Objective To investigate the effect of preoperative visit on reducing anxiety of patients undergoing carotid endarterectomy. Methods 120 cases of patients with carotid endarterectomy were randomly divided into the observation group and the control group with 60 patients in each group, in the control group, before surgery, the nurse of ward gave routine preoperative nursing care and health education.In the observation group, in addition to routine preoperative care and health education, there were preoperative visits by intensive care unit nurses, the anxiety level was compared 1 day before surgery and 2 to 3 days after surgery. Besides, the cooperation degree of patients was also compared. Results There was no significant difference in anxiety levels in the observation group, but there was significant difference in anxiety levels in the control group, there was significant difference in patients coordination degree between two groups. Conclusions Preoperative visits by intensive care unit nurses can reduce the anxiety level of patients, shorten hospital stay and promote early recovery of patients.

Objective Comparative study of the disinfection expense , turnover rate and the effect on health of ortho-phthalaldehyde and glutaraldehyde used for disinfection of bronchofiberscope , to provide the basis of the promoted application of domestic ortho -phthalaldehyde .Methods Based in turnover time of each bronchofiber-scope, the maxminal disinfection expense in month , the maxminal number of bronchofiberscope in month and the maxminal net value were compared with medical revenue in month .Two different disinfections are calculated .Ques-tionnaires about the effects were sent to twenty workers from the supply room involved in using two different disinfec -tion liquid, and the results were analyzed .Results The disinfection expenses of ortho -phthalaldehyde were higher than that of glutaraldehyde , but bronchofiberscope turnover rate increased by 50%, while medical net revenue in-creased by 40%.According to the questionnaires , the respiratory and conjunctival irritation of the workers were mi-nor, and the symptom of any skin irritation did not appear .Conclusion Although the expense increased , ortho-phthalaldehyde obviously improved the bronchofiberscope turnover rate and medical net revenue ,reduced the staff oc-cupational exposure and equipment residual effects on patients .Thus, ortho-phthalaldehyde is an efficient disinfect-ant that is worthy of being promoted in clinical practice .

Objective To observe the changes of circumpapillary retinal nerve fiber layer (CP-RNFL)thickness and optic disk parameters in retinitis pigmentosa (RP) eyes.Methods Prospective clinical case-control study.A total of 25 patients (42 eyes) with RP were in the RP group,and 42 age matched healthy subjects (84 eyes) in the control group.All subjects underwent optical coherence tomography (OCT) examination,in which 37 eyes with 3D optic disk scanning and 5 eyes with circle optic disk scanning.The parameters included average thickness of entire CP-RNFL,thickness of nasal,superior,temporal and inferior quadrant of CP-RNFL,disc area,disc cup area,rim area,cup/disc (C/D) area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume and disc rim volume.Results The average thickness and the thickness of temporal and nasal quadrants of CP-RNFL in RP group were significantly thicker than the control group (t=2.27,3.73,6.44;P=0.027,0.00,0.00),while the thickness of inferior and superior areas were the same as control group(t=-1.49,-1.19;P=0.14,0.24).The disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume in RP group were significantly bigger than control group (P＜0.05),while rim area and rim volume were not significant differences (t=1.75,0.40;P=0.08,0.59).Conclusion In comparison with the healthy subjects,the average thickness and temporal and nasal areas of CP-RNFL in RP eyes were thicker,and the disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume in RP eyes were bigger.

Objective To research the applications of resting-state functional MRI in conjunction with voxel-based morphometry on cerebral functions and structures in patients with schizophrenia. Methods Thirty-two patients with schizophrenia and 32 healthy people underwent resting state functional magnetic resonance imaging (Rs-fMRI)and sagittal scanning T1WI with 3D FFE Pulse Sequence. Rest1.8 software was applied to calculate the differences of amplitude of standardized low-frequency fluctuation(ALFF)between the two groups,then the voxel-based morphometry(VBM)data of abnormal brain regions were evaluated to compare the differences of grey matter intensity. Finally,combining with ALEF and VBM,we explored the changes of cerebral functions and structures. Results As compared to the control group ,the ALFF-elevated regions were the right putamen ,the left orbital frontal cortex extending to the left putamen and left dorsal-lateral superior frontal gyrus;the ALFF-decreased regions were the right inferior tempotalgyrus,the left posterior cingulated gyrus and the left angular gyrus(P<0.05). No elevated regions of grey matter intensity were found in the patient group. Conclusions Extensive abnormal active regions of the brain under resting state could be found in patients with schizophrenia ,the grey matter intensity of abnormal regions also decreased generally. They are in accordance with the glutamate-hypothesis of schizophrenia ,which involves extensive impairments of neurons ,disorders of neurotransmitter′s circulations and balances.

Objective To study and evaluate the therapeutic efficacy of CT-guided radioactive 125Iseeds implantation combined with percutaneous vertebroplasty for spinal vertebra metastases.Methods Fifteen patients and 21 lesions were enrolled in this study.Based on the CT images,a computer-based treatment planning system (TPS) was used to determine the optimal seeds distribution.Under CT-guided,radioactive 125I seeds were implanted into the lesions.Based on the X-ray and CT image after the implantation,quality check was carried out with TPS.The ostalgia-relieving degree and the image alterations of the spinal vertebra metastases lesions were observed.Two months later,15 patients underwent percutaneous vertebroplasty with DSA guidance,bone cement was made according to the ratio methyl acrylic resin polymer/liquid methyl acrylic resin monomer/contrast as 3 ∶ 2 ∶ 1 in injecting paste form.The puncturation through pedicle of vertebral arch and lateral posterior body of vertebra was both adopted in thoracic and lumbosacral vertebrae site.After making sure that the puncturation was completed and there was no leakage in vertebral body,the bone cement was injected into vertebral body quickly.Results Accepted radioactive 125I seeds plantation,relief of pain was obtained.Among 15 patients,8 patients were powerful,6 patients were effective and 1 patient was inefficiency.After treatment,the pain grading significantly decreased.After treatment for 2 months,CT was used to recheck,7 lesions were local controlled,12 lesions had no changes,2 lesions were progress.The responsive rate was 90.5％ (19/21).No serious side-effect happened.Conclusions Radioactive 125I seeds implantation can be a safe and effective method in treating spinal vertebra metastases and obtaining good clinical effects with minimal damage and few complications.Percutaneous vertebroplasty can strengthen the target and relief pain quickly.CT-guided radioactive 125I seeds implantation combined with percutaneous vertebroplasty for the treatment of spinal vertebra metastases has complementary advantages.

Objective To discuss the influences of fasting on the embolism adverse reactions, sense of hunger, blood amylase, blood glucose and anxiety of patients with hemoptysis of pulmonary tuberculosis after embolism operation. Methods Selected 92 cases of patients with hemoptysis of pulmonary tuberculosis who have taken bronchial artery embolism in Pulmonary hospital of Changsha central hospital from June 2014 to December 2015,randomly divided the patients into three groups according to operating date, namely, the non-fasting group, 6h fasting group and 24h fasting group. The non-fasting group have routine diet after the operation; the 6h fasting group and 24h fasting group respectively fasted for 6 hours and 24 hours. Then compared the embolism adverse reactions, sense of hunger, blood amylase, blood glucose and anxiety of the patients in the three groups so as to check whether there is difference. Results Before operation, there was not significant difference in adverse reaction of embolism, sense of hunger, anxiety, blood glucose and amylase between the three groups (P > 0.05). After operation, there was significant difference in hunger sense of difference between the three groups(F=13.308,P<0.05), the hunger sense of 24 h fasting group was more serious than 6h fasting group than non-fasting group;the anxiety score of 24h fasting group is higher than the other two(F=6.509,P<0.05), and the value of the next morning fasting blood glucose in fasting group 24h is higher than other two(F=6.642,P<0.050). comparing the score of anxiety in 6h fasting group and non-fasting group, there was not significant difference, and comparing the post-embolism adverse reaction, 72 h blood amylase of all three groups and these groups one to one, there was also not significant difference ( P>0.05). Conclusion Fasting will cause and intensify the sense of hunger, anxiety and nutrition disorder of patients with hemoptysis of pulmonary tuberculosis after embolism.

Objective To establish a luciferase labeled McA-RH7777 hepatoma rat model,which could be used for gross observation to further observe the effect of selective ligation of the portal vein and bile duct on tumor growth and metastasis.Methods The luciferase gene was transfected into rat McA-RH7777 hepatoma cells with pCDH-puromycin-CMV as the carrier,which were subcutaneously inoculated into Buffalo rats.Tumor pieces were then heterotransplanted into the left lateral lobe of the allogenic rat liver to observe the tumor growth in vivo.After the successful hepatoma modeling,the rats were randomly divided into three groups,namely the implanted portal vein group with combined portal vein and bile duct ligation,the implanted portal vein group with single portal vein ligation and sham operation group.The rats were executed at the 1 st week and 2nd week after ligation,and the livers were dissected to record the tumor growth and metastasis inside and outside the liver,respectively.Results The tumor formation rates of Buffalo rats after subcutaneous and intrahepatic implantation were both 100％.The fluorescence signal implanted into the liver lobe could be observed in vivo after the intrahepatic implantation of luciferase transfected Luc-McA-RH7777 at 2nd week,the range and intensity of which increased over time.Only local tumor growth could be found at the 4th week,without obvious intrahepatic and lung metastasis.However,both an increased in situ tumor volume and the pulmonary metastasis could be observed in the implanted portal vein group with combined portal vein and bile duct ligation at 2nd week after the ligation.Immunohistochemistry showed AFP positive immunoreactions in the vast majority of intrahepatic tumor cells and Luc positive immunoreactions in part of tumor cells.Conclusion Luc-McA-RH7777 cells could be used to establish the heptoma rat model and the in vivo analysis within the Buffalo rat liver demonstrated that the combined ligation of the portal vein and bile duct can accelerate the development and metastasis of liver cancer.

Objective To investigate the effects of lipid-associated membrane proteins ( LAMPs) derived from Mycoplasma pneumoniae ( M.pneumoniae) strains on the expression of heme oxygenase 1 ( HO-1) in a human monocyte cell line (THP-1).Methods THP-1 cells were in vitro cultured with different concentrations of LAMPs for different times.The cytotoxicity of LAMPs to THP-1 cells was analyzed by using lactate dehydrogenase ( LDH) releasing test.The expression of HO-1 at protein and mRNA levels were de-tected by Western blot and real-time RT-PCR, respectively.The enzymatic activity of HO-1 protein was ex-amined by colorimetric assay.THP-1 cells stimulated with PBS and LPS were set up as the negative and pos-itive controls, respectively.Results A significantly enhanced LDH releasing rate was observed in THP-1 cells treated with 10 μg/ml of LAMPs.The expression of HO-1 at protein and mRNA levels in THP-1 cells were induced by LAMPs in a dose-dependent and time-dependent manner.The highest level of HO-1 protein was detected in THP-1 cells treated with 5.0 μg/ml of LAMPs.The transcriptional levels of HO-1 induced by LAMPs were significantly elevated at 3 h, peaked at 9 h and were decreased at 12 h.The expression of HO-1 protein in THP-1 cells was enhanced after 8 h of treatment with LAMPs and a significant decrease was observed at 20 h after reaching peaks at 12 h and 16 h.The activity of HO-1 protein was significantly en-hanced along with the increased expression of HO-1 protein.Conclusion The LAMPs derived from M.pneumoniae strains induced the expression of HO-1 at mRNA and protein levels.Moreover, the enzyme activity of HO-1 protein was enhanced in LAMPs treated THP-1 cells.

Objective To probe into the clinical features, ways of diagnosis and treatment measures of concurrent paratyphoid fever A after renal transplantation. Methods The 5 patients were all town or village people under the county level. After the operation, the immunosuppressive scheme of ciclosporin A (or Tacrolimus) + mycophenolate mofetil (MMF) + prednisone acetate was adopted. One case was caused by catching cold and the rest 4 had no any distinct inducement. Five patients fell ill respectively at the 5th, 7th, 7th, 9th and 14th month after the operation. On the admission, the 5 patients suffered from gastrointestinal symptoms such as vomiting and diarrhea to varying degrees; 3 from toxic symptoms such as fever, intolerance of cold, hypodynamia and headache; 3 from symptoms of the respiratory system such as stuffy nose and congestion of throat; 1 from elevation of blood pressure; 1 from relative slow pulse. In 3 patients with decrease of urine volume, 1 suffered from gross hematuria, swelling of transplanted area of the kidney, pain on pressure and rise of blood pressure. Only 1 patient's paratyphoid fever A antibody in the Widal's test gastroenteritis or untoward reaction of MMF and the curative effect was bad. After definite diagnoses,the combined treatment of the third-generation cephalosporin and FQNS were given to all of them.After treatment for 7-10 days, the symptoms in all patients all disappeared. During the treatment, 1 patient was diagnosed as acute rejection and given the methylprednisolone shock for 3 days. After that, the patient's graft function was improved; 3 patients suffered from relatively great fluctuation of blood concentration of immunosuppressive agent and toxic symptoms such as decrease of the graft function, etc. After adjustment of dosage, their indicators of renal function became normal. Conclusion Early symptoms and accessory examinations of paratyphoid fever A after renal transplantation lack specificities. Diagnosis of paratyphoid fever A after renal transplantation mainly depends on blood culture. Drugs of first choice include FQNS and the third-generation cephalosporin. During the treatment, the doctor should closely monitor blood concentration of the immunosuppressive agent.

Objective: To evaluate the treatment efficacy of reverse flaring technique applied by two rotary instruments, Hero 642 and ProTaper, on complicated molar root canal preparation. Methods: 100 molars with curved root canals (maximum curved angle ≥25 degrees) suffered from pulpitis or periapicities were randomly divided into two groups. In experimental group reverse flaring technique was applied by rotary instruments while in control group reverse flaring technique was not adopted. 50 experimental teeth with curved canals were operated with K files, Hero 642 and ProTaper in sequence. Lateral condensation obturation method was utilized in both groups. Root canal preparation and obturation efficiency were evaluated by X-ray, root canal preparation time and complication incidence (1 year follow-up rate was 95%). Results: Reverse flaring technique applied by Hero 642 and ProTaper Ni-Ti rotary instruments on complicated (curved) root canal preparation in group A demonstrated better root canal coning and smoothness, without instrument fractures, while instrument fractures occurred in control group. Significant difference was found in exact root canal obturation rate and not enough full rate, root canal smoothness and postoperative pain between two groups(P<0.05). Conclusion: Reverse flaring technique applied by Hero 642 and ProTaper NI-Ti rotary instruments indicates complementary potencies, demonstrating satisfactory root canal shape and obturation effectiveness, and lower complication incidence. Reverse flaring technique applied by Ni-Ti rotary instruments is apt for medium/severe curved root canal preparation and worthy of clinical application.