Alzheimer′s patients bring heavy burden to their family and society, causing potential safety prob-lems unable to escort for a long time with the family, physical constraints between protection and between self-es-teem and the mental health law,the quality of life and life values produce a series of contradiction and ethical is-sues,also make close contact with their nursing staff have to face the moral and ethical dilemma.The suggestions are:Hospital provides professional full-time, professional pension caregivers of alzheimer′s patients for long-term care, Strengthen the communication of nursing staff and patients′families, Reasonable and legitimate use tools, Perfect medical system construction, buildMedical support combinedcare system, Carry out the comprehensive rehabilitation nursing intervention, improve the patients quality of life, Change service concept, strengthening the study of ethical knowledge and application to promote the doctor-patient relationship.

ObjectiveTo evaluate the effects of all-trans retinoic acid(ATRA) on melanin content,activity and protein expression of tyrosinase,mRNA expression of Cu/Zn superoxide dismutase(SOD) in A375 cells irradiated with ultraviolet B(UVB).MethodsCultured A375 cells were classified into 6 groups:ATRA+UVB group treated with ATRA after UVB irradiation,hydroquinone+UVB group treated with hydroquinone after UVB irradiation,UVB group and ATRA group treated with UVB irradiation and ATRA respectively,negative control group receiving no treatment.Melanin content and tyrosinase activity were determined by NaOH solubilization assay and dopa-oxidation assay respectively at 24,48 and 72 hours after the addition of ATRA into medium.Western blot was performed to detect the protein expression of tyrosinase,and real-time quantitative PCR to measure the mRNA expressions of tyrosinase and Cu/Zn SOD in A375 cells after 24-hour culture with ATRA.ResultsThe melanin content and tyrosinase activity decreased in UVB-irradiated cells after being treated with ATRA for 24,48 and 72 hours.The protein (gray scale) and mRNA (2-△△Ct value) expression levels of tyrosinase were 0.72 ± 0.070 and 1.400 ± 0.135 respectively at 24 hours after UVB irradiation,decreased to 0.42 ± 0.056(P ＜0.01) and 0.810 ± 0.062(P ＜ 0.01 ) respectively after additional treatment with ATRA.The mRNA expression level of Cu/Zn SOD was 0.323 ± 0.066 in A375 cells at 24 hours after UVB irradiation,and increased to 0.625 ±0.103 (P ＜ 0.01 ) after additional treatment with ATRA.ConclusionATRA can suppress UVB-induced increase in melanin synthesis and elevate Cu/Zn SOD level in A375 cells,likely through tyrosinase pathway.

Objective To observe clinical efficacy of brinzolamide on mechanical contusion ocular trauma . Methods 50 patients(57 eyes) of mechanical contusion ocular trauma were selected and divided into observation group and control group randomly and evenly ( 29 eyes in the observe group ,28 eyes in the control group ) .On the basis of mechanical contusion ocular trauma basic treatment for all the patients , the observing group was added brinzolamide ophthalmic suspension .Their vision , intraocular pressure and ERG were observed .Results The vision of patients in the observing group was obviously better than that in the control group (χ2 =4.49,P<0.05).Intraocular pressure in the observing group (14.88 ±0.83)mmHg was obviously lower than that in the control group (19.64 ± 2.30)mmHg(P<0.05).Sum of a-wave amplitude and sum of b-wave amplitude after treatment were better than those before treatment ,and those in the observing group were higher than theose in the control group ( observation group:ta =0.44,tb =0.24;the control group:[ ta =1.03,tb =0.32;between two grous:ta =3.35,tb =2.37,P<0.05 ) ] .Conclusion Using Brinzolamide ophthalmic suspension to treat mechanical contusion ocular trauma preven -tively can obviously improve patients′vision, control their intraocular pressure and promote the recovery of retinal function.It has positive clinical effect .

Objective: To understand the change of smoking status among middle school students in Quzhou City from 2012 to 2017, and to provide a basis for school tobacco control. Methods: Through stratified cluster sampling method, Zhejiang youth health-related behavior questionnaire survey was conducted among 1 454 students in May 2012 and among 1 655 students in May 2017. Results: Among middle school students in Quzhou, attempting smoking rate, ever-smoking a whole cigarette reporting rate and current-smoking report rate decreased from 31.36%, 17.81% and 8.73% in 2012 to 21.70%,12.45% and 6.22% in 2018 respectively, with statistically significant differences(χ2=37.30,17.52,7.12,P<0.01). Among the current-smoking students, the rate of smoking frequency≥20 d/month and heavy-smoking rate decreased from 30.71% and 7.09% in 2012 to 15.53% and 0.97% respectively. It showed that attempting smoking rate, ever-smoking a whole cigarette reporting rate and current-smoking report rate of male students were higher than that of female students(χ2=117.50,63.99;47.14,51.26;110.18,22.50), and the non-ordinary high school students were higher than that of ordinary high school students and middle school students across two waves surveillance(χ2=47.14,51.26;70.34,43.77;62.67,22.50)(P<0.01). Conclusion School tobacco control have made a great progress，the tobacco use behavior of middle school students declines sharply in Quzhou.

Objective To investigate the undergraduates′cognition ,attitude and behavior about low‐carbon life and then to provide a relatively scientifically strategy .and provide scientific basis to formulate countermeasures about undergraduates′low‐car‐bon lifestyle .Methods By multistage sampling ,382 students′knowledge ,attitude and practice about low‐carbon life in Wuhan Uni‐versity of science and technology were analyzed .Results The students′cognition about low‐carbon life was good ,the awareness rate of girl was higher than that of boy ;Their attitude was positive ,grade and knowledge awareness were the two influence factors ;the behavior situation was unsatisfactory ,the origin of students and attitude enthusiasm were the elements affect rationality of be‐havior .Conclusion Undergraduates should strengthen the cognition of low‐carbon life ,improve attitude enthusiasm ,and form a good behavioral habit of low‐carbon life .

Aim To evaluate the effects of notoginsen-oside R1 on store-operated calcium entry ( SOCE ) in pulmonary arterial smooth muscle cells ( PASMCs ) of chronic hypoxia ( CH)-and monocrotaline ( MCT)-in-duced pulmonary hypertension ( PH) rats. Methods Mn2+ quenching of Fura-2 and measurement of intra-cellular free calcium concentration ( [ Ca2+] i ) using fluo-3 were examined in PASMCs of CH-exposed and MCT-treated rats. Results ①CH-exposed and MCT-treated rats exhibited profound PH when examined 3 weeks after hypoxia exposure or MCT injection, respec-tively. ②In the presence of 3 μmol·L-1 nifedipine, 10 μmol · L-1 notoginsenoside R1 significantly re-duced cyclopiazonic acid ( CPA )-induced the percent reduction in Fura-2 fluorescence measured 500 sec af-ter application of Mn2+, the maximal rate of Mn2+quenching, the amplitude of the Ca2+ influx transient and the resting [ Ca2+] i in PASMCs of CH-exposed and MCT-treated rats. Conclusion Notoginsenoside R1 inhibits SOCE and reduces resting [ Ca2+] i in PASMCs of CH-and MCT-induced PH rats.

Objective To compare the differences between the schizophrenics with negative and positive symptoms on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy ( 1 H-MRS). Methods 58 negative subtype and 51 positive subtype schizophrenics were examined at prefrontal lobe and thalamus by multivoxel 1H-MRS before antipsychotic treatment The N-acetylaspartate (NAA), choline-containing compounds ( Cho), and creatine compounds (Cr) were measured and the ratios of NAA/Cr, Cho/Cr were determined. Results On right thalamus,the NAA/Cr ratio in negative subtype patients ( 1.40 ± 0.29 ) demonstrated lower than that in positive subtype ( 1.62 ± 0.33 ), the same phenomenon were appeared on male, female, non-first-episode, with-medicine and without-medicine patients (P ＜ 0.05 or 0.01 ). The Cho/Cr ratio on right thalamus in negative subtype of female,non-first-episode,without-medicine schizophrenics were lower than those in positive subtype (P ＜ 0.05 ).On left prefrontal lobe,left thalamus and right thalamus, the NAA/Cr ratios both in negative subtype and positive subtype schizophrenics were significantly negatively related with age of onset(P＜0. 05 or 0.01 ). In negative subtype schizophrenics,the Cho/Cr ratio on right thalamus was positively related with age of onset ( r = 0. 25, P ＜0.05 ). In negative subtype schizophrenics of non-first-episode, without-medicine, the correlation was negative between the NAA/Cr ratio and the course of disease( r= -0.48, -0.46, P＜0.05 ) ,and was positive between Cho/Cr ratio and the course of disease on right thalamus( r= 0.58,0.56, P＜ 0.01 ). Conlusion Compared with positive subtype schizophrenics,negative subtype schizophrenics have greater impairments on 1 H-MRS on right thalamus. The course of disease has greater effects on 1 H-MRS in negative subtype schizophrenics.

Objective To identify the metabolite levels in prefrontal lobe and thalamus in patients of schizophrenia with proton magnetic resonance spectroscopy (1H-MRS). Methods Twenty-six schizophrenics with medicine-free for at least 7 d and 28 normal controls were assessed in this study. All subjects underwent examination of multi-voxel 1H-MRS on prefrontal lobe and thalamus within 24 h. The NAA, Cho and Cr were measured and the ratios of NAA/Cr, Cho/Cr and NAA/(Cho+Cr) were determined. Results Compared with the controls, the NAA/Cr ratio of schizophrenics was significantly lower in left prefrontal lobe and bilateral thalamus (all P＜0.05). No statistical difference of NAA/(Cho+Cr) ratio and the Cho/Cr ratio was found between two groups. Conclusion Abnormalities in neuronal function and/or integrity are present at left prefrontal lobe and bilateral thalamus simultaneously in schizophrenics.

OBJECTIVE: To investigate the incidence rate of deviated nasal septum (DNS) of the young men who are going to join the army, and of the students in key high schools in Jimo, and record their educational background, then analysis the influence of DNS on the youth's learning quality. METHOD: Random select 3085 young men who are going to be recruited in 2006-2008, and 2628 students in 3 key high schools of Jimo. Investigate the two groups' incidence rate of DNS and make a correlative statistic analyses with their educational background. RESULT: There are 395 young men with DNS, which account 12.8% of the 3085 men, with the educational background of college degree and above account 3.0%; high school diploma 12.4%; junior secondary education 27.5%. One hundred and ninety-four students with DNS in key high schools, which account 7.4, and the subsequent entrance examination results shows, undergraduate students account 14.9%, junior college students and considerable education 32.5%, and graduates 52.6%. CONCLUSION DNS can influence the learning quality of the adolescent. It is necessary to operate on those patients and improve the complaint symptom.
Adolescent ; Educational Status ; Female ; Humans ; Learning ; Male ; Nasal Septum ; abnormalities ; Students ; Young Adult

Objective To investigate the value of quantitative analysis of the left ventricular longitudinal strain in patients with hypertrophic cardiomyopathy (HCM) and with normal left ventricular ejection fraction (LVEF) by using two-dimensional speckle tracking imaging.Methods Twenty-eight HCM patients with normal LVEF (all of the cases were non obstructive HCM),who were diagnosed by clinical and ultrasound echocardiography between January 1,2015 and January 1,2016 in the First Affiliated Hospital of Dalian Medical University,served as the experimental group.And twenty healthy volunteers served as the healthy control group.The peak longitudinal strain (LPS) of the left ventricle and the systolic peak of the left ventricle were calculated by the STE technique.The indexes such as the transmural gradient (△ LS=LPSEndo-LPSEpi)and the transmural gradient percentage (△ LS％=△ LS/LPSEndo) were calculated.The Peak systolic longitudinal strain of endocardium (LPSEndo),the peak systolic longitudinal strain of mid-cardium (LPSMid),the peak systolic longitudinal strain of epicardium (LPSEpi),the peak systolic longitudinal strain of basal segment (LPSb),the peak systolic longitudinal strain of middle segment (LPSm),the peak systolic longitudinal strain of apical segment (LPSa),the global peak systolic longitudinal strain (GLPS) and other left ventricular myocardial strain,such as △ LS,△ LS％,in both the HCM group and the healthy control group,were analyzed by using independent samples t test comparison.For each layer of the left ventricle and the overall myocardial longitudinal strain,two independent sample t test was used for comparison between groups,and LSD-t test was used for intra-group comparison.Results (1) There was a gradient of LPS among the three layers and the three segments in both of the two groups:LPSEndo and LPSMid [(18.36±4.97)％ vs (13.80±4.23)％,(26.41±2.93)％ vs (22.19±2.49)％],the difference was statistically significant (t=5.550,8.529,P ＜ 0.05);LPSEndo and LPSEpi [(18.36±4.97) ％ vs (11.91 ±3.63)％,(26.41±2.93)％ vs (19.43±2.20)％],the difference was statistically significant (t=5.550,8.529,P ＜ 0.05);There was significant difference between LPSMid and LPSEpi in the healthy control group [(22.19 ± 2.49)％ vs (19.43 ± 2.20)％,t=3.709,P ＜ 0.05)],that was,LPSEndo ＞ LPSMid ＞ LPSEpi.LPSa and LPSm,the difference was statistically significant (t=4.029,6.839,P ＜ 0.05);LPSa and LPSb,the difference was statistically significant (t=5.304,9.887,P ＜ 0.05);There was significant difference between LPSm and LPSb in the healthy control group (t=4.170,P ＜ 0.05);that was,LPSa ＞ LPSm ＞ LPSb.In the HCM group,LPS in the 3 layers,3 segments,and the whole left ventricular wall were lower than that of the the healthy control group,the differences were statistically significant [GLPS:(14.63± 3.75)％ vs (22.68±2.51)％,t=-8.347;LPSEndo to LPSEpi:t=-6.477,-7.909,-8.242;LPSa to LPSb:t=-6.647,-8.790,-7.267;all P ＜ 0.05).(2) Compared with the healthy control group,both the segmental gradient and global transmural gradient in the HCM group were found reduced,but the difference had no statistical significance (all P ＞ 0.05).(3) The transmural gradient percentage both in the healthy control group and the HCM group were reduced from the apical segment to the basal segment,the difference were statistically significant (HCM group:t=9.985,5.969;healthy control group:t=17.513,7.043;all P ＜ 0.05).Compared with the healthy control group,the △ LS％a and the △ LS％m of HCM group were significantly higher [(58.86± 11.32)％ vs (43.70±4.73)％,(28.43± 11.48)％ vs (20.30± 3.66)％],and the difference was statistically significant (t=5.634,3.049,all P ＜ 0.05).Conclusions (1) Using 2D-STI could accurately determine the regional or the global left ventricular systolic function in patients with HCM.(2) The transmural gradient percentage can be more sensitive to reflect the change of the transmural gradient,and more research needed to explore its value for clinical application.