The aim of this article is to explore the dual-system of German geriatric nursing, curriculum of geriatric nursing, concept of major and evaluation mode, which could provide references and reflection for national geriatric nursing development.

Objective To obtain the molecular epidemiology of human Parechovirus (HPeV)infections m children with central nervous system (CNS)-related disease and sepsis,as well as understand the pathogenic properties of HPeV infections by detecting HPeV in cerebrospinal fluid (CSF) and blood samples.Methods From January to December in the year of 2009,a total of 359enterovirus-negative specimens including 210 CSF and 149 blood samples were collected from 328children ＜14 years of age who were hospitalized for CNS-related disease and sepsis at Children's Hospital,Fudan University,Shanghai,China.HPeV was detected by nested reverse transcription polymerase chain reaction (RT-PCR),and then directly genotyped by sequencing nested RT-PCR product of VP3/VP1 region.Ninty-nine blood samples from healthy children were collected as controls during the same period.Results Twenty-seven children (8.2％) were HPeV positive in 328 children.HPeV infections were found in all age groups of children and the highest frequency was seen in children ＜3 months old (18.2％,12/66).HPeV was detected in several months,with the peak in December (18.8％,9/48).Of all the positive samples,20 were genotyped successfully and identified to be HPeV1.No HPeV infections were found in blood of healthy controls.ConclusionsHPeV is the pathogen of CNS infections and sepsis in children.HPeV screening should be enrolled in the routine virus testing in specimens obtained from children.HPeV1 is the prevalent type in children in the year of 2009 in Shanghai.

Objective To develop cadres' stress scale for the Chinese people' s armed police forces.Methods Based on the stress theory and principles of the psychometrics,combined with characteristics of armed police forces. The cadres' stress scale was developed by ourselves. 802 cadres were evaluated as samples and statistic the data by item analysis ,factor analysis, reliability and valid analysis. Results The scale included four dimensions: task stress, economy stress, interpersonal stress and development stress. The internal consistency reliability was 0.893 ,the split-half reliability coefficient was 0.812. Retest reliability coefficient was 0.813. The criterion related validity to the stress scale and SCL-90 was good and the correlation coefficient with somatization, anxiety,depression, interpersonal sensitivity was 0. 376,0. 383,0. 396,0. 387 individually (P ＜ 0.05 ). Conclusion Cadres stress scale for cadres of Chinese people's armed police forces has good reliability and validity.

ObjectiveTo investigate the diagnostic value of transbronchoscopic lung biopsy (TBLB) without X-ray fluoroscopy in patients with peripheral pulmonary lesions.Methods Fifty patients with peripheral and diffuse pulmonary lesions and without cavity lesions from January to December 2011 were selected and examined by conventional hronchoscopy.According to the anatomical orientation of CT image and bronchial tree path,TBLB was performed by electronic bronchoscope.ResultsThere were 63 cases of TBLB in 50 patients and 30 patients got confirmed diagnosis (60.0％),including 24 cases in 35patients with peripheral pulmonary lesions (68.6％),and 6 cases in 15 patients with diffuse pulmonary lesions (40.0％).There was no severe complication during and after electronic bronchoscopy.ConclusionsTBLB without X-ray fluoroscopy is a convenient,safe and repeatable operational method with fewer complications.It has higher clinic diagnostic value in pulmonary diseases.

Objective To explore the sleep characteristics in first-episode schizophrenics and the effects of olanzapine on body weight and sleep-breathing disorder.Methods 36 first-episode schizophrenics (patient group) and 33 normal controls (control group) were tested with polysomnography(PSG),and compared the difference of PSG,sleep-breathing index and body mass index(BMI) before and after treatment in patient group.Results Before treatment,compared with control group,the patient group had significantly prolonged sleep latency((83.64± 10.62) min vs (29.41 ± 10.05) min),shortened total sleep time ((286.43 ± 17.04) min vs (343.66 ± 16.38)min),decreased sleep efficiency((65.73 ±11.47) vs (86.13 ± 8.15)),increased awake time and arousal number((65.70 ± 10.33) min vs (25.93 ± 9.60) min ; (38.26 ± 6.88) vs (14.40 ± 2.72)) in sleep continuity ; and increased N1 stage ((87.43 ± 11.35) min vs (36.55 ± 6.40) min),decreased N2,N3 stage ((100.53 ± 10.42)minvs (143.35±13.52)min;(49.83±7.51)minvs (87.52±9.74)min) in sleep structure (P ＜ 0.05).After treatment,sleep continuity and sleep structure in patient group were improved,compared with control group,only BMI,arousal index and hypopnea index had statistic difference (P ＜ 0.05).Conclusion The first-episode schizophrenics have both sleep continuity and sleep structure deficits.Although olanzapine treatment can improve sleep quality,long-term use of it may cause overweight and sleep-breathing disorder.

Objective To explore the changes in fractional anisotropy (FA) among cerebral infarction pa-tients using MR diffusion tensor imaging (DTI), and to verify the relationship between any FA changes and functional recovery. Methods Thirty-eight cerebral infarction patients were divided into two groups according to their recovery level using Brunnstrom's criteria. All the patients accepted routine MR and DTI examination, and FA values were measured during the acute, subacute and chronic stages of their recovery. Results Average FA values in the lesion area were significantly lower than in the corresponding contralateral area, and were highest daring the acute stage.There was no significant difference between the subacute and chronic stages. Conclusions The FA values of cere-bral infarction patients change during the different stages of recovery with a certain regularity. This may be valuable for clinical treatment and prognosis.

Objective To study the clinical characteristics of Behcet's disease (BD) complicated with leukemia and analyze the relationshp between the two diseases. Methods Five cases in the medical literature were retrieved and their data were analyzed. Results The clinical characteristics were : oral ulcersand fever (5 cases), skin lesions (3 cases), vulva ulcers (3 cases), eye lesions (3 cases), arthralgia (4 cases), diges-tive tract ulcerations and hemorrhage (1 cases). All cases coexisted with leukemia were shown to have various degrees of peripheral blood changes and history of immunosuppressive therapy. Among these, 3 cases were coexisted with acute granulocytic leukemia, 1 case with acute monocytic leukemia, 1 case with plasma cell leukemia respectively. All patients died within one year. Conclusion Close relationship can be observed between BD and leukemia from the point of view of the provocating factors, clinical features and drug use.

Objective To investigate the outcomes of patients undergoing off-pump coronary artery bypass grafting (OPCABG) under morphine-fentanyl combined anesthesia. MethodsSeventy-two patients aged 41-64 yr undergoing OPCABG were randomly divided into 2 groups (n = 36 each): Ⅰ group morphine + fentanyl (group MF) and Ⅱ group fentanyl (group F). Anesthesia was induced with midazolam, etomidate, and vecuronium.Fentanyl 10-20 μg/kg was given iv when needed. The patients were mechanically ventilated after tracheal intubation. Anesthesia was maintsined with inhalation of 0.5%-2.0% isoflurane and intermittent iv boluses of vecuronium in both groups. Morphine 0.15 mg·kg-1·h-1 + fentanyl 8 μg·kg-1·h-1 were infused during operation in group MF, while in group F fentanyl 10 μg·kg-1·h-1 was infused. Morphine 0.75 mg/h was infused in group MF or fentanyl 10 μg/h in group F for postoperative analgesia after extubation. Recovery from anesthesia was assessed using a nine point (QoR) questionnaire. Pain was measured with VAS score and sedation with Ramsay sedation score ( 1 = fully awake, 6 = asleep, no response to verbal stimulus). The postoperative complications were recorded. ResultsQoR scores were significantly higher in group MF and in group F. The incidence of postoperative febrile reaction was significantly reduced in group MF. There was no significant difference in Ramsay sedation score and other postoperative complications between the 2 groups. ConclusionMorphine-fentanyl combined anesthesia is more beneficial for the prognosis in patients undergoing OPCABG compared with fentanyl combined anesthesia.

Objective To determine the roles of thymic stromal lymphopoietin receptor (TSLPR) and its antibody in airway inflammatory response in asthmatic mice, and to promote maturation and activation of dendritic cells (DCs) in mouse airway. Methods BALB/c mice were randomly divided into group A, B and C. The mice in group B and C were intraperitoneally injected with OVA for allergization while the mice in group A were intraperitoneally injected with PBS as the normal control. The mice in group B and C were treated by inhalation of non-specific IgG and TSLPR IgG respectively, before provocation of asthma using OVA. The bronchoalveolar lavage fluid (BALF) of the mice in different groups were collected for cell differential counts and quantitative detection of IL-4, IL-5, IFN-γand IL-10 levels by ELISA. Moreover, the pulmonary tissue specimens of the mice were collected for pathological examination, and the numbers and phenotypes of DCs from the local lymph nodes and pulmonary tissue were determined by flow cytometry. Results The levels of all the tested cytokines in the BALF from mice in group B and C were remarkably higher compared to those from mice in group A (P<0.01). However, both the IL-4 and IL-5 levels in the BALF from group C mice that pre-blocked with TSLPR IgG were lower than those from group B (P<0.05, P<0.01), whereas both the IFN-γ and IL-10 levels in the BALF from group C mice were higher than those from group B (P<0.05, P<0.01). Furthermore, the numbers of total cells, eosinophils and lymphocytes in the BALF from group C mice were also lower than those from group B (P<0.01). A large number of inflammatory cell infiltration around the bronchus, beaker cell proliferation and mucous secretion reinforcement could be found in the samples from group B mice, while slight inflammatory cell infiltration and beaker cell proliferation in the samples from group C mice. The numbers of DCs in mediastinal lymph node and the levels of I-Ad, CD40, CD80 and CD86 expression of pulmonary DCs from group B mice were higher than those from group C mice (P<0.05). Conclusion TSLP/TSLPR have an effect on promoting asthma, which is closely relative to its regulation of DCs activation. And the interference of TSLPR antibody can decrease the effect of TSLP/TSLPR which indicating a potential of the antibody as a novel anti-asthma drug.

Aim To investigate the myocardial hypertrophy,the expression of transforming growth factor ?1(TGF-?1),Smad3 and Smad7 proteins in spontaneous hypertensive rats(SHR)and the effects of benazepril and candesartan.Methods SHRs of 12 weeks old were given benazepril and candesartan for 12 weeks.The tail arterial pressure was measured every two weeks.At 12 th weekend,cardiac configuration,heart mass index,area of cadiocytes,concertrations of AngⅡin plasma and myocardium,expressions of TGF-?1、Smad3 and Smad7 proteins were measured respectively.Results The arterial pressure,wall thickness,heart mass index,area of cardiocytes and the expressions of TGF-?1,Smad3 proteins increased in SHRs but were attenuated after the treatment of benazepril or candesartan.After the combined treatment,the synergistic effect could be observed.The levels of cardiac tissue and plasma AngⅡwere reduced.The expressions of Smad 7 were up-regulated after the treatment of benazepril or candesartan,while they were stable after the combined use.Conclusion There is a synergistic effect of attenuating myocardial hypertrophy in SHRs by combined use of benazepril and candesartan.It may be related to the regulation of Ang Ⅱ,decreasing the expressions of TGF-?1 and Smad3.