BACKGROUND: With the increase of senile population, it needs to further improve their mental health when improving their physical health. To study the depressive status of retired elderly people in order to provide basis for effective community nursing intervention.OBJECTIVE: To investigate and analyze the depression incidence among retired elderly people and conducted correlative factors analysis in order to improve the nursing service to aged people's mental health.DESIGN: Cross-sectional sampling study towards retired senior people.SETTING: Nursing department of a medical college.PARTICIPANTS: This study was completed in Nursing Department of North China Coal Medical College during September to December 2002. It conducted questionnaire survey to 1 000 retired people in Tangshan city by family visit. There were 574 male and 426 female who aged from 60 to 88years old with mean age of 67 years.METHODS: To adopt geriatric depression scale and general condition questionnaire investigation to individuals.MAIN OUTCOME MEASURES: Depression scale score, depression incidence and frequency of correlative factors RESULTS: Mild depression accounts for 17.2% while moderate and severe depression account for 5% among retired elderly people. There is close relationship between factors such as retired veterans, female, low education,lack of social support, empty life, lack of exercise and poor self-assessed health and depression incidence(x2 = 9.80 - 175.93, P ＜ 0. 05).CONCLUSION: The incidence of senile depression among retired elderly people is pretty high so that it is important to pay attention to mental care towards retried people when doing community nursing, especially to divorced, widowed, female and low educated retired people.

Objective To evaluate the effect and safety of Yufeng Ningxin drop pills in treating nervous headache with blood- stasis syndrome.Methods A double- blind,randomized,parallel- control and multi- center trial was carried out.Treatment group was treated by Yufeng Ningxin drop pills (15 pills,tid) and placebo tablet (5 tablets,tid); Yufeng Ningxin tablet (5 tablets,tid) and placebo drop pills(15 pills,tid) served as positive control.The course of treatment lasted 4 weeks.There were 60 patients in every group.Results No significant differences were found in total therapeutic effect rate( 90 % in both two groups) ,effective rate in relieving symptoms and signs( 95 % in treatment group and 91.6 % in control group) ,attacking frequency of headache,lasting- time of headache,average lasting- time of each time of headache,severity of headache,scoring of headache and scoring of symptoms and signs between the two groups.Conclusion Both Yufeng Ningxin drop pills and Yufeng Ningxin tablet are effective and safe in treating nervous headache.No obvious adverse reaction is found. 

BACKGROUND: Geriatric depressive disorder is a common psychological disorder in elderly people, and it can lead to the decline of various organic functions, and it also does great harm to elderly people and their family.OBJECTIVE: To investigate the influencing factors of depressive disorder in retired cadres and people, so as to provide basic evidence for enhancing the mental nursing in retired cadres and people and reducing the prevalence of geriatric depressive disorder.DESIGN: A sampling survey.SETTING: Department of Nursing, North China Coal Medical College.PARTICIPANTS: Between August and December 2002, 1 000 retired cadres and people living in the urban area of Tangshan city were investigated. There were 574 males and 426 females, aged from 60-88 years, the average age was 67.04 years, 851 of them were married, 10 were divorced and 139 had lost their spouses: the educational level was primary school and below in 159 cases, junior middle school in 362 cases, senior middle school in 280 cases, university and above in 199 cases.METHODS: The elderly people were investigated with the geriatric depression scale (GDS) and individual general information inventory by means of family visit. The investigative purpose and methods were introduced to the subjects before the investigation, and they all signed the informed consent, the form of without recording name was used. The strictly trained investigators were qualified by examination, which ensured the concordance of the investigative results. The pretesting was performed before the investigation to detect whether there were words,sentencesand items hard to understand, so as to avoid the information bias. The questionnaires were filled by the elderly people themselves or by the investigator if there was any difficulty for the elderly people in writing according to the their choice after reading the questions for them.in retired cadres and people of different age, gender and educational level:ferent marriage status.RESULTS: Totally 1 000 questionnaires were sent out, and 1 000 valid der was obviously higher in females than in males (27.0%, 18.6%, P ＜ 0.05).ple with the educational level of primary school and below, junior middle school, senior middle school, university and above were 33.9%, 22.1%,20.0%, 16.1% respectively, and it was decreased with the elevation of emarkedly higher in retired people than in retired cadres (25.4%, 13.6%,higher than in those having or had lost spouse (50.0%, 21.2%, 26.6%, P ＜ 0.05).CONCLUSION: The prevalence of depressive disorder is higher in retired cadres and people. More attentions should be given to the mental health care and social support of retired cadres and people, especially for the divorced ones.

Objective To investigate the morphological abnormalities of the brain cortex in schizophrenic patients and their parents. Methods We recruited 33 schizophrenic patients, 63 their unaffected biological parents. Thirty well matched healthy controls served as control group 1 (for patients), and 28 well matched healthy controls as control group 2 (for parents). The high-resolution magnetic resonance imaging (MRI) and Freesurfer software were used to measure the gray matter volume, cortical thickness, cortical surface area, curvature and volume of subcortical regions on all the sub-jects. Results The patients demonstrated significant reduction of cortical thickness in the left middle-anterior cingulate, middle occipital gyrus, inferior circular sulcus of the insula, lateral occipito-temporal sulcus, the right lateral occipito-temporal gyrus, middle temporal gyrus, superior circular sulcus of the insula, inferior temporal sulcus, the bilateral poste-rior-dorsalcingulated gyrus and superior temporal sulcus (P<6.0×10-4,corrected by Bonferroni method). Compared with control group 2, the unaffected parents exhibited slight reduction of cortical in the left subcentral, triangular part of the in-ferior frontal gyrus, middle frontal gyrus, superior circular sulcus of the insula, occipital pole, inferior frontal sulcus, mid-dle occipital sulcus and lunatus sulcus, lateral orbital sulcus, the right middle occipital gyrus, lingual gyrus, posterior lat- eral sulcus and inferior precentral sulcus, but the reduction was not significant after correction for multiple comparisons. Conclusions Our results indicate that cortical thickness can specifically reflect the brain morphological abnormalities of schizophrenia and the reduction of cortical thicknes may be a heritable phenotype of schizophrenia.

Objective To optimize the process of hyperglycemia management in hospitalized diabetic patients,to standardize behaviors of medical staff and reduce the incidence of adverse events.Methods The team of hyperglycemia management was established to reformulate flowchart of hyperglycemia management for diabetic patients,and to design and implement the intervention scheme by applying Healthcare Failure Mode and Effect Analysis (HFMEA).Results After the application of HFMEA,the reporting rate of hyperglycemia was increased from 74.56％ to 77.98％,the rate of insulin injection was increased from 91.12％ to 94.08％;the qualification rate of theoretical knowledge among nurses was increased from 56.25％ to 93.75％,the qualification rate of insulin injection practice was increased from 43.75％ to 93.75％;the incidence of adverse events related to insulin injection was decreased from 7.31‰ to 1.9‰.The differences were statistically significant (P＜0.05).Conclusion Utilization of HFMEA to optimize the process of hyperglycemia management can effectively standardize behaviors of medical staff and reduce the incidence of adverse events associated with insulin injection.

OBJECTIVETo evaluate the association of major histocompatibility complex class I chain related gene A (MICA) antibodies with acute rejection (AR), chronic rejection (CR) and renal function after renal transplantation.

METHODSSerum MICA antibodies were detected with ELISA before and after transplantation with also examinations of panel reactive antibodies (PRA), serum creatinine, urine, graft ultrasound, lymphocyte subsets and the pathology of graft biopsy. The study was carried out in two parts to monitor MICA antibodies in acute and chronic rejections after renal transplantation.

RESULTSIn the first part of the study 18 of the 41 recipients experienced episodes of acute rejection, and the incidence rate was markedly higher in MICA(+) group than in MICA(-) group (P<0.05). Compared with the recipients with stable renal functions, the patients with acute graft rejection showed a significantly higher positivity rate of MICA antibodies. Postoperative MICA antibody monitoring showed that MICA antibody level increased gradually 2-3 days after the occurrence of acute rejection; anti-rejection treatment lowered serum creatinine to a normal level but MICA antibodies remained positive. In the second part, 21 of 40 patients had chronic graft rejection and showed significantly higher positivity rate of MICA than the patients with stable renal functions (P<0.05). In patients with chronic rejections, the serum creatinine levels were significantly higher in MICA(+) than in MICA(-) cases (P<0.05). Graft biopsy of all MICA(+) cases showed C4d deposition.

CONCLUSIONThe status of MICA antibodies can predict the occurrence and treatment outcomes of acute rejection, and also as one of the major causes of chronic graft rejection, they affect the long-term survival of the renal grafts.

Adolescent ; Adult ; Antibodies ; blood ; immunology ; Complement C4b ; metabolism ; Creatinine ; blood ; Follow-Up Studies ; Graft Rejection ; blood ; immunology ; pathology ; HLA Antigens ; immunology ; Histocompatibility Antigens Class I ; immunology ; Humans ; Kidney ; metabolism ; physiopathology ; Kidney Transplantation ; Peptide Fragments ; metabolism ; Young Adult

Objective:To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) on the discharge outcome in elderly patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis (IVT).Methods:Elderly patients with AIS received IVT in the Department of Neurology, the Second Affiliated Hospital of Soochow University from August 2018 to August 2020 were retrospectively included. The modified Rankin Scale was used to evaluate discharge outcome, and the score >2 was defined as poor outcome. Symptomatic intracranial hemorrhage (sICH) was defined as any intracranial hemorrhage found on imaging examination accompanied by neurological deterioration, where the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 from baseline or bleeding led to death. Multivariate logistic regression analysis was used to determine independent risk factors for sICH and poor discharge outcome. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of NLR for sICH and poor discharge outcome. Results:A total of 228 elderly patients with AIS receiving IVT were enrolled, including 118 males (51.8%), aged 73.64±8.16 years, with a baseline NIHSS score of 6.23±6.54. Ninety patients (39.5%) had poor outcome at discharge, and 16 (7.0%) developed sICH. Univariate analysis showed that the NLR in the poor outcome group was significantly higher than that in the good outcome group ( P<0.01). Multivariate logistic regression analysis showed that a higher NLR was an independent risk factor for poor discharge outcome (odds ratio [ OR] 1.245, 95% confidence interval [ CI] 1.044-1.484; P< 0.05) and sICH ( OR 1.124, 95% CI 1.010-1.251; P<0.05). ROC curve analysis showed that the area under the curve of NLR for predicting poor discharge outcome was 0.693 (95% CI 0.620-0.765; P<0.01). The optimal cutoff value was 4.345. Its corresponding sensitivity and specificity were 47.8% and 87.7%, respectively. The area under the curve of NLR for predicting sICH was 0.651 (95% CI 0.498-0.804; P<0.05). The optimal cutoff value was 3.515. Its corresponding sensitivity and specificity were 68.8% and 61.8%, respectively. Conclusions:A higher NLR is independently associated with sICH and poor discharge outcome in elderly patients with AIS receiving IVT, and have certain predictive value for sICH and poor discharge outcome.

Objective:To explore the effect of a Chinese medicinal composition ( Xiadanqi) on the prevention of radon exposure induced injuries of lung in vitro and in vivo. Methods:Mice were randomly divided into three groups of blank control group, radon-exposed group alone and radon-exposed group intervened with Chinese medicinal composition. The pathological changes of lung tissues in each group after 120 WLM were observed by HE and Masson staining, and the expressions of α-SMA protein and Vimentin protein in lung tissues were detected by immunohistochemistry staining. The levels of oxidative stress in lung tissue of each group were detected with SOD and MDA kits. At the same time, a radon exposed cell model and a radon exposure + Xiadanqi intervention cell model were constructed using an ecological radon chamber. The cell adhesion abilities of different groups were detected by an adhesion kit. The cell migration ability of each group was determined by the transwell migration experiment. The expression of E-cadherin and Vimentin protein was detected by Western blot. Results:Compared with the radon exposure group, the concentration of MDA was decreased ( t=4.43, P<0.05), the activity of SOD was increased ( t=3.22, P<0.05), and α-SMA and Vimentin protein expressions were decreased ( t=3.08, 7.57, P<0.05) in lung tissue of mice intervened with 2 mg/g Xiadanqi. In vitro, compared with radon exposure group, the migration ability was reduced ( t=4.78, 13.01, P<0.05), the cell adhesion property was enhanced ( t=3.41, 12.55, P<0.05), the expression of E-cadherin protein was increased ( t=2.96, 19.57, P<0.05), and the expression of Vimentin protein was obviously reduced ( t=21.00, 33.32, P<0.05) in radon-exposed cells with the treatment of Chinese medicine (150 μg/ml and 200 μg/ml). Conclusions:The Chinese medicinal composition ( Xiadanqi) has a certain radioprotective effect on radon exposure induced injury by reducing oxidative stress, attenuating EMT and fibrosis, and thus it may be applied as a protective agent for radon induced injury.

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.