Objective To investigate the compassion fatigue and stress status and the relationship between them of nurses working in secondary hospitals of integrated areas of urban and rural places, and explore the social factors that influence the compassion fatigue and stress status. Methods 378 nurses from secondary hospitals in urban-rural integrated area were selected as samples in Nanjing. Paramedic′s Compassion Fatigue Scale and Chinese Nurse Stressor Questionnaire were adopted to develop the survey. Results The nurse compassion fatigue score was (15.9 ± 1.83) points; Stress status score was (86.18 ± 19.96) points. Urban-rural fringe secondary hospital nurse compassion fatigue status was positively associated with the pressure (r=0.218, P<0.01), and loss of enthusiasm, nervousness, loss of ability to doubt, and morale were on the medical staff work pressure had significant influence (P<0.05). Conclusions The nurse compassion fatigue and stress level were in the medium level; Nursing managers should pay more attention to the psychological health level of the nurses, increase nurses' enthusiasm, alleviate the occupational stress of nurses caused by compassion fatigue.

1.4,n=39),Group B(0.90≤ABI≤1.40,n=353)and Group C(ABI1.4 and had higher waist circumference(91.03?7.82)cm vs (87.33?8.93)cmand higher waist/hip ratio(0.95?0.06 vs 0.92?0.06),higher uric acid(273.26?108.10)?mol/L vs (225.06?75.49)?mol/Land CRP(2.60?2.69)mg/L vs(1.76?2.00)mg/Llevel,more smokers(41.0% vs 29.5%)and more hypertension(51.3% vs 35.4%),comparative with those with normal ABI,but no difference except CRP with those ABI 1.40 have more macrovascular risk factors,which is similar with those ABI

To investigate the relationship of body mass index and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus. Three hundred and eleven patients with type 2 diabetes mellitus diagnosed according WHO 1999 consensus criteria and 366 healthy subjects were enrolled in the study. Medical history was acquired and physical examination was conducted, and blood sugar, liver and kidney functions, lipid profile and abdominal ultrasonography color were examined. Sixty seven out of 366 healthy subjects were confirmed to have non-alcoholic fatty liver disease (NAFLD) ,including 51 mild case ( 13.9％ ) ,15 moderate cases(4. 1％ ) and 1 severe case(0. 3％ ) ; while in 311 diabetic patients NAFLD was detected in 144 cases, including 85 mild cases (27.3％) ,53 moderate cases( 17.3％ )and 19 severe cases( 1.9％ ). The prevalence rate of NAFLD was higher in diabetic patients than control group in BMI ＜ 23.0 kg/m2 group, 23.0 -24. 9 kg/m2 group and 25.0 -29. 9 kg/m2 group(P ＜0. 01 ) ; however, there was no difference between two groups when BMi ≥30 kg/m2 (P ＞0. 05 ). The prevalence of NAFLD increased with BMI whether in control group or in diabetic group, especially when BMI ＞ 25 kg/m2. In addition to the prevalence of NAFLD, metabolic syndrome increased with BMI in diabetic patients. These findings indicate that type 2 diabetic patients have a high prevalence of NAFLD, especially in obese patients.

BACKGROUND: Memory impairment is the main manifestation of Alzheimer disease (AD) and mild cognitive impairment (MCI) conspicuous in the early stage. However, such patients very often develop attentional dysfunction, which may affect their normal work and daily life.OBJECTIVE: To investigate the attentional function, including continuous attention, selective attention and divided attention, of patients with mild AD and of those with MCI.DESIGN: A case-control study.SETTING: Department of neurology of a university hospital and department of psychology in a university.PARTICIPANTS: The research was completed in the Laboratory of Neuropsychology, the First Hospital of Peking University from November 2003 to January 2004. Totally 18 patients with mild AD and 19 with MCI were enrolled in this study, with 20 normal elderly subjects also included to serve as the normal control group.INTERVENTIONS: Several tests were designed to assess the attentional functions of all the subjects, including continuous performance task (CPT) test for assessing continuous attention, simplified Stroop test for selective attention, and dual task test for divided attention.MAIN OUTCOME MEASURES: The reaction time (RT) and the percentage of false response were recorded in CPT test and Stroop test, and performance decrement in dual task test was observed.RESULTS: In CPT test, the RT of mild AD patients was much longer, and the rates of missing and false responses were higher than those of normal control group [(539.29±103.86) vs (458.47±40.87) ms, 4.08% (3. 13, 13.64) vs0.91% (0.60, 1.90), and 1.51% (0.64, 2.54) vs 0.43% (0.37, 0. 84), respectively, P ＜ 0. 05]. The difference between MCI group and normal control group failed to reach statistical significance. The rate of missing response of all the three groups grow higher with the prolongation of time, with the highest occurring in the third 5 minutes of the test.More AD patients showed sustained attention deficiency after 10 minutes of test (33.33% within 10 minutes and 77.8% within 20 minutes). In Stroop test, all the three groups tended to make more false responses under incongruous condition[11.25% (7.50, 22.50), 2.50% ( -2.50, 5.00), 2.50% (0.00, 4. 38) ], exhibiting significant interference effect, which was the most obvious in mild AD group ( P ＜ 0.05). Patients with mild AD responded more slowly than MCI patients and normal control subjects [ (579. 19 ± 89.93) ms,(524.28 ± 68. 96) ms, (486. 75 ± 51.58) ms, respectively, P ＜ 0.05 ]. MCI group made more false responses than normal control group during the whole course of the test as well as under coincident and neutral conditions[5.83% (4. 17, 8.33) vs2.92% (1.67,3.96); 5.00% (2.50, 7.50) vs0.00% (0.00, 2.50); 5.00% (2.50, 10. 00) vs 2.50% (0.00, 5.00), P ＜ 0. 05]. In dual-task test, a significant decrement in mild AD patients was noted without statistical difference between MCI and normal control group[ 1.03 (0.49,3.75),0.46 (0.08, 1.02),0. 10 ( -0.25, 0. 64), P ＜0.05]. Within mild AD group, more patients showed deficiency in Stroop test and CPT test than in dual-task test (81.25%, 77.8%, and 29.41%, respectively).CONCLUSION: Patients with mild AD suffer impairment in continuous,selective and divided attentions, especially obvious in the former two attentional functions. MCI also impairs selective attention as compared with normal aged subjects, with the continuous and divided attention remaining normal. Mild AD patients, MCI patients and normal elderly subjects all show decreased continuous attention, and longer time (than 10 ninutes) of CPT may more sensitively identify continuous attention deficit.

Objective:To observe the diagnosis effect about the MRI and CT examination for the patients with lacunar cerebral infarction(LAC).Methods: 82 cases early LAC patients during April 2014- June 2016 were diagnosed by two methods, MRI and CT, respectively. And the application effect of the two methods were compared based on image result.Results: In 82 cases of LAC 742 lesions confirmed by MRI and only 145 lesions confirmed by CT, and there was statistical significant between the two methods; especially in front lobe and thalamic, lesions detection rate using MRI was higher than CT, and there was statistical significant between the two methods(x2=6.59,x2=5.64,x2=6.42;P<0.05); the difference of detection rate in capsula internal also was statistical significant(x2=7.43,P<0.05); the number of lesion diameter less than 5mm was 256 using MRI and it was 3 using CT, the difference also was statistical significant(x2=6.39,P<0.05).However, in parietal lobe, basal ganglia and brainstem, all of the difference were not statistical significant (x2=0.18,x2=1.25,x2=0.81;P>0.05);Conclusion: Both of CT and MRI can be used in early diagnosis of LAC, and MRI examination is more accurate for early or micro lesions and lesions happened in the frontal lobe, thalamus, capsula internal than CT. Therefore, MRI can be used as first choice eximination method in early diagnosis of LAC.

Objective To determine whether the sustained,selective and diverted attention functions are affected in patients with mild Alzheimer's disease(AD).Methods Several tasks designed to test the attention functions on the computer were performed in patients with mild AD as well as elderly controls: Continuous Performance Task(CPT) for assessing sustained attention function,simplified Stroop task for selective attention function,dual task for diverted attention function.Results In CPT test,mild AD patients responded more slowly((539.29?103.86)ms vs(458.47?40.87)ms,P

Objective To observe the differences in functional capacities generated by different simple breathing balloons extruded by different hand types and methods.Methods The lung functional measurement instrument was used to measure the generated functional capacities of two types of simple breathing balloon extruded by different hand methods: using big-, mid- and small-size hands with 5 fingers generally separately open and maximally extended states or with both small-size hands to extrude balloon; the effective generated gas quantity of the above methods were compared.Results ① Comparison between different balloons: the functional capacity generated by black rubber balloon extruded by any hand type was 68 - 132 mL lower than that generated by light blue silicon balloon. ② The comparison between different hand types: the functional capacities generated by any hand at maximally extended state in extruding balloon was 13 - 70 mL higher than that by hand commonly separate state; extrusion by a small size hand was nearly unable to reach 400 mL, while the functional capacity was 520 - 650 mL when the balloon was extruded by a big size hand, and 435 - 635 mL by a mid-size hand; it was necessary to use both small hands when the black rubber balloon was extruded, when the light blue silicon air bag was extruded, the functional capacity could reach 430 - 440 mL with a small size hand. ③ Difference in extruding methods: the functional capacity generated by either big size hand or mid-size hand with 5 fingers maximally extending state to extrude balloon was significantly higher than that with 5 fingers commonly separate state, the functional capacity generated by both small size hands with fingers maximally separating and extending state to extrude balloon was obviously higher than that generated by 5 fingers generally separating and extending state, the functional capacities generated by light blue silicon balloon were obviously higher than those by black rubber balloon, no matter the 5 fingers of big- or mid-size hand being at generally separating or extending state (mL: 623.00±21.11 vs. 522.00±41.85 by big size hand with common 5 fingers separate state, 649.00±26.01 vs. 575.00±58.55 by big sizehand with maximum 5 fingers extending state; 566.00±37.77 vs. 436.00±21.19 by mid-size hand with common 5 fingers separate state, 637.00±30.02 vs. 505.00±37.49 by mid-size hand with maximum 5 fingers extending state); the light blue silicon balloon extruded by small hand with 5 fingers at generally separate state and at maximally extending state could generate functional capacities (mL)432.00±13.02 and 444.00±37.18 respectively, significantly higher than those using the 2 types of hand state extruding a black rubber balloon (the tidal volume < 400 mL), the functional capacities generated by both small hands extruding a light blue silicon balloon was obviously higher than that by using a black rubber balloon (mL: 557.00±54.98 vs. 489.00±40.12, allP < 0.05).Conclusions Different functional capacities will be generated by different hand sizes, different hand extruding methods and types of simple breathing balloon, clinical application should be based on patients' body weights to decide their tidal volumes, and combined with the rescuers' hand sizes and types of simple breathing balloon to choose a proper extruding method for a certain patient, thus sufficient oxygen can be surely provided in time for him/her and rescue successful rate can be elevated.

Objective: To identify the most appropriate meteorological variable for forecasting the health risk of high temperatures. Methods: The surveillance on causes of death, meteorological data and surveillance on air quality among registered residents in Ningbo City, Zhejiang Province during the period between May and October from 2013 to 2019 were collected. The association models of daily minimum temperature, average daily temperature, daily maximum temperature, daily minimum heat index, average daily heat index, daily maximum heat index, average daily apparent temperature and torridity index with deaths and years of life lost (YLL) were created using time series analysis and distributed lag non-linear models, and the model fitting effect was evaluated using the minimum Akaike information criterion (AIC) procedure. The most appropriate meteorological variable for forecasting gender-, age- and mortality-specific health risks of high temperatures was identified. Results: A total of 120 628 deaths were reported during the study period, with daily deaths of 94 cases, and daily YLL rate of 19.74 person-years/105. Except for daily minimum heat index and torridity index, the exposure-response relationships between other six meteorological variables and deaths and overall YLL rate all appeared a “J” shape. The lowest AIC values and the optimal model fitting effects were measured for the association models between average daily temperature and whole populations, females, subjects at ages of 65 years and older, and deaths and YLL rates due to circulatory diseases and respiratory diseases. Conclusion High model fitting effects are observed between average daily temperature and deaths and YLL rates, which are more suitable for forecasting the health risk of high temperature.

Objective To investigate the related factors of phlebitis caused by PICC and support effective preventive nursing measures. Methods 163 patients diagnosed as malignant tumor who first used peripherally inserted central catheters (PICC) were recruited. Patients were observed for 3 months. According to the diagnostic criterion of infection, 34 patients with phlebitis were divided into the phlebitis group and others were divided into the control group. All patients were investigated for general information survey :sex, age, tumor type, allergic history,location of inserted vein, one-time success rate,activity after catheter, elbow bending,phlebitis occurred time, grade and type. Laboratory markers:WBC,neutrophils,immune parameters, fasting plasma glucose. Trait anxiety inventory (T-AI)was used for assessment of emotional state. Case-control study between groups was carried out. Results The results of univariate analysis showed that location of inserted vein,times of inserting vein,activity of inserted limb,elbow bending,blood sugar level and emotion were associated with phlebitis. Sex, age, tumor type, allergic history, immune function,WBC,neutrophils were not involved with phlebitis. The results of multivariate logistic regression analysis showed that PICC through basilica vein was the protective factor. Multiple insertions, more activity of inserted limb,durative anxious emotion were the risk factors of phlebitis. Conclusions Different location of vein,times of inserting vein,activity of inserted limb,elbow bending,high blood glucose level and persistent anxious emotion are the risk factors of phlebitis. Taking effective preventive measures before,during, and after PICC can reduce the incidence of phlebitis.

Dysfunction after stroke caused great burden to patients,families and society,early rehabilitation training is an effective and economic way to improve the function.Motor relearning program (MRP) is a popular rehabilitation method in recent years.In this reviw,the concept and characteristics of MRP are introduced firstly,then we summarize three elements in implementation of MRP,including time,strength and environment,and finally,the application of MRP in clinical stroke patients is emphasized.