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

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

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 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.

[Abstract ] Objective The spleen plays an important role in brain ischemia-induced cerebral injury.This study aimed to ex-plore the correlation of the spleen mass index with the neurological function scores and infarction volume following permanent occlusion of the middle cerebral artery ( pMCAO) in rats. Methods Thirty male SD rats were equally randomized into a sham operation, a 3-day brain ischemia, and a 7-day brain ischemia group.The pMCAO model was established by ligation in the right brain of the rats. Neurological function scores were obtained with the Longa 5-Point Scale at 0, 3, and 7 days after modeling, and at 3 and 7 days, the spleen mass index was calculated, the infarction volume measured by TTC, and brain histopathological changes evaluated by HE stai-ning. Results Compared with the 7-day ischemia group, the 3-day ischemia rats showed significantly reduced spleen mass index ([1.62 ±0.58] vs [0.87 ±0.59] mg/g) and increased neurological function score (1.00 [1.00, 1.25] vs 2.00 [1.75, 2.25]) and infarct volume ([18.67 ±7.92] vs [36.20 ±14.92]%) (all P<0.05).An extremely significant decrease was found in the spleen mass index of the 3-day ischemia rats in comparison with that of the animals in the sham operation group ([1.90 ±0.22] mg/g) (P<0.01).HE staining revealed more obvious pathological injury of the cerebral cortex in the 3-day than in the 7-day group.The spleen mass index was negatively correlated with the neurological dys-function score (r=-0.851, P=0.019) and infarction volume (r=-0.717, P =0.013). Conclusion In pMCAO rats, measure-ment of the spleen mass index contributes significantly to the preven-tion and improvement of ischemia-induced cerebral injury.

Objective To explore the effect of carnosine in the expression of B cell lymphomal/leukemia-2 (bcl-2) and bcl-2-associated X protein (bax) after focal cerebral ischemia in rats. Methods Thirty male SD rats (SPF scale) were ran?domly divided into 3 groups:sham-operated group, model group and carnosine treated group (n=10 for each group). The mid?dle cerebral artery occlusion model (MCAO) was induced in model group and carnosine treated group. Rats were received carnosine [1 000 mg/(kg·d), orally] in carnosine treated group, and the other rats were received the same volume of normal sa?line (NS) in shame-operated group and model group. The neurological deficit score was used to evaluate the neurological function at 24 h and 72 h after MCAO. Morphological changes were observed by HE staining. TCC staining was used to label infarct volume, and immunohistochemistry was used to detect the expression of bcl-2 and bax. Results Compared with model group, the score of neurological function and infarct volume were significantly declined in carnosine treated group at 72 h after injury (P<0.05 or P<0.01). The changes of ischemic impairment were lighter in carnosine treated group than that of model group. Compared with sham-operated group, the expression levels of bcl-2 and the ratio of bcl-2/bax were de?creased while the expression of bax was increased in model group (P<0.05). Compared with model group, carnosine could sig?nificantly increase the expression of bcl-2 and the ratio of bcl-2/bax, and reduce the expression of bax (P<0.01 or P<0.05). Conclusion Carnosine can enhance bcl-2 expression, decrease bax expression and increase the ratio of bcl-2/bax, which is likely to be one of the mechanisms of neuroprotection.

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.