Objective To investigate the incidence of pain for the.elderly with dementia in our country.Methods The Chinese version of Doloplus-2 was used to assess pain in 103 patients with dementia.Results One or more specific diseases may cause pain in 94 patients,degeneration of bone and joint top of the list;69 patients with pain score geater than or equal to 5 points,the incidence of pain as much as 67% .Older persons in different age groups the incidence of pain is different,with the age increased the incidence of pain increased;different older age groups pain scores had no significant difference.Conclusion Pain in patients with dementia should be of great importance to the medical staff and give full play to the nursing staff in pain management.

Objective To evaluate the efficacy of intramuscular parecoxib for postoperative analgesia in patients undergoing total knee arthroplasty.Methods Fifty-four ASA Ⅰ-Ⅲ patients,aged 65-75 yr,scheduled for unilateral total knee arthroplasty,were randomly divided into 2 groups (n =27 each)∶ tramadol group (group T) and parecoxib group (group P).Total intravenous anesthesia was used in both groups.Group P received intramuscular injection of parecoxib 40 mg at 12 h before operation and 12,24,36,48,60 and 72 h after operation,and group T received tramadol 100 mg at the same time points.When VAS score was more than 3 after operation,intramuscular parecoxib 50 mg was given as rescue analgesic.The ineffective analgesia at rest and during activity was recorded.The time for knee range of motion to reach 90° and cardiovascular events were recorded.The ultrasonic inspection was performed on veins of the bilateral lower extremities at 7 and 14 days after operation for detection of vein thrombosis.Results Compared with T group,the rate of ineffective analgesia at rest and during activity was significantly decreased,the time for knee range of motion to reach 90° was shortened,and the incidence of deep vein thrombosis was significantly decreased (P ＜ 0.05 or 0.01),and no significant change was found in the incidences of cardiovascular events and intramuscular venous thrombosis in group P (P ＞ 0.05).Conclusion Parecoxib 40 mg injected intramuscularly before and after operation can significantly relieve postoperative pain,is helpful for the hip function rehabilitation and can reduce the occurrence of deep vein thrombosis in patients undergoing total knee arthroplasty.

Objective To determine the effect of calcitonin gene-related peptide (CGRP) on triggering receptor expressed on myeloid cells-1 (TREM-1) in the lipopolysaccharide (LPS)-induced macrophages and its signal transduction pathway. Methods The levels of TREM-1 mRNA in the macrophages were observed by reverse transcription-polymerase chain reaction (RT-PCR), and flow cytometry was performed to detect TREM-1 protein expression levels in the macrophages. Results CGRP had no regulating effect on the expression of TREM-1 in the macrophages; LPS could up-regulate macrophages to express TREM-1; CGRP increased TREM-1 mRNA expression in LPS-induced macrophages in dose and time-dependent manner; CGRP increased TREM-1 protein expression in LPS-induced macrophages, which could be partially reversed by H-7 or H-89 (P<0.05). Conclusion CGRP can regulate the LPS-induced macrophages synthesis and secretion of TREM-1, and the intracellular signal transduction pathway is related to PKA and PKC.

Objective To evaluate the attitudes of clinical nurses toward caring for the dying patients, and possible influencing factors concerning the attitudes were investigated, so as to provide a scientific basis for further intervention, thus improving the positive attitudes toward care of the dying patients in the future research. Methods A convenience sampling method was used to recruit 770 nurses from 15 hospitals located in 5 provinces in China. A demographic survey, Chinese version of Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B-C) and Chinese version Death Attitude Profile-Revised were employed in the survey. Results FATCOD-B-C scale was used to evaluate the attitudes of nurses toward caring for dying patients, with the mean score of all FATCOD-B-C item being 95.62 ± 7.45. To analyze relationship among demographic variables and the total score of FATCOD-B-C. Univariate analysis revealed that age group (F=2.285), years employed as a nurse (F=3.353), educational background (F=5.581), technical title (F=5.692), level of hospital (t=2.058), religious beliefs (t=-2.788), previous education on death and dying(F=9.743), previous experience in dealing with terminally ill persons (t=2.761) had significant influence on the nurses' attitudes toward caring for dying patients and families(P<0.05). Multiple linear regression analysis indicated that nurses' attitudes toward caring for dying patients had been affected by those factors, among which the most influential factor was educational background. Conclusions It shows that nurses'FATCOD-B-C scores are at a low level. It is suggested to improve nurses' positive attitudes of caring for dying patients and their families by making the specific methods based on the influencing factors, thus improving the development of palliative care.

Objective To clone,express and purify thioredoxin (named as N5),a specific diagnostic antigen of hepatitis E virus (HEV),and to initially evaluate its antigenicity and serological test performance.Methods Based on the gene sequences of HEV-ORF2 and carboxyl terminal ORF3 on GenBank,the codon was optimized by the Escherichia coli codon preference,inserted it into prokaryotic expression vector M48 following total gene synthesization,and expressed in Escherichia coli fusion protein N5 recombined with Thioredoxin (TRX).Fusion protein was purified in affinity chromatography,evaluating its antigenicity with Western blot technology,then evaluating its serological test performance using the negative and positive serum samples confirmed of HEV infection with laboratory and clinical tests.Results The recombinant plasmid expressing N5 diagnostic antigen was successfully established; high-level expression and purification to obtain soluble diagnostic antigens; Western blot results indicating fusion protein N5 can be bound specifically with the serum of HEV IgM antibody positive,showing satisfactory antigencity; using fusion protein N5 as the capture antigen to build indirect ELISA,testing 40 serum samples of HEV cases confirmed by pathogen detection and clinical diagnosis and 40 serum samples of healthy people,with the sensitivity and specificity of 95％ (38/40) and 90％ (36/40) respectively.Conclusion Recombinant plasmid expressing the HEV diagnostic antigen recombined with thioredoxin was successfully established,and soluble fusion protein N5 was obtained with high expression and strong antigenicity,promising in its future applications.

To investigate the effect of prophylactic aucubin (AU) on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice. 
 Methods: Male BABL/c mice were randomly divided into a control group, an ALI group, and an AU treatment group, 16 mice in each group. ALI mice were injected with LPS (5 mg/kg, intratracheal injection), and AU (10 mg/kg) was injected intraperitoneally 30 min ahead. After LPS injection for 6 hours mice were sacrificed, the morphological changes of lung tissues were detected by HE staining and the lung injury score was obtained. The mRNA expression of tumor necrosis factor-α (TNF-α) and interleukin 10 (IL-10) in lung tissue was detected by real-time PCR. The total protein and lactate dehydrogenase (LDH) activity, the cell count, and the protein content of TNF-α and IL-10 in the mouse bronchoalveolar lavage fluid (BALF) were detected.
 Results: Compared with ALI mice, the pathological damage score of lung tissue was significantly reduced in the AU group, the total number of BALF cells, neutrophils, and macrophages were significantly decreased, LDH activity and the total protein content were also significantly decreased (all P<0.01). In addition, AU can reduce the mRNA and protein expression of TNF-α in lung of ALI mice, and increase the mRNA and protein expression of IL-10 (all P<0.01).
 Conclusion: AU can reduce LPS-induced ALI in mice.
Acute Lung Injury ; chemically induced ; Animals ; Bronchoalveolar Lavage Fluid ; Iridoid Glucosides ; Lipopolysaccharides ; Lung ; Male ; Mice ; Tumor Necrosis Factor-alpha