Increasing aged care requisite has become a serious challenge all over the world. Compared with developed countries, aged care in China still has some limitations, i.e., lack of qualified professionals, aged care system needs to be improved, and lack of aged long term care insurance. This article discussed these points and put forward the corresponding countermeasures.

Objective To determine the independent risk factors for postoperative nausea and vomiting (PONV) after endoscopic retrograde cholangio-pancreatography (ERCP) under total intravenous anesthesia.Methods Ninety patients,47 males and 43 females,aged 18 years old or more,falling into ASA physical status Ⅰ-Ⅲ,undergoing ERCP under total intravenous anesthesia from July 18,2016 to August 31,2016 in Ruijin Hospital were included in our study.General information and intraoperative situation of patients were collected.The incidence of PONV within 24 h was recorded.A multivariate Logistic regression model was performed to analyze the independent risk factors of PONV after ERCP under total intravenous anesthesia.Results In total,90 patients were included in this study,with 33 patients (36.7%) suffering PONV.Logistic analyses showed that female (OR=3.73,95%CI 1.36-10.27),history of PONV/motion sickness(OR=4.39,95%CI 1.40-13.76),and serum-amylase greater than 3 times the normal value (OR=5.22,95%CI 1.30-20.95) were the independent risk factors for PONV after ERCP under total intravenous anesthesia.Conclusion Female,history of PONV/motion sickness,and serum-amylase greater than 3 times the normal value were the independent risk factors for PONV after ERCP under total intravenous anesthesia.

Child ; Cystitis ; Eosinophils ; Humans ; Male

Premature ejaculation (PE) is a most common sexual dysfunction, for which dapoxetine, a novel selective serotonin (5-HT) re-uptake inhibitor (SSRI), is the only licensed oral medicine at present. With the advantages of fast absorption, rapid action, on-demand medication, and short half-life time, dapoxetine has been proved by clinical trials to be effective in prolonging the intravaginal ejaculation latency time (IELT) and improving the overall condition of PE patients in various areas and populations. Compared with the traditional SSRIs, dapoxetine has a better safety and tolerability. The most frequently reported dapoxetine-related adverse events include nausea, diarrhea, headache and dizziness, but with very few severe or serious cases.
Benzylamines ; therapeutic use ; Biomedical Research ; Ejaculation ; drug effects ; Humans ; Male ; Naphthalenes ; therapeutic use ; Premature Ejaculation ; drug therapy ; Reaction Time ; drug effects ; Serotonin Uptake Inhibitors ; therapeutic use ; Treatment Outcome

China ; Humans ; Immunization Programs ; Poliomyelitis ; prevention & control ; Poliovirus Vaccines ; administration & dosage

Visfatin is a highly conserved protein expressed by visceral fat tissues that previously identified as pre B cell colony-enchancing factor (PBEF). Visfatin is a 52 ku cytokine and has been shown to exert multiple distinct biological activities. By interacting with insulin receptors, visfatin exhibits insulin mimicking or antagonizing effects under different circumstances. In addition, it possesses an nicotinamide phosphoribosyl transferase (Nampt) activity inside the cells, which functions at the rate-limiting step along the pathway of nicotinamide adenine dinucleotide (NAD) biosyntheses. And finally, as an extracellular cytokine, visfatin is able to induce the expression of inflammatory cytokines, such as TNF?, IL-1? and IL-6. Visfatin has drawn increasing attentions to researchers for its close association with a variety of human metabolic and acute/chronic inflammatory diseases or disorders, including diabetes, obesity, acute lung injury, rheumatoid arthritis, sepsis, myocardial infarction and inflammatory bowel disease. Recently, the SNP (single nucleotide polymorphism) analyses of visfatin and its promoter regions have provided more in-depth understandings of its roles in disease pathogenesis. A discussion in the current knowledge of the structure and diversified functions of visfatin, as well as its connections with a variety of common diseases was given.

AIM: To establish quality standard for Compound Shengui Capsules. METHODS: Glycyrrhiza uralensis Fisch.、Panax notoginseng(Burk.) F.H.Chen、Salvia miltiorrhiza Bge.and Ligusticum chuanxiong Hort.were identified by TLC.Ammonium glycyrrhizinate and tanshinoneⅡ_A were determined by HPLC.(RESULTS): (TLC) spots developed were fairly clear and the blank test showed no interference.The linear rangers were 0.5-4?g(r=0.999 8)for ammonium glycyrrhizinate;0.04-0.32?g(r=0.999 6) for tanshinoneⅡ_A.The average recoveries of them were 98.9%,97.8%,respectively. CONCLUSION: The methods is effective for the quality control of Compound Shengui Capsules.

Objective To establish an evaluation index system for the quality and safety of the specialized nursing care in cardiovascular medicine. Methods To screen and evaluate the safety quality evaluation index via a group discussion with Delphi method and analytic hierarchy process referenced to the literatures from the evaluation index of domestic nursing safety quality (NSQ)and on the base ofthe factor quality- quality of links-final quality3-dimensional quality structure theory by Donabedian. Results The first and second round of expert consultation and the recovery rate were 97.05% (33/34) and 94.12% (32/34) respectibely, the effective rate was 100%;The authoritative coefficient of expert of the safety quality evaluation index of the specialized nursing care is 0.867 and 0.879 respectively. In the first round, the average of the importance rating is 3.50-5.00, the standard deviation is 0-0.042 and full mark rate is 34.10%-100%. In the second round, the average of the importance rating is 3.80-4.70, the standard deviation is 0~0.047 and full mark rate is 31.60%-100%. The fluctuation degree of the first round is more than 0.10 with a low coordination degree. However, the fluctuation degree of the second round result is less than 0.10. The coordination coefficients from all qustionnair scores by experts in the two roudns are 0.169 and 0.286. The difference was statistically significant according to the chi-square analysis (X2=6.842, P=0.002). The NSQ evaluatin index included 3 first degree indexes (weight coefficient including 0.2684,link qualing 0.6144,and quality 0.1172),16 second degree indicators (weight coefficient 0.034~0.0859) and 61 third degree indexes ( weight coefficient 0.034~0.0859) and 61 third degree indexes (weight coefficient 0.0052~0.0412). Conclusions This paper preliminary established a specialied NSQ evaluation index with factor quality- quality of links-final quality 3-dimensional quality structure in the field of cardiovascular medicine, which is based on Delphi method and analytic hierarchy process. NSQ provides a measurement tool for nurses in CME.

Objective To provide a scientific basis for logistic health support by analyzing the relationship between altitudes and rate of staff depletion due to acute mountain sickness (AMS). Methods Rate of staff depletion due to AMS at different altitudes was obtained from relevant literature, and statistical methods including descriptive statistics, curve estimation etc. were applied to analyze the relationship between the altitude and rate of AMS-associated staff depletion. Results The AMS-associated staff depletion was positively correlated with the altitude (Pearson correlation r=0.868, P<0.01). The curve fitting equation of AMS-associated staff depletion rate (P) and the square of the altitude (h) in the range of 3500-5270m altitude was: P=64.542-0.034h+4.90×10-6h2, and the goodness-of-fit test showed a very good curve fit (coefficient of determination R2=0.835, F=35.492, P<0.01). There was a remarkable difference in rate of AMS-associated staff depletion between 3000-4000m and 4000m or higher (t=-3.097, P<0.05), with a mean of 5.74%±3.70%, and 95%CI of 2.64%-8.83% and a mean of 17.53%±10.16% and 95%CI of 9.72%-25.34% respectively. Conclusion AMS-associated staff depletion rate is positively correlated with the altitude. The results of this study provide a scientific basis for predicting AMS-associated staff depletion.

Objective To investigate the effect of tumor necrosis factor-α (TNF-α) on the levels of ezrin-radixin-moesin (ERM) proteins and the phosphorylated ERM proteins (p-ERM) in rat pulmonary microvascular endothelial cells (PMVEC),and to explore Rho kinase (ROCK) influencing on modulation of the ERM proteins phosphorylation.Methods Cultured rat pulmonary microvascular endothelial cells were randomly divided into dose-dependent and time-dependent groups.In dose-dependent group,cells were cultured with different doses of TNF-α (0,0.1,1,10 μg/LTNF-α) for 60 min.In time-dependent group,cells were cultured with TNF-α (10 μg/L) for 0,15,30,60,90,120,180 min.In ROCK inhibitor (Y27632) intervention group,cells were cultured with TNF-α (10 μg/L) or Y27632 (30 μmol/L) + TNF-α (10 μg/L) for 60 min respectively.The levels of ERM proteins and p-ERM were determined by western blot.One way analysis of variance (ANOVA) was employed for statistical analysis by using SPSS version 16.0 software to compare values among all groups.A significant difference was presumed as a P value ＜ 0.05.Results Western blot revealed that ERM and p -ERM proteins were present in rat PMVEC.Stimulation withTNF-α gradually up-regulated the level of pERM proteins in a dose-dependent manner [0 μg/LTNF-α group:(0.648 ± 0.102),0.1 μg/LTNF-αgroup:(0.728-±0.082),1 μg/LTNF-α group:(0.926±0.121),10 μg/LTNF-α group:(1.245 ±0.134),all P =0.000].In time-dependent group,the level of p-ERM proteins rose at 15 min (0.777 ±0.151),peaked at 90 min (1.295 ±0.176),then decreased gradually at 120 min (0.802 ±0.139),but stayed higher level at 180 min (0.669 ±0.128) than that in un-stimulated 0 min group (0.631 ±0.123,P=0.004,0.000,0.001,0.016,respectively).When PMVEC pre-incubated with ROCK inhibitor and TNF-t,the level of p-ERM proteins caused a marked attenuation of TNF-αstimulation [(0.634 ± 0.112) vs.(0.875 ± 0.164),P =0.002],however,there are no significant differences compared to ROCK inhibitor alone group (0.661 ± 0.108) and no intervention group (0.654 ± 0.125),P =0.973,P =0.900,respectively).Conclusions TNF-α could induce up-regulation of the level of the phosphorylated ERM proteins in rat PMVEC,and ROCK signal molecules might involve in modulation of the ERM proteins phosphorylation.