Objective To compare the influence of cardiopulmonary bypass(CPB) on brain injury in the infants with compli‐cated congenital heart disease(CHD) and simple CHD by analyzing and monitoring the perioperative cerebral electric impedance co‐efficient ,serum S‐100βprotein and neuron specific enolase (NSE) .Methods Forty infants with CHD were randomly selected and divided into two groups:the complicated group(n=20 ,13 cases of tertralogy of fallot ,7 cases of transposition of great arteries) and the simple group(n=20 ,8 cases of atrial septal defect ,12 cases of ventricular septal defect) .Blood samples were taken and the cere‐bral electric impedance coefficients before operation(T1 ) ,at 10 min after CPB(T2 ) ,immediately after aortic clamping(T3 ) ,aortic o‐pening(T4 ) ,end of CPB(T5 ) ,at 5 h(T6 ) and 24 h (T7 ) after CPB were measured by the BORN‐BE noninvasive brain edema moni‐tor .Serum levels of S‐100βprotein and NSE were detected by ELISA .Results There was no statistically significant difference in the cerebral electric impedance coefficient ,S‐100βprotein and NSE before surgery(P>0 .05) .The cerebral electric impedance coef‐ficient ,S‐100βprotein and NSE were significantly increased from the beginning to the end of CPB(P< 0 .05) ,and gradually de‐creased after CPB(P<0 .05) .The cerebral electric impedance coefficient ,S‐100βprotein and NSE were obviously higher in the com‐plicated group than those in the simple group at the same time points(P<0 .05) .The cerebral electric impedance coefficient was re‐spectively correlated with S‐100βprotein and NSE .Conclusion The influence of CPB on brain injury in complicating CHD infants is more serious than that in simple CHD infants .The BORN‐BE noninvasive brain edema monitor can be used during CPB periopera‐tive period in complicating CHD infants for conducting the real time monitoring in order to reduce brain damage .

Objective:To examine the relationship between regulatory emotional self-efficacy and childhood abuse,and the mediating role of regulatory emotional self-efficacy between childhood abuse and depression in col-lege students.Methods:Totally 475 college students from 4 universities in Harbin were assessed with the Chinese version of the Regulatory Emotional Self-Efficacy Questionnaire (RES),Childhood Trauma Questionnaire-Short Form (CTQ),and Center for Epidemiologic Studies Depression Scale (CES-D).The survey of CTQ was manipula-ted retrospectively.Results:Physical neglect and physical abuse had significant direct negative effects on perceived self-efficacy in expressing positive affect (POS)(β=-0.38,-0.52).Emotional neglect and sexual abuse had significant direct negative effects on perceived self-efficacy in managing despondency/distress (DES)(β=-0.35,-0.31).Physical neglect had a significant direct negative effect on perceived self-efficacy in managing anger/irri-tation (ANG)(β=-0.23).Physical neglect and physical abuse had significant direct positive effects on depres-sion (β=0.78,3.20).The POS mediated relationships between emotional neglect and depression,physical neglectand depression,and sexual abuse and depression (with intermediary effects of 0.021 -0.029).The DES imposed mediating effects on relationships between emotional neglect and depression,physical neglect and depression,physi-cal abuse and depression,and sexual abuse and depression (with intermediary effect of 0.017 -0.040).The ANG was a mediator in the relationships between emotional neglect and depression,and physical neglect and depression (with intermediary effects of 0.016 -0.019).Conclusion:It suggests that childhood abuse may be an important factor related to low regulatory emotional self-efficacy.Regulatory emotional self-efficacy may play a mediating role between childhood abuse and depression.

Objective To investigate the level of self-care behaviors and self-efficacy among adult type 2 diabetes patients in community and discuss current problems.Methods A convenient sample of 85 patients with type 2 diabetes in Haiyuncang community was interviewed,using diabetes self-care scale and diabetes self-efficacy scale.Totally 85 questionnaires were got and underwent analysis.Results The index score of self-care behaviors and self-efficacy among adult type 2 diabetes patients in community were 66.98% and 69.02%.There were no significant difference in self-care behaviors of patients whether they attended diabetes lectures or not.Self-efficacy correlated significantly with self-care behaviors.Conclusions The self-care behaviors and self-efficacy of diabetes patients need to be improved,and diabetes education in community should be emphasized and carried out effectively.

Objective To observe the influence of the insulation blanket applied in general anesthesia on the incidence of postoperative delirium.Methods 60 patients with elective laparoscopic cholecystectomy under generalanesthesia with ASA of grade Ⅰ-Ⅱ were selected.According to the random number table,the patients were divided into group A(without insulation blanket)and group B (with insulation blanket),each group in 30cases.The dosage and drug batch number of anesthetic drugs were same.Evaluated each patient using the confusion assessment method-chinese revised (CAM-CR).Recorded the number of cases of delirium for each group when 24 hours,48 hours, 72 hours after operation.Results The incidence of postoperative delirium in group A was 6.7%,which in group B was 0.0%.The incidence of postoperative delirium of group B was lower than group A (P <0.05 ).Conclusion Using insulation blanket to protect body temperature in perioperative operation can reduce the incidence of postopera-tive delirium in perioperative operation.

[Objective]To study the effect of End-to-side neurorrhaphy for protection target muscle.[Method]Twenty-six wistar rats were divided into two groups,with 13 in each group,peroneal nerve was transacted on the right side of all the animals,in one group,the proximal end of peroneal nerve was turned back and ligated,the distal end was sutured to the side of tibial nerve with perineurial window,in another group,both ends of the transacted peroneal nerve were turned back and ligated as contrast,no operation was done on the left side.Three months after operation,the peroneal nerve and the tibial muscle were taken for histologic exmination,and the muscle's wet weight was examed.[Result]Significant difference was seen between the two groups in the muscle wet weight,the muscle fiber cross sectional area,the moter endplate area and color(P

Objective To explore the protective effect of bone marrow mesenchymal stem cells (MSC) on diabetic myocardium and anoxic pre-conditioning (AP).Methods Eight-week-- old male Sprague-Dawley rats were given with a single intraperitoneal injection of streptozotocin (STZ) (60 mg/kg)to induce diabetes mellitus (DM).Donor rats were 8-week-old male Sprague - Dawley rats.Before transplantation,MSC were incubated in CM-DiI at a concentration of 2 μg/mL for 20 min.AP-MSC were exposed to 3 hours of anoxia.At 4 months after STZ injection,diabetic rats were randomly given with an intramyocardial injection of one of the followings:150 μL of Dulbecco's modified Eagle's medium ( DMEM),5 ×106 MSC/150 μL,or 5 × 106 AP - MSC/150 μL (n =10 for each group).Three months after STZ injection and 2 weeks after transplantation,we evaluated the cardiac function by echocardiography,and also evaluated the cardiac conditions by alkaline phosphatase staining,western blot analysis for apoptosis related proteins and signal pathways.Results MSC,especially AP- MSC increased fractional shortening (FS) of diabetic heart (P ＜0.01 vs DMEM respectively).AP-MSC greatly increased the capillary density of diabetic myocardium (P ＜0.01 vs DMEM and MSC group respectively).AP-MSC are anti-apoptotic in the rat DCM model,possibly mediated through cardiac upregulation of Bcl-2/Bax ratio ( P ＜ 0.05 ) and inhibiting the expression and activation of caspase - 3 ( P ＜ 0.01 ).Conclusions Intramyocardial transplantation of APMSC has a protective effect on diabetic cardiomyopathy.

Over the last decade, chronic critically ill (CCI) has emerged as an epidemic in intensive care unit (ICU) survivors worldwide. Advances in ICU technology and implementation of care bundles has significantly decreased early deaths of critically ill patients, and have allowed them to survive previously lethal multiple organ failure (MOF). However, more and more survivors leave persistent low grade organ dysfunctions, depend on continues organ support, need to stay in ICU, and become CCI patients. These patients experience a persistent immune dysregulation with persistent inflammation, immunosuppression, and catabolic syndrome. Therefore, malnutrition is an important feature of patients with CCI, and nutritional support is a crucial part of their treatment. The main strategies of nutritional support are as follows: providing sufficient calories and proteins with appropriate anabolic agents to promote anabolic metabolism, using immunomodulators to improve immune suppression and inflammatory responses, and supplementing micronutrients to enhance metabolic support. In this review, the nutritional assessment, calorie assessment, protein assessment and other nutrient supplementation (such as β blocker, testosterone and oxandrolone, immunonutrition, vitamins) of CCI patients were reviewed, so as to provide reference for the treatment of CCI.

Objective To examine the interrelation between the cognitive deviation and loneli-ness levels of medical students and its influencing factors. Methods Totally 220 medical students in grade two of one medical school were selected by method of cluster random sampling. The data of the research were obtained through cognitive bias questionnaire (CBQ) and emotional-social loneliness questionnaire. Interrelation between the cognitive deviation type and condition of emotional-social lone-liness of medical students were analyzed by Pearson product-moment correlation two-tailed test. Multi-ple stepwise regression analysis was conducted by taking score of emotional-social loneliness as de-pendent variable and score of CBQ as independent variable. Differences in cognitive deviation and loneliness levels between rural and urban students as well as between students from single child family and students from non single child family were analyzed by independent-sample t test. Results Neg-ative cognitive deviation of depression-distortion type was positively correlated with medical students' emotional isolation (r=0.161, P=0.021),social isolation (r=0.266,P=0.000), emotional loneliness (r=0.340, P=0.000) and social loneliness (r=0.385, P=0.000). The regression equation was: score of emotional-social loneliness=27.165+1.908 (depression-distortion)+0.836 (depression-non distortion).Students from non single child family had higher scores than students from single child family in the perspectives of depression-distortion”(P=0.017), social isolation(P=0.001), emotional loneliness(P=0.016), social loneliness(P=0.000). Rural students had higher scores in the above four perspectives than urban students(P<0.05). Conclusions Negative cognitive deviation levels of medical students is positively correlated with emotion and social isolation conditions and loneliness experiences. Regres-sion analysis shows that unhealthy cognitive disposition and thinking mode probably are one of the im-portant reasons leading to medical students' stress disorder. Students from single child family and rural area may experience social loneliness more deeply and students from single child family have obvious cognitive deviation.

Objective: To explore the protective roll of ifbroblast growth factor 21 (FGF21) in endoplasmic reticulum stress (ERS) induced rat's H9c2 cardiomyocyte apoptosis with its mechanism. Methods: pcDNA4 was used as gene vector, pcDNA4-FGF21 plasmid was constructed and transfected into rat's H9c2 myocardiocytes for 48 h. ERS model was established by 10 μM tunicamycin (TM) induction for 24 h. The experiment was conducted in 4 groups:①Control group,②TM group, the cells were treated by TM,③pcDNA4-FGF21+TM group,④pcDNA4+TM group. The expressions of FGF21, protein kinase R-like ER kinase (PERK) and c-Jun N-terminal kinases (JNK) mediated apoptosis pathway related protein were measured by Western blot analysis; cell survival rate was examined by CCK-8 method and apoptosis rate was detected by TUNEL technique. Results: pcDNA4-FGF21 vector was successfully constructed and overexpressed in H9c2 myocardiocytes. Compared with Control group, TM group and pcDNA4+TM group had up-regulated endogenous FGF21 expression, increased PERK and JNK mediated apoptosis pathway related protein expression; reduced cell survival rate and elevated apoptosis rate. Compared with TM group and pcDNA4+TM group, pcDNA4-FGF21+TM group had down-regulated PERK and JNK mediated apoptosis pathway related protein expression; increased cell survival rate and decreased apoptosis rate. Conclusion: FGF21 overexpression can reduce ERS induced apoptosis rat's H9c2 myocardiocytes which might be partly related for inhibiting PERK and JNK mediated signal transduction of apoptosis pathway.