Objective To investigate the ability level of institutionalized elderly people and its correlation with pension service demand.Methods Ability assessment for older adults and a self-designed questionnaire about pension service demand were used to survey the ability level and service demand of 332elderly people in 7 institutions of Yancheng city in Jiangsu province in July 2014.The influence factors of pension service demand were analyzed by the binary classification Logistic regression.Results 67.8％ (225/332),14.8％(48/332) and 15.7％(52/332) institutionalized elderly's ability level were mild,moderate and severe impairment.The impairment of ability levels of the elderly had positive impact on helping eating,bath,cleaning,medical service and other services agency and negative impact on culture and entertainment.Conclusions The ability of institutionalized elderly were poor in Yancheng city in Jiangsu Province.We should provide service according to their abilities and demand,in order to ensure the rational use of the limited resources.

ObjectiveTo investigate the value of shear wave elastography (SWE) in the evaluation of liver damage in patients with Budd-Chiari syndrome (BCS).MethodsSixteen patients with BCS which were all conifrmed by interventional therapy or inferior vena cava angiography were enrolled in the study. And iffty healthy volunteers who were conifrmed with no liver disease history, no surgical history and no metabolic disease such as diabetes were included in this study. All the subjects underwent conventional ultrasound and no obvious abnormality was detected. All the BCS patients and the volunteers underwent SWE. The elastic graph and the quantitative elastic value, including the average value, the maximum value and the minimum value, were acquired and compared between BCS patients and the volunteers.ResultsThe elastic graphs for the healthy volunteers were uniform light blue while the elastic graphs for BCS patients were hybrid images of blue, green and yellow. The average value, the maximum value and the minimum value of BCS patients were (18.1±9.4) kPa, (20.6±10.5) kPa and (15.5±8.5) kPa, which were statistically higher than those of healthy volunteers [(6.2±1.0) kPa, (7.5±1.2) kPa and (4.8±1.1) kPa,t=7.69, 8.94 and 7.83, allP<0.01].ConclusionsSWE can reflect the liver damage of patients with BCS before the change of the two-dimensional ultrasound. It can play an important role in the accurate selection of treatment and the accurate evaluation of treatment effect and the prognosis.

BACKGROUND:Several researches have highlighted the selective dissolution of Ni ion from the nickel-titanium (NiTi) alloy during the corrosion process,which can lead to potential damage to human body.Different surface treatments will improve the corrosion resistance of NiTi implants.In modern medicines,it is necessary to analyze the characteristics of surface modified NiTi implants.OBJECTIVE:To study the effects of coated and uncoated materials made by elastic nickel-titanium alloy internal fixator on fracture healing and to compare the effects of continuous compressive stress after internal fixator of different types on fracture healing by setting up control group of bone nail internal fixation.DESIGN,TIME AND SETTING:A randomized,controlled,animal experiment was performed at the Laboratory of Tissue Engineering,Institute of Orthopedics,Second Hospital Affiliated to Lanzhou University between September 2004 and March 2005.MATERIALS:Diamond-like carbon coated and nickel-titanium alloy and uncoated nickel-titanium alloy embracing fixator (type 4H8-40) were provided by Lanzhou Ximai Memory Co.,Ltd.,China.Intramedullary nails (type ZQY-01) were purchased from Tianjin Jinxingda Industries Co.,Ltd.,China.METHODS:Thirty Chinchilla rabbits of 4-6 months old were randomly divided into 3 groups (n = 10):diamond-like carbon coated nickel-titanium alloy embracing fixator (group A),uncoated nickel-titanium alloy embracing fixator (group B),and intramedullary fixator (group C).Following anesthesia by injection of 1% sodium pentobarbital (25 mg/kg),transverse fracture models in middle part of the femur were made through a lateral femoral incision and fixed with diamond-like carbon coated nickel-titanium alloy embracing fixator,uncoated nickel-titanium alloy embracing fixator,and intramedullary fixator respectively.MAIN OUTCOME MEASURES:The inorganic substance level,osteocalcin,alkaline phosphatase (ALP) and tumor necrosis factor (TNF) expression in callus surrounding fracture site were detected 4 weeks postoperatively.Ni ion level in muscles surrounding fracture site,live tissue,and brain tissue were also detected.RESULTS:Inorganic substance level and ALP,osteocalcin,and TNF expression were significantly higher in the groups A and B than in group C (P＜0.05).Ni ion level in the liver tissue,brain tissue,and muscles surrounding the fracture were significantly lower in the groups A and C than in group B (P＜0.05).CONCLUSION:Elastic fixation promotes fracture healing.Diamond-like carbon coated nickel-titanium alloy embracing fixator has a better histocompatibility than uncoated group.

BACKGROUND: Although shape memory alloy has been extensively used in modem medicine, including orthopaedics and dental surgery, the body fluid could influence the stability of biomaterial and some ions released by materials may cause toxic and side effect to human body. The technology for the modification of shape-memory materials is of crucial importance for clinical use of shape memory alloy.OBJECTIVE: To investigate the biocompatibility of diamond-like carbon (DLC) coated Nickel-Titanium shape memory alloy and uncoated shape memory alloy with osteoblasts cultured in vitro. DESIGN, TIME AND SETTING: A comparative observation. The study was performed at the Institute of Othopaedics of Lanzhou University from March to June 2005.MATERIALS: A total of 30 DLC-coated Nickel-Titanium shape memory alloy disks, 6 minx7 mmx0.5 mm, and the same amount of uncoated ones of equal size were provided by College of Materials, Lanzhou University. METHODS: Rabbit osteoblast suspension of the third passage at density of 10 × 108/L were incubated with DLC-coated Nickel-Titanium shape memory alloy disks and uncoated shape memory alloy in 12-well culture plate in 5% CO2 at 37 ℃.MAIN OUTCOME MEASURES: Culture media were counted at 1, 2, 3, 4 and 5 days of culture to determine alkaline phosphatase (AKP) activity and nickel (Ni2+) concentration.RESULTS: The proliferation of osteoblasts and the concentration of AKP in DLC- coated group were greater than uncoated group; while the uncoated group released more Ni2. into the cells culture media than coated group (P < 0.05). CONCLUSION: DLC-ceated Nickel-Titanium shape memory alloy appears to have better biocompatibility with osteoblast cultured in vitro compared to uncoated ones.

Objective To discuss the operative strategies for cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic kyphosis.Methods Retrospectively analyzed 21 cases of cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic kyphosis,who underwent surgeries from January,2007 to August,2014.Twenty males and 1 female were included.Mean age was (48.6±7.5) years (range,36-65 years).The preoperative American Spine Injury Association (ASIA) classification distribution:2 cases of Grade A,6 cases of Grade B,7 cases of Grade C,5 cases of Grade D,and 1 case of of Grade E.The investigative surgical methods including posterior cervical open reduction,internal fixation and bone graft fusion;posterior cervical open reduction/decompression,internal fixation and bone graft fusion;or combined posterior and anterior cervical decompression,bone graft fusion and instrumentation.The operative time and blood loss were recorded,the clinical therapeutic effect was evaluated by visual analogue scale (VAS) score,ASIA grade improvement,cervical curvature (the angle between a line drawn parallel to the inferior endplate of C2 and a line drawn parallel to the inferior endplate of C7 in the lateral plane of an X-ray image) and radiological assessment (including bone graft fusion condition and internal fixation position).Results One case died from severe pulmonary infection and respiratory failure at the 45th day after operation.All the other 20 patients obtained complete follow-up with a mean time of (39.4±8.76) months (range,25-59 months).7 cases received posterior cervical open reduction,internal fixation and bone graft fusion,average operative time was (92.1±5.4) minutes and average blood loss was (96.1+23.7) ml.9 cases received the posterior cervical open reduction and decompression,internal fixation and bone graft fusion,mean operation time was (121.4± 14.0) minutes and blood loss was (250.0±38.9) ml.3 cases experienced combined posterior and anterior cervical decompression,bone graft fusion and fixation,average operative time was (222.4± 14.9) minutes and average blood loss was (354.3+46.7) ml.Mean of VAS scores at the 3th month postoperatively was 2.76±0.46,significantly lower than the preoperatively VAS scores (8.95±0.36).Mean of VAS scores at the 24th month postoperatively was 1.77±0.39,significantly lower than those at the 3th month postoperatively.The neurological function of spinal cord achieved significant improvement after operations and continued recovered gradually in the subsequent follow up.ASIA Classification distribution at the 24th month postoperatively was:0 case of Grade A,0 case of Grade B,3 cases of Grade C,8 cases of Grade D,9 case of Grade E.Mean of the cervical curvature after operation was-7.1°± 1.9°,significantly higher than preoperatively(-13.4°±3.3°) and did not have any loss of Cobb's angles at 24th month after operation.All the surviving cases achieved solid bone graft fusion.Mean bone graft fusion time was 5.8 months (range,4-9 months).There was no internal fixation loose,fracture and dislocation occurred during follow up.Conclusion All procedures can significantly relieve the painful symptoms,effectively restore the normal cervical alignment and stability,and remarkably improve the neural function of the patients suffering cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic junction kyphosis.

Objective:To investigate the effect of HSM on the inflammation and pulmonary fibrosis in mice with cecal ligation and puncture ( CLP) . Methods: Both 5 day and 10 day timepoint pulmonary fibrosis were induced by CLP;mice were randomly divided into three groups,including sham group (sham,n=5),model group (CLP,n=11),therapy group (HSM,n=11). HSM extract (200 mg/kg,less than human dose of 0. 27 g/kg) was orally administered to HSM group 2 hour before surgery and repeated everyday, while sham group and model group were given the same dose of normal saline. We used Q-PCR assay to analyze the expression of in-flammatory molecules ( IL-1β and TNF-α) and fibrogenic cytokines ( TGF-β, MMP9 and TIMP1 ) from lung tissues , we used FACS assay to analyze the amount of Th1 cells in PBMC and spleen sections,as well as Treg in spleen sections. Besides,lung sections were subjected to HE stain and immunohistochemical staining withα-SMA and fibronectin. Results:The amount of model group's Th1 cells in PBMC and spleen sections,as well as Treg in spleen sections were significantly lower than sham group's,whereas HSM succeeded in raising them. By day 5, the expression of inflammatory molecules IL-1β and fibrogenic cytokines (TGF-β,MMP9 and TIMP1) from CLP group's lung sections were remarkably improved,by day 10,the expression had decreased but was higher than sham group's;HSM inhibited these cytokines' expression. The expression of TNF-α of CLP group and HSM group had no significant changes. The CLP group's HE results showed obvious pulmonary inflammatory damage,by day 10,the situation had improved,whereas HSM reduced the histopathologic alterations;contrast to sham group,model group's expression of α-SMA and fibronectin was remarkably improved,while HSM group showed lower expression. Conclusion: HSM extract can suppress inflammation, balances immune system and relieves pulmonary fibrosis.

Objective To analysis the reliability of the examination of Introduction of Nursing by using the methods of generalizability theory and to give advice on how to modify examination paper.Methods Estimation value of variance component from different variations and precision indexes were calculated by applying the principle of generalizability theory.Results The generalizability coefficient and index of dependability were greater than 0.4 in choice question and terminology explanation,the generalizability coefficient of short-answer question was also greater than 0.4.Short-answer question's index of dependability and generalizability coefficient and index of dependability of comprehensive problem were less than 0.4.Conclusions Generalizability theory can be used in analysis the reliability of the examination of Introduction of Nursing.Its result is helpful to improve the framework of examination papers and the reliability of examination.

Objective:To explore the effect of histone demethylase JMJD3 on B cell activation and apoptosis.Methods:B cells were sorted and purified from the peripheral blood of healthy people and SLE patients by using magnetic bead.After B cells were treated with IFN-αor R848 or IFN-α+R848,the percentages of CD86+B cells,CD69+B cells,CD86+Annexin V+B cells and CD69+Annexin V+B cells were detected by flow cytometry.The expression of JMJD3 was detected by Real Time PCR and Western blot.Results:The purity of sorted B cells was up to 95%.IFN-αenhanced both the activation and apoptosis and the JMJD3 expression of TLR7-activated B cells.The expression of JMJD3 was dependent on MAPK signal pathway,but not the NF-κB signaling pathway.Moreover,JMJD3 was highly expressed in B cells of peripheral blood from SLE patients compared to those from healthy people.Furthermore,JMJD3 inhibitors could inhibit the activation and apoptosis of IFN-αand R848 activated B cells.Conclusion:JMJD3 participated in the activation and apoptosis of IFN-αand TLR7-induced B cells, suggesting JMJD3 inhibitors may possess therapeutic effect for alleviating symptom of SLE.

Objective:To explore the change of B cell numbers in active MRL/lpr lupus mice , and their regulation mechanisms.Methods:B cell cycle and the percent of B cells in spleen lymphocytes of active MRL /lpr lupus mice and normal C 57/B6 mice were analyzed by using flow cytometry .The apoptotic B cells and their subclass were analyzed by Annexin V and PI staining.Further more ,B cells were purified by magnetic sorting , and real-time quantitative PCR was carried out to detect apoptosis-related gene.Results:Compared with the C57/B6 mice,the percent of B cells in active MRL/lpr lupus mice were significantly reduced (P<0.01),while the percent of apoptotic cells were significantly increased (P<0.01).The percent of early apoptotic B cells were sig-nificantly increased ( P <0.01 ) which including the immature and mature B cells , while the late apoptotic B cells were unchanged.Further more,we found that the anti-apoptotic protein BIRC3 was significantly reduced in active lupus B cells (P<0.01), while the pro-apoptotic protein BCL2L1 and BBC3(PUMA) were significantly increased(P<0.01).Conclusion: B cells in active lupus mice were significantly reduced while early apoptotic B cells were increased , which may be attributed to the changed balance between the anti-apoptotic and pro-apoptotic proteins , suggesting the reduction of B cells in SLE patients may be related to their increased early apoptosis .

Objective:To investigate the effect of HSM on the immunoreaction and renal fibrosis in mice with cecal ligation and puncture (CLP).Methods: Renal fibrosis was induced by CLP;mice were divided into three groups,including sham group (sham,n =5),model group (CLP,n =11),therapy group (HSM,n =11).HSM extract [200 mg/(kg?d)] was orally administered to HSM group2 hour before surgery and repeated everyday throughout 10 days,while sham group and model group were given the same dose of normalsaline.FACS assay was used to analyze the amount of macrophages ,neutrophils and Treg in PBMC,as well as macrophages in peritonealfluid;we used Q-PCR assay to analyze the expression of inflammatory molecules (IL-1βand TNF-α) and fibrogenic cytokines (TGF-β,MMP9 and TIMP1) from renal sections.Besides,renal sections were subjected to HE stain and immunohistochemical staining with α-SMA and fibronectin.Results: The amount of model group′s macrophages and neutrophils in PBMC,as well as macrophages in theperitoneal fluid were significantly higher than sham group ′s,whereas HSM succeeded in lowering them;contrast to sham group,Tregs′amount of CLP group and HSM group in PBMC had no significant changes .The expression of inflammatory molecules (IL-1βand TNF-α) and fibrogenic cytokines (TGF-β,MMP9 and TIMP1) from CLP group′s renal sections were remarkably improved ,whereas HSM inhibitedthat.The CLP group′s HE results showed obvious renal inflammatory damage ,whereas HSM reduced the histopathologicalterations;contrast to sham group,model group′s expression of α-SMA and fibronectin was remarkably improved,while HSM groupshowed lower expression.Conclusion: HSM extract could regulate immunity response and had effect in improving renal fibrosis .