Objective To study the clinical efficacy and safety of esophageal pacing in termination of old patients with paroxysmal supraventricular tachycardia heartbeat.Methods A total of 68 elderly cases with paroxysmal supraventricular tachycardia heartbeat were given the esophageal pacing termination of therapy,who were treated with overdrive suppression method and a burst termination,and the clinical curative effect and adverse reaction in the two groups were observed.Results 34 cases were given overdrive suppression method,19 cases were successful,the success rate was 55.9％,the direct restoration of sinus rhythm includes 14 cases after the termination,accounting for 73.6％,heartbeat bradycardia occurred in 3 cases after termination,heart rate less than 50 beats per minute,and then disappeared.With a burst of 34 cases,31 cases were successful,the success rate was 91.2％,the direct restoration of sinus rhythm includes 25 cases after the termination,accounting for 80.6％,heartbeat bradycardia occurred in 4 cases after termination,heart rate less than 50 beats per minute,and then disappeared.Conclusion Esophageal pacing is an electrophysiological examination and treatment method with noninvasive,safe and effective advantages,the termination of PSVT has higher success rate,and it can distinguish between different types of PSVT.Compared with overdrive suppression method,burst terminate PSVT pulse method has higher success rate,it is worthy application in clinical.

Objective: To observe the changes of electroencephalogram (EEG) and its clinical significance in patients with acute cerebral infarction. Methods: From January 2017 to January 2019, 96 patients with acute cerebral infarction treated in Zhejiang Xiaoshan Hospital were randomly selected as observation group, and 96 healthy persons of the same age from the same period in our hospital were selected as control group.All the participants were given EEG examination.The values of alpha, beta, delta, theta and DTABR were compared between the two groups.The focal cerebral infarction and large area cerebral infarction in observation group were compared.The values of alpha, beta, delta, theta and DTABR of the dead patients were observed, and the factors affecting the prognosis of the patients with good prognosis and poor prognosis were observed.Logistic multivariate regression analysis was carried out with the prognosis of the patients as a strain to analyze the factors affecting the prognosis of the patients. Results: The values of delta, theta and DTABR of patients in the observation group were (43.26±10.51)Hz, (29.30±9.88)Hz, (1.14±0.40), respectively, which were higher than those in the control group[(22.49±5.37)Hz, (26.42±5.73)Hz, (0.92±0.37)](t=17.243, P=0.000; t=2.471, P=0.014, P=0.014; t=3.956, P=0.000). The alpha and theta of patients with focal cerebral infarction were (15.94±5.33)Hz and (30.76±10.02)Hz, respectively, which were higher than those of patients with large cerebral infarction[(11.37±4.06)Hz and (27.55±7.75)Hz](t=6.683, P=0.000; t=2.483, P=0.014). Delta and DTABR in patients with focal cerebral infarction were (37.42±5.33)Hz and (1.03±0.52)Hz, which were lower than those of patients with massive cerebral infarction[(52.36±5.21)Hz and (1.48±0.45)Hz](t=19.640, P=0.000; t=6.412, P=0.000). There was no significant difference in beta between the two groups (P>0.05). The patients with good prognosis had higher levels of alpha and beta on the affected side[(27.18 ±9.65)Hz and (14.83±5.06)Hz] than those with poor prognosis[(14.06 ±3.94)Hz and 9.03±4.33)Hz](t=8.034, P=0.000; t=5.841, P=0.000). The delta, theta, DTABR of affected side, affected side DTABR/contralateral DTABR were (31.42±9.83)Hz, (32.19 ±8.57)Hz, (0.916±0.371)Hz, (1.051±0.246), respectively, which were lower than those of patients with poor prognosis[(40.13±14.37)Hz, (37.44±10.11)Hz, (1.331±0.712)Hz, (1.376±0.352)](t=3.529, P=0.001; t=2.739, P=0.007; t=3.728, P=0.000; t=5.329, P=0.000). Logistic multivariate regression analysis was used to analyze the prognosis of patients with acute cerebral infarction.DTABR on the affected/healthy side was the factor influencing the prognosis of patients with acute cerebral infarction. Conclusion EEG in patients with acute cerebral infarction may increase the value of delta, theta and DTABR, and decrease the value of alpha and beta.DTABR in the affected side and the contralateral side is the prognostic factor.

Objective To study the expression of co-stimulatory molecules, GL50-ICOS, in thyroid tissue of patients with Graves' disease (GD) and to explore their relationship with the immune pathogenesis of GD.Methods RT-PCR, Western blot, immunohistochemistry were applied to detect the expression of GL50-ICOS in thyroid of GD. Thyrocytes were cultured in the absence or presence of pro-inflammatory cytokines. The expression of GL50 on thyroid follicular cells (TFC) was further measured by flow cytometry. Results (1) In GD patients,the percentage of CD4+ CD28- T cells was significantly increased as compared with the control healthy individuals. The expression of co-stimulatory molecule ICOS was up-regulated. (2) The mRNA level of ICOS was significantly increased in GD patients than that in nontoxic goiter(NTG) patients(P＜0.01). (3)Compared with NTG control group, the GL50 protein expression was much higher in thyroid tissues of GD patients (P ＜0.01). (4)The results of immunohistochemistry showed that GL50 expression was observed in all GD thyroid tissues, while no expression of GL50 was detected in NTG thyroid tissues(P＜0. 01). (5) The expression of GL50on primary cultured thyroid follicular cells was significantly increased under the stimulatation of pro-inflammatory cytokines in vitro. Conclusion GL50-ICOS is expressed abnormally in thyroid tissue of patients with GD.

Objective: To investigate the occupation stress and job burnout of orphan child care workers in Nanjing and nursing staff in Yangzhong primary hospital, to compare the differences of occupational stress and job burnout between the two social service workers. Methods: From February to May 2017, a cross- sectional survey was conducted. Cluster sampling method was used to investigate the occupation stress and job burnout of orphan child care workers in Nanjing and nursing staff in Yangzhong primary hospital, totally 403 people, by a combination of the Internet of things assessment system of occupational stress and traditional questionnaire. Results: There were statistically significant differences of occupational stress and job burnout scores of both social service workers (P<0.05). Orphan child care workers in job control, technology utilization, job routinization, work risk, role ambiguity and participation decision-making, anxiety state, body complain, life attitude, behavior characteristics, ambition, anxiety trait, social support, logic, family-work relationship and depersonalization were higher than those of Yangzhong primary nurses (P<0.05); Primary nurses in Yangzhong in quantitative load and change, workload, role conflict, job prospects, promotion, depressive symptom, daily stress, self-esteem, task strategy, time management, work input, and personal accomplishment reduction scored higher than those of Orphan child care workers (P<0.05). The logistic regression analysis of the occupational depletion positive rate of the two social service personnel showed that the protective factors of the nursing staff of the orphans and disabled children had behavioral characteristics and family support(OR=0.877, P=0.044; OR=0.691, P=0.001) . The contributing factors of the primary nursing staff in Yangzhong were task control, workload, work psychological control source (OR=1.110, P=0.019; OR=1.128, P<0.001;OR=1.066, P=0.032) . The protection factors were technical utilization, opportunities for improvement, and mental health (OR=0.775, P=0.005; OR=0.765, P=0.006; OR=0.914, P=0.002) . Conclusion The work content, the service object and the nature of the unit of primary caregivers influence the state of occupational stress and job burnout. The influencing factors of occupational stress and job burnout are not identical, Different social service personnel show occupational stress and occupational exhaustion in different aspects, and it is necessary to propose mitigation measures for two kinds of social service personnel.

Objective: To investigate the occupation stress of orphan child care workers in Nanjing, to explore the influence of different demographic characteristics on occupational stress of orphan child care workers and propose measures. Methods: Cluster sampling method was used to investigate the occupation stress of 236 people of orphan child care workers in Nanjing by a combination of the Internet of things assessment system of occupational stress and traditional questionnaire. Results: The scores of workload, job prospects, participation decision-making, anxiety and logical in different age groups among orphan child care workers were statistically different (P<0.05) ; The scores of organizational loyalty in different education groups among orphan child care workers were statistically different (P<0.05) ; The scores of task control, resource control, workload, job prospects, job satisfaction, mental health, anxiety and ambition were statistically different among orphan child care workers with different job titles (P<0.05) ; The scores of role conflict, role ambiguity, job satisfaction, mental health, anxiety, self-esteem, colleague support, family support and task strategy were statistically different orphan child care workers in different classes (P<0.05) . Conclusion Different demographic characteristics will have certain influence on occupational stress of orphan child care workers.

Objective:To explore the status quo of occupational stress and its influencing factors of nursing staff for orphaned and disabled children in Nanjing, and to put forward measures for adverse reactions to occupational stress, so as to ensure the psychological health of this occupational population.Methods:From February to May 2017, 236 nursing assistants for orphans and disabled children in Nanjing social welfare home were selected by cluster sampling method. The occupational stress index(occupational stress indictor, OSI) was used to investigate occupational stress response and occupational stress factors. Partial correlation and multiple linear regression were used for statistical analysis.Results:The scores of job satisfaction, mental health and depressive symptoms in occupational stress reaction were (43. 99±6. 83) , (36. 09±4. 59) and (17. 31±2. 44) re- spectively. In terms of job satisfaction, work monotony, logic and compound change were the contributing fac- tors ( P<0. 05) , task strategy and task control were negative factors ( P<0. 05) ; on mental health, opportunities were raised and participation in decision-making Self-esteem, technology utilization, environmental control, time management, task strategy and support of colleagues as contributing factors ( P<0. 05) , ambition and role conflicts as negative factors ( P<0. 05) ; on depression, work input, participation Decision-making, promotion opportunities and behavioral characteristics were protective factors ( P<0. 05 ) . Conclusion:Occupational stress among caregivers of orphans and disabled children cannot be ignored. Occupational stress reaction is serious. Occupational stress factors should be reduced and individual stress coping ability should be enhanced.

Objective:To explore the status of job burnout of nurses for orphans and disabled children in Nanjing and its influencing factors, so as to provide reference for promoting the mental health of nurses for orphans and disabled children.Methods:From February to May, 2017, a cross-sectional survey was conducted among 236 nurses working in social welfare institutions for orphans and disabled children in Nanjing, using Occupational Stress Indicator (OSI) and Maslach Burnout Inventory (MBI) . It investigated the status of job burnout among nurses of orphans and disabled children, logistic regression analysis was used to explore the effect of occupational stress on the incidence of job burnout of nurses for orphans and disabled children.Results:The results showed that the incidence of job burnout was 67.37% (159/236) , the incidence of job burnout was negatively correlated with behavioral characteristics and family support, the incidence of emotional exhaustion was positively correlated with task control and job monotony ( P<0.05) , and negatively correlated with role ambiguity and job satisfaction ( P<0.05) . The incidence of depersonalization was negatively correlated with job monotony and peer support ( P<0.05) . Conclusion:The nurses of orphans and disabled children have serious job burnout. Occupational stress factors, personality characteristics and relieving factors have influence on the incidence of job burnout.

Objective:To explore the status quo of occupational stress and its influencing factors of nursing staff for orphaned and disabled children in Nanjing, and to put forward measures for adverse reactions to occupational stress, so as to ensure the psychological health of this occupational population.Methods:From February to May 2017, 236 nursing assistants for orphans and disabled children in Nanjing social welfare home were selected by cluster sampling method. The occupational stress index(occupational stress indictor, OSI) was used to investigate occupational stress response and occupational stress factors. Partial correlation and multiple linear regression were used for statistical analysis.Results:The scores of job satisfaction, mental health and depressive symptoms in occupational stress reaction were (43. 99±6. 83) , (36. 09±4. 59) and (17. 31±2. 44) re- spectively. In terms of job satisfaction, work monotony, logic and compound change were the contributing fac- tors ( P<0. 05) , task strategy and task control were negative factors ( P<0. 05) ; on mental health, opportunities were raised and participation in decision-making Self-esteem, technology utilization, environmental control, time management, task strategy and support of colleagues as contributing factors ( P<0. 05) , ambition and role conflicts as negative factors ( P<0. 05) ; on depression, work input, participation Decision-making, promotion opportunities and behavioral characteristics were protective factors ( P<0. 05 ) . Conclusion:Occupational stress among caregivers of orphans and disabled children cannot be ignored. Occupational stress reaction is serious. Occupational stress factors should be reduced and individual stress coping ability should be enhanced.

Objective:To explore the status of job burnout of nurses for orphans and disabled children in Nanjing and its influencing factors, so as to provide reference for promoting the mental health of nurses for orphans and disabled children.Methods:From February to May, 2017, a cross-sectional survey was conducted among 236 nurses working in social welfare institutions for orphans and disabled children in Nanjing, using Occupational Stress Indicator (OSI) and Maslach Burnout Inventory (MBI) . It investigated the status of job burnout among nurses of orphans and disabled children, logistic regression analysis was used to explore the effect of occupational stress on the incidence of job burnout of nurses for orphans and disabled children.Results:The results showed that the incidence of job burnout was 67.37% (159/236) , the incidence of job burnout was negatively correlated with behavioral characteristics and family support, the incidence of emotional exhaustion was positively correlated with task control and job monotony ( P<0.05) , and negatively correlated with role ambiguity and job satisfaction ( P<0.05) . The incidence of depersonalization was negatively correlated with job monotony and peer support ( P<0.05) . Conclusion:The nurses of orphans and disabled children have serious job burnout. Occupational stress factors, personality characteristics and relieving factors have influence on the incidence of job burnout.