Objective To survey the social support status and demands for family caregivers of the disabled elderly.Methods A cross-sectional survey based on convenience sampling was conducted among 779 disabled elderly and their family caregivers from May to June 2013 in five communities of Beijing Dongcheng District.Barthel index was used to measure the degree of functional impairment of the elderly.Self-rating Depression Scales (SDS) was used to evaluate depression symptoms of caregivers.Social Support Rating Scale (SSRS) and social support demand questionnaire were used to measure the social support status and social support demands of caregivers,respectively.Multiple linear regression analysis was used to analyze the influence factors of social support.Results Total 779 caregivers were identified and 744 caregivers completed the questionnaires with a valid response rate of 95.5％.Among 744 family caregivers the social support levels were low with an average SSRS score of 31.16 ± 6.86.There were significant differences in SSRS scores among caregivers of disabled elderly with different characteristics (age,married status and the Barthel index score) (all P ＜ 0.05);and there were significant differences in SSRS scores among caregivers with different characteristics (age,educational level,married status,current employment,relationship with patients,caregiving time daily,subjective care burden,living with patients,number of caregivers and depression status) (all P ＜ 0.05).Multiple linear regression analysis showed that the Barthel index score of the disabled elderly,the relationship with the elderly,depression status of the caregivers and the subjective care burden were correlated with the social support level of family caregivers (all P ＜0.05);the standard regression coefficients of above significant factors were 0.098,0.190,0.134 and 0.155,respectively.The social support demands of family caregivers were various;the average score was 2.44 ± 0.64,the top three demands were provision of care subsidy for the disabled elderly (average score was 2.95 ± 0.93),provision of care allowance for family caregivers (average score was 2.90 ± 0.93) and the guidance of safe medication (average score was 2.83 ± 0.83).Conclusions Family caregivers for the disabled elderly obtain low level social support in the surveyed area.Since the earegivers have various social support demands,the social support and assistance for them should be specific,effective and comprehensive.

Objective To investigate the effect of community comprehensive intervention on health behavior and self-rated health status among family caregivers of disabled elderly.Methods One hundredand twenty family caregivers of disabled elderly were selected from community health service centers of Beijing Dongcheng District,and were given 6 month-comprehensive community intervention (intervention group);121 family caregivers of disabled elderly from another community were selected as the control group.The knowledge and skills of caregiving,health behaviors (daily exercise time,daily relaxation time) and self-rated health status were evaluated before and 6 months after intervention.Results The knowledge and skill scores in intervention group were improved by 50.781 points,the daily exercise time and daily relaxation time were prolonged by 0.491 h and 0.837 h,respectively after the intervention (all P＜0.05).There was no significant difference in self-rated health status of two groups before and after intervention (P ＞0.05).Conclusion Community comprehensive intervention improves the knowledge and skills of caregiving,and the health behaviors among family caregivers of disabled elderly,but the intervention measures does not impact the self-rated health status of family caregivers.

Objective To explore the relationship between care burden and social support among family caregivers of disabled elders in Beijing urban area.Methods A cross-sectional survey based on convenience sampling was conducted among 744 family caregivers in Dongcheng District in Beijing urban area.All subjects were interviewed by the Zarit Burden Interview (ZBI),Social Support Rating Scale (SSRS) and general social and demographical material lists.And then we analyzed the correlation between social support and care burden.Results The mean scores of ZBT and SSRS were (40.3 ± 15.2) and (31.1 ± 6.9)respectively.And a negative correlation existed between the level of caregiver burden and total social support.The care burden of disability elders was negatively associated with objective support,subjective support and social support availability (P ＜ 0.05).Conclusions There is a close relationship between care burden and social support among family caregivers of disabled elders.The more objective support,subjective support and social support availability the caregivers acquire,the less burden they bear.

Objective To compare the outcomes of homeopathic bidirectional-traction reduction device and traction table in surgical treatment of femoral intertrochanteric fractures.Methods A retrospective case control study was made on 94 cases of femoral intertrochanteric fractures treated from July 2015 to December 2015.There were 26 males and 68 females,aged 60-75 years.According to the Evans classification,the fractures were type Ⅱ in 24 cases,type Ⅲ in 32 and type Ⅳ in 38.Fifty-seven cases sustained chronic diseases.According to the random number table,the subjects were assigned to receive homeopathic bidirectional-traction reduction (homeopathic reduction group,48 cases) and traction table reduction (control group,46 cases).All fractures were fixed with proximal femoral nail antirotation.Operation time,reduction time,tluoroscopy time,blood loss and rate of closed reduced cases were recorded.Fracture union and rotation of the affected femur to the tibia were detected after operation.Functional outcome was evaluated using the Harris score at the final follow-up.Results All fractures were reduced closely in homeopathic reduction group,while 15 fractures in control group were reduced via a small-incision anterior approach.Operation time,reduction time and fluoroscopy time in homeopathic reduction group were (62.9 ± 12.1) min,(6.8 ± 1.5) min and (11.3 ± 5.6) s respectively,significantly less than the corresponding data in control group (all P ＜ 0.05).One month after operation,rotation of the affected femur to the tibia was (2.8 ± 1.2) ° in homeopathic reduction group,significantly less than that in control group [(11.5 ± 4.7) °] (P ＜ 0.05).Bone union was observed in all cases.At the final follow-up,Harris hip score was (92.6 ± 7.6)points in homeopathic reduction group,significantly higher than that in control group [(87.3 ± 6.5) points] (P ＜ 0.05).Conclusion For the elderly patients with intertrochanteric fractures,homeopathic bidirectional-traction device has advantages of high rate of closed reduction,shorter operation time,less radiological exposure and satisfactory function recovery of the affected hip joint.

Objective To establish a stable and reliable model of brain death in swine, and to provide a more stable model for investigating pathomorphology in brain tissue and for studying transplantation immunology during brain death. Methods Base on the classic methodology of increasing epidural intracranial pressure, Codman intracranial pressure moni-toring probes were implanted in landrace pigs invasively. According to the relationship between ICP and MAP, brain death models were established by increasing intracranial pressure slowly and intermittently, with real-time monitoring of the intra-cranial pressure. Results Among twelve experimental landrace pigs, one died from anesthetic accident, while the rest elev-en were successfully established as brain death models. With effective respiratory and circulatory support, those brain death models can be maintained for (31.3 ± 4.7) h. Brain death model establishement is a stable and reliable process demonstrated by transcranial Doppler, EEG, ECG, mean arterial blood pressure and other monitoring methods. After brain death is con-firmed, animal models can be maintained for a long time. Conclusion Our methodology of inducing brain death model un-der ICP monitoring is stable and easy to be standardized. It can also provide a more stable model for studying brain tissue pathomorphology and transplantation immunology.

Ipsilateral femoral neck and shaft fractures are rare injuries,which are often caused by high-energy trauma and combined with multiple injuries,such as thoracic and abdominal injury,head injuries,and fractures of other sites.Delayed or missed diagnosis of the ipsilateral femoral neck fracture often occurs.When patients with femoral shaft fractures caused by high-energy trauma are admitted into hospital,physical examination should be conducted carefully.In addition to femoral shaft fractures,radiographs of the ipsilater hip and knee joints should been taken,simultaneously taking into consideration the potential effect of anteversion angle on the demonstration of femoral neck fracture.Computed tomograph and magnetic resonance imaging are advised to perform if necessary to facilitate early and accurate diagnosis of ipsilateral femoral neck fracture.Comprehensive evaluation should be done based on age,physical condition,associated injuries as well as fracture site,classification and injury severity.Accordingly,proper and reasonable surgical plan is made.During the operation,anatomical reduction of the fractures,especially femoral neck fractures,should be achieved,and then fixed with appropriate internal implants.Besides,attention should also be paid to the treatment of associated injuries as well as the prevention and management of complications.

Ipsilateral femoral neck and shaft fractures are rare injuries,which are often caused by high-energy trauma and combined with multiple injuries,such as thoracic and abdominal injury,head injuries,and fractures of other sites.Delayed or missed diagnosis of the ipsilateral femoral neck fracture often occurs.When patients with femoral shaft fractures caused by high-energy trauma are admitted into hospital,physical examination should be conducted carefully.In addition to femoral shaft fractures,radiographs of the ipsilater hip and knee joints should been taken,simultaneously taking into consideration the potential effect of anteversion angle on the demonstration of femoral neck fracture.Computed tomograph and magnetic resonance imaging are advised to perform if necessary to facilitate early and accurate diagnosis of ipsilateral femoral neck fracture.Comprehensive evaluation should be done based on age,physical condition,associated injuries as well as fracture site,classification and injury severity.Accordingly,proper and reasonable surgical plan is made.During the operation,anatomical reduction of the fractures,especially femoral neck fractures,should be achieved,and then fixed with appropriate internal implants.Besides,attention should also be paid to the treatment of associated injuries as well as the prevention and management of complications.

Objective To observe the effect of yin-tonifying and fire-removing prescription on IL-10 and IL-18 in systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency.Methods A total of 86 systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency were enrolled and randomly divided into control group and research group,43 cases in each group.The control group was treated with conventional western medicine,while research group was treated with yin-tonifying and fire-removing prescription on basis of control group.The TCM symptom score,serum IL-10 and IL-18 levels and the incidence rate of adverse reactions were compared between the two groups.The clinical efficacy of the two groups was evaluated.Results Mter treatment,the levels of IL-10 and IL-18 in both group decreased significantly,and the levels in research group were significantly lower than control group (P ＜ 0.05).The total effective rate was 95.35％ in research group,which was significantly higher than 69.77％ in the control group (P ＜ 0.05).The incidence rate of adverse reactions was 6.98％ in the research group,whichwas similar to 9.30％ in the control group (P ＞ 0.05).Conclusion For systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency,yin-tonifying and fire-removing prescription can significantly improve the clinical efficacy,alleviate clinical symptoms,and will not increase the incidence rate of adverse reactions.

Objective To observe the effect of yin-tonifying and fire-removing prescription on IL-10 and IL-18 in systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency.Methods A total of 86 systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency were enrolled and randomly divided into control group and research group,43 cases in each group.The control group was treated with conventional western medicine,while research group was treated with yin-tonifying and fire-removing prescription on basis of control group.The TCM symptom score,serum IL-10 and IL-18 levels and the incidence rate of adverse reactions were compared between the two groups.The clinical efficacy of the two groups was evaluated.Results Mter treatment,the levels of IL-10 and IL-18 in both group decreased significantly,and the levels in research group were significantly lower than control group (P ＜ 0.05).The total effective rate was 95.35％ in research group,which was significantly higher than 69.77％ in the control group (P ＜ 0.05).The incidence rate of adverse reactions was 6.98％ in the research group,whichwas similar to 9.30％ in the control group (P ＞ 0.05).Conclusion For systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency,yin-tonifying and fire-removing prescription can significantly improve the clinical efficacy,alleviate clinical symptoms,and will not increase the incidence rate of adverse reactions.

Ghrelin is a hormone produced by the stomach that regulates energy metabolism after acting on the central nervous system.Cocaine amphetamine-regulated transcriptional peptide(CART)neurons participate in the regulation of feeding behavior and energy balance.It is known that CART neurons are influenced by hormones to regulate energy homeostasis,but whether ghre-lin exerts its pro-appetite function by influencing CART neurons is unknown.Therefore,this study focuses on the role of VMHCART neurons in the regulation of feeding and relative body weight by ghrelin.Firstly,the whole brain expression of CART was determined by immunofluorescence.Then the effect of intraperitoneal injection of ghrelin on the expression of DMHCART neurons was evalua-ted.Finally,the ghrelin was delivered to DMH and the changes of food intake and relative body weight of mice were measured.CART immunoreactive neurons were detected in medial preoptic nucleus(MPA),arcuate nucleus(ARC),dorsomedial hypothalamic nucleus(DMH),thalamic pa-raventricular nucleus(PVT)and raphe nucleus(ROb).Compared with the control group,periph-eral injection of ghrelin significantly increased the expression of DMHC ART immunoreactive neurons(P=0.037 3).DMH long-term injection of ghrelin resulted in an increase in body weight(P=0.004 0)and feed intake(P=0.023 1).The results provide anatomical evidence for the whole brain distribution of CART,which proves that ghrelin affects feed intake and body weight of mice through CART neurons in DMH,suggesting that specific neuron types and regional specificity are involved in ghrelin regulation of feed intake and energy homeostasis.