As a type of experiential psychotherapy,Satir communication model can help the individual system and the family system achieve a state from dysfunction to healthy function,which can enrich the intervention connotation of family support and provide a new direction for the realization of full-life circle care.This paper aims to introduce the concept,core elements,common treatment techniques,application and effects,current challenges and relevant suggestions of Satir communication model in the nursing field from the perspective of family support,in order to provide references for the localization development and clinical integration of Satir communication model in the field of nursing in China.

BACKGROUND: China bears the biggest atrial fibrillation (AF) burden in the world. However, little is known about the incidence and predictors of AF. This study aimed to investigate the current incidence of AF and its electrocardiographic (ECG) predictors in general community individuals aged over 60 years in China. METHODS: This was a prospective cohort study, recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District, Shanghai, China. The subjects were then followed up from 2015 to 2019 annually. Data on sociodemographic characteristics, medical history, and the resting 12-lead ECG were collected. Kaplan-Meier curve was used for showing the trends in AF incidence and calculating the predictors of AF. Associations of ECG abnormalities and AF incidence were examined using Cox proportional hazard models. RESULTS: This study recruited 18,738 subjects, and 351 (1.87%) developed AF. The overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 person-years. Multivariable Cox regression analysis indicated age (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.06-1.09; P < 0.001), male (HR, 1.30; 95% CI: 1.05-1.62; P = 0.018), a history of hypertension (HR, 1.55; 95% CI: 1.23-1.95; P < 0.001), a history of cardiac diseases (HR, 3.23; 95% CI: 2.34-4.45; P < 0.001), atrial premature complex (APC) (HR, 2.82; 95% CI: 2.17-3.68; P < 0.001), atrial flutter (HR, 18.68; 95% CI: 7.37-47.31; P < 0.001), junctional premature complex (JPC) (HR, 3.57; 95% CI: 1.59-8.02; P = 0.002), junctional rhythm (HR, 18.24; 95% CI: 5.83-57.07; P < 0.001), ventricular premature complex (VPC) (HR, 1.76; 95% CI: 1.13-2.75, P = 0.012), short PR interval (HR, 5.49; 95% CI: 1.36-22.19; P = 0.017), right atrial enlargement (HR, 6.22; 95% CI: 1.54-25.14; P = 0.010), and pacing rhythm (HR, 3.99; 95% CI: 1.57-10.14; P = 0.004) were independently associated with the incidence of AF. CONCLUSIONS The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China. Among various ECG abnormalities, only APC, atrial flutter, JPC, junctional rhythm, short PR interval, VPC, right atrial enlargement, and pacing rhythm were independently associated with AF incidence.
Humans ; Male ; Middle Aged ; Aged ; Atrial Fibrillation/epidemiology* ; Prospective Studies ; Incidence ; Atrial Flutter/complications* ; Risk Factors ; China/epidemiology* ; Electrocardiography

Objective:To investigate the clinical pathological and epidemiological characteristics of primary esophageal malignant melanoma (PMME).Methods:The clinical pathology data of 180 PMME patients in the esophageal cancer database of the key laboratory of esophageal cancer research in Henan Province from 1973 to 2016 were collected, of which 136 were male, aged (58.5±9.0) years, 44 were female, aged (56.7±12.2) years. Kaplan-Meier and Log rank test were used for survival analysis, Cox regression scale model was used for risk factor analysis.Results:The incidence of PMME is 0.036% (180/500, 000), mostly were male (about 3∶1 for men: female). The common sites of PMME were the lower part of the esophagus (48.9%, 85/174), followed by the middle section of the esophagus (46.0%, 80/174) and the upper part of the esophagus (5.2%, 9/174). No black particles were seen in the PMME cells of 3 patients under microscope, and strong positive expressions of Melan-A and HMB453 were observed in these 3 patients by immunohistochemical results. Of the 129 patients who had a routine preoperative esophageal biopsy, 69 were undiagnosed with PMME (53.5%). The medium survival time of the whole group was 7.9 months, and the survival rates of 1, 2, 3, 5 years were 25.0%, 7.9%, 6.6% and 1.3%, respectively. The univariate analysis showed that N, M, TNM phase and radiotherapy were related to the overall survival of patients ( P<0.05). Multivariate analysis showed that TNM phase and radiotherapy were the independent risk factors for overall survival of patients ( P<0.05). Conclusions:PMME is more common in men, the common site of the disease is the lower part of the esophagus. The preoperatively missed diagnosis rate of Chinese PMME is high. TNM phase and radiotherapy are the independent risk factors for overall survival of patients.

Objective:To investigate the clinical pathological and epidemiological characteristics of primary esophageal malignant melanoma (PMME).Methods:The clinical pathology data of 180 PMME patients in the esophageal cancer database of the key laboratory of esophageal cancer research in Henan Province from 1973 to 2016 were collected, of which 136 were male, aged (58.5±9.0) years, 44 were female, aged (56.7±12.2) years. Kaplan-Meier and Log rank test were used for survival analysis, Cox regression scale model was used for risk factor analysis.Results:The incidence of PMME is 0.036% (180/500, 000), mostly were male (about 3∶1 for men: female). The common sites of PMME were the lower part of the esophagus (48.9%, 85/174), followed by the middle section of the esophagus (46.0%, 80/174) and the upper part of the esophagus (5.2%, 9/174). No black particles were seen in the PMME cells of 3 patients under microscope, and strong positive expressions of Melan-A and HMB453 were observed in these 3 patients by immunohistochemical results. Of the 129 patients who had a routine preoperative esophageal biopsy, 69 were undiagnosed with PMME (53.5%). The medium survival time of the whole group was 7.9 months, and the survival rates of 1, 2, 3, 5 years were 25.0%, 7.9%, 6.6% and 1.3%, respectively. The univariate analysis showed that N, M, TNM phase and radiotherapy were related to the overall survival of patients ( P<0.05). Multivariate analysis showed that TNM phase and radiotherapy were the independent risk factors for overall survival of patients ( P<0.05). Conclusions:PMME is more common in men, the common site of the disease is the lower part of the esophagus. The preoperatively missed diagnosis rate of Chinese PMME is high. TNM phase and radiotherapy are the independent risk factors for overall survival of patients.

Objective: To evaluate the efficacy and safety of intravenous thrombolysis with recombinant tissue-plasminogen activator (rt-PA) in elderly patients with early-stage mild ischemic stroke (IS). Methods: This was a prospective, open-label, controlled study.Ninety-four elderly patients with mild IS admitted to our hospital from January 2014 to December 2017 were randomized into a thrombolysis arm (TA, n=46) and a control arm (CA, n=48). The short-term endpoints were the National Institutes of Health stroke scale (NIHSS) scores on 3^rd, 7^th, 14^thday after admission and the secondary endpoints were the modified Rankin Scale (mRS) score and the morbidity of recurrence IS within 90 days.Safety was evaluated by the incidence of intracranial hemorrhage (IH) and early neurological deterioration (END) during hospitalization. Results: The baseline NIHSS scores of patients in the TA and CA groups were similar [(4.1±0.7) vs.(4.1±0.7)]. However, there were significant differences in the NIHSS score on 3^rd [(3.4±1.2) vs.(4.2±1.4)], 7^th[(3.0±1.8) vs.(4.1±1.6)] and 14^thday [(2.5±2.0) vs.(3.4±1.6)], respectively, between the TA group and the CA group.Furthermore, the TA group was associated with a significantly higher proportion of patients with good prognosis (mRS, 0-2), compared with the CA group (71.7% vs.35.4%, P<0.01). Receiver operating characteristic curve analysis showed that patients with baseline NIHSS>3 could benefit from thrombolytic therapy.There were 1 case of symptomatic IH and 1 case of progressive stroke in the TA group, and 1 case of IH and 2 cases of progressive stroke in the control group.There were no significant differences in the rate of either END or IH between the two groups (P>0.05). Two patients in the TA group and three patients in the control group had recurrent IS within 90 days and the recurrence rate of IS was also similar within 90 days (P>0.05). Conclusions Intravenous thrombolytic therapy with rt-PA can improve the prognosis of elderly patients with mild stroke without increased risk of END, IH, or recurrence of IS.

Objective To analyze the influence of care ability of family caregivers on the readmission of stroke patients.Methods A total of 139 stroke patients and their family caregivers were followed up for 90 d.The information of patients diseases were collected by general questionnaire,and Chinese version of family care ability scale nameed family care test inventory,(FCTI) was used to evaluate the caregivers'ability,and the number of rehospitalization at 30,90 d after discharge was investigated.Results Out of 139 patients with stroke,there were 12 (8.63％) rehospitalized patients at 30 d after discharge,and 22 (15.83％) at 90 d.The scores of family caregivers'care ability in patients who had rehospitalization at 30,90 d were higher than that of non rehospitalized patients (P ＜ 0.05).Conclusion Chinese version of family care ability scale (FCTI) investigation shows that the higher of caregivers ability scores is,the lower care ability is.So stroke patients at 30,90 d in patients with stroke are more inclined to readmission.

Objective To analyze the influence of care ability of family caregivers on the readmission of stroke patients.Methods A total of 139 stroke patients and their family caregivers were followed up for 90 d.The information of patients diseases were collected by general questionnaire,and Chinese version of family care ability scale nameed family care test inventory,(FCTI) was used to evaluate the caregivers'ability,and the number of rehospitalization at 30,90 d after discharge was investigated.Results Out of 139 patients with stroke,there were 12 (8.63％) rehospitalized patients at 30 d after discharge,and 22 (15.83％) at 90 d.The scores of family caregivers'care ability in patients who had rehospitalization at 30,90 d were higher than that of non rehospitalized patients (P ＜ 0.05).Conclusion Chinese version of family care ability scale (FCTI) investigation shows that the higher of caregivers ability scores is,the lower care ability is.So stroke patients at 30,90 d in patients with stroke are more inclined to readmission.

Objective To analyze the efficacy and safety of tetrandrine in the adjuvant treatment of relapsed/refractory acute leukemia (except M3).Methods A total of 58 patients with relapsed/refractory acute leukemia (except M3) admitted to six tertiary hospitals in Jiangsu Province from January 2015 to December 2017 were included in this study.The tetrandrine-adjuvant standard chemotherapy regimen and standard chemotherapy regimen were given to treatment and control groups respectively.There were 17 and 41 patients in treatment and control groups.The treatment group was given tetrandrine for 5 days before the use of standard chemotherapy.The dose of tetrandrine was 4 mg ·kg-1 ·d-1,and patients had continuous oral administration of 5 days.After that,the patients in the treatment group started chemotherapy immediately.On the other side,the control group received standard chemotherapy without any other multidrug reversal medicine.Then the clinical efficacy and safety outcomes in both groups were analyzed.Results In the treatment group,5,3,and 9 cases achieved complete remission (CR),partial remission (PR),and nonremission (NR) respectively,and the total effective (CR+PR) rate was 47.06 ％ (8/17);in the control group,14,10,and 17 cases achieved CR,PR,and NR,and the total effective rate was 58.54 ％ (24/41).There was no significant difference in the total effective rate between the two groups (x2 =0.64,P =0.424).There was no significant difference in the efficacy between the two groups of patients with different genders (P ＞ 0.05).When the disease duration was 6-11 months,the difference of efficacy between the two groups was statistically significant (P =0.041).There was no significant difference in the proportion of myeloid leukemia cells,white blood cell count,platelet count,red blood cell count,and hemoglobin between the two groups before and after treatment (all P ＞ 0.05).There was no significant difference in clinical safety indicators (urine,faecal routine,liver and kidney function,and electrocardiogram) between the two groups (all P ＞ 0.05).Conclusions Tetrandrine is more effective in patients with relapsed/refractory acute leukemia (except M3) with shorter duration of disease.Compared with chemotherapy alone,the clinical efficacy of adding tetrandrine in chemotherapy cannot be considered superior to the former.

Objective To investigate the value of ischemic modified albumin (IMA) and microRNA-126 (miR-126) in diagnosis of posterior circulation transient ischemic attack (PTIA) and in prediction of secondary cerebral infarction.Methods The clinical materials of 112 patients with PTIA were retrospectively analyzed.Serum IMA and miR-126 levels were measured at 3,6 and 12 h,and the correlation between serum IMA,miR-126 levels and PTIA as well as secondary cerebral infarction was analyzed by ABCD2 score.Results Serum IMA level was (54.19 ± 10.10) U/L in 80 healthy controls,and were (85.81 ±20.21),(62.98 ±12.79),(57.66 ±13.39) U/L at 3,6 and 12 h,respectively,in 112 patients with PTIA.and its levels of miR-126 at 6,12 h after PTIA attack were significantly decreased compared with (9.35 ± 1.76) in the healthy controls(P =0.036,P =0.001).In the patients with PTIA,the level of IMA at 3 h was negatively correlated with the level of miR-126 at 12 h (r =-0.3 13,P =0.0 00).When IMA and miR-12 6 levels were 6 7.5 2 U / L and 8.64,the sensitivity and specificity were 73.20,96.20,82.10,81.20,respectively.The followed up was lasted for 30 days in 112 patients with PTIA,and there were 11 cases (9.82％) with secondary cerebral infarction within 7 days,17 cases (15.18％) within 8 to 30 days.The relative risk rate of IMA level at 3 h and miR-126 level at 12 h in secondary ischemic stroke after PTIA were Rr =8.45,9.84;CI:1.10 to 65.03,1.13 to 86.02;P =0.040,0.039.Conclusion The early detection of IMA and miR-126 levels is of great value in diagnosis of PTIA and in prediction of secondary cerebral infarction.

Objective To investigate the value of ischemic modified albumin (IMA) and microRNA-126 (miR-126) in diagnosis of posterior circulation transient ischemic attack (PTIA) and in prediction of secondary cerebral infarction.Methods The clinical materials of 112 patients with PTIA were retrospectively analyzed.Serum IMA and miR-126 levels were measured at 3,6 and 12 h,and the correlation between serum IMA,miR-126 levels and PTIA as well as secondary cerebral infarction was analyzed by ABCD2 score.Results Serum IMA level was (54.19 ± 10.10) U/L in 80 healthy controls,and were (85.81 ±20.21),(62.98 ±12.79),(57.66 ±13.39) U/L at 3,6 and 12 h,respectively,in 112 patients with PTIA.and its levels of miR-126 at 6,12 h after PTIA attack were significantly decreased compared with (9.35 ± 1.76) in the healthy controls(P =0.036,P =0.001).In the patients with PTIA,the level of IMA at 3 h was negatively correlated with the level of miR-126 at 12 h (r =-0.3 13,P =0.0 00).When IMA and miR-12 6 levels were 6 7.5 2 U / L and 8.64,the sensitivity and specificity were 73.20,96.20,82.10,81.20,respectively.The followed up was lasted for 30 days in 112 patients with PTIA,and there were 11 cases (9.82％) with secondary cerebral infarction within 7 days,17 cases (15.18％) within 8 to 30 days.The relative risk rate of IMA level at 3 h and miR-126 level at 12 h in secondary ischemic stroke after PTIA were Rr =8.45,9.84;CI:1.10 to 65.03,1.13 to 86.02;P =0.040,0.039.Conclusion The early detection of IMA and miR-126 levels is of great value in diagnosis of PTIA and in prediction of secondary cerebral infarction.