Objective To understand current status and influencing factors of long-term care for elderly people who lived in rural areas of Beijing.Methods A total of 1022 elderly people (age＞60 years old) were enrolled in this cross-sectional study during December,2012 and January,2013.Demographic information,health status and needs of and intent to long-term care were learned through a questionaire survey.Chi-square test and muhiple non-conditional logistic regression analysis were used to identify the factors that were related to the respondents' selection.Results Nearly 6.6％ (61/1016) participants showed needs for long-term care.82.3％ (841/1013) respondents preferred household-based long-term care,while 7.53％ (77/1013) preferred community-based long-term care.In single factor analysis,education level,occupation,household income,living conditions,number of children living together,medical insurance,pension insurance,chronic diseases and self-report hearing ability,taste and touch were related with longterm care needs (x2values were 33.03,136.17,99.32,88.83,58.07,147.71,108.11,9.85,33.78,30.45 and 22.22,respectively; all P＜0.05).Multivariate analysis showed that occupation,income per capita,spouses living conditions,new corporative medical systems and self-report visual status were correlated with household-based long-term care (odds ratio (OR) were 2.48 (95％ confidence interval (CI) 1.21-5.10),0.82(0.71-0.95),1.64 (1.08-2.49),4.78 (2.93-7.82) and 0.72 (0.59-0.89),respectively).Conclusion Householdbased long-term care and health management system may be needed and chosen by the elderly living in rural areas of Beijing.

Objective To investigate the trend of cytokines in patients with hemophagocytic lymphohistiocytosis (HLH) and analyze its significance.Methods 16 patients with HLH from January 2011 to May 2013 were selected.The patients were divided into remission group and death group by prognosis.Serums of the two groups were collected when they were hospitalized and at 7 th,14 th,21st,28th and 42nd day during chemotherapy,and they were fractionated HLH 1-6 groups and HLH a-d groups again,then the levels of IL-18,IL-10,IL-12,NF-κB,TNF-α and neopterin were tested by enzyme linked immuno sorbent assay (ELISA) to analysis their trend.Results The levels of all of cytokines in the remission group declined with chemotherapy,the difference between HLH1 group and another HLH groups was statistically significant (P ＜ 0.05).In the death group,the levels of NF-κB,IL-12 and neopterin had no downward trend with chemotherapy,and the difference between HLHa group and another HLH groups was not statistically significant (all P ＞ 0.05).The level of TNF-α declined with chemotherapy,and the differences between HLHa group and HLHc group,HLHa group and HLHd group were statistically significant (P =0.049,0.000).The level of IL-10 declined sharply in the first week of chemotherapy,and the difference between HLHa group and HLHb group was statistically significant (P =0.00).The level of IL-18 declined after the 2nd-weeks' chemotherapy,and the differences between HLHa group and HLHb group,HLHa group and HLHc group were statistically significant (P =0.03,0.02).Conclusions In the remission patients,the levels of serum IL-18,IL-10,IL-12,NF-κB,TNF-α and neopterin declined after chemotherapy.In the death patients,the downward trend is not obvious.It was preliminarily confirmed that the prognosis of HLH is related to the trend of cytokines during chemotherapy.

Objective: To explore the clinical effects of electroacupuncture (EA) at Zusanli (ST 36) and Fenglong (ST 40) in treating senile dementia. Methods:A total of74 patients were randomly divided into an EA group and a medication group based upon the random digital table, 37 cases in each group. EA at Zusanli (ST 36) and Fenglong (ST 40) was given in the EA group, once every day, for six treatments per week. Donepezil Hydrochloride Tablets were given to the medication group, 5 mg per time and once a day in the former four weeks, 10 mg per time and once a day after 4 weeks, oral administration before sleep at night. The courses of the treatment were 12 weeks in both groups. The scores of mini-mental state examination (MMSE) and Barthel index (BI) were observed before and after the treatment, for processing the comparative analysis of the clinical effects after the course of the treatment. Results:The total effective rate was 86.5% in the EA group and 70.3% in the medication group. The therapeutic effect was better in the EA group than that in the medication group, and the difference between the two groups was statistically significant (P<0.05). MMSE and BI scores after the treatment in the two groups were all elevated than those of the same groups before the treatment (P<0.05,P<0.01). The improving situation was obviously better in the EA group than that in the medication group, and the difference between the two groups was statistically significant (P<0.05). Conclusion:EA at Zusanli (ST 36) and Fenglong (ST 40) is affirmative in the therapeutic effect for senile dementia and can also improve the cognitive function and enhance the patients’ quality of life .

Objective To learn current status of health management services in the elderly individuals living in rural areas of Beijing,so as to provide evidence for healthcare improvement.Methods The elderly residents aged 60 or above from several rural districts of Beijing were selected by using multistage random sampling method in January 2013.The health management programme those participants obtained and their satisfactory scale were evaluated.Results A total of 719 of 1 023 (71.3％) individuals had health check-up over the past years.Only 4 subjects (0.4％) obtained mental health management,and 35 (4.9％) finished follow-up studies for chronic diseases.The percent of the elderly who received physical examination,profiles of medical record,health education,medical consultation,health evaluation,cancer screening or vaccination showed statistically significant difference of regional distribution (x2 values were 15.7,39.4,30.5,25.2,24.1,18.4 and 19.3,respectively; all P＜0.05).Sites for health check-up,profiles of medical record and health education were also found to have statistically significant regional distribution difference (all P＜0.05).In ordinal logistic regression analysis,age,occupation,health insurance,self health assessment and health medical affected satisfaction of the respondents with health management.Conclusions Our investigation shows a gap between current health management programme and national standard requirement for equal public health services,and the elderly's satisfaction with health management needs to be improved.

Objective To investigate the stress reaction of the medical staff who suffered workplace violence,and provide reference for nursing interventions.Methods 13 medical staff who suffered work-place violence were interviewed through semi-constitutional formula,the data were analyzed by phenomenological method of qualitative research.Results The psychological stress of medical staff mainly included 3 themes:complex emotions,eager to help; psychological adjustment required internal and external integration; different stress reaction affected the psychological state.Conclusions The medical staff suffer seriously from the workplace violence both on the physical and mental health,individuals should learn how to deal with it correctly,and the relevant departments should pay full attention to the humane care to victims of violence,guide them to view the stress correctly,and to take effective measures to prevent and control workplace violence.

Objective To evaluate the diagnostic value of expression of MG7-Ag diflferentiation and guidance of follow-up mucosal biopsy in the patients with suspected malignanct gastric ulcer.Methods The expression of MG7-Ag in 58 patients who were suspected as having malignant gastric ulcer under routine endoscopy was studied by immuno-histochemical staining.The follow-up endoscopy was pefformed 1 to 72 weeks(mean 7 weeks)later and biopsy was taken.Results There were 19 cases of gastric carcinoma in 30 patients with positive MG7-Ag expression(63.3%)and only 5 in 28 patients with negative MG7-Ag expression(P＜0.01).Conclusion The positive expression of MG7-Ag is correlated with gastrie carcinoma in patients with suspected malignant gastric ulcer.

Objective To investigate the variation characteristics of adenovirus type 55 (HAdV-B55) gene on plateaus.Methods Throat swabs were collected from HAdV-B55 infected patients and used for virus isolation in HEp-2 cells.The whole-genome sequence was obtained by PCR and sequencing.HAdV-B55 gene sequence was blast with the previously reported virus.Results HAdV-B55 strains were isolated from throat swabs, which were named LS89/Tibet/2016.The whole-genome sequence was obtained and submitted to GenBank with the accession number of KY002683.No large fragment gene recombination was found between this HAdV-B55 strain and previous strains, and the sequence similarity with QS-DLL strain was 99.9%.Conclusion This study provides more information for the evolution patterns of adenovirus 55 and will contribute to the prevention and control of HAdV-B55 infection in the future.

Objective:To investigate the ultrasonographic features and evolution of thyroid shrinking nodules in order to improve the differential diagnosis and management strategy and avoid unnecessary biopsy.Methods:A total of 245 patients with old bleeding of benign thyroid nodules diagnosed via fine needle aspiration cytology (FNAC) from May 2015 to July 2020 in the southern part of the Shanghai General Hospital Affiliated to the Medical College of Shanghai Jiaotong University, including 263 nodules. The sonographic parameters such as size, shape, aspect ratio, echo, edge, boundary, periphery, halo, calcification, posterior echo enhancement and posterior acoustic attenuation of nodules were analyzed retrospectively, and the ultrasonic appearances of nodules were classified; 41 nodules from 40 patients, who did ultrasound examinations more than twice and had both complete ultrasonographic data, were compared and then classified in order to explore the evolution rules of the nodules.Results:Two hundred and sixty-three thyroid shrinking nodules in 245 cases were classified into 4 types: "cystic wall shrinkage sign" type(71.48%, 188/263), "carcinoma-like" type (22.05%, 58/263), "inflammation-like" type(3.04%, 8/263) and "undefined atypical solid nodules" type(3.42%, 9/263). Of the 41 consecutive follow-up nodules, 37 cases showed obvious cystic wall shrinkage sign, and 7 of them developed into "carcinoma-like" type and 6 cases into "inflammation-like" type.Conclusions:The ultrasonographic appearance of thyroid shrinking nodules is a dynamic process, which can be divided into 4 types: "cystic wall shrinkage sign" , "carcinoma-like" , "inflammation-like" and "undefined atypical solid nodules" types. The "cystic wall shrinkage sign" type is typical and common. The "cystic wall shrinkage sign" type can develope into the "carcinoma-like" type or the "inflammation-like" type.

Cognitive impairment after infectious meningitis seriously affects the activities of daily living for survivors. There has been lack of systematic researches on the cognitive impact of infectious meningitis so far, it is not clear how to early identify and evaluate the cognitive impairment after meningitis, how to properly carry out early rehabilitative intervention to improve the activities of daily living and to reduce the social and economic burden of patients. This article reviews the characteristics, evaluation methods and rehabilitative interventions of cognitive impairment in patients after infectious meningitis, to provide reference for clinical application.

Objective:To optimize the ethanol reflux extraction process of total saponins in total saponins of Trillium tschonoskii Rhizome. Methods:On the basis of single factor tests, making the total extraction rate of three main compounds [paris saponin Ⅵ, paris saponin Ⅶ and pennogenin-3- O-α-L-rhamnopyranosyl-(1→4)-[O-α-L-rhamnopyranosyl (1→2)]- O-β-D-glucopyranoside (PRRG)] as the indicator, the optimal extraction parameter was selected with the main influencing factors: the ethanol concentration, solid-liquid ratio, and extraction time by the central composite design-response surface method.Results:The optimal extraction parameter for the ethanol extract of total saponins of Trillium tschonoskii Rhizome was as follows: ethanol concentration 69%, extraction time 1.9 h, and solid liquid ratio 1∶9.7. The binomial fitting complex correlation coefficient r = 0.966 1, and the deviation between the extracted predicted value and the actual value is 4.68%. Conclusion:The central composite design-response surface method is simple and reliable for the optimization of extraction process of total saponins of Trillium tschonoskii Rhizome.