excellent rate of anaesthesia was higher in observation group than in control group (92.0％ vs.68.0％,x2 =9.033,P=0.011).There were significant differences in mean arterial pressure (MAP),heart rate (HR) and arterial pulse oxygen saturation (SpO2) between the control and the observation group after anaesthesia [(86.3±3.0) mm Hg vs.(83.1±2.5) mm Hg,(83.2±4.5) times/min vs.(81.1±4.0) times/min,(94.4±5.5)％ vs.(92.0±6.0)％,respectively,t=5.794,2.466,2.085,all P＜0.05].There were significant differences in the onset time of anesthesia,surgery time,recovery time,and hospital stay days between the control and the observation group [(26.6± 6.6)min vs.(5.1±1.3) min,(4.6±2.1) min vs.(2.3±1.2) min,(4.9±2.3) min vs.(2.8±1.1)min,(205.5±121.1) minvs.(121.3±89.3) min,respectively,t=22.600,6.724,5.824,3.957,all P＜0.01].The scores of life quality and UCLA function were significantly higher in observation group than in control group after anesthesia (t =16.873,8.485,both P =0.000).Conclusions The treatment of combined sevoflurane and remifentanil treatment has a good clinical efficacy in elderly patients with shoulder dislocation.It can improve the scores of UCLA and life quality of elderly patients with shoulder dislocation.

Currently, some students place more emphasis on the pursuit of their individual values, but less on their social responsibilities. This can be attributed to the students themselves and the society as well. In order to develop their sense of social responsibilities, the article suggests that we should maintain proper guidance on their values,convert our concept of intellectual fostering and direct college students to participate in social practice.

Objective To explore the clinical study of surgical treatment of the senile acute cholangitis severe type in old person.Methods According to the relationship between the senile pathophysiologic characteristics and senile acute cholangitis severe type(ACST),83 patients were selected to the study.Results In operation group with which included 83 cases,4 cases were died,the total mortality is 5.0%.Rate of remnant stone is 15.0%.Ulcer was healed in 79.0%,significantly improved in 14.0%and poor in 9.0%of patients.Conclusion When conditions turned to be stable,operation should be done in time.The main Causes of death of senile ACST are the delay of operation,severe complications and old man.

ObjectiveTo compare the clinical efficacies of heat-sensitive point suspended moxibustion versus heat-sensitive point medicinal moxibustion in treating lumbar intervertebral disc herniation.MethodSixty patients with lumbar intervertebral disc herniation were randomly allocated to treatmentand control groups, 30 cases each. The treatment group received heat-sensitive point medicinal moxibustion and the control group, heat-sensitive point suspended moxibustion. The lumbar vertebra JOA score was recorded before and after treatment.ResultThe lumbar vertebra JOA score decreased significantly in both groups of patients after treatment (P<0.05). There was a statistically significant post-treatment difference in the lumbar vertebra JOA score between the treatment and control groups (P<0.05). There was a statistically significant difference in the total efficacy rate between the two groups (P<0.05).ConclusionThe results show that the lumbar vertebra JOA score decreased in both groups after treatment. The total efficacy rate of heat-sensitive point medicinal moxibustion is superior to that of heat-sensitive point suspended moxibustion in treating lumbar intervertebral disc herniation.

Objective To improve the content determination of eight-positive particles,and better control drug quality.Methods Gardenin, emodin and chrysophanol of eight-positive particles were determined by HPLC.Revised content determination standards and improved the standards of quality control. Results The revised content determinations of gardenin, emodin and chrysophanol were simple and feasible, and had high sensitivity.Conclusion Unification the quality standards of eight positive granules,the standards provide the basis for standardizing the market of eight-positive particles.

Nutritional therapy constitutes the basis for the integrated treatment of diabetes.It is essential for diabetic dietary management to be an individualized and balanced diet pattern based on total calorie control Carbohydrates is the main dietary ingredient to affect postprandial blood glucose levels.Dietary structure,way of eating,and physical exercise all contribute to the control of postprandial blood glucose levels.

Aim] To summarize and introduce the clinical experience of Chang Qing in the treatment of refractory asthma. [Method] To analyze the clinical experience and academic views of Chang Qing in the treatment of refractory asthma from the perspective of etiology and pathogenesis; and to discuss his basic prescription compatibility and flexible drug-applying characteristics. [Result] According to Chang Qing's clinical experience, while addressing the symptoms, treating the root is badly needed. He insists that in the period of acute exacerbation the adjustment of traditional Chinese medicine dosage should be used to rapidly bring the asthma under control until the symptoms disappear or obviously ease, then nourishing spleen and kidney to reduce the relapse of asthma. [Conclusion] In the aspect of treating the refractory asthma, Chang Qing has got rich clinical experience and effective. methods to relieve the asthma,his clinical dialectic thinking and the originality of prescription are greatly worth learning.

The clinical data was collected from 26 orthodontics patients at our hospital .All of them received straight wire appliance .The observed teeth were randomly classified into experiment and comparison groups.After the mounting of orthodontic bracket , Duraphat was smeared on the surface of maxillary central incisor, maxillary lateral incisor, maxillary canine, maxillary first premolar and maxillary first premolar in the experiment group while no Duraphat was applied in the comparison group .After wearing orthodontic appliance for 1, 3, 6 and 9 months, enamel demineralization of each tooth was observed .And the enamel decalcification index ( EDI ) of different areas of each tooth at different timepoints was recorded .More demineralization areas existed in the comparison group than the experiment group (P<0.01).In addition, no Ⅲ degree enamel demineralization was observed in the experiment group after Duraphat applying for 1 month.EDI were 0.20, 0.24, 0.21 and 0.16 in the experiment group after Duraphat applying for 1, 3, 6 and 9 months versus 0.37, 0.44, 0.44 and 0.34 in the comparison group during the same time periods.Therefore EDI and demineralization areas were significantly smaller in the experiment group than those in the comparison group (P<0.01).