Objective: In order to search the credible parameters of evoked potentials (EP) for the depth of anesthesia. Method: The end-expiratory concentration of isoflurane was increased gradually from 0.2MAC by step of 0.1MAC in each of ten volunteers. The change of EP and the consciousness were observed at every end expiratory anesthetic concentrations. The explicit and implicit memories about intra-experiment events were investigated an hour after stopping inhalation of isoflurane. Result: The explicit memory disappeared at 0.2 and 0.3MAC of isoflurane without the stimulation of pain; The response to command disappeared at 0.3 and 0.4MAC; 0.4MAC of isoflurane could not vanish implicit memory in all subjects. The latencies of waves Pa and Nb of the MLAEP and P_(25) of the SEP prolonged gradually with increased concentrations of isoflurane in a linear relationship, and varied with the changes of response to command. The latency corresponding to the partial response increased significantly compared with that to the full response, but without difference between the partial and no response. Meanwhile the latencies of waves Pa, Nb and P_(25) increased significantly with the disappearances of explicit and implicit memory, without differences between the conscious and unconscious awareness. The critical values of latencies about those waves which could be applied to assess the disappearance of explicit memory, were defined. Conclusion: The disappearance of consciousness is not all-ornone but gradual. The sequence of disappearance about consciousness is explicit memory, response to command, then implicit memory. There is no explicit memory about stimulation of pain after response to command has vanished, but implicit memory may still exit. The waves Pa and Nb of MLAEP and the wave P_(25) of SEP may be regarded as important parameters to evaluate the depth of anesthesia about consciousness.

Objective To understand the current situation of the operational mechanism of medical research subsidization in the army so as to make suggestions for improvement. Methods Using the methods of literature review and expert consultation, an investigation through questionnaires was made into the operational mechanism of medical research subsidization in the army. Results The group of experts held that in subsidizing medical research in the army, stress ought to be laid first of all on the encouragement of innovation(scoring 450 points) . Next in line were respectively the highlighting of military use (scoring 340 points), the guarantee of urgent needs(scoring 310 points), and fair competition( scoring 123 points). Conclusion It is imperative to further perfect the operational mechanism of medical research subsidization in the army, reinforce the implementation of rules and regulations, constandy improve the assessment index, and reduce administrative intervention.

Objective By analysing the relation between the proportion of NBCA and the arteriovenous circulation time will give the optimal proportion of NBCA for embolizing cerebral AVM with microcatheter clinically.Methods (1) The fresh aterial blood fractions from intracranial hemorrhage in vitro of 16 cases were mixed with the 20%、33%、50%、70% and 80% NBCA respectively and evaluated the coagulation times with the different densities of NBCA in the fresh aterial blood in vitro; (2) two cases were performed with superselective embolotherapy to five feeding arteri. Results (1) the correlation index between different densities of NBCA and the fresh areterial blood in vitro , T (c) =e 1.9994-1.487D , (2) about 90% nidus of AVM were occluded after embolization, and the fistulas of AVF were basically closed after embolization.Conclusions There is a mathematical model between the arteriovenous circulation time and the proportion of NBCA, thus providing the theoretical clinical application of the embolotherapy of CAVM with microcatheter.

Objective To discuss influence and curative effect of bifid triple viable capsules combined with lactulose on colonic transit function of patients with chronic functional constipation(CFC). Methods A total of 78 cases with CFC were divided into research group and control group randomly. The patients in two groups were given basic medical treatment, such as diet structure adjustment, plenty of water, defecation training and etc. The patients in research group were additionally bifid triple viable capsules combined with lactulose oral fluid, with 420 mg bifid triple viable cap-sules, three times a day with warm boiled water, and 10 mL lactulose oral fluid, three times a day, 30 minutes before dinner for 6 weeks. The patients in control group were only given lactulose oral fluid with the same method, dose and course of treatment were same as in research group. The changes of total colonic transit time (TCTT) in two groups before and after medical treatment were observed, and the clinical curative effect, adverse drug reactions(ADR) and re-occurrence rate of one-year following-up were compared as well. Results After 6 weeks'treatment, TCTT in two groups were obviously declined than before (P<0.05 or P<0.01), and the declining rate in research group was much higher than that in control group (P<0.05). The total clinical efficiency of patients in research group was much higher than that in control group (χ2=5.19, P<0.05). 6 cases of ADR were appeared in two groups during the medical treatment, with 4 and 2 cases in control group and research group respectively with light symptom, and after comparing the occurrence rates in two groups, no statistical differences were appeared (χ2=0.18, P>0.05). According to one-year following-up, the reoccurrence in research group was much lower than that in control group (χ2=5.19, P<0.05). Conclusion Compare with pure lactulose oral fluid, bifid triple viable capsules combined with lactulose oral fluid have better curative effect and with favorable security on CFC, which can obviously improve the colonic transit function, shorten TCTT, improve constipation symptom and reduce the reoccurrence rate.

Objective: To investigate the current situation and related factors of the ecological environment and health literacy level of medical college students in Shiyan City, so as to propose relevant countermeasures and suggestions for improvement in these domains. Methods: From May to June 2023, 1 312 medical students from Hubei University of Medicine in Shiyan City were selected by accidental sampling to investigate the level and influencing factors of the ecological environment and health literacy among this population. The Chi square test and binary multivariate Logistic regression analysis were performed to analyze the different characteristics and main influencing factors of the ecological environment and health literacy levels in this population. Results: The level of the ecological environment and health literacy level among medical students in Shiyan City was 24.3%. Different levels of ecological environmental and health literacy were observed among medical students by gender, grade, major and ethnicity ( χ 2=5.13, 54.87 , 64.71, 5.99, P <0.05). Higher rates were also observed among public health major students than among students of other majors. The first three classification literacy levels consisting of basic literacy, basic knowledge, and basic skills were 4.6%, 49.5 % and 50.4%, respectively. The possession rates of six secondary classification indicators were as follows:basic cognition ( 53.2 %), basic attitudes (34.5%), scientific knowledge (3.0%), behavioral knowledge (22.5%), cognitive skills (59.5%) and operational skills (48.6%). The results of multivariate Logistic regression showed that ethnic minorities and biomedical majors were negatively correlated with medical students ecological environment and health literacy ( OR =0.61,0.52), while female students, public health majors, sophomores and seniors were positively correlated with medical students ecological environment and health literacy ( OR=1.44, 1.95, 2.16, 2.24, P <0.05). Conclusions The overall level of ecological environment and health literacy among medical students in Shiyan City is low. Schools should popularize environmental health knowledge from different perspectives in order to improve the overall literacy level of environmental health literacy among medical students.

Objective:To understand the current situation of nurses′ implementation of oral care for elderly patients, so as to improve oral care practice standard and quality of oral care constantly.Methods:Using convenient sampling method, 190 nurses in the general ward of the General Hospital of Ningxia Medical University were selected as the research object from September to November 2020. The self-designed questionnaire was used to investigate and analyze the implementation of oral care among elderly patients.Results:A total of 190 questionnaires were collected in this survey, 84.74%(161/190) of the nurses reported that the hospital or department had oral care practice standard; The proportion of nurses who evaluated the oral status of elderly patients by the oral care assessment tool was 17.89%(34/190).Only 14.74%(28/190) and 16.84%(32/190) of the nurses could always set the expected rehabilitation goals and formulate the corresponding nursing plans for the oral problems of elderly patients, respectively. When the elderly patients had special oral problems, 26.32% (50/190) of the nurses would proactively communicate with doctors or search literature; the oral knowledge and oral hygiene habits of the elderly patients would be known to nurses accounting for 5.26% (10/190).Conclusions:Nurses′ cognition of oral care for elderly patients is at a low level on the structure, process and outcome.Relevant nursing managers still need to further improve the oral care operation norms and the training of nurses′ knowledge and skills, so as to continuously promote the oral health of elderly patients.

Objective To evaluate the efficacy and safety of the modified docetaxel plus prednisone scheme for the metastatic castration resistant prostate cancer patients who got poor tolerance to chemotherapy.Method The clinical data of 50 metastatic castration resistant prostate cancer who received docetaxel + prednisone chemotherapy from March 2010 to October 2015 were analyzed retrospectively.23 cases received the modified DP regimen (modified group),27 cases received the standard DP regimen (standard group).The median age of the modified group and the standard group were 69 years (47-80 years) and 63 years (52-77 years) (P =0.005).There were 19 and 24 cases with pain in modified group and standard group respectively;10 and 19 cases with lymph node metastasis respectively;3 and 4 cases of visceral metastasis respectively;all of the 50 patients were complicated with bone metastasis.For the pathological Gleason score,there were 7 cases scored ≤7 points,13 cases scored ≥ 8 points and 3 cases unscored in the modified group;7 cases scored ≤7 points,15 cases scored ≥8 points and 5 cases unscored in standard group.There was no significant difference of the pain,metastasis,and Gleason score between the two groups (P ＞ 0.05).Progression free survival (PFS),overall survival (OS)and adverse events were analyzed using Kaplan-Meier curves,and the differences were assessed using the log-rank test.Results In the modified group and standard group,the median follow-up times were 11.0 months and 14.0 months respectively,the median chemotherapy cycles were 4.5 cycles and 5.0 cycles respectively;OS were 18.0 months and 27.5 months respectively (P =0.746).The PFS of the two groups were 6.0 months and 5.2 months,respectively (P =0.822).The PSA response were 13 cases and 17 cases in the modified group and standard group respectively (P =0.615),and the pain response were 8 cases and 7 cases (P =0.927),grade 3 to 4 adverse events were 3 cases and 14 cases (P =0.003).The main adverse events were blood toxicity,neutrophils,gastrointestinal reaction,edema,fatigue and oral mucositis etc.Conclusions Compared with the standard DP scheme,the modified DP scheme had no significant difference in OS,PFS,pain response rate and PSA response rate,while the incidence of grade 3 to 4 adverse events was significantly reduced.Modified DP scheme may be a better choice for patients with metastatic castration resistant prostate cancer who get poor tolerance to chemotherapy.

Objective To investigate the dose of docetaxel appropriate for patients with metastatic castration-resistant prostate cancer and its affects to the prognosis.Methods A retrospective analysis was performed on the clinical data of 75 patients with metastatic castration-resistant prostate cancer admitted from March 2010 to July 2016 who received docetaxel combined with prednisone chemotherapy.The patients were divided into the low-dose group (n =43,docetaxel ＜ 65 mg/m2),the middle-dose group (n =21,docetaxel 65-70 mg/m2) and the high-dose group (n =11,docetaxel ＞ 70 mg/m2).The median age in the low-dose group,middle-dose group and high-dose group was 67 (53-80),66 (56-78) and 61 (47-76) years old,respectively.Among 75 patients with bone metastasis,2 patients had no evidence of bone metastasis in the low-dose group.The lymph node metastasis was found in 26,13 and 6 cases in each group,respectively.And visceral and other metastasis were founded in 11,4 and 2 cases,respectively.The Gleason score in the low-dose group was≤7 points in 15 cases,≥8 points in 22 cases and no score in 6 cases.The Gleason score inthe middle-dose group was ≤7 points in 4 cases,≥8 points in 13 cases and no score in 4 cases.The Gleason score in the high-dose group was ≤7 points in 3 cases,≥8 points in 5 cases and no score in 3 cases.The number of patients with pain in the low-dose group,middle-dose group and high-dose group was 36,12 and 9,respectively,there were no significant differences in the above indicators (P ＞ 0.05),except age,which showed relatively more aged patients in the low-dose group,(P =0.045).Kaplan-Meier method was used to compare the overall survival (OS),progression-free survival (PFS) and the incidence of ≥CTCAE-4 grade 3 adverse reactions between the two groups.The Cox regression model was adopted to analyzed the factors that might affect patient prognosis,including the effective time of first-line endocrine therapy,hemoglobin level,ECOG score,pain score,number of cycles of chemotherapy,age,dose of docetaxel and alkaline phosphatase (ALP).Kaplan-Meier method was used to analyze the effect of dose of docetaxel on the prognosis,and log-rank method was used to test the significance of the results.Results The median OS was respectively 24.1,18.5 and 23.5 months in the low-dose group,middle-dose group and high-dose group,respectively.The median PFS was 5.3 months in all three groups,which didn't show statistically significant differences.The incidence of grade 3/4 adverse reactions in the low-dose group,middle-dose group and high-dose group was 15 cases (34.9％),8 cases (38.1％) and 5 cases (45.5％) respectively.It showed an increasing trend,but no statistically significant difference.The single factors related to OS mainly include the effective time of first-line endocrine therapy,hemoglobin level,ECOG score,pain score,number of cycles of chemotherapy,there was no significant correlation with age,docetaxel dose,ALP and PSA value.Conclusions It is common to receive lower doses of docetaxel in clinical practice for patients with metastatic castration-resistant prostate cancer in China.The efficacy of low-dose docetaxel is similar to that of high doses (standard dosage).There was no significant correlation between the OS and the actual dose of docetaxel in the tolerable range.