Objective To investigate the quality of life and its influencing factors of families primary caregivers of dementia patients .Methods The typically self made questionnaire ,WHO quality of life measurement profile (WHOQOL‐BREF) ,zarit bur‐den of care scale(ZBI) ,social support rating scale (SSRS) et al were adopted to investigate 64 caregivers of AD patients .Results (1) The overall quality of life of family caregivers of total subjective feelings were significantly lower than the general health status of subjective feeling score (t= -2 .217 ,P=0 .030) .The field of physiological and psychology points have no statistically significant difference in comparison with Chinese norm (t= -0 .252 ,-1 .994 ,P=0 .801 ,0 .050);the field of social and environment points have statistically significant difference compared with norm(t= -3 .830 ,3 .658 ,P=0 .000 ,0 .001) .(2) caregiver who have spouse , poor parent child relationship and patients with somatic diseases and mental behavior symptoms have lower quality of life(P<0 .05) .(3)Total score of Quality of life was negatively associated with total score of care burden (r= -0 .433 ,P=0 .000) ,while was significant positive associated with total score of the social support (r=0 .346 ,P=0 .005) .(4)Marital status ,parent‐child rela‐tionship ,physical illness and social support were the main factors affecting the quality of life(r2 =0 .409) .Conclusion Strengthen the social support and psychological intervention of dementia caregivers who has a spouse ,poor parent-child relationship and poor physical condition may help to improve the quality of life .

Objective To summarize the sonographic features and differential diagnosis points of mass-type cornual pregnancy. Methods The sonographic ifndings of 23 pathological proven mass-type cornual pregnancy cases enrolled in PUMCH from 2011 January to 2013 January were retrospectively analyzed. Results All pathological proven mass-type cornual pregnancy were located at one corner of the uterus presenting as a heterogenous outward mass. Well-deifned margins were found in 20 cases, and interstitial-line signs were found in 15 cases. The surrounding muscle thickness is 0.1-0.3 cm. Typical hyperechoic villi were found on sonography in cases with bloodβ-hCG>20 000 IU/L. On Doppler, the lesion showed abundant peripheral vascularity with low resistance in 22 cases, 9 lesions also showed abundant internal vascularity. Among 23 mass-type cornual pregnancy cases, 7 cases were misdiagnosed as gestational trophoblastic neoplasia (GTN) due to the similar sonographic characteristics including mixed-echo and abundant vascularity with low resistance. Sixteen cases were diagnosed by ultrasound preoperatively, with featured sonographic signs including mass located in the endometrial extension line;clear margin;peripheral vascularity;or detection of interstitial-line sign and typical villus. Conclusions Mass-type cornual pregnancy may be correctly diagnosed according to the location, boundary of the mass and the distribution of blood flow combining with clinical manifestation and bloodβ-hCG level. Transvaginal sonography could play an important role in diagnosis of cornual pregnancy.

Objective To investigate the pathogens distribution in neonatal blood culture and their drug resistance to antibacteri‐al drugs in Dalian City .Methods The routine blood culture ,identification and drug sensitivity test were carried out in the hospital‐ized neonates from August 2014 to August 2015 .And the obtained data were analyzed .Results A total of 186 strains of pathogenic bacteria were detected from 1 570 cases of neonatal blood culture and the positive rate was 11 .8% .Gram positive bacteria accounted for 74 .2% (138/186) and were dominated by Staphylococcus epidermidis .Gram negative bacteria accounted for 25 .3% (47/186) , which were mainly onion burkholderia bacterium .One strain was fungus ,accounting for 0 .5% .The drug sensitivity test results showed that Gram positive bacteria had the higher resistance rate to penicillin and erythromycin (80 .0% -90 .0% ) ,100 .0% sensi‐tivity to vancomycin ,linezolid and teicoplanin ;E .coli and K .pneumoniae had the highest resistance rate to ampicillin (88 .2% -100 .0% ) ,100 .0% sensitivity to imipenem ,amikacin ,low resistance rate to piperacillin/tazobactam ,cefoperazone/sulbactam ,amoxi‐cillin/clavulanic acid ,cefepime and ceftazidime (0% -10 .0% ) .The resistance rate of onion burkholderia bacterium to ticarcillin/clavulanate and meropenem was higher than 80 .0% ,which had 100 .0% sensitivity to cefoperazone /sulbactam ,levofloxacin ,mino‐cycline and compound sulfamethoxazole .Conclusion The neonatal blood culture pathogen in Dalian City is dominated by Gram pos‐itive bacteria ,coagulase negative staphylococcus is the main pathogen .Due to the different regional environmental ,pathogens and drug resistance should be regularly monitored and analyzed to provide objective and accurate basis for clinical rational use of anti‐bacterial drugs .

Objective To study the effect of Xuebijing injection on transfusion and systemic inflammation in traumatic coagulopathy patients. Methods Seventy-nine patients were randomly divided into Xuebijing Group (36 cases) and Control Group (43 cases). Xuebijing group received Xuebijing injection in addition to the regular treatment received by control group. Levels of TNF-α, IL-6, IL-8 and transfusion amount between two groups were compared. Results Coagulation abnormality was almost corrected in all patients after treatment. In Xuebijing Group, transfusion of RBC, FFP and cryoprecipitate were significantly less than that in control group (P<0.05). At 72 h after admission, TNFα, IL-6 and IL-8 were significantly lower in Xuebijing Group (P < 0.05). Conclusion Xuebijing injection could reduce transfusion in traumatic coagulopathy patients , possibly resulting from its antagonism against systemic inflammation.

Objective To develop anxiety scale suitable for Chinese pregnant women and evaluate its reliability and validity. Methods Based on existing research results and clinical experience,this study compiled pregnancy anxiety scale(PAS). A sample of 509 pregnant women were selected for investigation and 65 of them were randomly retested for test-retest reliability with 2 week interval. Item analysis was con-ducted to screen valid items. Then the construct validity of the scale was tested by exploratory factor analysis ( EFA) and confirmatory factor analysis(CFA). Finally the reliability and criterion validity of the scale were evaluated using Cronbach's α coefficient,retest reliability coefficient and Pearson correlation coefficient. Re-sults The PAS was composed of 27 items in four factors,including worry about delivery,worry about them-selves,worry about fetal health and general anxiety. The four factors were extracted by EFA which could ex-plain 62. 48% of the total variance. Besides,the result of CFA demonstrated that the model fitted the data with well construct validity (χ2/df=1. 89,RMR=0. 04,RMSEA=0. 06,IFI=0. 92,TLI=0. 91,CFI=0. 92, PGFI=0. 70,PNFI=0. 74,PCFI=0. 81). The score of the pregnancy-related anxiety scale and its factors scores were positively correlated with the scores of pregnancy-related anxiety questionnaire(PAQ) and child-birth attitudes questionnaire(CAQ). The correlation coefficients were 0. 60-0. 80 and 0. 50-0. 78 respectively (all P<0. 01). The Cronbach's α coefficient was 0. 93 for the total scale and that of the four factors ranged from 0. 82 to 0. 90. The test-retest reliability was 0. 68 for the total scale and ranged from 0. 54 to 0. 75 for the four factors. Conclusion The PAS has a good reliability and validity,and it can be used as a valid tool to measure the anxiety level of pregnant women.

Compared to that with laparoscopic assisted approach, intracorporeal anastomosis with totally laparoscopic radical total gastrectomy has the advantages of smaller incision, and better vision for operation, and may also be fit for patients with large size lesion, high-located lesions, or obesity. It remains controversial though several surgeons have reported the safety and feasibility of intracorporeal anastomosis with totally laparoscopic total gastrectomy. This review describes the recent technical advances in intracorporeal anastomoses with totally laparoscopic total gastrectomy, focusing on the reconstruction skills and indications. Current data on totally laparoscopic total gastric resection for gastric carcinoma revealed that all digestive tract reconstructions were performed with esophagus-jejunum Roux-en-Y anastomosis, and different reconstruction techniques of such Roux-en-Y anastomosis have certain advantages and disadvantages. Surgeons should make choice based on tumor location, esophageal diameter and personal skills in order to achieve maximal benefit to patients.
Anastomosis, Roux-en-Y ; methods ; Gastrectomy ; methods ; Humans ; Laparoscopy ; methods ; Stomach Neoplasms ; surgery

OBJECTIVETo study the effect of GABA transporter (GAT-1) on the analgesic action of oxysophoridine (OSR) in the central nervous system of mice.

METHODHot plate test was used to observe and analyze the effect of gamma aminobutyric acid and the inhibitor of GAT-1 (NO-711) on the analgesic action of oxysophoridine. Real time RT-PCR was used to investigate the influence of OSR on the expression of GAT-1 mRNA induced by formalin in spinal cord and brain of mice.

RESULTBoth GABA (2.0 mg x kg(-1), icv) and NO-711(0.125 mg x kg(-1), icv) enhanced the analgesic action of OSR (32.0 mg x kg(-1), iv) in the hot plate test, and the latencies was markedly increased (P < 0.05, P < 0.01). OSR (500.0 mg x kg(-1), iv) significantly inhibited the expression of GAT-1 mRNA induced by formalin (P < 0.05).

CONCLUSIONGAT-1 was involved in the analgesia effect of OSR and the down-regulation of GAT-1 mRNA enhanced the analgesic effect.

Alkaloids ; pharmacology ; Analgesics ; pharmacology ; Animals ; Brain ; drug effects ; metabolism ; Down-Regulation ; drug effects ; Female ; GABA Plasma Membrane Transport Proteins ; genetics ; metabolism ; Gene Expression Regulation ; drug effects ; Male ; Mice ; RNA, Messenger ; analysis ; Spinal Cord ; drug effects ; metabolism

Objective To evaluate the differences among five representative and useful Doppler parameters in the diagnosis of the three common types of renal artery stenosis (RAS). Methods Five Doppler parameters including renal peak systolic velocity (RPSV), renal-aortic ratio (RAR), renal-interlobar ratio (RIR),acceleration time (AT),and resistant index (RI) were measured in 221 patients before renal arteriography. Differences between the groups of patients with various clinical causes of RAS were analyzed by Chi-Squared test. One-way ANOVA or t test were used to compare the means between different groups.The optimal cutoff value was determined with the maximum sum of sensitivity and specificity. Results Of the 442 renal arteries (main and accessory renal arteries) demonstrated at arteriography,214 were normal or stenosed less than 50 %, 204 stenoses 50% - 99 %, and 24 occlusions. RIR, RAR and RI were significantly different between the atherosclerotic and non-atherosclerotic RAS groups (P ＜0.05), while RPSV and AT were not. The optimal cutoff values of RAR,RIR and RI for detecting RAS between the atherosclerotic and non-atherosclerotic groups were much different (2.5 versus 1.9, 5. 1 versus 6.5, 0.57 versus 0.50,respectively) ,but those of RPSV and AT were similar or the same (170 cm/s versus 200 cm/s,51 ms versus 51 ms,respectively). Conclusions In the case of RAS (diameter reduction≥50%),it is advised to establish separate cutoff values of RAR, RIR and RI according to atherosclerotic and non-atherosclerotic RAS, but the same cutoff value of RPSV and AT can be applied. RIR is a good Doppler parameter in the diagnosis of RAS,especially atherosclerotic and fibromuscular dysplasia RAS.

Objective To investigate the relation between intrauterine growth and the development of carotid atherosclerosis in later life. Methods The intima-media thickness of carotid was measured with ultrasonography in 2036 people aged above fifty who had complete birth records, and divided into normal and abnormal group. They were asked to fill in the cardio-cerebrovascular questionnaire, and venous blood samples were taken and analysed for various biochemical parameters. The relation between carotid atherosclerosis and various parameters at birth and in adult life was assessed. Results The birthweight and head circumference in abnormal group were less than those in normal. The prevalence of carotid atherosclerosis was greatest in those weighed 2500g or less, whose risk of carotid atherosclerosis was greater than those weighed between 3000g and 3500g, after adjustment for cardiovascular risk factors. Conclusions Increased atherogenesis may be one independent mechanism mediating the epidemiological link between impaired fetal growth and vascular disease.

Objective: To investigate the promotional effect of the new teaching method of goal orientation combined with plan-do-check-act (PDCA) cyclic improvement on specialized medical knowledge and operation skills among physicians in critical care medicine. Methods: A total of 84 physicians who received critical care medicine training in Department of Critical Care Medicine in Foshan Hospital of Traditional Chinese Medicine from January 2013 to December 2015 were selected, and according to the time of admission, they were divided into control group with 41 physicians and experimental group with 43 physicians. The physicians in the experimental group received the new teaching method of goal orientation combined with PDCA cyclic improvement, i.e., the physicians started systematic learning according to the learning goals sent out by the teaching secretary, summarized problems during learning and looked for optimal solutions every week, and then continued learning in the next week through PDCA cyclic improvement. The physicians in the control group received traditional teaching combined with bedside teaching, but no learning goals were set for them. The two groups were compared in terms of theoretical examination scores, clinical operation skills, and results of the questionnaire survey. The t-test and Wilcoxon ranksum test were used for comparison of scores between the two groups by SPSS 18.0. Results: Compared with the control group, the experimental group had significant increases in the scores of theoretical examination (91.50±4.18 vs. 87.80±3.63) and operation skills (88.80±3.34 vs. 85.40±2.88). The questionnaire survey showed that compared with the control group, the experimental group had a significantly higher degree of satisfaction, significantly greater learning interests, and significantly greater improvements in operation skills, clinical thinking ability, and self-confidence. Conclusion The new teaching method of goal orientation combined with PDCA cyclic improvement can stimulate learning interests, clarify learning goals, help physicians to master important and difficult issues, and thus improve their learning outcomes and scores in Department of Critical Care Medicine.