Objective To explore the feelings of the caregivers of dementia patients,and find the resource of the caregiver's abuse tendency to dementia patients in community.Methods The data of 10 caregivers were collected through deep interviews,and the Colaizzi analysis method was used to analyze the data.Results Through repeatedly reading,arranging,analysis,separation,and theme refining,five themes were drawn:lack of related knowledge and care skills,care tasks making caregivers tired,the economic burden,lack of social support,low sense of worth.Conclusions When concerning the problems caused by dementia patients,it's necessary to appeal the society and government to provide feasible service and assistance on the issue of abuse tendency,which is produced by the caregivers during the process of taking care of them.

Objective To explore the relationship between police' s occupational pressure and their job burnout and health. Methods 251 policemen completed the police occupational pressure questionnaire, Maslach Burnout Inventory-General Survey and general heath questionnaire. Results Occupational pressure was positively related to emotional exhaustion and cynicism( r = 0.365 ～ 0.472 ), and not related to diminished personal accomplishment( r = - 0.004 ). Occupational pressure had negative effect on mental health (β = - 0. 1 89 ). Job burnout and its three dimensionalities were negatively related to mental health( r= -0.331 ～ -0.662). With both occupational pressure and job burnout as predictors of mental health, only did job burnout negatively predict mental health (β = - 0. 698). Conclusion Both occupational pressure and job burnout can predicted policemen' general health.

ObjectiveTo investigate the effect of thalidomide on the proliferation and apoptosis in human pancreatic cancer cell SW1990 in vitro.MethodsSW1990 cell line was treated with thalidomide at different concentrations (3.125,6.25,12.5,25,50,100,200 and 400 μg/ml) for 24,48,72 h,and then cell proliferation were evaluated by MTT.Cell cycle was determined by flow cytometry,apoptosis was determined by annexin V/PI fluos staining,Bcl-2,Bax protein expression and Bcl-2/Bax ratios were measured by Western Blot in vitro.ResultsThalidomide inhibited the proliferation of SW1990 cells in a time and dosedependant manner.The proportion of G0/G1 phase of SW1990 cells with 200 μg/ml thalidomide treatment increased from (41.15 ± 2.23 ) ％ to (58.83 ± 2.33 ) ％,apoptosis rate increased from 2.6％ to 28.0％,the expression of Bax protein up-regulated from 0.17 ± 0.03 to 0.33 ± 0.04,the expression of Bcl-2 protein downregulated from 0.35 ± 0.02 to 0.17± 0.01,the ration of Bcl-2/Bax decreased from 2.17 ± 0.44 to 0.52 ±0.07.ConclusionsThalidomide can inhibit the proliferation of pancreatic cancer SW1990 cells by upregulating Bax,down-regulating Bcl-2,inducing cell apoptosis and cell Go/G1 phase arrest.

Objective To observe the effect of penehyclidine hydrochloride (PHCD) combined with mechanical ventilation on inflammatory response in rats with acute respiratory distress syndrome(ARDS)induced by hydrochloric acid(HCl)inhalation. Methods 32 adult healthy male Sprague-Dawley(SD)rats were randomly divided into four groups:sham operation group,ARDS model group,PHCD group(intraperitoneal injection of 0.5 mg/kg PHCD at 30 minutes before HCl instillation)and mechanical ventilation group〔mechanical ventilation was given after PHCD treatment,ventilator settings were as follows:tidal volume(VT)=4 mL/kg,respiratory rate(RR)= 70 beats/min,the time ratio of inspiration to expiration(I:E)=1:2,fraction of inspired oxygen concentration(FiO2)=0.21〕,8 rats in each group. The rat ARDS model was created by HCl(0.1 mol/L,1.2 mL/kg) intratracheal instillation. After mechanical ventilation for 4 hours,the experiment was stopped. Arterial partial pressure of oxygen(PaO2)was measured,and the oxygenation index as well as lung wet/dry weight ratio(W/D)were calculated respectively. The pathological changes in lung tissues were observed under light microscope,and the pathological score was evaluated. The levels of myeloperoxidase(MPO),interlukin-8(IL-8)and nuclear factor-κB (NF-κB)in homogenate of lung tissues were all measured respectively by enzyme linked immunosorbent assay (ELISA). Results In rats of ARDS model group, there were significant infiltration of inflammatory cells, collapse of extensive pulmonary alveoli and hyaline membrane formation in lung tissues,but the edema in pulmonary mesenchymal tissue and congestion of micro vessels were not obvious. Compared with sham operation group,the lung tissue pathological score(9.88±2.03 vs. 1.38±0.92),lung W/D ratio(7.67±0.96 vs. 4.08±0.65)were significantly increased(both P<0.01),while oxygenation index〔mmHg(1 mmHg=0.133 kPa):213±29 vs. 428±28〕was markedly decreased in model group(P<0.01);and the concentrations of MPO(μg/L:34.18±3.99 vs. 20.92±1.40), IL-8(ng/L:864±53 vs. 583±91)and NF-κB(ng/L:1 229±133 vs. 803±130)in homogenate of lung tissues were significantly higher in model group(all P<0.01). The pathological changes in lung tissues including inflammatory cell infiltration,collapse of alveoli and pulmonary edema,etc. were obviously improved when treated by PHCD or mechanical ventilation and the lung pathological score and W/D ratio were significantly decreased compared with those of model group,oxygenation index in these two groups were both significantly increased,meanwhile, the concentrations of MPO,IL-8 and NF-κB were sharply decreased when compared with those of model group (all P<0.05). The degree of improvement in all above indexes were greater in mechanical ventilation group than those in PHCD group(lung injury score:5.63±1.85 vs. 7.63±1.67,lung W/D ratio:5.35±1.05 vs. 6.46±1.17, oxygenation index:325±57 vs. 272±44,MPO:25.80±3.36 vs. 29.88±3.93,IL-8:736±53 vs. 802±53, NF-κB:984±75 vs. 1 109±118,all P<0.05),however they did not reach the levels of the sham operation group (P<0.05 or P<0.01). Conclusion PHCD can inhibit the inflammatory response in ARDS rats induced by HCl inhalation,thus it may protect the lung tissue from injury induced by HCl,and the protective role of PHCD plus menchanical ventilation is superior to that of PHCD only.

Objective To explore the issues of everyday expenses list used in the cadre wards and find out countermeasures for the purpose of reducing medical disputes and improving the patients’satisfaction.Method Seventy-four patients admitted in our department from July to September 2012 were set as control group,where an investigation was conducted to find out the issues in the practical use of every expenses list and corresponding measures were worked out and used in observation group,which included 78 patients admitted in the department from October to December 2012.The two groups were compared in terms of self-paid articles, re-recording of missed expenses,failure to timely refunding,charging by other means,disagreement on curative nursing items and unclear items for charging.Result The observation group was significantly better than the control in self-paid articles,re-recording of missed expenses and failure to timely refunding(all P<0.05).Conclusions There are some issues in the use of everyday expenses list in the cadre wards.We should take corresponding countermeasures to ensure the interests of the hospital and the patients and the enhanced degree of patients’comfort.

Objective To investigate the efficacy of externally applied diclofenac diethylamine emulgel on the prevention of PICC-induced mechanic phlebitis. Methods One hundred cancer patients with PICC were divided into two groups. diclofenac diethylamine emulgel and mucopolysaccharide polysulfate cream were applied three times a day for 7 days after catheterization in the two groups,respectively. Results There was no significant difference on the incidence of mechanic phlebitis between the two groups (4% vs. 8%,P>0.05). Conclusion The efficacy of externally applied diclofenac diethylamine emulgel on the prevention of PICC-induced mechanic phlebitis is the same as mucopolysaccharide polysulfate cream. Except their common virtue of convenient and simple operation,the price of diclofenac diethylamine emulgel is lower than mucopolysaccharide polysulfate cream and worthy to be spread in clinical practice.

Objective Retrospective analysis of 56 cases of the surgical humerus neck of children that treated with abduction brace combined with manipulative reduction,and discuss the significance of abduction brace combined with manipulative reduction in treatment of fracture of the surgical humerus neck about children.Methods This study consisted of 56 children with fracture of the surgical humerus neck,among these,41 were males and 15 were females,9 were road accident and 47 were falling injury,average 7.67 years.They were all treated with abduction brace combined with manipulative reduction,after 1 month fixation,dismantled the abduction brace and did the functional exercise.Results Follow-up study was carried out in 56 cases,followed 6 months to 5 years,average 2.96 years,accoding to the standard of fracture healing,excellent result was obtained in 35 cases and good in 21 cases,the excellent-good rate was 100%.Conclusions Abduction brace combined with manipulative reduction is an effective treatment for fracture of the surgical humerus neck in children.

Objective To analyze the complications during and after the surgical treatment for long bone fractures in children with titanic elastic intramedullary nail(TEN),in order to improve the technique and potential shortcomings in these surgeries,and reduce the incidence of complications.Methods A retrospective study was done on the 182 children with long bone fractures treated with TEN from Jan.2005 to Jan.2008.A summary and analysis was made on the complications of these cases.Results All the 182 cases had the bones healed.During the operation,split in bone cortex was found in 3 cases,penetration into epiphysis by nails was found in 1 case.After operations,irritated skin and exposed nail was found in 3 cases,prolonged bone healing in 2 cases,limitation of range of motion in the knee in 1 case,bent nail in 1 case,difficulty in retracting the nail in 10 cases,shortening in 2 cases,second fracture of the healed long bone in 1 case.The results were excellent in 173 cases,good in 6 and fair in 3,and the rate of excellent and good was 98 %.Conclusions Though it has certain complications,the technique of TEN in the treatment of children's long bone fractures has more advantages over other internal fixations.Carefully performing the procedure according to the principal of TEN can decease and prevent most of these complications.

Objective To evaluate the effect of early surgical treatment for primary lower limb varicose veins complicated by thrombophlebitis.Methods The clinical date of 42 patients with primary lower extremity varicose veins complicated by thrombophlebitis treated in 4 years were analyzed retrospectively.The CEAP classification was adopted to establish the diagnoses of the all patieats.In the early stage,high ligation and stripping of the varicase veins were performed.After removal of varicose veins and thrombi,both anti-inflammation therapy and anticoagulant therapy were applied.Results All patients made a good recovery.After surgery,3 patients had skin callous and swelling,and 3 patients had foot nerve paresthesia.But,no serious complications,such as deep venous thrombosis or pulmonary embolism,were observed.The was no recurrence during 2 months to 4 years follow-up.Conclusions Early surgical treatment for primary lower limb varicose veins complicated by superficial thrombophlebitis not only has good results but also helps control of deep venous thrombosis and pulmonary embolism,and other serious complications that can result from superficial venous thrombosis.