Objective To study the effect of preemptive analgesia with tramadol on ovarian cancer patients with stress reaction.Methods 80 cases with ovarian cancer undergoing elective surgery under general anesthesia were divided into the observation group and the control group according to the computer randomly generated control table,40 cases in each group.Patients in the observation group with PECA were pumped into tramadol after anesthesia induction,while the control group was in the same conditions of pumping tramadol after operation.Patients were all treated with intravenous patient -controlled analgesia with sufentanil after waking up.The blood concentrations of cortisol (COR),adrenal cortical hormone (ACTH),angiotensin Ⅱ (AT Ⅱ)were determined by radioimmunoassay, and the blood concentrations C reactive protein (CRP)was determined by immune turbidity method.The adverse reactions and the VAS score of patients after 2h,6h,12h,24h,48h were recorded.Results The COR,ACTH,AT Ⅱ, CRP concentrations of the two groups had no significant differences (all P >0.05)before operation.After each time point,COR[(208.5 ±31.6)ng/mL vs (446.3 ±19.8)ng/mL],ACTH[(35.7 ±8.2)pg/mL vs (63.5 ±9.1)pg/mL],AT Ⅱ[(46.8 ±10.9)pg/mL vs (75.9 ±12.5)pg/mL],CRP[(3.9 ±0.7)mg/mL vs (40.5 ±2.9)mg/mL] concentrations were significantly higher than those of pre -operation (all P <0.05 );The concentration of COR [(446.3 ±19.8)ng/mL vs (570.8 ±67.2)ng/mL],ACTH (63.5 ±9.1)pg/mL vs (85.2 ±12.5)pg/mL),AT Ⅱ[(75.9 ±12.5)pg/mL vs (108.5 ±18.1)pg/mL]and CRP[(40.5 ±2.9)mg/mL vs (51.8 ±8.5)mg/mL]in the observation group was significantly lower than those in the control group (all P <0.05);After operation,the VAS scores of rest (2.4 ±0.7)and cough (3.4 ±1.0)in the observation group were significantly lower than those in the control group in 2h (t =5.812,P =0.017;t =14.606,P =0.044);At rest,the other time point of the two groups of VAS scores had no significant difference (P >0.05);At the time of coughing,the two groups were significantly differ-ent only at the 6h[(2.5 ±0.6)vs (3.1 ±0.8)]and 12h[(2.1 ±0.6)vs (2.9 ±0.4)]time point (t =13.406, P =0.012;t =12.625,P =0.025).Conclusion Preemptive analgesia with tramadol and sufentanil for postoperative analgesia can effectively reduce the radical resection of postoperative pain and the stress reaction after surgery.It is a safe and effective analgesic method.

Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.ResultsTwo groups at T0, T1 esophageal temperature no significant difference, study group t2-t6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference (P<0.05), and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).ConclusionThe surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.

Objective To observe the therapeutic effects of the co-administration of γ-aminobutyric acid (CABA), sodium dimercaptopropane sulfonate (Na-DMPS) and vitamin B6 in large doses on liver and heart of rats with acute tetramine intoxication, and compare their separate effects of either GABA or Na-DMPS alone with those of the triad combination. Method Thirty rats were randomized into control group (n = 6), tetramine intoxication without treatment group (n = 6), tetramine intoxication treated with GABA group (n = 6), tetramine intoxication treated with Na-DMPS group (n = 6) and tetramine intoxication treated with triad combination (GABA + Na-DMPS + vitamin B6, GNDV n = 6) group. Samples of blood, liver tissue and heart tissue of rats with acute tetramine intoxication were collected immediately two hours after medication with different drugs. Serum alanine aminotrasferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) were measured, and the pathological changes of liver tissue and heart tissue were observed under microscope. Results The symptoms of poisoning were apparently relieved and the latency for convulsion/muscular twitch were obviously delayed in poisoned rats treated with GABA, Na-DMPS and GNDV separately. Furthermore, combination group showed the latent period delayed longer than either GABA or Na-DMPS groups The GABA, Na-DMPS and GNDV significantly lowered the serum levels of ALT, AST, CK and CK-MB in rats with tetramine intoxication, and those serum levels of enzymes were lower in GNDV group than those in either GABA group or Na-DMPS group. However, there were no difference in those serum enzymes between GABA group and Na-DMPS group. Moreover, the intoxicated rats treated with combination treatment had the slightest pathological changes in liver and heart (GNDV < GABA or Na-DMPS). Conclusions The co-administration of γ-aminobutyric acid, sodium demercaptopropane sulfonate and vitamin B6 in large doses for the treatment of tetramine intoxication is a method of choice.

[Abstra ct] Objective To investigate the long-term efficacy and adverse effects of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods A total of 869 patients with biopsy-proven NPC without distant metastasis who underwent the whole course of IMRT from 2009 to 2010 were enrolled.Of all the patients, 84.8%received cisplatin-based chemotherapy.The prescribed dose to the primary lesion in the nasopharynx was 66-70Gy in 30-32 fractions, and the dose to the positive lymph nodes in the neck was 66 Gy in 30-32 fractions.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for difference analysis and univariate prognostic analysis , and the Cox proportional hazards model was used for multivariate prognostic analysis .Rseu lts The 5-year overall survival( OS ) , local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, and disease-free survival ( DFS ) were 84.0%, 89.7%, 94.5%, 85.6%, and 76.3%, respectively.In the patients with locally advanced NPC,concurrent chemotherapy tended to reduce distant metastasis (83.6%vs.75.7%, P=0.050) and improve OS (82.6%vs.77.0 %, P=0.082).Induction chemotherapy tended to improve OS ( 80.7% vs.71.4%, P=0.057 ) , and the induction chemotherapy containing docetaxel or gemcitabine tended to improve OS (83.3%vs.72.2%, P=0.058).The patients who received a boost after the initial radiotherapy had a significantly lower DFS rate than those who did not (52.2%vs.71.1%, P=0.004).The concurrent chemotherapy increased the incidence rates of long-term xerostomia and trismus, while a high dose of cisplatin increased the incidence rates of xerostomia and hearing impairment.Conclusions IMRT for NPC provides satisfactory long-term efficacy.Concurrent chemotherapy combined with IMRT tends to reduce the incidence of distant metastasis, and other values need further investigation.The boost therapy after radiotherapy may be associated with poor prognosis.Chemotherapy increases the incidence of long-term toxicities.

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.

Objective: To understand sexual and reproductive health (SRH) knowledge and access to sexual health information among pupils in higher grades, and to provide the scientific basis for conducting sexual education in family and school. Methods: A total of 1 098 pupils in grade four and five from 4 primary schools in a county, Jiaxing City, Zhejiang Province were selected for an anonymous computer assisted self-interview to get the information, including sexual and reproductive information and its sources, the condition about getting sexual education from school and family, and so on. Results: The percentage of correct answers about boy’s and girl’s puberty changes ranged from 15%~54%, and about reproduction and physiology ranges from 14%~70%. The awareness of private body parts ranged from 59%~98%. About 70%~95% could correctly identify sexual abuse scenes. The average score for knowledge on puberty changes, reproduction and physiology, identification of private body and identification of sexual abuse scenes was 31.89, 38.21, 77.03, and 85.72, with total average score of 58.21. In general, girls and students from urban areas or in grade five had higher knowledge level than boys and students from rural areas or in grade four did (P<0.05). Participants mainly obtained SRH knowledge from their mother(63.02%), father(40.53%) and teachers(27.50%). Girls and students from urban areas or in grade five reported higher proportion in access to information on human development, puberty development and health care, self-protection from parents and school teachers than boys and students from rural areas or in grade four(P<0.05). Conclusion Pupils in higher grades lacked SRH knowledge. It is necessary to raise awareness among school teachers and parents about the importance of providing sexuality education for pupils.

Objective To investigate the relationship between occupational noise exposure and glycated hemoglobin (HbA1c) levels, as well as prediabetes diagnosed by HbA1c. Methods A total of 1 181 workers from a cigarette factory were selected as the research subjects using a judgment sampling method. Workers were divided into control, low-level noise exposure and high-level noise exposure groups, consisting of 236, 359, and 586 individuals, respectively. The blood sample was collected for HbA1c test and occupation noise exposure intensity in workplace was detected by an area-sampling method. Results There were no statistical significant differences in HbA1c levels and prediabetes prevalence among the three groups of workers (all P>0.05). After adjusting for potential confounding factors such as years of service, gender, smoking, pack-years of smoking, alcohol consumption, and body mass index, multiple linear regression analysis showed that the high-level noise exposure group had higher HbA1c level than the control group (P<0.05). Multivariable logistic regression analysis results showed that the high-level noise exposure group had higher risk of prediabetes compared with the control group (P<0.05). Conclusion Occupational noise exposure could be a risk factor for the increased HbA1c levels and prediabetes incidence among the occupational population. More attention should be paid to the effects of occupational noise exposure on the HbA1c level in occupational health surveillance.

Objective: To investigate the effects of two anesthetic modes on cognitive function in elderly patients undergoing laparoscopic cervical cancer resection. Methods: From August 2016 to April 2018, 60 elderly patients undergoing laparoscopic cervical cancer resection in the General Hospital of Armed Police were divided into control groupand observation group according to odd and even of bed number, with 30caese in each group.Intravenous anesthesia was used in the control group, and intravenous anesthesia combined with inhalation anesthesia was used in the observation group.The anesthetic effect, MMSE score, MoCA score and the incidence of cognitive dysfunction were compared between the two groups. Results: The anesthesia effect time, extubation time and recovery time of the observation group were (1.62±0.30)min, (15.68±3.26)min, (8.69±3.68)min, respectively, which were significantly shorter than those of the control group[(4.68±0.91)min, (27.46±4.03)min, (20.36±4.58)min](all P<0.05). There were no statistically significant differences in MMSE score and MoCA score between the two groups before operation (all P<0.05), and there was statistically significant difference in MMSE score between the two groups at 2 h and 6 h after operation (all P<0.05). The MMSE score in the observation group was higher than that in the control group(all P<0.05), but there was no statistically significant difference on the 1st day after operation (P>0.05). At 2 h, 6 h, 1 d after operation, the MoCA scores in the observation group were significantly higher than those in the control group (all P<0.05). The incidence of cognitive dysfunction in the observation group was 6.67%(2/30), which was significantly lower than 26.67%(8/30) in the control group (P<0.05). Conclusion Compared with intravenous anesthesia alone, intravenous anesthesia combined with inhalation anesthesia for elderly patients undergoing laparoscopic cervical cancer resection has a good anesthetic effect and can reduce the incidence of cognitive dysfunction, which is worthy of further application in clinical practice.

Objective To investigate the effect of lead exposure on blood pressure of lead workers. Methods A total of 665 lead workers from some lead-acid battery enterprises in Wuhan were selected as the lead exposure group, and 708 ordinary workers without lead exposure were selected as the control group. The blood pressure in the workers of both groups was measured. The blood lead concentrations were measured in the lead-exposed group. The independent samples t-test was used to compare the blood pressure between the two groups. Linear regression model was used to analyze the relationship between the blood lead concentration and the blood pressure in the lead-exposed group. Logistic regression analysis was used to analyze the relationship between the risk of hypertension and blood lead concentration in lead-exposed group. Results The mean values of systolic blood pressure, diastolic blood pressure and pulse in the lead exposure group were significantly higher than those in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in pulse pressure difference between the two groups (P>0.05). Linear regression analysis revealed that blood lead concentrations were significantly correlated with both systolic and diastolic blood pressure in the lead exposure group. For each increase of 1μg/L of blood lead concentration in the lead exposure group, the systolic blood pressure of lead workers increased by 0.011 mmHg, and the diastolic blood pressure increased by 0.007 mmHg. Logistic regression analysis found that men in the lead-exposed group had a higher risk of hypertension than women. The older the age and the higher the blood lead concentration, the higher the risk of development of hypertension. Conclusion There is a positive correlation between the blood lead concentration and the systolic and diastolic blood pressure in lead workers. The older the lead worker, the higher the risk of developing high blood pressure. The higher the lead concentration in lead workers, the higher the risk of developing high blood pressure.