Objective To survey the social support status and demands for family caregivers of the disabled elderly.Methods A cross-sectional survey based on convenience sampling was conducted among 779 disabled elderly and their family caregivers from May to June 2013 in five communities of Beijing Dongcheng District.Barthel index was used to measure the degree of functional impairment of the elderly.Self-rating Depression Scales (SDS) was used to evaluate depression symptoms of caregivers.Social Support Rating Scale (SSRS) and social support demand questionnaire were used to measure the social support status and social support demands of caregivers,respectively.Multiple linear regression analysis was used to analyze the influence factors of social support.Results Total 779 caregivers were identified and 744 caregivers completed the questionnaires with a valid response rate of 95.5％.Among 744 family caregivers the social support levels were low with an average SSRS score of 31.16 ± 6.86.There were significant differences in SSRS scores among caregivers of disabled elderly with different characteristics (age,married status and the Barthel index score) (all P ＜ 0.05);and there were significant differences in SSRS scores among caregivers with different characteristics (age,educational level,married status,current employment,relationship with patients,caregiving time daily,subjective care burden,living with patients,number of caregivers and depression status) (all P ＜ 0.05).Multiple linear regression analysis showed that the Barthel index score of the disabled elderly,the relationship with the elderly,depression status of the caregivers and the subjective care burden were correlated with the social support level of family caregivers (all P ＜0.05);the standard regression coefficients of above significant factors were 0.098,0.190,0.134 and 0.155,respectively.The social support demands of family caregivers were various;the average score was 2.44 ± 0.64,the top three demands were provision of care subsidy for the disabled elderly (average score was 2.95 ± 0.93),provision of care allowance for family caregivers (average score was 2.90 ± 0.93) and the guidance of safe medication (average score was 2.83 ± 0.83).Conclusions Family caregivers for the disabled elderly obtain low level social support in the surveyed area.Since the earegivers have various social support demands,the social support and assistance for them should be specific,effective and comprehensive.

Objective To evaluate the earlier changes of degeneration discs in vivo using magnetic resonance diffusion tensor imaging (DTI).Methods From September 2010 to March 2011,88 consecutive outpatients [age 16-63 years,mean age (37 ± 13) years] were enrolled in this study.The excluded criteria were as follows: spinal deformity,spinal tumors and post-operation of spine.The mean diffusion (MD) and fractional anisotropy (FA) values on DTI images of 428 intervertebral discs which without susceptibility artifacts were measured.Fiber track (FT) images of annulus of intervertebral discs were analyzed.MD and FA were also measured on FT.The quartile and median were used to record the nonnormal distribution dates.The Chi-square test statistic was applied by SPSS1 1.0 software package.Results Annulus fibrosis type had closely related to the Pfirrmann grading.Three types were divided based on FT charts of degenerated intervertebral disc.Intact type was noted in 135 discs,Pfirrmann Ⅱ level has a high percentage(92 discs,68.15％) in this type; Scrambled type was noted in 195 discs,Pfirrmann Ⅲ and Ⅳ level were accounted for 63.07％ (123 discs) ; Conglomerate type was noted in 98 discs,the Pfirrmann Ⅳ and Ⅴ level were accounted for 83.68％ (82 discs) (Mantel-Haenszel test,x2 =183.90,P ＜ 0.01).Different annulus types had different MD and FA values.The median(range)of FA of complete,messy and clumps type fibrous ring were 0.32 (0.29-4.35),0.35 (0.33-0.38),0.54 (0.46-0.62).The corresponding median(range)of MD were 12.40(11.50-13.20) x 10-10,11.10(9.92-12.00) × 10-10,6.30(5.03-7.72) × 10-10 mm2/s.Scrambled annulus fibers had lower MD values and higher FA values,which had significant difference (x2 =219.74,243.88,P ＜0.01).Conclusions DTI is a non-invasive method to assess intervertebral disc structural changes in vivo.MD and FA values are helpful to evaluate the intervertebral disc degeneration.

Objective To investigate the effect of community comprehensive intervention on health behavior and self-rated health status among family caregivers of disabled elderly.Methods One hundredand twenty family caregivers of disabled elderly were selected from community health service centers of Beijing Dongcheng District,and were given 6 month-comprehensive community intervention (intervention group);121 family caregivers of disabled elderly from another community were selected as the control group.The knowledge and skills of caregiving,health behaviors (daily exercise time,daily relaxation time) and self-rated health status were evaluated before and 6 months after intervention.Results The knowledge and skill scores in intervention group were improved by 50.781 points,the daily exercise time and daily relaxation time were prolonged by 0.491 h and 0.837 h,respectively after the intervention (all P＜0.05).There was no significant difference in self-rated health status of two groups before and after intervention (P ＞0.05).Conclusion Community comprehensive intervention improves the knowledge and skills of caregiving,and the health behaviors among family caregivers of disabled elderly,but the intervention measures does not impact the self-rated health status of family caregivers.

Objective To explore the relationship between care burden and social support among family caregivers of disabled elders in Beijing urban area.Methods A cross-sectional survey based on convenience sampling was conducted among 744 family caregivers in Dongcheng District in Beijing urban area.All subjects were interviewed by the Zarit Burden Interview (ZBI),Social Support Rating Scale (SSRS) and general social and demographical material lists.And then we analyzed the correlation between social support and care burden.Results The mean scores of ZBT and SSRS were (40.3 ± 15.2) and (31.1 ± 6.9)respectively.And a negative correlation existed between the level of caregiver burden and total social support.The care burden of disability elders was negatively associated with objective support,subjective support and social support availability (P ＜ 0.05).Conclusions There is a close relationship between care burden and social support among family caregivers of disabled elders.The more objective support,subjective support and social support availability the caregivers acquire,the less burden they bear.

Coronary Occlusion ; therapy ; Coronary Vessels ; Humans ; Percutaneous Coronary Intervention

Objective To investigate the effect of phosphoinositide-3-kinase inhibitor LY294002 on the differentiation of human embryonic stem cells (HESC) into more mature insulin-producing cells. Methods HESCs were induced to differentiate into insulin-producing cells through five stages. Nicotinamide and B27 (group B27), nicotinamide and LY294002 (group LY) were used to induce the nesting positive cells into mature insulin-producing cells. The morphological change of each stage was observed under microscope , and expressions of insulin, c-peptide, somatostatin and glucagon were identified by immunofluorescence staining. Results After 14 days in stage 5 , there was no significant difference in rate of insulin positive cells between group LY and group B27 (P﹥0.05), but rates of somatostatin and glucagon positive cells in group LY were lower than those in group B27(P﹤0.05). Furthermore, the co-stained rate of somatostatin and insulin in group LY was also lower than that in group B27 (P﹤0.05). Conclusion HESCs can be induced to differentiate into more mature insulin-producing cells by phosphoinositide-3-kinase inhibitor LY294002 in serum-free culture medium.

Objective To observe the efficacy of antithrombotic treatment of acute ST-segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden,and its effect on elective percutaneous coronary intervention.Methods Eight acute ST-segment elevation myocardial infarction patients were enrolled,who suffered from failure of primary percutaneous coronary intervention because of high thrombus burden.Summarize the antithrombotic strategies in perioperative and postoperative period,the operative strategies and the follow-up coronary intervention were recorded and reviewed.Results All the patients were male and most of them had acute inferior myocardial infarction with right coronary occluded because of high thrombus burden.Four patients received thrombus aspiration and balloon dilation.One patient received thrombus aspiration and the other three patients did not receive coronary intervention.Tirofiban were given in perioperative period to all the patients.Low molecular weight heparin was given to 6 patients.Dual antiplatelet therapy was given to 6 patients (aspirin 100 mg/day plus clopidogrel 75 mg/day) and 1 patient required up-titration of aspirin to 200 mg/day.Coronary angiography were repeated (29.00 ± 23.25) days later,and the thrombus in the culprit vessels disappeared in two patients,and coronary stent implantation was performed in three patients.Conclusions The routine antithrombotic strategies play limited roles in thrombus clearance in acute ST segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden.The time for the thrombus to be totally organized and the timing of elective percutaneous coronary intervention are still uncertain and need to be further studied.

Objective:To evaluate the efficacy of continuous infusion of lidocaine via urinary catheter for postoperative analgesia in patients undergoing urological surgery.Methods:Forty male American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 65-75 yr, with body mass index of 18-25 kg/m 2, scheduled for elective percutaneous nephrolithotomy, were divided into 2 groups ( n=20 each) using a random number table method: continuous infusion of lidocaine through urinary catheter group (group L) and patient controlled intravenous analgesia (PCIA) group (group PCIA). All the patients underwent total intravenous anesthesia, and a matched type of sterile urethral irrigation catheter was inserted after the operation.In group L, 0.5% lidocaine was continuously infused at a rate of 5 ml/h via the urinary catheter, while the equal volume of 0.9% normal saline was continuously infused via the urinary catheter, and PCIA was connected in group PCIA.PCIA solution contained sufentanil 125 μg (diluted to 250 ml in normal saline), and the PCA pump was set up with a 5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 5 ml/h.When visual analogue score was>4, sufentanil 0.05 μg/kg was injected intravenously as rescue analgesic.The development and severity of catheter-related bladder discomfort (CRBD) were recorded immediately at the end of the operation (T 1), and at 6 h (T 2), 24 h (T 3) and 48 h (T 4) after the operation, respectively.Riker sedation-agitation scale (SAS) score was recorded at T 1, 2, and QoR-9 scale was recorded at T 3, 4.The concentrations of serum cortisol (Cor), norepinephrine (NE), epinephrine (E) and blood glucose (Glu) were measured by enzyme linked immunosorbent assay.First off-bed time, exhaust time, length of hospital stay after surgery, and the requirement for rescue analgesia and adverse reactions (nausea and vomiting, respiratory depression, hypotension, skin itching) within 48 h after the operation were recorded. Results:Compared with group PCIA, the incidence of CRBD and the severity were significantly decreased at T 1-4, SAS score was decreased at T 1, 2, QoR-9 score was increased at T 3, 4, Cor, NE, E and Glu concentrations were decreased at T 1-4, the incidence of postoperative rescue analgesia was decreased, first off-bed time, exhaust time and length of hospital stay after surgery was shortened, and the incidence of postoperative nausea and vomiting, respiratory depression, hypotension, skin itching was decreased in group L ( P<0.05). Conclusion:Continuous infusion of lidocaine through the urinary catheter can provide good postoperative analgesia, reduce postoperative stress response and adverse reactions, and facilitate early postoperative recovery in patients undergoing urological surgery.

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.

Objective: To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions. Methods: In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing. The definition of procedure success was defined as residual stenosis less than 20% after implantation of drug eluting stent and rotational atherectomy. After the procedure, the patients were followed up to observe major adverse cardiac and cerebral vascular events which including cardiogenic death, myocardial infarction, cerebrovascular accident, and target lesion revascularization. Results: The 1.25 mm diameter burr was firstly selected in 80.6% (25/31) patients,and 96.8%(30/31) patients used only 1 burr to complete the rotational atherectomy procedure. The complication rate was 9.8% (3/31) including 1 patient with coronary dissection and 3 patients with slow flow or no flow. There was 1 patent with both coronary dissection and slow flow. The procedure success rate was 96.8%(30/31). Interventional treatment related myocardial infarction occurred in 3 patients during hospitalization.The 30 patients with procedure success were followed up 36(11, 96) months. The incidence rate of major adverse cardiac and cerebral vascular events was 13.3% (4/30), of which the cardiogenic death rate was 3.3% (1/30), the myocardial infarction rate was 6.7% (2/30), cerebrovascular accident rate was 3.3%(1/30),and the target lesion revascularization rate was 6.7% (2/30). Conclusion Rotational atherectomy is safe and effective in the interventional treatment of coronary CTO lesions.