Objective To develop a Chinese version of Death Attitude Proevaluate its reliability and validity by applying it in the Chinese Christians.Methods After undergoing forward and backward translation of the DAP-R by expert consultation and in-depth interview,150 Christians over 40 years old were recruited to complete the Chinese version of DAP-R,And then factor analysis,correlation analysis and reliability analysis were applied to establish the scale's construct validity and reliability.Results The final scale consisted of five dimensions with 25 items; the varimax rotation factor analysis of the scale identified seven principal factors and explained for 67.075% variances; the correlation coefficient between each item and its domain was 0.432～0.850; Cronbach's α coefficient of five domains were 0.585～0.853,the Cronbach's α and split-half coefficient for the whole scale were 0.840 and 0.843 respectively.Conclusions The Chinese version of DAP-R possesses acceptable validity and reliability in the setting of Christians,and more in-depth study on the scale needs to be done in a wider population.

BACKGROUND:Bisphosphonates that can increase bone density and inhibit bone resorption have been clinical y confirmed, but the structure of the bone matrix has been less studied.
OBJECTIVE:To observe the effects of alendronate on bone structure and bone matrix metabolism, and then to investigate the control ing mechanism by which alendronate improves bone mass and increase bone intensity.
METHODS:An ovariectomized rat model was prepared and intervened with alendronate as treatment group. Model and sham-surgery groups were set as controls. Alendronate effects on bone mineral density, bone metabolism, bone biomechanics, and bone structure were observed in bone loss rats using bone imaging, bone tissue pathology and biomechanical test and enzyme-linked immunosorbent assay.
RESULTS AND CONCLUSION:Alendronate intervention could fight against bone loss as compared with model group at weeks 4, 8, and 12 after treatment (P<0.05). Compared with the model group, the expression of urinary deoxypyridinoline and serum carboxyterminal propeptide of type Ⅰ procol agen was decreased significantly after alendronate intervention (P<0.05);the maximal load, maximal pressure and modelus on the lumbar vertebrae and femur were increased as wel as ratio of urinary pyridinoline/deoxypyridinoline of type Ⅰ procol agen (P<0.05). These findings suggest that alendronate intervention can inhibit bone loss in rats induced by estrogen deficiency, increase biomechanical properties, improve bone matrix structure, and meanwhile, recover the Ⅰ col agen crosslinking component due to ovariectomy.

ObjectiveTo design the scale of death attitude for Chinese nurses and evaluate its validity and reliability.MethodsThe scale draft was formed through the literature review,the formal scale was got via expert consultation and interview survey of 20 cases of small sample.120 clinical nurses were selected for investigation.Then item analysis,factor analysis,correlation analysis and reliability analysis were applied to establish the scale′s validity and reliability.ResultsThe nursing staff death attitude scale consisted of 25 items,the varimax rotation factor analysis of the scale identified seven principal factors and explained for 63.732％ variances.The correlation coefficient between each item and its domain was 0.498～0.808,the Cronbach′s α coefficient of five domains was 0.595～0.774,the Cronbach′s α and split-half coefficient for the whole scale were 0.824 and 0.868 respectively.ConclusionsThe scale has high reliability and validity,and it can be the effective test instrument for death attitude of nurses in China.

OBJECTIVE:To investigate the healing-promoting effect of total tanshinone on sore and ulcer of model rats. METH-ODS:Staphylococcus aureus levitation liquid was made to reproduce model rats with sore and ulcer,sc. 50 rats were randomly di-vided into normal group(equal volume of CMC-Na solution),model group(equal volume of CMC-Na solution),ampicillin group (positive drug 20 mg/kg)and total tanshinone high and low dose groups(200 and 100 mg/kg),ig,once a day for continuous 12 d. The general conditions were observed. The content of lysozyme(LZM)and immunoglobulins G(IgG)in serum were tested af-ter 12 d;the content of LZM and IgG in purulent secretion of model rats were respectively tested after dosing of 4 d,8 d and 12 d. The integral of wound deterioration were evaluated. RESULTS:Compared with normal control group,the index was worse in model group. Compared with model group,the appetite and activity amount of total tanshinone in high dose group (200 and 100 mg/kg)were increased,with no secretion on the wound and a clean escharosis;content of LZM and IgG in serum of rats in in to-tal tanshinone high and low dose group were increased after 12 d;also,the content of LZM and IgG in purulent secretion of rats in total tanshinone high and low dose groups were increased after dosing of 4 d,8 d,and 12 d;the integral of wound deterioration in total tanshinone high dose group were decreased after dosing of 8 d and 12 d,with significant difference (P<0.01 or P<0.05). CONCLUSIONS:Total tanshinone can promote the wound healing on sore and ulcer of model rats by a mechanism that is related to the content of LZM and IgG in serum and purulent secretion.

Background and purpose: Reports showed that berbefine not only had an effect ofdetoxification and inflammation but also could induce the cell to apoptosis. Berberine may also inhibit the migration and metastasis of tumor. To investigate the effects and mechanism of berberine on migration and metastasis of A549 cells, the proliferation, mobility and adhesion of A549 cells were observed after incubation with berberine. Methods: The proliferation was determined by MTT. Wound healing assay and adhesion test were used to observe the mobility and adhesion rate. The mRNA and protein expressions of MMP2 and MMP9 were assessed by semi-quantitive RT-PCR and gelatin zymography, respectively. Results: Berberine could significantly inhibit the proliferation ofA549 within a certain range of treating time and dose (P<0.05). The mRNA and protein expression of MMP2 and MMP9 gene were decreased slightly by the treatment ofberberine (P<0.05), especially at dose of 100 μg/ml. Conclusion: Berberine can inhibit the migration and adhesion abilities of A549 cells, probably by down-regulating the expression and activation of MMP2 and MMP9.

Objective:To investigate the compliance with early Warfarin anticoagulation therapy after cardiac mechanical valve replacement(MHVR)and its related factors in elderly patients.Methods:The convenience sampling method was used to prospectively recruit 210 patients undergone MHVR at the Ningbo Medical Center of Lihuili Hospital from January 2017 to October 2019.Six months after discharge, face-to-face interviews or telephone follow-ups were conducted to assess general information, warfarin anticoagulation knowledge, anticoagulant treatment compliance and social support.Results:The overall compliance of early Warfarin anticoagulation therapy was excellent, with 99.5% of patients compliant with medication and 99.0% compliant with INR monitoring, both higher than the rate of compliance with advised lifestyle adjustment(92.1%). Anticoagulation knowledge and age were the main influencing factors for compliance in elderly patients after MHVR.Conclusions:The compliance with early Warfarin anticoagulation therapy after MHVR is good in elderly patients in the Ningbo area.The correlation analysis suggests that medical professionals need to promote education on anticoagulation knowledge and pay more attention to anticoagulation compliance in elderly people.

How to effectively using the electronic health records (EHR) in contracted family doctors service was studied according to the new model of HER-based community medical service with community health service station as a center in combination with large hospitals,and suggestions were put forward for the solution of problems in contracted family doctor service,namely establishing and perfecting the community health service system,enlarging the scale of HER,strengthening the construction of general doctors team,and training the technically competent community health service staff.

Diabetes mellitus is a chronic disease, it is thus necessary for its patients to participate in its treatment and self-management. The emerging foreign and domestic methods for self-management of diabetes mellitus pa-tients were detected on different Websites and suggestions were proposed for its treatment and self-management in order to improve the quality of life in diabetes mellitus patients.

Objective To investigate the blood-saving effect of tranexamic acid in off-pump coronary artery bypass (OPCAB). Methods Two hundred and sixty ASA Ⅰ- Ⅲ and NYHA Ⅰ- Ⅲ patients of both sexes,aged 18-64 yr, with body mass index 16-22 kg/m2 , undergoing OPCAB, were randomly divided into 2 groups (n = 130 each): control group (group C) and tranexamic acid group (group T) . Anesthesia was induced with iv injection of midazolam 0.1 mg/kg, fentanyl 5-10μg/kg and pipecuronium 0.1 mg/kg. The patients were tracheal intubated and mechanically ventilated. PEr CO2 was maintained at 35-45 mm Hg. A bolus of tranexamic acid 1 g was infused intravenously within 30 min after indution followed by continuous infusion at 400 mg/h until the end of operation in group T. While equal volume of normal saline was given in control group. Anesthesia was maintained with inhalation of isoflurane and intermittent iv injection of fentanyl and pipecuronium. Venous blood samples were taken before induction, at the end of operation and at 24 h after operation for determination of Hb, platelet count (P1t), prothrombin time (PT) and international normalized ratio (INR). The volume of chest tube drainage was collected and recorded at 6 and 24 h after operation. The requirement for transfusion of allogeneic red blood cells and fresh frozen plasma was also recorded. Results There was no significant difference in Hb, Plt, PTand INR at each time point between the two groups ( P ＞ 0.05). The requirement for transfusion of allogeneic red blood cells and fresh frozen plasma was significantly reduced in group T as compared with group C ( P ＜ 0.05 or 0.01 ). No deaths and complications occurred during hospital stay in the two groups. Conclusion Tranexamic acid exerts the blood-saving effect in OPCAB.

OBJECTIVE:To provide reference for rational drug use in elderly patients with depression. METHODS:A total of 96 elderly outpatients and inpatients with depression were selected from 39 mental health institutions of Hebei province during Jul. 2nd to 9th,2012. The drug use were surveyed by using self-made questionnaires on the basis of prescriptions/medical orders. The results of investigation were analyzed statistically. RESULTS:In this study,96 questionnaires were distributed and all were collect-ed with effective recovery rate of 100%. Among 96 respondents,95 elderly patients used a new type of antidepressants,mainly by selective serotonin reuptake inhibitors(SSRIs),accounting for 75.0% of the total. The top 5 drugs in the list of use frequency were sertraline(23 cases,24.0%,daily dose:25-200 mg),paroxetine(22 cases,22.9%,daily dose:20-60 mg),escitalopram(20 cas-es,20.8%,daily dose:5-40 mg),venlafaxine (13 cases,13.5%,daily dose:75-300 mg),mirtazapine (12 cases,12.5%,daily dose:8-30 mg). Among all respondents,22 patients (22.9%) were treated with mono-antidepressant and the other 74 patients (77.1%) were treated with drug combination therapy among which 47 cases were treated with two antidepressant drugs,22 were treated with three drugs,4 were treated with four drugs and 1 was treated with five drugs. 6 cases combined with mood stabilizers, 21 cases with antipsychotic,50 cases with benzodiazepine(6 of them combined with two benzodiazepine),2 cases with other hyp-notic drugs,14 cases with anxiolytic drugs and 2 cases with anticholinergic drugs. CONCLUSIONS:The drug use of elderly pa-tients with depression in mental health institutions of Hebei province basically in line with current trends. However,there are still the phenomenon of irrational drug use as drug dose meets or exceeds the prescribed maximum dose;many varieties are used in combination therapy;route of administration is improper.