The rational drug use of elderly patients with chronic diseases had many problems which seriously affect the live and life safety of patients.To convey the importance of rational drug use from the perspective of humanistic care for patients can help to improve the treatment compliance of patients,promote the ability of self-management and build a harmonious doctor-patient relationship.Medical staff should pay attention to enhance the care for the elderly patients,optimize drug treatment programs,improve diversified social support systems and use various medium and forms to propaganda the knowledge of rational drug use.

BACKGROUND: Sleep deprivation cannot only cause learning and memory impairment of animal and human, but also lead to increased content of nitric oxide in brain tissue of rats. Melatonin has the effects of antifreeradical and antioxidation. It has been reported that melatonin can improve aluminum chloride and morphine abstinence induced learning and memory impairment of animal, however, whether it has influence on sleep deprivation induced learning and memory impairment is not very clear. OBJECTIVE: To observe the effect of melatonin on memory of rats after sleep deprivation and analyze its possible mechanism. DESIGN: Randomized controlled trial.SETTING: Teaching and Experiment Center of Basic Medicine and Department of Nursing, the Fourth Military Medical University.MATERIALS: The experiment was performed in Teaching and Experiment Center of Basic Medicine of the Fourth Military Medical University in January 2005. A total of 24 adult male Sprague Dawley rats were selected and randomly divided into 3 groups, namely, control group, small dosage of melatonin group and large dosage of melatonin group, with 8 in each group on the basis of random digits table.METHODS: To rats in small dosage of melatonin group and large dosage of melatonin group, the dosage of melatonin was 5 mg/kg and 15 mg/kg respectively, which was made into 2 mL solution and intraperitoneally injected into the rats at 17:00 o'clock every day, while rats in control group were injected with 2 mL physiological sodium at the same time, once a day for continuous 7 days. Then a 3-day sleep deprivation was given to the rats; melatonin or physiological sodium were also given according to different groups during these days. Rat model of sleep deprivation was established by "Flower Ppot" technique; water maze was used for detecting the memory of rats after 48-hour and 72-hour sleep deprivation; took escape latency (s) as indicator of changes of learning and memory of rats; the shorter the escape latency, the better the spacial memory of rats. When sleep deprivation was finished, all the rats were put to death and hippocampus and cerebral cortex were taken out in ice bath. The content of nitric oxide in cerebral cortex and hippocampus was detected with the method of nitrate reduction, and malondialdehyde (MDA) with the method of thiobarbital acid.MAIN OUTCOME MEASURES: Results of escape latency after 48hour and 72-hour sleep deprivation. Contents of nitric oxide and MDA in cerebral cortex and hippocampus of rats.There was significant difference in escape latency in water maze after 48-hour and 72-hour sleep deprivation among each group (F=11.886, P=0.000)and (F=5.440, P=0.012); the escape latency after 48-hour and 72-hour sleep deprivation remarkably decreased both in small and large dosage of melatonin groups as compared with control group, and the latency after 48-hour sleep deprivation was shorter in large dosage group than that in small ide and MDA in brain of rats among each group, namely, nitric oxide in cerebral cortex (F=14.038, P=0.000), MDA in cerebral cortex (F=27.414,P=0.000), nitric oxide in hippocampus (F=22.692, P=0.000), MDA in hippocampus (F=14.316, P=0.000). Compared with control group, the contents of nitric oxide and MDA in cerebral cortex and hippocampus in the two experimental groups decreased significantly, and there was obvious difference in the content of nitric oxide in hippocampus between large and small dosage groups, which showed a dose-effect relationship.CONCLUSION: Melatonin can improve memory impairment of rats after sleep deprivation, which may be closely related to the effect of inhibiting the increase of nitric oxide and MDA in their cerebral cortex and hippocampus.

BACKGROUND: Poor mental health status of nursing students can affect their learning and living. OBJECTIVE: To explore mental health status of nursing students at different studying stages.DESIGN: Grouping stratified sampling survey on the basis of nursing students studying in higherschool.SETTING: Nursing Department of the Fourth Military Medical University of Chinese PLA, Laboratory Center of Basic Faulty, and Department of Rehabilitative Physioltherapy of Xijing Hospital.PARTICIPANTS: Totally 515 nursing students at different studying stages of three educational levels (the technical secondary school level, junior college level and undergraduate level) were observed with grouping stratified sampling in December 2004.METHODS: Symptom checklist-90(SCL-90) was used for survey. SCL-90 contained 90 items, being interpreted in the context of nine symptom dimensions, including somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Each item was scored from grade Ⅰ to grade Ⅴ (symptomless, mild, moderate, little severe, and severe). Scores of total items and 9 symptoms were recorded. The more the scores of total items were, the lower the total level of mental health was; the more the scores of any symptom was, the severer the symptom of mental health was. Data were analyzed with t test. MAIN OUTCOME MEASURES: Scores of total items and 9 symptoms. RESULTS: Totally 515 nursing students were randomly selected in this survey except 5 students because of uncompleted survey, and the response rate was 99.0%. There were 501 qualified questionnaires, which were accounted for 98.2%. Mental health status of nursing students at various stages was different: the score of nursing students in grade 1 and 3 was higher than that in grade 2 in technical secondary school; the score of nursing students was the highest in grade 2 in junior college; and the score of nursing students was the highest in grade 3 at undergraduate level. The order of SCL-90 scores was obsessive-compulsive, interpersonal sensitivity and depression from high to low.CONCLUSION: SCL-90 scores of nursing students are high in grade 1and grade 3 at the technical secondary school level and also in middle grade at junior college level and undergraduate level. The main mental psychological symptoms are obsessive-compulsive, interpersonal sensitivity and depression. Psychological predisposition of nursing students should be cultured according to different psychological characteristics at various learning stages.

Objective To investigate the incidence and influencing factors of depression in empty-nest elderly, so as to provide evidence for reducing depression in empty-nest elderly. Methods During July to August 2016, the elderly over 60 years old in Shaanxi Province, including 504 empty-nest elderly and 194 non-empty-nest, were selected convenience sampling method. The Geriatric Depression Scale (GDS), Social Support Scale, and self-designed questionnaire about the general condition were used. ANOVA was applied to analyze the depression scores; Pearson correlation analysis was used to analyze the relation between social support and depressive symptoms; and Logistic regression analysis had been used to analyze the influencing factors of depression. Results The detection rate on depression of empty-nest elderly was 45.63%, and that of the non-empty-nest elderly was 32.99%, the difference was statistically significant (χ2=10.447,P< 0.05). The scores of GDS of the empty-nest and non-empty-nest elderly were (9.68±5.26) and (8.51±4.69) respectively, and the difference was statistically significant (t=7.390,P< 0.01). Logistic regression analysis showed that living pattern (OR=0.596), degree of education (OR=0.799), age (OR=1.394), place of abode (OR=1.699), happiness degree of later life (OR=1.663) and current life satisfaction (OR=1.474) were correlated with depressive symptom (P<0.05). In addition, Pearson correlation analysis indicated that the social support of the empty-nesters was negatively correlated with depression (r=-0.260,P<0.01). Conclusions The incidence of depression is high in empty-nest elderly, which seriously affects the physical and mental health of them. Targeted measures should be taken to provide more comprehensive social support for empty-nest elderly, improve their life quality and reduce the incidence of depression.

Objective To make volunteer service for the aged of university students as an important complement for the aged care to establish a long-term mechanism of volunteer service for the aged. Methods The teaching model integrated volunteer service for the aged into nursing practice teaching was built by adding practice of community volunteer service for the aged to the courses of community nursing. Results This research structured the organization and management model in volunteer service for the aged nursing practice teaching and preliminarily created an appraisal and motivation mechanism through setting up rules and regulations, evaluation for service effects as well as excitation mechanism. Conclusions We found a teaching model integrated with nursing practice teaching and volunteer service for the aged as well as an approach to attain a long-term and persistent development of volunteer service for the aged so as to provide a practical and theoretical basis basis for a long-term development volunteer service for the aged of university students.

Objective? To understand the heaLth seeking behavior among ruraL residents of Yanchuan County in Yan'an City and to anaLyze its infLuencing factors. Methods? From JuLy 2017 to August 2017, we seLected 552 ruraL permanent residents of Yanchuan County in Yan'an City by convenience sampLing. ALL of them were investigated with the seLf-designed heaLth seeking behavior questionnaire for ruraL residents. The binary Logistic regression was used to anaLyze the infLuencing factors of heaLth seeking behavior among ruraL residents. ResuLts? When ruraL residents were iLL, 224 (40.58%) ruraL residents bought medicines for treatment, 216 (39.13%) knew disease reLated knowLedge and 352 (53.01%) ruraL residents attended ruraL cooperative medicaL care. Binary Logistic regression showed that the infLuencing factors of heaLth seeking behavior of ruraL residents incLuded ages, monthLy income, attending insurance or new ruraL cooperative medicaL care, knowing disease reLated knowLedge, diet ruLes and the proportion of vegetabLes and meats each meaL. ConcLusions? HeaLth conscious of ruraL residents is weak; the heaLth seeking behavior is traditionaL, backward and negative;they Lack knowLedge on heaLth, medicaL treatment, heaLth care and emergency treatment and their medicaL insurance participation is inactive. Government sector shouLd pay attention to heaLth seeking behavior of ruraL residents, strengthen the deveLopment of ruraL doctor team and cLinics in viLLages and towns,improve medicaL care system and ruraL cooperative medicaL care so as to soLve the probLems high cost and difficuLty of getting medicaL service among ruraL residents.