Objective To understand head nurse's leadership behavior and analyze the influence of it on nurse's involvement and self-efficacy.Methods General information questionnaire was taken,and the data of 280 nurses to head nurse's leadership behavior,involvement and self-efficacy were investigated.Results There were differences in nurse's involvement and self-efficacy between head nurse's transformation and transaction leadership behavior (F=4.39,2.37,2.94,2.17,P ＜0.05).The transformation leadership behavior dimensions were positive correlation with nurse's involvement and self-efficacy,P＜0.05.Conclusion Head nurse should fully play a positive role of transformation leadership behavior,in order to promote involvement and improve self-efficacy.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.

Objective To study the literatures distribution and research status of the elderly tuberculosis published in the Chinese Medical Association Journals (CMAJ) from 2004-2013 in order to provide literature methodological data for the tuberculosis research.Methods The literatures on the elderly tuberculosis published in 82 kinds of CMAJs from 2004-2013 were classified and analyzed.The publication year,distribution,content,author,institution and region of these literatures were analyzed.Results There were 66 articles about the elderly tuberculosis published in 20 kinds of the Chinese Medical Association Journals.These literatures were published mostly in 2011 (16 articles,24.2％),secondly in 2012 (13 articles,19.6％) and 2010 (7 articles,10.6％),which were published mostly in Chinese Journal of Geriatrics (15 articles,22.7％).The main contents included clinical diagnosis and treatment,epidemiological investigation and drug research.The most published form was treatise (55 articles,83.3 ％).Most of the articles involved in pulmonary tuberculosis (34 articles,51.6 ％).The provinces or cities in which the most articles were published were Beijing (28 articles,42.4％) and Shandong (6 articles,9.1％).There was significantly difference in the article number between 2004-2008 and 2009-2013 (P＜ 0.05).The epidemiology,drug resistance mechanism,influencing factors,clinical characteristics,diagnosis and treatment strategy of the elderly tuberculosis,especially diagnosis and treatment development were well discussed in these literatures.Conclusions The literatures of the elderly tuberculosis published in Chinese Medical Association Journals are insufficient in quantity,with number increases of articles significantly over the past 5 years.Projects supported by the foundation is less and discipline construction should be strengthened.The distributions of authors and the primary population of tuberculosis are different,and early diagnosis and treatment of pulmonary tuberculosis in the elderly are concerned especially.

Objective To analyze the citation status of Chinese Journal of Geriatrics,and to evaluate the authority and quality of this journal.Methods Literatures including original research articles,short reports of original studies,reviews and clinical case reports etc.from 2003 to 2007 were collected from China national knowledge internet (CNKI) and Wanfang Database.The citation frequency,author distributions,relevant journals and foundation status were statistically analyzed.Results Totally 1649 papers were published in Chinese Journal of Geriatrics from 2003 to 2007,among which 1280 papers were cited 9062 times by 946 kinds of journals,the average citation times was 7.08 times,and the top citation times was 131 times.270 articles were cited 10 or more times (21.09％).The top 3 relevant journals with high citations from Chinese Journal of Geriatrics were Chinese Journal of Gerontology,Chinese Journal of Geriatrics and Chinese Journal of Misdiagnostics (totally 591 times,6.52％).The self-citation rate was 1.95％.445 articles were supported by different kinds of funds (totally 112 kinds),and majority of articles were supported by National Natural Science Foundation of China.Articles supported by 106 kinds of funds were cited and the total citation times was 2312 times.Conclusions Literatures in Chinese Journal of Geriatrics have high quality and authority with an amount of readers and relatively stable relevant journals.Journal quality and academic level are highly improved,but further efforts are needed to promote the coordinated development of regions.

Objective To develop a scientific system of core information of health and evaluation index for the elderly Chinese people,which is suitable for the situation of our country.Methods The framework was established by extensive literature review and topic discussions.The index system was constructed with the Delphi method.Results 58 experts in different fields of health were selected in the two rounds of Delphi consultation research.The effective response rates in the two rounds were 96.88％ and 100％ respectively.The average value of the authoritative coefficient was between 0.80 and 0.96.And coefficients of variation were between 6.20 and 12.13.Based on the Delphi consultation research,the core information of health and evaluation index system for the elderly Chinese people were composed of 8 primary indicators closely associated with the positive awareness of aging and senescence and 31 other indicators.Conclusions The architecture of the core information of health and evaluation index system for the elderly Chinese people is stable,and the consultant experts tend to reach a consensus.The evaluation index system contains the most influential factors for the elderly Chinese people,and has the affirmative scientificity,applicability and feasibility.

Objective To evaluate the reporting quality of Meta-analyses published on Chinese journals of geriatrics.Methods Papers of Meta-analyses on geriatrics published in nine major Chinese journals of geriatrics before November 21,2013 were retrieved,their basic information were abstracted and evaluated through system assessment and preferred reporting items for systematic reviews and Meta-analyses (PRISMA) statement.Statistical analyses were performed with the SPSS17.0 software.Results Among the 71 internalized papers,1 was from 《Geriatrics & Health Care》,1 from 《Practical Geriatrics》,10 from 《Chinese Journal of Geriatric Care》,45 from 《Chinese Journal of Gerontology》,3 from 《Chinese Journal of Multiple Organ Diseases in the Elderly》,1 from 《Chinese Journal of Geriatric Dentistry》,5 from 《Chinese Journal of Geriatric Heart Brain and Vessel Diseases》,5 from 《Chinese Journal of Geriatrics》.55 papers (77.5％) were published in recent 3 years.The mean overall PRISMA score was(16.75±3.04)ranged from 4 to 24.The main influencing factor for the quality of Meta-analyses was the year of publication (adjusted β=-0.342,P=0.003).Conclusions The quantity and quality of Meta-analyses published on Chinese journals of geriatrics are increased and improved in recent years,but there are still some problems on the writing norms.We should promote PRISMA statement and standardize reporting format to improve the quality of Meta-analyses in the field of geriatric medicine.

Objective To analyze the distribution characteristics of Pseudomonas aeruginosa and Acinetobacter baumannii ,and to investigate the changing pattern of antimicrobial resistance of these strains isolated during 2012 - 2014 .Methods Strains of Pseud‐omonas aeruginosa and Acinetobacter baumannii isolated from January 2012 to December 2014 were collected .Antimicrobial suscep‐tibility of clinical isolates was tested by Kirby‐Bauer method .Results In the past three years ,214 strains of Pseudomonas aerugino‐sa and 347 strains of Acinetobacter baumannii were isolated .The nosocomial infection rate of Pseudomonas aeruginosa decreased year by year ,while the Acinetobacter baumannii ′s increased .Most strains were isolated from sputum ,wound secretion and urine . The strains of Pseudomonas aeruginosa and Acinetobacter baumannii were distributed in various departments of the hospital .The detection rates of these strains were the highest in ICU ,respectively 27 .6% and 34 .9% .Both the resistance rates of Pseudomonas aeruginosa to ceftazidime ,imipenem ,Amikacin and Acinetobacter baumannii to Piperacillin/Tazobactam and imipenem had in‐creased ,while the resistance rates of Acinetobacter baumannii to polymyxin B had decreased with each passing year .Conclusion Pseudomonas aeruginosa and Acinetobacter baumannii causes severe nosocomial infections and the antimicrobial resistance rates in‐creased ,especially the resistance rates to carbapenem are becoming more higher in recent years .Acinetobacter baumannii shows strong antibacterial activity in vitro to Polymyxin B .Therefore ,antimicrobial resistance surveillance should be strengthened to direct rational use of antibiotics .

With the aging of the global population,frailty is now considered a unique old age syndrome,has become an important worldwide public health problems.The elderly people is at increased risk of falls,hip fractures,disability,death and other risks.Motor system disease as an independent risk factor participates in frailty progress and interacts with each other.This article reviews recent studies on frailty and motor system diseases.

Frailty is a geriatric syndrome that has been implicated as a causative and prognostic factor for cardiovascular disease (CVD).Frailty and CVD are often concurrent and mutually promotive.The prevalence of frailty ranges from 10％ to 60％ in patients with CVD,depending on different tools and cutoffs chosen to define frailty.Short-and long-term prognosis of CVD are both affected by frailty.The presence of frailty is correlated with an increase in complications,outpatient and emergency department visits,hospital admissions and stays,and mortality in patients with CVD.Early prevention and clinical intervention can delay or even reverse the development of frailty,thus improving the prognosis for CVD.

Objective:To explore the alteration of brain‐derived neurotrophic factor (BDNF) signaling and the influ‐ence of irbesartan on it in hippocampus of angiotensin‐converting enzyme 2 (ACE2) knock‐out (KO) mice . Meth‐ods:The 10~11‐week ACE2 KO (Ace2/y ) mice received daily treatment with angiotensin II (Ang II) type 1 (AT1) receptor blocker irbesartan (50 mg/kg) or placebo for two weeks. The wild‐type mice (WT ,Ace2+ /y ) were regarded as normal control. Western blotting method was used to measure levels of BDNF and extracellular signal regulated kinase 1/2 (ERK1/2) in the mice hippocampus. Radioimmunoassay was used to measure plasma Ang level in mice . Results :Compared with normal WT control mice ,there were significant down‐regulations of BDNF protein expres‐sion [ (1 ± 0.16) vs .(0.54 ± 0.16)] in hippocampus and plasma Ang‐ (1‐7) level [ (55.6 ± 7.5) pg/ml vs .(42.8 ± 5.8) pg/ml] ,and significant rise in ERK1/2 phosphorylation [ (1 ± 0.28) vs .(1.79 ± 0.29)] in ACE2 KO mice (P<0.01 all). After irbesartan treatment ,there were significant rise in BDNF protein expression (0.88 ± 0.13) in hippocampus and plasma Ang‐ (1‐7) level [(59.4 ± 8.4) pg/ml] ,and significant reduction in ERK1/2 phosphoryla‐tion level (1.33 ± 0.19) in ACE2 KO mice (P<0.05 or <0.01) .Conclusion:There are BDNF protein expression down‐regulation and enhanced ERK1/2 phosphorylation in hippocampus of ACE2 KO mice. AT1 receptor blockade irbesartan can improve Ang‐ (1‐7 ) level and hippocampus BDNF expression , while reducing hippocampus ERK phosphorylation signal in ACE2 KO mice ,suggesting that AT1 receptor blockade possesses certain brain protective effect.