Objective To understand the depression status and its influencing factors of Chenzhou rural widowed elderly with different genders.Methods A random sample of 342 widowed elderly from 30 villages was investigated using the Geriatric Depression Scale and a self-designed questionnaire.Results Widowed elderly depression detection rate was 29.8％,depressive symptoms among elderly women detection rate was 34.7％,higher than men's depressive symptoms detection rate,which was 22.9％.Binary Logistic regression analysis showed:Alone,decreased self-care ability was the common risk factors of depressive symptoms of widowed elderly.The impact on men was bigger than on female.Age,chronic diseases were the main factors affecting depression status of elderly men,and economic security was the main factors affecting the depression status of elderly women.Conclusions The incidence of depressive symptoms in rural widowed elderly is high,but there are differences between widowed elderly with different genders in depression status and influencing factors.Therefore the community workers need to take targeted interventions to promote mental health for the elderly.

Scanning near-field optical microscopy (SNOM) is developing on the base of near-field optical theory and SPM technique, and producing the highest optical resolution to break through the diffraction limit. It is able to study cellular ultrastructure, function and interaction between biomolecules without destructing the living cells. Recent advances in applying SNOM to cellular and molecular biology were introduced in this review.

Objective To study the distribution and clinicopathological characteristics between VEGF-C and pefitumoral lymph vessels density(PLVD) in breast cancer tissue, and to investigate the development and the mechanism of breast cancer-related lymphoedema (BCRL). Methods VEGF-C and VEGFR-3 were detected by using immunohistochemical technique for the detection of VEGF-C and its receptor VEGFR-3 in forty-seven breast cancer specimens. We measured the patients' circumferences of bilateral upper limbs to determine whether there was lymphoedema and made classification in the follow-ups. Results VEGF-C was positive in 33 out of 47 cases. PLVD significantly increased in VEGF-C positive groups (30.39±10. 46) than in negative groups (23.16±11.67) (P<0.05). VEGF-C semi-quantitative score was in a positive correlation with PLVD (r=0.334). The positive expression rate (42.55%) and semi-quantitative score (3.68±1.59) of VEGF-C increased in the lymph node positive group than in the negative group, PLVD increased in the lymph node positive group compared with that in negative group (32.12±10.29 vs. 24.82±11.06), P<0.05. The risk of lymphoedema increased in the VEGF-C negative group (5/14) compared with that in the positive group (3/33) (P<0.05). Conclusion VEGF-C has a high rate of positive expression in breast cancer, and is positively correlated with PLVD. High expression of VEGF-C can reduce the risk of BCRL in breast cancer.

Objective To explore the effects of acupoint application of midnight-noon ebb-flow with hour-prescription of points on dysfunction for sufferers with senile osteoporosis(SOP).Methods In this study,76 patients with SOP in clinic in this hospital were recruited and randomly divided into the experimental group(n=38) and the control group(n=38) in accordance with random number table.Both were on the basic treatment of Caltrate D.The experimental group performed acupoint application of midnight-noon ebb flow with hour-prescription of points,while the control one performed common acupoint application.Oswestry Disability Index(ODI) was used to evaluate the dysfunction before,after 4 weeks and 8 weeks of intervention.SF-36 was adopted to evaluate the patients' quality of life before and after 8 week's intervention.Results The ODI scores of the experimental group after 4 weeks and 8 weeks were lower than those of the control group(P＜0.01).Repeated ANOVA indicated that the scores of ODI in group effect,time effect and interaction effect were of statistical significance(P＜0.01).Further comparison showed that the scores of ODI in three different time sections suggested that the latter time point were lower than those of the former time point(P＜0.01).The scores of eight dimensions of SF-36 after the intervention of the experimental group were higher than those of the control group(P＜0.05).Conclusion The acupoint application of midnight noon ebb flow-with hour-prescription of points can effectively improve the dysfunction whose curative effect enhanced with time increasing and improve the quality of life.

Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.

Objective To label the modified human epidermal growth factor receptor 2 (HER2) affibody with 68Ga at cysteine position of carboxyl-terminal Gly-Gly-Gly-Cys (GGGC) sequence,and to image the mice model bearing HER2-expressed breast cancer with microPET.Methods The HER2 affibody with carboxyl-terminal cysteine was produced by gene engineering.The 1,4,7,10-tetraazacyclododecane-1,4,7-tris-aceticacid (DOTA) was conjugated to the thiol (SH)-group of cysteine by DOTA-10-maleimidoethylacetamide (MMA-DOTA).The newly eluted 68Ga was labeled to DOTA-HER2 affibody at 90 ℃.The labeled mixture was purified by C18 cartridge and eluted with anhydrous alcohol.The purified 68Ga-labeled affibody was prepared for cell binding analysis and microPET imaging.The HER2-expressed breast cancer cells MBA-MD-361 were used to analyze cell binding and establish cancer model with BALB/c nude mice.68Ga-labeled affibody (3.7 MBq) was administered to 4 nude mice with breast cancer via tail vein for microPET imaging at 20 and 60 min post injection.The mice were sacrificed immediately after imaging in unconscious state and their tissue/organs (tumor,muscle,bone and heart) were removed for weighing and radioactivity counting by γ counter.The tumor to normal organ ratios of radioactivity (tumor to liver,muscle,bone and heart)were calculated.Results The purity of HER2 affibody was more than 95％.The radiochemical purity of 68Ga-labeled HER2 affibody was 97％.The KD value (affinity) of 68Ga-labeled HER2 affibody was 1.5 nmol/L in HER2positive cells.MicroPET imaging showed that 68Ga-labeled HER2 affibody could bind HER2-positive cancer rapidly and excreted mainly through urinary system.The radioactivity ratios of tumor to liver,muscle,bone and heart were 17.4±1.0,35.1±10.9,20.7±6.2 and 20.9±4.0,respectively.Conclusions 68Ga could be labeled to HER2 affibody.The 68Ga-labeled HER2 affibody may be useful for PET imaging of HER2-positive tumor.

Objective To investigate the level of the clinical nurses' critical thinking disposition and the competence about nursing ethical decision making,and analyze the relationship between them.Methods A total of 359 clinical nurses were recruited by stratified random sampling method.They were investigated with general situation questionnaire,critical thinking disposition inventory-Chinese version (CTDI-CV) and judgment about nursing decisiors(JAND).Results The total score of CTDI-CV was (285.06±26.79),the total score of JAND was(267.91±16.62).The influencing factors of clinical nurses' competence about nursing ethical decision making was education background,ways of obtaining occupational knowledge,training of nursing ethical decision.The clinical nurses' competence about nursing ethical decision making was positively correlated with critical thinking disposition.Conclusions The level of clinical nurses' critical thinking disposition and competence about nursing ethical decision making are medium,in order to improve the level of competence about nursing ethical decision making,both school education and the continue education among hospital should strengthen the training of nurses' critical thinking disposition.

Objective To assess the effect and feasibility of group reminiscence therapy on depression in the elderly.Methods We searched the Cochrane Central Register of Controlled Trials (-2013),Medline (1982-2013),Embase (1974 2013),AMED (-2013),CINAHL(-2013),CMB (1994-2013),VIP,CNKI and Wanfang to collect the randomized controlled trials (RCTs) in which the group reminiscence therapy was used to treat depression in elderly patients.The studies were selected according to the inclusion and exclusion criteria by two reviewers,and the quality of included studies was evaluated according to Cochrane Handbook and performed meta analyses by using the Cochrane Collaboration's RevMan 5.2 software.Results A total of 10 RCTs involving 944 patients were included.The results of meta-analysis showed that as compared with conventional treatment,group reminiscence therapy on the basis of conventional treatment was more effective in decreasing depression score [MD=-4.86,95 ％ C I(-5.10,-4.65)].Compared with psychological counseling,group reminiscence therapy had more effect on decreasing depression score [MD=-9.34,95％ CI (-10.77,-7.91)].There was no significant difference in the dropout rate between group reminiscence therapy and other control treatments [RR=1.22,95％ CI (0.79-1.88)].The descriptive analysis showed that group reminiscence therapy was effective in alleviating the symptoms of depression.Conclusions Group reminiscence therapy can improve the symptoms of depression in elderly patients and conforms to the principle of economic benefit.However,the results should be interpreted with caution because of the low quality of the included studies.

Objective To evaluate the efficacy ofintravitreal injection (IVI) ofexpansile gas alone to treat idiopathic full-thickness macular hole (FTMH).Methods This is a prospective interventional case series.Twenty FTMH patients (26 eyes) who underwent IVI with expansile gas alone were enrolled in this study.There were 5 males (5 eyes) and 21 females (21 eyes),with the mean age of (59 ± 12) years.All patients received the best corrected visual acuity (BCVA),slit lamp microscope,indirect ophthalmoscopy,fundus color photography and three-dimensional optical coherence tomography (OCT) examinations.The BCVA was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution visual acuity.The diameters of macular holes and the interface between vitreous and macular were observed by OCT (Topcon,OCT-2000).Based on the diameter,the holes were classified as small FTMH (equal or lesser than 250 μm),medium FTMH (more than 250 μm but equal or lesser than 400 μm) and large FTMH (more than 400 μm).The mean BCVA was 0.85 ± 0.29.There were 7,10 and 9 eyes with small,medium and large FTMH.There were 10 eyes with vitreous-macular traction (VMT).All the eyes received IVI of 0.2 ml C3F8 followed facedown positioning for 7-14 days.The follow-up ranged from 1 to 23 months.The BCVA,FTMH closure and complications were observed.If holes failed to close at 1 month after IVI,vitrectomy combined with internal limiting membrane (ILM) peeling and C3F8 tamponade would be performed for these eyes.Results FTMHs was able to close in 17/26 eyes (65.4％) had hole closure,failed to close in 9/26 eyes (34.6％).All 10 eyes with VMT achieved vitreous-macula separation after IVI of gas.The eyes failed in the closure initially with IVI of gas alone,all succeed with hole closure after vitrectomy combined with ILM peeling and C3F8 tamponade.The closure rate of small (6 eyes),medium (8 eyes) and large FTMH (3 eyes) was 85.7％,80.0％ and 33.3％ respectively.The diameter of FTMHs in holes-closure eyes and failed-closure eyes was (307.8 ± 122.8),(431.6± 128.4) μm respectively,the difference was significant (t=-2.407,P=0.024).VMT was found in 6 eyes and 4 eyes in holes-closure group and failed-closure group,respectively,the difference was significant (t=-2.196,P=0.038).The mean preoperative BCVA was 0.51 ±0.36.There was a significant difference between pre-and postoperative BCVA (t=4.758,P＜ 0.05).Two eyes developed local retinal detachment,which achieved hole closure and retinal reattachment after vitrectomy.Conclusion IVI of expansile gas alone is an effective way in treating FTMH with a diameter smaller than 400 μm and with VMT before surgery.

AIM: To study the cytoskeleton of mesench ymal stem cells (MSCs), the ultrastructure and function relationship by using atomic force microscope (AFM). METHODS: The ultrastructures and morphological feature of MSCs c ultured for 1 d and 5 d were studied by AFM. RESULTS: The special structures that possess peculiar morphologi cal characteristic of MSCs such as cytoskeleton, pseudopod, microfilament etc we re identified by AFM, and these special structures are difficult to observe unde r electronic microscopy or other conventional optical microscopy. CONCLUSIONS: AFM is a powerful tool to study ultrastructures, mo rphological features, and cytoskeleton of stem cells in near physiological condi t ions. Its application prospect in cellular biology is extensive. The special cyt oskeleton and other structures of MSCs observed above may represent the structur al base of multi-differentiation potential of MSCs.