Objective To investigate long-term care needs and its influencing factors among old people with chronic diseases in nursing homes in rural area of Liaoning. Methods A total of 502 elderly with chronic diseases were recruited using convenience sampling method from eight nursing homes in rural area of Liaoning, and were investigated with the general information questionnaire, Short Form 36-item Health Survey (SF-36) and long-term care needs questionnaire from March 2015 to January 2016. Results Logistic regression analyses were used to identify that age (P=0.000), old patients′ disease condition (P=0.008), marriage (P=0.013) and quality of life (P=0.000) were major factors affecting long-term care needs. The top three highest percentage services were seeing the doctor 85.26% (428/502), assisting with taking the medicine 80.28% (403/502), assisting with bathing 70.32% (353/502). Conclusions This study suggests that we should improve the quality of services of long-term care needs based on the demands of old people with chronic diseases in nursing homes in rural area.

Objective To assess the effectiveness of pedicled iliac periosteal flap graft for treatment of old femoral neck fracture in adolescents.Methods Between June,2005 and December,2013,15 patients (15 hips) of old femoral neck fracture in adolescents treated with vascular pedicled iliac periosteal.There were 11 males and 4 females with an average age of 15.8(range 12 to 18) years.Based on the location of fracture,there was 5 cases of subcapital,8 cases of transcervical and 2 cases of basal.6 cases were treated with lower limb traction,3 cases with internal fixation and 6 just without any treatment.The average duration from injury to the second operation was 4.8 (range 1 to 19) months.There were 2 cases of femoral head necrosis after femoral neck fracture.Open reduction,pedicled iliac periosteal flap grafting and cannulate screw fixation were performed.Results All incisions healed by first intention.All patients were followed up 12 to 90 months (mean,46 months).The HHS was increased from (48.7 ± 8.3) pre-operation to (91.3 ± 6.1) at last followed-up,indicating a significant difference between before and after operation (P ＜ 0.01).One patient underwent total hip arthroplasty at 10 months after operation because of fracture nonunion and femoral head necrosis.Fracture healed successfully in 14 cases and the average time of fracture healing was 4 (range 3 to 6) months.Certain extent of remodelling and bulge of the head were observed in 2 cases of collapsed heads.Conclusion Pedicled iliac periosteal flap graft can provide good osteogenesis and vascular reconstruction for femoral head and promote fracture healing in treatment for old femoral neck fracture in adolescents.

Objective To investigate the effects of labeling Schwann cells with different concentrations of SPIO, and to investigate the feasibility of in vitro MR imaging. Methods The C57BL/6 mices'Schwann cells were isolated, purified, and then 0.5 × 106, 1.0 × 106, 5.0 × 106 cells were labeled with 25.0 μg/ml, 50.0 μg/ml SPIO. Prussian blue stain and transmission electron microscope (TEM) were performed for showing intracellular iron. The signal intensity of cells were evaluated by 3.0 MRI with different sequences in vitro. Results Different cell population (0.5 × 106, 1.0 × 106,5.0 × 106) were cultured with different concentration SPIO about 24 hours. Dyeing degree of labeling cells stained by Prussion blue gradually deepened from 25.0 μg/ml to 50.0 μg/ml. Transmission electron microscope indicated that iron particles accumulated inendosomes/lysosomes. The MR signal intensity of labeling cells were inversely correlated with the concentration of SPIO groups in T2WI and GRE/30° imaging in vitro. Conclusion Schwann cells could be labeled effectively with SPIO, and MRI could be used to monitor these labeled cells in vitro.

Objective To evaluate the effect of chronic disease nursing of traditional Chinese Medicine (TCM) on depression in patients with chronic hepatitis B (CHB).Methods From June 2015 to June 2016, 120 CHB patients with various degree of depression were divided into control group and observation group with 60 each. Patients in control group received routine medical treatment and nursing. Patients in the observation group on the basis of routine medical treatment and nursing were combined with chronic disease nursing of TCM. We compared the difference of SDS score, TCM syndrome and SF-36 score between the two groups before and after intervention.Results After intervention, the SDS score of observation group dropped from (57.95±3.42) to (47.68±4.46). The SDS score of control group dropped from (57.40±3.83) to (49.62±5.30). The SDS score of the observation group was lower than that of the control group (t=2.1619,P<0.05). The total effective rate of TCM syndromes in observation group was 86.67%. The total effective rate of TCM syndromes in control group was 71.67% (χ2=6.4423,P<0.05). The difference total score of SF-36 between before and after in the observation group(1.00 ± 0.65) was higher than that of the control group(0.73 ± 0.74) (t=2.1318,P<0.05). Conclusions The nursing management of chronic diseases in TCM can relieve the depression and improve the quality of life in CHB patients.

Objective To assess the effectiveness of osteoperiosteal decortication and extracortical bone-bridging in the treatment of atrophic humeral nonunions.Methods Nineteen patients with atrophic humeral nonuninon were treated by osteoperiosteal decortication and extracortical bone-bridging between March 2008 and April 2016.They were 12 men and 7 women,aged from 23 to 68 years (mean,36.6 years).The fracture was located at the left side in 10 cases and at the right side in 9.Before admission to our hospital,8 had received surgery once,6 twice and 5 thrice.The time from fracture to hospitalization ranged from 12 to 106 months (average,26.3 months).Shoulder function was evaluated by Neer scoring and elbow function by Mayo elbow performance score (MEPS) at final follow-ups.Results All incisions healed by first intention.Two cases reported transient radial nerve symptoms of numbness.All the 19 patients were followed up for 28.9 months on average (range,from 13 to 78 months).Radiographic examinations showed signs of bone remodeling,disappearance of fracture lines and formation of extracortical bone bridge at 6 to 8 weeks after operation.All of them achieved radiographic union within 10 to 46 weeks (16.8 weeks on average).The Neer scores averaged 82.5 (range,from 70 to 98),giving 12 excellent cases,5 good ones and 2 fair ones.The MEPS averaged 84.4 (range,from 70 to 96),giving 11 excellent cases,5 good ones and 3 fair ones.Conclusion Osteoperiosteal decortication and extracortical bone-bridging in treatment of atrophic humeral nonunions can effectively induce osteogenesis and increase stability of broken ends,promoting bone healing.

This study was aimed to investigate the estrogenic effects ofCoicis Semen in order to preliminarily discuss the mechanism. Mouse uterine weight test and MCF-7 cell proliferation assay were used to evaluate the estrogenic effects ofC. Semen. Reporter gene assays were adopted to explore the action mechanism ofC. Semen. In reporter gene assay, HEK293 cells were co-transfected with pERE-TAL-luc, pβgal-Control, pCXN2-hERα, or pCXN2-hERβ. And the expression of reporter gene luc was controlled by ERE. Mouse uterine weight test showed that compared with the control group, the aqueous extracts ofC. Semen can increase the uterus index of premature female mice (P<0.01). It can significantly promote the proliferation of MCF-7 cells in the medium without estrogen (P<0.01). The reporter gene controlled by ERE technology showed thatwhen mediated by ERα or ERβ respectively, the normalized luciferase activity of aqueous extracts ofC. Semen was significantly higher than activity of the control group (P< 0.05 orP< 0.01). It was concluded that the aqueous extracts ofC.Semen can increase the uterus index of premature female mice and promote the proliferation of MCF-7 cells in the medium without estrogen. We found the estrogenic effects ofC. Semen for the first time. And the estrogenic effects ofC. Semen were mainly mediated by ERβ.

OBJECTIVETo investigate the intestinal absorption kinetics of gambogic acid (GA) in rats.

METHODIn situ single-way intestinal perfusion model was established to study the intestinal absorption kinetics of GA in different absorption segments, and the concentration of GA in the perfusate was determined by HPLC. The effect of drug concentrations on intestinal absorption was also detected.

RESULTGA showed a higher absorption rate than other intestinal segments (P < 0.05) and kept unchanged in duodenum after addition in drug concentration.

CONCLUSIONGA can be absorbed in all intestinal segments in rats with the higher absorption rate in duodenum. Its mechanism is passive diffusion.

Objective:To investigate the optimal dose of dexmedetomidine combined with propofol for anesthesia in patients undergoing modified electroconvulsive therapy (MECT).Methods:One hundred and sixty patients of both sexes, aged 20-60 yr, weighing 45-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective MECT, were allocated into 4 groups ( n=40 each) by a random number table method: different doses of dexmedetomidine combined with propofol group (D 1, D 2 and D 3 groups) and routine anesthesia group (group C). Dexmedetomidine 0.2, 0.4 and 0.6 μg/kg were intravenously injected in D 1, D 2 and D 3 groups, respectively, the equal volume of normal saline was given instead in group C, and propofol 1.0 mg/kg and succinylcholine 0.5 mg/kg were intravenously injected in turn 10 min later.Venous blood samples were collected before giving dexmedetomidine (T 0) and at 1 min after the end of MECT (T 1) for determination of the plasma epinephrine (E) and norepinephrine (NE) concentrations.Propofol consumption, occurrence of cardiovascular events, duration of epilespsy and energy suppression index were recorded. Results:Compared with group C, the plasma E and NE concentrations were significantly decreased at T 4, and the propofol consumption was reduced in D 1, D 2 and D 3 groups ( P<0.05). Compared with group D 2, the plasma E and NE concentrations were significantly increased at T 1 in group D 1 and decreased at T 1 in group D 3 ( P<0.05). The incidence of adverse cardiovascular events was significantly increased in group D 3 than in the other 3 groups ( P<0.05). There was no significant difference in duration of epilespsy or energy suppfession index among the 4 groups( P>0.05). Conclusion:The optimal dose of dexmedetomidine combined with propofol 1.0 mg/kg is 0.4 μg/kg when used for anesthesia in the patients undergoing MECT.

Objective:To investigate the risk of new-onset stroke caused by cerebral microbleed (CMB) and asymptomatic lacunar infarction (ALI) and their risk factors.Methods:A prospective observational study over a 18 month period was conducted on 397 non stroke patients who visited the Affiliated Hospital of Xuzhou Medical University from March 2020 to June 2022. By the presence of CMB and ALI about magnetic resonance imaging, they were divided into th control group (without CMB and ALI, 117 cases, 29.5%), ALI group (101 cases, 25.4%), CMB group (89 cases, 22.4%) and CMB-ALI group (90 cases, 22.7%).They were followed up for 18 months, the risk factors for CMB, ALI, and the risk of new stroke were analyzed.Results:The systolic blood pressure and uric acid in the CMB group were higher than those in the control group: (155.2 ± 24.2) mmHg(1 mmHg = 0.133 kPa) vs. (138.2 ± 19.0) mmHg, (387.0 ± 28.3) μmol/L vs. (354.0 ± 21.5) μmol/L, there were statistical differences ( P<0.05). After followed up for 18 months, the incidence rate of cerebral infarction, cerebral hemorrhage and TIA in the CMB group and CMB-ALI group were higher than those in the control group: 13.5%(12/89), 13.3%(12/90) vs.5.1%(6/117); 9.0%(8/89), 10.0%(9/90) vs. 2.6%(3/117); 5.6%(5/89), 6.7%(6/90) vs. 0.8%(1/117), there were statistical differences ( P<0.05). Conclusions:CMB is prone to abnormal systolic blood pressure and uric acid. CMB, CMB-ALI are prone to new onset ischemic stroke, cerebral hemorrhage and TIA.

Cognitive frailty is a heterogeneous clinical syndrome with cumulative effects in the negative events. The key link of prevention and management of cognitive frailty is to carry out community-based screening, effectively integrate and identify the predictive factors of cognitive frailty, early control the risk factors of cognitive frailty, and reduce the incidence. Building risk prediction models for disease diagnosis and risk prediction gradually becomes a research hotspot. This paper summarizes the risk factors, overview of risk prediction models, and comparison of different risk prediction models for cognitive frailty among the elderly in the community, in order to provide reference for grassroots medical and nursing staff to intervene in cognitive frailty among the elderly in the community.