Objective To get the information about the geriatric syndromes in the elderly with different age and gender so as to provide the basis for management of the geriatric syndromes.Methods A questionnaire survey was used to investigate and analyze the geriatric syndromes in 2 778 older subjects aged 60 years and above from Zhejiang and Jiangsu province.Results Among all 2 778 old adults,(3.4 ± 1.8)geriatric syndromes in average were found.The difference in geriatric syndromes number between different age groups showed a statistical significance(F =145.135,P＜ 0.001),but a significant difference in geriatric syndromes number between male and female group was not found(t=0.817,P=0.414).On the top incidence rate of geriatric syndromes were daily life ability defects 2 199 cases(79.2％),falls 1 828 cases(65.8％),urinary incontinence 1 356 cases(48.8％),sleeping disorder 1 023 cases(36.8 ％),cognitive impairment 908 cases (32.7 ％) and visual impairment 896 cases (32.3 ％).Among above six geriatric syndromes,the incidence of daily life ability defects,falls,urinary incontinence,sleeping disorder and cognitive impairment seemed to increase with ageing (P＜0.001).The incidence of daily life ability defects,falls and urinary incontinence was higher in males than in females (P＜ 0.05).The incidence of sleeping disorder and cognitive impairment was higher in females than in males(P＜0.05).The elderly patients with 3 or more geriatric syndromes exceeded about 66.4 ％.The most common clusters of geriatric syndromes were daily life ability defects combined with falls and urinary incontinence,which seemed to significantly increase along with ageing (x2=202.523,P＜0.001).Conclusions Geriatric syndromes are common in the elderly,medical care workers should pay attention to the management of the geriatric syndromes,and promote the development of the elderly healthcare.

Objective To observe the effects of Eldepryl on expressions of tyrosine hydroxylase (TH) and glial cell line-derived neurotrophic factor (GDNF) in substantia nigra and striatum in Parkinson’s disease (PD) and to explore the protective mechanism of Eldepryl on dopaminergic neuron . Methods Healthy male Sprague-Dawley (SD) rats (n=72) were randomly divided into control group, model group and Eldepryl group (n=24 in each group). Each group was divided random?ly into 2 subgroups as 4 day treatment group and 8 day treatment group (n=12 in each subgrop). Pakinson’s disease model was established by injecting rotenone subcutaneously back the neck, rats in the control group were injected with an equal vol?ume of sunflower oil subcutaneously at the same location. Rats in the Eldepryl group were then given Eldepryl 0.5 mg·kg-1 in?tragastrically every day for 4 or 8 consecutive days and rats in model group and control group were given an equal volume of saline instead. The expression of TH and GDNF in substantia nigra and striatum were detected by immunohistochemistry and Western blotting. Results Immunohistochemistry and Western blotting showed that strong expression of TH positive cells with little expression of GDNF positive cells were seen in substantia nigra and striatum in rats of control group, and there was no significant difference between subgroup of 8 day treatment and 4 day treatment within control group. The expression of TH cells and GDNF were both significantly reduced in model group compared with those in control group (both P<0.05), and there was no significant difference between subgroup of 8 day treatment and 4 day treatment within each group. The ex?pression of TH positive cells were significantly reduced in Eldepryl group compared with those in control group, and were sig?nificantly increased compared with those in model group. The expression of GDNF positive cells were significantly increased in Eldepryl group compared with those in control group and model group (all P<0.05). And there were significantly more ex?pression of TH positive cells and GDNF positive cells at subgroup of 8 day treatment compared with those at subgroup of 4 day treatment within Eldepryl group with (all P<0.05). Conclusion These data suggest that Eldepryl can protect the dam?age of dopaminergic neurons in substantia nigra and striatum of PD rats. And its therapeutic mechanism may be associated with increased expression of GDNF.

Objective To explore the effect of salubrinal (sal,an endoplasmic reticulum stress inhibitor) on radiosensitivity of human head and neck squamous carcinoma cells (HNSCC).Methods Cells were divided into two groups of sal treatment and its control.For drug treatment group,cells were treated with 10 mmol/L sal for different time (12,24,36 h) and then irradiated.The levels of a core protein GRP78 of endoplasmic reticulum stress (ERS) in HNSCC (KB,Fadu,and Detroit 562 cells)were analyzed by Western blot assay at different time (0,20 min,1 h,3 h,6 h,12 h,24 h and 48 h) after irradiation.Cell survival was measured with colony formation assay.Results Western blot assay revealed that the protein levels of GRP78 in three kinds of HNSCC significantly increased from 20 min to 1 h and peaked at 3 h after radiation (t =12.72,13.37,18.31,P ＜ 0.05).Compared with the control group,treatment of cells with sal decreased GRP78 protein levels (t =14.25,5.34,3.12,P ＜ 0.05) in three cell lines and also significantly enhanced radiation damage and reduced cell viability.The sensitization enhancement ratios (SER) of sal in three cell lines were 1.16,1.05 and 1.06,respectively.Conclusions Rradiosensitivity of HNSCC could be effectively enhanced by sal treatment.

Objective To discuss the influence of eldepryl on the expressions of glial fibrillary acidic protein (GFAP) and cd11b in substantia nigra and striatum in the rats with Parkinson’s disease (PD),and to clarify the regulatory role of eldepryl in the gliacytes.Methods 72 SD rats were randomly divided into control group,PD model group and eldepryl group,and each group was divided randomly into 4 d and 8 d subgroups (n=12)after the success of model preparation.The PD rat models were established by injecting rotenone in subcutaneous.The number of GFAP and cd11b positive cells and the expressions of GFAP and cd11b were detected by immunohistochemistry and Western blotting method.Results The GFAP and cd11b positive cells were all in a resting state in control group, the GFAP-positive cell body was slender and irregular and had elongated protrusions;the cd1 1 b-positive cell body was small and branch-like,and it had more slender protrusions.The GFAP and cd11b positive cells were all in a active state in model group, the GFAP-positive cell body was hypertrophy, the proj ections increased thickening;the cd1 1 b-positive cell body was more bigger, the proj ections were shorter and thicker, and the number was increased.Compared with model group, the GFAP-positive cell body and protrusions were more slender, the CD11b-positive cell body was more smaller,the projections were more slender,and the number was decreased in eldepryl group.There were a small amount of expression of GFAP and cd11b positive cells in substantia nigra and striatum in the rats in control group,and there was no significant difference between 8 d group and 4 d group(P>0.05). The number of GFAP and cd11b positive cells and the protein expression levels were significantly increased in model group compared with control group(P<0.01);there was more expression in 8 d group compared with 4 d group,but there was no significant difference(P>0.05).The number of GFAP and cd11b positive cells and the protein expression levels in eldepryl group were significantly reduced compared with model group(P<0.01);there were less expression in 8 d group compared with 4 d group, and there was significant difference (P<0.05 ). Conclusion There are activation and proliferation of the gliacytes in substantia nigra and striatum in the rats with PD,and eldepryl can inhibit the activation and proliferation of gliacytes.

Objective:To investigate the early predictors of respiratory depression in patients with glufosinate poisoning, and provide reference for clinicians to make decisions.Methods:In March 2022, the clinical data of patients with glufosinate poisoning admitted to the intensive care unit of the Affiliated Xiangshan Hospital of Wenzhou Medical University from March 2018 to January 2022 were retrospectively analyzed. The patients were divided into respiratory depression group and non-respiratory depression group according to the occurrence of respiratory depression during hospitalization. The clinical data such as age, gender, past history, intake, initial treatment and laboratory examination were compared between the two groups. Multivariate logistic regression was used to analyze the predictors of respiratory depression in patients with glufosinate poisoning, and its predictive value was analyzed by receiver operating characteristic (ROC) curve.Results:A total of 34 patients with glufosinate poisoning were enrolled, including 13 patients in non-respiratory depression group and 21 patients in respiratory depression group. There were significant differences in intake, blood amylase and bicarbonate radical in arterial blood gas between the two groups ( P<0.05). Respiratory depression occurred at 6.5-48.0 h after ingestion, with a median of 15.0 (9.5, 24.0) h. Multivariate logistic regression analysis showed that the intake of glufosinate ( OR=1.440, 95% CI: 1.033-2.009, P=0.032) and bicarbonate radical in arterial blood gas ( OR=0.199, 95% CI: 0.040-0.994, P=0.049) were predictors of respiratory depression in patients with glufosinate poisoning, and the area under the curve (AUC) of ROC curves were 0.936 and 0.842. The optimal cut-off values were 15.0 g (sensitivity=95.2%, specificity=76.9%) and 17.6 mmol/L (sensitivity=71.4%, specificity=84.6%), respectively. Conclusion:The intake of glufosinate and bicarbonate radical in arterial blood gas have good prediction effects on the occurrence of respiratory depression in patients with glufosinate poisoning.

Objective To explore the mechanism underlying the effect of endoplasmic reticulum stress pathway inhibitor Salubrinal on enhancing the apoptosis of head and neck squamous carcinoma cells.Methods Three types of head and neck squamous carcinoma cell lines (KB,Fadu,Detroit562) were divided into the control,Salburinal (sal),irradiation (IR) and sal combined with IR (IR+sal) groups.The expression levels of p-ATM/ATM,DNA-PK and cleaved Caspase-3 were quantitatively measured.The cell apoptosis rate was detected among four groups.The effect of Salburinal on cell viability was evaluated by MTT assay.Results Compared with the IR group,the expression level of p-ATM/ATM (t =3.5,8.43 and 9.42,all P＜0.05) was significantly up-regulated,whereas that of DNA-PK (t =9.19,17.44,16.67,all P＜ 0.05) was considerably down-regulated in the IR+sal group.The expression level of cleaved Caspase-3 in the IR+sal group was significantly higher compared with those in the other three groups (t=6.79,9.76 and 9.7g,all P＜0.05).Compared with the IR group,the cell apoptosis rate was significantly enhanced in the IR +sal group (t=5.67,6.95 and 7.28,all P＜0.05).Salubrinal exerted an effect upon the apoptosis of three cell lines in a concentration-and time-dependent manner.Conclusions As an endoplasmic reticulum stress pathway inhibitor,Salubrinal can enhance the apoptosis rate of head and neck squamous carcinoma cells.The underlying mechanism is probably correlated with irradiation-induced DNA double strand injury,suppressing the repairing of DNA damage and thereby increasing the apoptosis of tumor cells.

The authors analyzed the opportunities and challenges faced by nurses in the time of elderly care with medical support using SWOT analysis, for the purpose of suggestions for the development of nurses to cope with such new scenario. Advantages of the nurses in such a time are as follows: professional nursing care, holistic care ability, and standardized assessment skill. Their disadvantages include: poor team leadership, insufficient business and management skills, and poor motivation for personal development. Their opportunities include: guidance of the national strategy, innovation of " Internet plus", and flexible working hours. Their challenges include: room of improvements for both quantity and quality of nursing personnel, better efficiency for integration and allocation of resources, and better capability to leverage" Smart elderly care". Four suggestions are raised in this regard, i. e., to strengthen the ability for elderly care with medical support, to improve multidisciplinary coordination, to cultivate their entrepreneurship, and to improving the ability of information application.

Major hepatectomy (MH) is a common treatment for benign and malignant liver diseases. Controlled low central venous pressure (CLCVP) is an important measure to reduce the intraoperative blood loss and transfusion requirement during MH. In this paper, the application standard of CLCVP at MH is discussed, and the specific measures to achieve CLCVP including fluid restriction, drug application, body gesture adjustment, reduction of tidal volume, suspension of respiratory ventilation, and infrahepatic inferior vena cava clamping (complete and partial) are systematically summarized.

ObjectiveTo analyze the clinical features， treatment and prognosis of patients with respiratory depression caused by glufosinate poisoning. MethodsThe clinical data of patients with respiratory depression caused by glufosinate poisoning admitted to the ICU of Xiangshan first people’s hospital medical and health group from March 2018 to January 2022 were retrospectively analyzed. ResultsA total of 21 patients with respiratory depression caused by glufosinate poisoning were included. The median （interquartile） intake of glufosinate was 30 （20， 40） g， and the median （interquartile） visit time was within 2.0 （1.0， 2.8） h. The initial symptoms were nausea and vomiting in 16 cases （76.2%）， and sore throat in 8 cases （38.1%）. Respiratory depression， convulsions and shock occurred 6‒48 hours after ingestion of glufosinate. Convulsion occurred in 13 cases （61.9%）， shock in 10 cases （47.6%） and bradycardia in 5 cases （23.8 %）. Among the patients with convulsion or shock， respiratory depression occurred earlier than convulsion and shock in 10 cases （76.9%） and 9 cases （90.0%）， respectively. All patients were treated with gastric lavage， catharsis， mechanical ventilation and symptomatic support. Blood purification was performed in 14 cases. The duration of mechanical ventilation was 5.0 （4.0， 7.0） d，and no patient died. The patients were divided into blood purification group and routine treatment group. There was no significant difference in complications and duration of mechanical ventilation between the blood purification group and the routine treatment group （P>0.05）. ConclusionRespiratory depression caused by glufosinate poisoning usually occurs earlier than convulsion and shock. The overall prognosis of patients with respiratory depression caused by glufosinate poisoning is good， which mainly depends on the early recognition and intervention of respiratory depression.

Objective:To investigate the early predictors of respiratory depression in patients with glufosinate poisoning, and provide reference for clinicians to make decisions.Methods:In March 2022, the clinical data of patients with glufosinate poisoning admitted to the intensive care unit of the Affiliated Xiangshan Hospital of Wenzhou Medical University from March 2018 to January 2022 were retrospectively analyzed. The patients were divided into respiratory depression group and non-respiratory depression group according to the occurrence of respiratory depression during hospitalization. The clinical data such as age, gender, past history, intake, initial treatment and laboratory examination were compared between the two groups. Multivariate logistic regression was used to analyze the predictors of respiratory depression in patients with glufosinate poisoning, and its predictive value was analyzed by receiver operating characteristic (ROC) curve.Results:A total of 34 patients with glufosinate poisoning were enrolled, including 13 patients in non-respiratory depression group and 21 patients in respiratory depression group. There were significant differences in intake, blood amylase and bicarbonate radical in arterial blood gas between the two groups ( P<0.05). Respiratory depression occurred at 6.5-48.0 h after ingestion, with a median of 15.0 (9.5, 24.0) h. Multivariate logistic regression analysis showed that the intake of glufosinate ( OR=1.440, 95% CI: 1.033-2.009, P=0.032) and bicarbonate radical in arterial blood gas ( OR=0.199, 95% CI: 0.040-0.994, P=0.049) were predictors of respiratory depression in patients with glufosinate poisoning, and the area under the curve (AUC) of ROC curves were 0.936 and 0.842. The optimal cut-off values were 15.0 g (sensitivity=95.2%, specificity=76.9%) and 17.6 mmol/L (sensitivity=71.4%, specificity=84.6%), respectively. Conclusion:The intake of glufosinate and bicarbonate radical in arterial blood gas have good prediction effects on the occurrence of respiratory depression in patients with glufosinate poisoning.