The article reviews the current status of elder abuse from the perspective of epidemiology, characteristics of abuse, risk factors and nursing assessment and management, presenting the idea that nurses are playing a major role in the prevention,detection and resolution of elder abuse. It also introduces that nurse can screen out the situation of elder abuse timely by applying the proper assessment tool flexible and respond to the occurrence of elder abuse as well as avoid the elder abuse again by comprehensive application of nursing knowledge and management skills. Some advices about future research and mismanagement in elder abuse being given.

0.05). Conclusions The expression of p16、 C-erbB-2 protein is correlated with gastric cancer and p16、C-erbB-2 protein can be used to evaluate the biological behavior and prognosis of gastric cancer.

[Objective]To explore the surgical management and its results of intercondylar fracture of humerus through approach of osteotomy of olecranon(AOO) with dual anatomical steel plate DASP.[Method]From July 2002 to March 2006,26 patients of intercondylar fracture of humerus were treated surgically through AOO,and the fracture was reduced and fixed with DASP.The patients were 19 males and 7 females with a mean age of 35 years (range 15～46 years),According to Riseborough and Radin classification,type Ⅱ fracture was found in 6 cases,type Ⅲ in 18,type Ⅳ in 2.Early rehabilitation exercises was taken.[Result]Twenty-five fractures were satisfactory reduced but one not too good,none had incision infection,injuries of the ulnar nerve.Twenty-two patients were followed up from 6 months to 19 months(average 13.5 months),of these 22 patients,all the osteotomies healed in 17 weeks averagely(range 14～24 weeks) and the injuried ulnar nerve recovered completely.The function of the elbow(according to Cassbaum scale) showed excellent in 5 cases,good in 13,fair in 3 and poor in 1.the good-excellent rate was 81.8%.[Conclusion]The technique of DASP for the treatment intercondylar fracture of humerus through transolecranon approach offers many advantages,such as sufficient exposure easy to get anatomical reduction,stable fixation and earlier exercise.

Objective To study gastroscopic features and clinical diagnosis of prepyloric mem-brane. Methods Clinical characteristics,gastroscopic manifestation and operational findings of 18 pa-tients,whose prepyloric membrane have been confirmed by operations,were retrospectively reviewed. Results Gastroscopie findings showed that all the 1 8 patients suffered gastric retention and pyloric obstruc-tion to some degree,with 4 cases of esophageal erosion and/or esophageal ulcer,five cases of erosive hemor-rhagic gastritis,one case of ulcer at gastric antrum,gastric comer and pylorus respectively. There were 2 ca-ses of aperture like narrowing in prepyloric region. And there were 9 cases that showed obvious congestion and edema in the prepyloric mucus,with uniform circular mucusal protrusion around the stenosing stoma,and volcano-like depression in the middle,three cases of which showed mucosal membrane standing out to the gastric cavity. The membrane found in the above 11 cases located in pyloric exit or tube,and they under-went membrane excision and py|oroplasty. The other 7 cases showed thick mucosal folds at the distal antrum with radial arrangement. Round or irregular stenosing stoma were observed. These cases proved to be antral membrane,1-3 cm away from the duodenum and pylorus,and underwent simple membrane resection. Conclusion Congenital prepyloric membrane is rare and it likely mis-diagnosed. The onset and the degree of symptoms depend on the diameter of aperture of the membrane. Early endoscopy,in addition to barium contrast,should be performed on those children who have intermittent bilious vomiting,where false-positive radiological findings can be avoided,therefore,to facilitate right diagnosis and appropriate operation.

Objective To explore the effects of a microbubble agent (SonoVue) on radiofrequency ablation(RFA).Methods Twenty rabbits underwent RFA with or without SonoVue on two areas per rabbit liver.SonoVue were injected in bolus intravenously in 0.1 ml/kg.The morphology of hyperechogenic area were observed by conventional ultrasonography.The size of RFA lesions and ablation time were measured.The correlation was analyzed between hyperechogenic area and ablation size.Results Microbubbles didn't change the size of RFA lesions.However,with the addition of SonoVue to ablation,the morphology of hyperechogenic area was showed more regular and stable,and hyperechogenic area and ablation size were well correlated (r =0.849,P =0.000).Besides,the ablation time was much shorter (P ＜ 0.05).Conclusions The addition of SonoVue to ablation improve the prediction of ablated areas and reduce the ablation time,therefore it might be useful to prevent the unfavorable ablation of adjacent organs and vessels.

Objective To investigate the effects of ultrasound radiation force(USRF) on adhering of targeted microbubbles in vivo.Methods A rat model of cremaster muscle Inflammation was developed,and microbubble(MB) or targeted microbubble of intercellular adhesion molecule-1 (MBICAM) was injected through the caudal vein.Immediately after intravenous MB or MBICAM injection,the cremaster was insonated for 5 minutes and the control group was in sham ultrasound exposure.All mice were divided into four groups randomly:① MB + false USRF; ② MB + USRF; ③ MBICAM + false USRF; ④ MBICAM + USRF.Fluorescence microscope was performed in twenty mice to evaluate microbubbles adhesion and video recordings were made with a high-resolution camera.Results The adhesion number of MBICAM was significantly greater in USRF group than that of MBICAM in false USRF group [(43.4 ± 2.1)/view vs (14.8± 1.8)/view,P =0.000].The adhesion number of MB in USRF group was greater than in false USRF group [(6.2 ± 1.3)/view vs (4.6 ± 0.9)/view].But there is no statistical significance (P =0.129).The adhesion number of MBICAM in both USRF group and false USRF group was significantly greater than the adhesion number of MB.Conclusions The ultrasound radiation force can significantly improve the adhesion of targeted microbubbles in vivo.

Objective To observe the effect of changes in CD34+ cell level on various degrees of chronic heart failure (CHF) in the elderly. Methods The enrolled patients were divided into four CHF groups according to the New York Heare Association(NYHA) functional class: NYHA class I (n=23), Ⅱ (n=27), Ⅲ (n = 20) and IV group (n= 16) , and there were 41 healthy controls over the same period. The levels of peripheral blood CD34+ cells were measured, and the tumor necrosis factor-α (TNF-α). its soluble receptors (sTNFR-1 and sTNFR-2) and vascular endothelial growth factor (VEGF) were also measured. Results The levels of CD34+ cells were elevated in the early CHF and depressed in the advanced CHF in elderly patients. The levels of CD34+ cells were (0. 6± 0.2) 109/L in control group, (2.4±0. 4) 109/L in NYHA class I group, (1.9±0.2)×109/L in NYHA class Ⅱ group, (1.3±0.1)×109/L in NYHA class Ⅲ group and (0.5±0.2)×109/L in NYHA class Ⅳ group, respectively (all P<0.01).And TNF-α, sTNFR-1, sTNFR-2 and VEGF were increased in severe chronic left ventricular failure CNYHA class IV vs. I group:TNF-α: (61.4± 15.7) ng/L vs. (28.4±10.8)ng/L; sTNFR-1: (2820.9±1282.8)ng/L vs. (690.8±62.7) ng/L; sTNFR-2: (4113.1±1102.2) ng/L vs. (740.8± 112.3)ng/L; VEGF: (996.3±487.1)ng/L vs. (423. 3±147. 9)ng/L, all P<0. 013. Conclusions The changes of CD34+ cell level may predict various degrees of chronic heart failure in elderly patients.

Objective To establish a rat model of ulcerative colitis ( UC) with spleen and kidney Yang deficien-cy.Methods The rat model of ulcerative colitis with spleen and kidney Yang deficiency was established by oral adminis-tration of Rhubarb decoction, intramuscular injection of hydrocortisone, and combined with ethanol enema of TNBS (2,4, 6-trinitrobenzene sulfonic acid).Sixty Wistar rats ( body weight 180 ±20 g, male:female=1∶1) were randomly divided into blank control group and groups of UC models with spleen kidney Yang deficiency for 7 days, 14 days and 21days.The serum levels of FT3, FT4, and T of the rats were detected by ELISA assay.Results Compared with the blank control group, the serum levels of FT3, FT4, and T in the groups of UC rat models with spleen kidney Yang deficiency for 7 days, 14 days and 21days were decreased to a different extent (P<0.05), especially, decreased dramatically in the model group for 21 days.Conclusions FT3, FT4, and T are sensitive indexes with spleen and kidney Yang deficiency.The detection of serum levels of FT3, FT4, and T can better verify the spleen and kidney Yang deficiency in the rats, and prove that the spleen and kidney Yang deficiency type UC animal model is successfully prepared.

Objective To explore the influencing mechanism of Zhengan Xifeng Decoction on blood pressure and gastrointestinal motility in SHR. Methods After 15 WKY and 90 SHR rats were were randomly divided into normal control group, model group, Benner Pury group, amlodipine group, Zhengan Xifeng Decoction high, middle, and low dose groups. The normal control group and model group were fed with distilled water daily. Rats in treatment group were administered with corresponding drugs daily. Blood pressure, gastric residual and intestinal propulsive ratio of rats was detected after eight-week intervention. Results Compared with the blank control group, systolic pressure, diastolic pressure, and mean arterial pressure were significantly higher than WKY rats of same age (P<0.05). Compared with the model group, the systolic pressure, diastolic pressure, and mean arterial pressure of treatment groups were significantly reduced (P<0.05). Compared with the blank control group, gastric residual rate of rats in the model group significantly decreased (P<0.05). Compared with the model group, the gastric residual rate in Zhengan Xifeng high dose group increased significantly, and intestinal propulsive ratio significantly increased (P<0.05), without statistical significance in the other treatment groups. Conclusion Zhengan Xifeng Decoction can reduce blood pressure in SHR, and regulate gastrointestinal motility.

Objective The cytotoxic effect of bile acids on trophoblast and fetal development in intrahepatic cholestasis of pregnancy(ICP) were studied through the observation of ultrastructure changes and expression of epidermal growth factor receptor(EGFR) of placenta. Methods Twenty two ICP (7 with FGR and 15 without FGR) and 15 normal late pregnancies were selected. The placental ultrastructure was observed with transmission electron microscope. The expression of EGFR in placenta was determined by immunohistological method and the related quantity of EGFR mRNA was analysed by reverse transcription polymerase chain reaction (RT PCR). Results The morphological changes found in syncytiotrophoblast were the following: decrease in the number of superficial microvilli, dilatation of rough endoplasmic reticulum, tumefation or myelination of the mitochondria and abnormal distribution of chromatin. These changes of syncytiotrophoblast were more obvious in ICP with FGR. In addition, decrease in the number of capillaries and proliferation of degenerated collagenous fibrils in villi interstitium were also observed. Compared with the normal pregnancies, the expression of EGFR in placenta from ICP decreased significantly and there was no significant difference of EGFR expression in ICP with and without FGR. Conclusion Bile acids cause distinct injuries on trophoblast in a dose dependent manner and that maybe account for the decreased expression of placental EGFR in ICP.