Objective To compare the effect of different sevoflurane induction methods on hemodynamics and immune function in elderly patients with tumor. Methods One hundred and sixty elderly patients with tumor underwent general anesthesia were enrolled, the patients were divided into observation group and control group according to the anesthesia method with 80 cases each. The observation group was received induction method of initial concentration of 2%sevoflurane and increased by 1% per 3 times breathing and then to a final concentration of 4%- 5%. The control group was received 5% sevoflurane induction concentration. The anesthesia induction time, intubation time, recovery time and untoward reaction were recorded. The changes of heart rate, mean arterial pressure (MAP), oxygen saturation of pulse (SpO2), bispectral index (BIS) and CD3+, CD4+, CD8+, CD4+/CD8+were observed. Results There were no statistical differences in BIS, heart rate, SpO2, CD3 +, CD8 + and incidence of untoward reaction between 2 groups (P>0.05). The MAP at immediate intubation in observation group was significantly higher than that in control group:(69.38 ± 10.42) mmHg (1 mmHg=0.133 kPa) vs. (58.52 ± 6.12) mmHg, but the MAP at after intubation was significantly lower than that in control group: (77.12 ± 11.31) mmHg vs. (90.13 ± 9.24) mmHg, there were statistical differences (P<0.05). The anesthesia induction time and intubation time in observation group were significantly longer than those in control group:(110.1 ± 14.2) s vs. (101.4 ± 15.8) s and (341.2 ± 57.3) s vs. (310.4 ± 60.8) s, but the recovery time was significantly shorter than that in control group: (271.2 ± 31.3) s vs. (321.8 ± 41.5) s, there were statistical differences (P<0.05). The CD4+and CD4+/CD8+at end of surgery and 1 d after surgery in observation group were significantly higher than those in control group, CD4+:0.241 ± 0.027 vs. 0.182 ± 0.034 and 0.332 ± 0.039 vs. 0.284 ± 0.042, CD4+/CD8+: 0.84 ± 0.12 vs. 0.69 ± 0.13 and 1.09 ± 0.52 vs. 0.93 ± 0.43, there were statistical differences (P<0.05). Conclusions Induction method of gradually increasing concentration of sevoflurane enables the hemodynamics of elderly tumor patients more stable. In addition, this method can reduce the inhibitory effect on T lymphocytes to some extent.

Objective To observe effect of personalized health education on drug compliance and efficacy in patients with multidrug-resistant pulmonary tuberculosis. Methods From October 2015 to May 2016, 100 cases with multidrug-resistant tuberculosis were selected. The patients were randomly divided into two groups, 50 cases in each group. The contorl group was given a routine clinical health education, the observation group were received personalized health education . Awareness of disease and medication, medication compliance and satisfaction after education in the two groups were compared. Results The total awareness rate in the observation group was 96.00% (48/50), the total medication compliance rate was 94.00% (47/50), the satisfaction degree was (87.62±6.95) points. The above three indicators in the observation group were better than those in the control group (P<0.05). Conclusion It is possible to improve the patient's awareness and adherence to disease and medication after taking the personalized health education program in patients with multidrug-resistant tuberculosis disease clinically. It can get a better satisfaction test result.

Objective:To investigate the anatomy of mandibular incisors using microcomputed tomography(Micro-CT).Methods:62 extracted mandibular incisors were selected from dental clinic and observed by Micro-CT.The anatomy of the teeth was analyzed. Results:83.9% of mandibular incisors had a single canal,72.6% had no accessory canal.The location of the apical foramen varied considerably.The mean distance from the root apex to the major lateral apical foramen was (0.613 ±0.298)mm.Of the canals the bucco-lingual diameter were greater than the mesio-distal diameters and the root bucco-lingual canal tapers were greater than the me-sio-distal.Conclusion:The morphology data of mandibular incisors were obtained using Micro-CT.

Objective To improve the recognition of intrahepatic biliary cystadenoma.Methods The clinical manifestations,radiologic features,diagnosis and surgical treatment of 18 patients with intrahepatic biliary cystadenomaadmitted in our hospital during the recent 8 years were retrospectively analyzed.Results Four cases were discovered by general medical examination,while the other 14 patients had varying symptoms that included right upper abdominal discomfort or pain in 11 cases,abdominal mass in 3 cases,and jaundice accompaniedby fever in 2 cases.B ultrasound and CT scan showed intrahepatic cystic occupying lesions consistingof multilocular or single cyst,and usually with papillary structures in the cyst wall.All of 18 cases received surgical resection.The patholgic dingnosis was intrahepatic biliary cystadenoma in all the 18 cases,and 6 of them showed malignant change.The average survival time of maligmant patients was 35(27-58)months.Conclusions Preoperative diagnosis of intrahepatic biliary cystadenoma is difficult.Intrahepatic biliarycystadenoma is easy to develop into cystadenocarcinoma.Early surgical resection is necessary,and can effectively prevent recurrence or malignant transformation.

Objective To explore the influencing factors of job stress of clinical nursing teachers in order to provide information for nurse managers formulating targeted stress management.Method Toally 185 clinical nursing teachers were evaluated with the Chinese nurses stressors scale (CNSS).Results The scores by CNSS was 75.4 ±23.6.Age,working experience,job rank,education background,working department,marriage status and demission intention were found to be adverse impacts on CNSS's scores (all P＜0.01).Conclusion Clinical nursing teachers have middle working pressure.Effective intervention should be provided by nursing managers to prevent and relieve job stress and negative psychological conditions of these teachers.

Objective To study the effect of comprehensive interventions on anxiety of nursing students at internship. Methods Comprehensive educational interventions were practiced at the beginning,middle-term and end of their internship. The Self-Rating Anxiety Scale(SAS)was adopted to assess their level of anxiety.Results There were differences in SAS scores between the three phases(F=2.680,P<0.05).The scores were decreased from the beginning to the end.Conclusion Targeted comprehensive educational interventions can reduce anxiety and stress of nursing students.

Objective To explore the stress perception among acute myocardial infarction (AMI) patients during acute stage.Methods Phenomenological method of qualitative study was adopted.18 AMI patients during the acute stage of 3～4 days after the onset of the disease were interviewed.Results Stress made AMI patients hard to accept the fact of illness,worry about the treatment of illness and the impact on future life,be difficult to alter living habits,be hard to relieve negative emotion.Conclusions AMI patients during acute stage will experience different levels of psychological stress.Stress management should be fabricated and effective measures should be adopted to relieve their negative emotions in terms of inducing factors.

BACKGROUND: High-energy vibration is easy to damage non-cavity organs of the body and the damage effect is remarkable, but few studies concern the process of high-energy vibration-induced injury.
OBJECTIVE: To understand physiological, biochemical and pathological changes of animal bodies after high-energy vibration-induced injury.
METHODS: A total of 32 dogs were randomly divided into four groups. Dogs in the mild vibration injury group, moderate vibration injury group and severe vibration injury group received 700, 1 000, and 2 100 m/s2 vibration. Dogs in the control group were considered as normal controls. Within 14 days after vibration, serum K+, Ca2+, Zn2+, S100β, and neuron specific enolase concentrations were detected. Immunohistochemical staining was observed in the spinal cord and the brain.
RESULTS AND CONCLUSION: Serum K+, Ca2+, Zn2+concentrations showed a regular change in the three vibration injury group, and no evident change was found immediately after vibration injury. K+ concentrations reached a minimum at 0.5 day after vibration injury. Ca2+ concentrations reached a minimum at 1 day after vibration injury. Zn2+concentrations reached a minimum at 0.5 or 1 day. Above concentrations gradual y increased and became normal at 14 days. Serum neuron specific enolase and S100β expression increased at 0.5 day after vibration in the three vibration injury groups, peaked at 1 day, gradual y diminished, and recovered to a normal level or higher level at 14 days. In the three vibration groups, bleeding point of contact position and hedge position could be found in the spinal cord and brain. The degree of bleeding was more significant when kil ed instantly after vibration compared with that at 14 days. S100β, glial fibril ary acidic protein and neuron specific enolase expression increased in the spinal cord and brain.

Objective To investigate the effect of Naoxintong on nuclear transcription factor-κB ( NF-κB ) , matrix metalloproteinase-9(MMP-9)and TNF-αin the brain of ischemic rat models.Methods One hundred and ten healthy male SD rats were randomly divided into sham operated group ( n=30 ) , model control group ( n=40 ) and Naoxintong treatment group(n=40).Each group was further divided into five sub group by 0.5d, 1 d, 3 d, 5 d and 7 d after ischemia-reperfusion.The middle cerebral artery occlusion ischemia reperfusion rat models were prepared by Zea Longa method;meanwhile the MRI and the Bederson score were used to select the successful models .In order to observe the changing process of the ischemic brain tissue after given Naoxintong capsule , six rats in each group each timepoint were examined by MRI .The expression levels of protein and mRNA of NF-κB, MMP-9 and TNF-αwere detected respectively by western blot and real time PCR .Results Cerebral infarction volume of Naoxintong treatment group was significantly reduced compared with the model control group .The mRNA and protein levels of NF-κB, MMP-9 and TNF-αof the Naoxintong treatment group decreased significantly compared with the model control group (P <0.05).The mRNA and protein levels of NF-κB, MMP-9 and TNF-αhad no significant difference between the sham group and Naoxintong treatment group .Conclusion Naoxintong has a neuroprotection effect on cerebral ischemia via alleviating the inflammatory factors in the ischemic area .

Objective To observe the dynamic change of activated cytotoxic T lymphocyte (CTL) percentage during periopera-tive period in the patients with breast cancer and to explore the value of detecting the peripheral blood activated CTL in monitoring the perioperative condition of breast cancer patients .Methods The lymphocytes in whole blood were defined by forward scatter and side scatter (FSC/SSC) signal parameters by adopting flow cytometry (FCM ) ,the CD3 ,CD8 and CD38 antigens on lymphocyte surface were detected by CD3-FITC ,CD8-APC and CD38-PE monoclonal antibody ,respectively .The CD3+CD8+CD38+ percentage in 20 healthy people were detected with the established method to determine the reference ranges ,and the dynamic changes of CD3+CD8+ CD38+ cells percentage in total T cells and cytotoxic T cells of 33 patients with breast cancer during perioperative period were observed .Results The percentages of CD3+ CD8+ CD38+ /CD3+ and CD3+ CD8+ CD38+ /CD3+ CD8+ in healthy group were (13 .46 ± 4 .08)% and (29 .98 ± 9 .1)% ,respectively .Both the CD3+ CD8+ CD38+ /CD3+ [(10 .44 ± 6 .61)% ] and CD3+ CD8+CD38+ /CD3+CD8+ [(22 .34 ± 10 .68)% ] before operation in 33 patients with breast cancer were significantly lower than those in healthy group (P<0 .05);CD3+CD8+CD38+ /CD3+ [(9 .64 ± 6 .16)% ] on postoperative 1 d was significantly lower than that in preoperation(P<0 .01);CD3+CD8+CD38+ /CD3+ [(12 .67 ± 7 .73)% ] and CD3+ CD8+ CD38+ /CD3+ CD8+ [(27 .42 ± 10 .65)% ] on postoperative 7 d were significantly higher than those in preoperation (P<0 .05) ,the difference with the healthy control had no statistical significance(P>0 .05) .Conclusion Observing the dynamic change of CD3+CD8+CD38+ cells percentage has an impor-tant significance for monitoring the perioperative condition of the patients with breast cancer ,contributing to get the activated CTL recovery situation of the patients and to choose the correct chemotherapy occasion for the patients .