The use of five or more drugs (polypharmacy) is common problem in the elderly,and need to attach importance.Optimization of drug treatment is a major part of medication in older adults,and also is a challenge to clinical physician.Beers Criteria provided by American Geriatrics Society (AGS) is a strong guarantee for improving medication safety in older adults

Objeetive To detect the influence of psychological nursing intervention in 215 Prlmiparas Methods Taking whole course psychological nursing intervention of 215 primiparas who were making appointments on obstetrical outpatient department.Take psychological care,education of in-hospital and person to person care of in-delivery room as experiment group.and choose 205 Primiparas who were delivery in ordinary way at random.Compare the rate of viginal delivmy and the rate of cesarean section and neonatal asphyxia and the rate of postpartum hemorrhage.Evaluate the effect of Psychological nursing intervention to Primiparas.Results The rate of、riginal delivery on experiment group Was higher than the control group.It also shorten the duration of labor,and control the rate of cesarean section,neonatal asphyxia and postpartum hemorrhage effectively.There ale significant difference between two groups(P＜0.05).Conclusion The psychological nursing intervention is positive to the primiparasis in labor.It can increase the of viginal delivery shorten the duration of labor.and decrease the rate of cesarean section neonatal asphyxia and postpartum hemorrhage.

Palliative and hospice care for patients suffering severe or end-stage illness with projected short life expectancy.Such services aim to improve patients' quality of life through prognosticating,prevention and treatment of their ailment.The main components include evaluation and treatment of symptoms,pain control,family care,alleviating and treating patients' psychological burden and depression,and offering comfort and dignity.Hospice and palliative care are different from euthanasia,because they neither hasten nor delay the dying process.Instead,they focus on patients'physical and psychological needs and helping patients to maintain their independence and make their own choice.As a new medical subspecialty,palliative and hospice care are considered one of the important frontier in modern medicine.They employ a multi-disciplinary team approach,and the team members require special skill sets including those in communication and symptom management.

Myocardial infarction and ischemic stroke share many common risk factors.Their pathophysiological processes are also similar and the 2 diseases often occur at the same time.Coronary artery disease is one of the important causes of embolic stroke in the elderly population.However,there are a few reported stroke events available after myocardial infarction.This article reviews ischenic stroke following acute myocardial infarction.

273 chinese have been studied with high voltage electrophoresis and immumofixation to survey the polymorphism of the third component of human complement in Shaanxi Provice Two C_3 phenotypes were found in this population, they are C_3SS and C_3FS The frequencies of C_3SS and C_3FS are 98.53% and 1.47% respectively. The frequency of C_3S gene is 0.9926 and C_3F gene 0.0073. These results are similar to other studies in China and this group was in Hardy-Weinberg equilibrium. Compared with Negro and Caucasian, the chinese population in Shaanxi Province has a significant difference in C_3 polymorphism.

A 27-peptide,a fragment of hepatitis delta antigen(HDAg),was synthesized and used to develop an ELISA method for ihe detection of anti-HD.It was found that positive anti-HD reaction occurred between the coated 27-peptide and a stored sample of serum which was known anti-HD positive.Absorption test revealed that the synthetic peptide competed with natural HDAg for anti-HD,suggesting that the peptide possessed the antigenicity similar to that of natural HDAg.The antigenicity of the synthetic peptide was quite specific wihtout cross reaction with normal human and mouse sera and with anti-HA.anti-HB and anti-HC sera.Among 300 blood donors,there was only 1 case(0.33%)anti-HD positive with an ALT level 2 times higher than normal.In 41 cases of non-B hepatitis and 52 cases of HAV hepatitis,none was anti-HD positive.In 211 cases of various types of HBV hepatitis,21 were(9.95%)anti-HD positive,among whom 2/82(2.5%)werehealthy HBV carriers,6/43(13.95%)were patients with a-cute icteric hepatitis,6/60(10.00%)were patients of chronic active hepatitis,4/18(22.20%)were patients of severe hepatitis,and 3/8(37.50%)were those with liver cirrhosis.These results were consistent with those in our previous reports.

In April 2016,the American Geriatrics Society(AGS)entered into a cooperative agreement with U.S.Department of Transportation.National Highway Traffic Safety Administration (NHTSA) updates and expands the Clinician's Guide to Assessing and Counseling Older Drivers to the 3rd Edition.The main goal of the Guide is to reduce traffic accidents and injuries to older drivers.According to the workflow of evaluation and management provided by Plan for Older Driver Safety(PODS),clinicians can conduct driving strategies after screening,evaluation and result analysis.The evaluation is done based on the Clinical Assessment of Driving Related Skills(CADReS) by a team including physicians,nurse practitioners,physician assistants,pharmacists,occupational therapists,driving rehabilitation specialists,and social workers.The CADReS including a series of assessment tools are used to evaluate in the key areas,such as vision,cognition,and motor/sensory function related to driving.Some measures will be taken based on the evaluation conclusions to help to explore the potential of driving safely for old adults.

Objective:To investigate the efficiency of CBCT in the diagnosis of impacted maxillary anterior teeth and the treatment effect of different guided eruption methods. Methods:34 impacted maxillary anterior teeth in 30 patients were examined by panoramic films and CBCT, the dental crowns, root, eruption space and other related items were measured and compared between 2 examinations. 20 cases were treated by closed guided eruption and traction( CGET) technique, 10 cases by circumferential supracrestal fibrotomy and exposed traction( CSF-EE) , results were compared. Results: CBCT was more effective than panoramic films in the revelation of tooth root bending, apical pore closure and eruption measurements(P<0. 05). 7-10 d after treatment 5 out off the 10 casses treated by CSF-EE showed different degrees of clinical crown elongation, poor gum appearance and low height of alveolar ridge as insufficient periodontal attachment. However, the treatment of CGET for 26 teeth (76. 47% of all cases) was highly successful and received very satisfactory re-sults, the rest 8 teeth (23. 53% of all cases) showed mediocre satisfaction. Conclusion: CBCT can accurately display the position, shape, relation with adjacent teeth of the impacted teeth. Closed guided eruption and traction is more effective for the treatment.

Objective To investigate the efficacy and safety of local immune regulation therapy of thyroid disease.Methods Totally 110 patients with confirmed diagnosis of autoimmune thyroid disease were recruited.All patients received thyroid local immune regulation therapy with glucocorticoids 1~3 courses of treatment and followed up for 2~3 years,each being taken good care of during the whole observation.Results About 94.0% of the patients had significantly improved their subjective symptoms,such as pain,fatigue,and lethargy.About 67.7% of the cases had reached normal or markedly improved thyroid function after thyroid local immune regulation therapy.About 92.0% of the volumes of thyroid were reduced.Serum antithyroperoxidase antibody levels were decreased from(338.2?43.2)mU/L to(266.9?42.2)mU/L(P