Objective:To observe the change and clinical significance of glucocorticoid receptor on peripher alleukocytes frompatients with Graves disease.Methods:By radioligand binding assay,GR contents of peripher alleukocytes were determinated in 61 patients with Graves disease,20 healthy volunteers as controls.Results:The GR contents in Graves disease group were significantly lower than that of the normal control group(t = 7.389,P = 0.000 1).In 61 patients with graves disease,GR contents gradually decreased(F = 7.389,P = 0.000 1)with increased Graves disease severity.GR contents were negatively correlated with FT3,FT4 and TSH,correlation coefficients were 0.741(t = 5.643,P = 0.013),0.689(t = 5.119,P=0.025)and 0.755(t =6.391,P=0.009),respectively.GR contents were decreased(t = 4.274,P= 0.000)while patients complicated bythyrotoxic exophthalmos,but GR contents were not statisticallysignificantlydeclined while patients complicated by hyperthyroid heart disease(t = 0.273,P = 0.786) or thyrotoxic periodic paralysis were(t =0.961,P = 0.336).Conclusion:The binding capacity of GR on peripheral leukocytes in the Graves disease patients is lower than normal.This change may play roles in the pathogenic process of Graves disease and probably relate to the disease severity,thyrotoxic exophthalmos complicated.

Objective To study the correlation of nurse -perceived organizational atmosphere climate and their job involvement. Method About 465 clinical nurses were involved in the investigation by nursing organizational climate scale and work engagement scale. Results The total score on the organizational climate and job involvement were (149.24 ± 21.36) and (52.80 ± 6.31), respectively. The nurse -perceived organizational climate was positively correlated with job involvement ( P <0.01). Conclusions The nurse-perceived organizational climate and job involvement are at a medium level. Nursing managers should create a good organizational climate and promote their positive status into nursing, thereby improving the quality of care.

Objective:To explore the real experience of family caregiver in providing care service and receiving home care organizational management after the disabled aged enjoyed the long-term care insurance so as to provide a scientific basis for standardizing the long-term care insurance home care service.Methods:From July to September 2019, this study selected 14 family caregivers of the home disabled aged enjoying the long-term care insurance in Guangzhou by purposive sampling to carry out the semi-structured interview so as to understand the personal feelings and suggestions of interviewees on long-term care insurance home care service. Colaizzi phenomenological analysis was used to data analysis.Results:A total of two themes were abstracted including the harvest of family caregiver and insufficient management model.Conclusions:Long-term care insurance home care service is instrumental in reducing the economic burden, care burden of family caregivers, and promoting the normative development of home care service. However, there is insufficient management model of family caregivers which needs to be improved.

Objective:To investigate the status and influencing factors of quality of life among disabled elderly whose home care services were paid by the long-term care insurance in Guangzhou, in order to provide a scientific evidence for improving their quality of life and improving the long term care insurance system.Methods:A convenience sample of 161 disabled elderly whose home care services were paid by the long-term care insurance were recruited and investigated. A cross-sectional survey was conducted by general information questionnaire, World Health Organization Quality of Life Brief Scale, Barthel Index, Self-rating Depression Scale, Self-rating Anxiety Scale and World Health Organization Happiness Index Scale.Results:The score of the quality of life among disabled elderly was 41.17±7.79. And the score of its four dimensions in descending order: environment, social relationships, psychological and physical with (11.38 ± 2.71), (10.36 ± 3.16), (9.86 ± 2.08), (9.56 ± 1.89) points. The multiple linear regression analysis found that frequencies of outdoor activities per week, frequencies of hospitalization in the past year, subjective well-being, depression and anxiety influenced the quality of life of the disabled elderly( P<0.05). Conclusions:The quality of life of disabled elderly is not optimistic. Nurses in home care institutions should formulate personalized nursing intervention based on influencing factors to improve the quality of life of disabled elderly, while providing a basis for optimizing long-term care insurance policies.

Objective To explore the correlation between resilience and psychological status of main caregivers among disabled elderly of Guangzhou region.Methods From June 2015 to December 2015, a total of 300 main caregivers of disabled elders were investigated with the general information questionnaire, the Chinese version of Connor-Davidson Resilience Scale (CD-RISC), Activities Daily Living Scale (ADLS), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) by convenience sampling.Results The total score of resilience, standard score of anxiety and depression were (58.2±15.8), (49.05±10.5) and (51.73±11.52) respectively among main caregivers of disabled elders. The competence dimension of CD-RISC had negative correlations with anxiety (r=-0.260,P<0.01) and depression (r=-0.316,P<0.01) in main caregivers of disabled elders, and the toughness dimension was negatively correlated with the depressive symptoms (r=-0.147,P<0.05).Conclusions Main caregivers of disabled elderly of Guangzhou region are with poor resilience along with the high ratio of detection in anxiety and depression suggesting that the mental status is not optimistic.