OBJECTIVES: The interaction between elderly people with disabilities and their caregivers and the improvement of caregiver burden is important for elderly people with disabilities and their caregivers. This study aims to explore the multiple mediating roles of caregiver's caring ability and resilience in depression in the elderly people with disabilities on caregiver burden. METHODS: A total of 246 elderly people with disabilities at home and their family caregivers from 5 regions were investigated by questionnaires, including the General Information Questionnaire, the Patient Health Questionnaire, the Family Caregiver Task Inventory, the Resilience Scale, and the Caregiver Burden Interview. A multiple mediation model was constructed and tested. RESULTS: Univariate analysis showed that the caregiver burden of disabled elderly men is higher than that of women; the lower the level of self-care of disabled elderly individuals, the greater the burden on their caregivers (both P<0.05). Correlation analysis showed that depression of the disabled elderly people was positively correlated with the caregiver burden (P<0.01). Caregiver's caring ability was positively correlated with caregiver's resilience (P<0.01), and both were negatively correlated with caregiver burden (both P<0.01). The multiple mediating effects of caregiver caring capacity and resilience between depression of the disabled elderly people and caregiver burden were significant, with the mediating effects of caregiver caring capacity and resilience accounting for 68.9% and 26.2% of the total effect, respectively. CONCLUSIONS Depression in the elderly people with disabilities can indirectly affect caregiver burden through the caregiver's caring ability and resilience. Families of older people with disabilities need to focus on both the elderly and their caregivers. It is possible to reduce the caregiver burden and improve the physical and mental health of the dyads by empowering the caregiver's caring ability and resilience.
Male ; Humans ; Female ; Aged ; Caregiver Burden ; Disabled Persons ; Caregivers ; Surveys and Questionnaires ; Mental Health

Osteoporosis (OP) is a systemic skeletal disease that primarily affects the elderly population, which greatly increases the risk of fractures. Here we report that Kindlin-2 expression in adipose tissue increases during aging and high-fat diet fed and is accompanied by decreased bone mass. Kindlin-2 specific deletion (K2KO) controlled by Adipoq-Cre mice or adipose tissue-targeting AAV (AAV-Rec2-CasRx-sgK2) significantly increases bone mass. Mechanistically, Kindlin-2 promotes peroxisome proliferator-activated receptor gamma (PPARγ) activation and downstream fatty acid binding protein 4 (FABP4) expression through stabilizing fatty acid synthase (FAS), and increased FABP4 inhibits insulin expression and decreases bone mass. Kindlin-2 inhibition results in accelerated FAS degradation, decreased PPARγ activation and FABP4 expression, and therefore increased insulin expression and bone mass. Interestingly, we find that FABP4 is increased while insulin is decreased in serum of OP patients. Increased FABP4 expression through PPARγ activation by rosiglitazone reverses the high bone mass phenotype of K2KO mice. Inhibition of FAS by C75 phenocopies the high bone mass phenotype of K2KO mice. Collectively, our study establishes a novel Kindlin-2/FAS/PPARγ/FABP4/insulin axis in adipose tissue modulating bone mass and strongly indicates that FAS and Kindlin-2 are new potential targets and C75 or AAV-Rec2-CasRx-sgK2 treatment are potential strategies for OP treatment.

Objective:To observe the effect and underlying mechanism of down-regulation of VEGFA on the radiosensitivity of esophageal cancer ECA-109 cells.Methods:Esophageal cancer cells were divided into four groups: sh-VEGFA group, vector control group, X-ray plussh-VEGFA group and X-ray plus vector group. The expressions of VEGFA gene and protein were detected by qPCR and Western blot, respectively. Cell proliferation and survival was measured by CCK8 assay and cloning formation, respectively. Cell apoptosis was detected by flow cytometry, and γ-H2AX foci were detected by immune-fluorescence assay.Results:Compared with the vector group, the expression of VEGFA gene was decreased in sh-VEGFA group ( t=11.98, P<0.05), and the expression of VEGFA protein was also reduced( t=12.38, P<0.05). After VEGFA being down-regulated, the cell proliferation( A450)was obviously inhibited( t=2.78, 7.25, 21.93, 13.21, P<0.05), and the cell clone formation of the sh-VEGFA group was significantly decreased so that D0, Dqand SF2 of sh-VEGFA group were decreased( t=5.83, 8.56, 7.68, P<0.05), and SERD0and SERDqwere increased. Compared with the vector group, the apoptosis rate in the sh-VEGFA group and the X-ray group was significantly increased and further increased in the sh-VEGFA plus X-ray group( t=17.63, 22.48, 33.87, P<0.05), and the number of γ-H2AX foci in both sh-VEGFA and vector groups were significantly increased within 2 h after X-ray irradiation. At 24 h after irradiation, the number of γ-H2AX foci returned to normal level in the vector group but remained at a higher level in the sh-VEGFA group ( t=7.00, P<0.05). Conclusions:Down-regulation of VEGFA inhibits the proliferation and colony formation, promotes apoptosis and hence increases the radiosensitivity of esophageal carcinoma cells via a pathway related to DNA damage repair.

Objective: To understand the concentrations and source of SO42-,NO3-,Cl- and NH4+ in atmospheric PM2.5 in Zhoushan,and to provide reference for controlling PM2.5 and formulating effective environmental protection measures. Methods: Monitoring sites in new districts of Zhoushan were set up to continuously collect PM2.5 from 10th to 16th of each month and under the hazy weather during 2015-2016（AQI > 200）. The mass concentration of PM2.5 was measured by weighing method,and the concentrations of SO42-,NO3-,Cl- and NH4+ in PM2.5 components was detected by ion chromatography. Results: The average daily concentration of PM2.5 in Zhoushan from 2015 to 2016 was（40.91±27.39）μg/m3. The concentration of the four water-soluble non-metal ions in PM2.5 components was 3.56-103.03 μg/m3,with an average of（23.06±20.00）μg/m3,accounting for about 56.64% of PM2.5 contents. The average monthly concentration of SO42- was the highest[（10.35±6.48）μg/m3],while the average monthly concentration of Cl- was the lowest [（0.49±0.73）μg/m3]. The concentration of the four ions was the highest in winter[（37.56±27.74）μg/m3]and the lowest in summer[（12.32±5.88）μg/m3]. The differences between different seasons was statistically significant（P<0.05）. The highest concentration of NO3- occurred in winter,which was（14.48±13.28）μg/m3. The concentration ratio of NO3- to SO42- ranged from 0 to 2.58,with an average of 0.55. There were 28 days（14.74%）with the ratio greater than one,22 days of which was in winter. Conclusion The concentration of SO42- was the highest and Cl- was the lowest in atmospheric PM2.5 in Zhoushan. The highest concentration of the four ions occurred in winter. The concentration of NO3- in winter was higher than that of SO42-,suggesting that motor vehicle exhaust might be the main source of PM2.5 in winter.

Objective To predict the tolerance range of set-up errors in clinical practice by predicting the virtual set-up errors of postoperative radiotherapy patients for breast cancer. Methods A retrospective analysis was made of the patients who underwent radiotherapy after breast cancer surgery in recent 3 years. According to different treatment method, 10 cases of breast cancer after modified radical mastectomy and 10 cases after breast conserving radical mastectomy were selected. The target area was delineated, the volume modulated radiation therapy plan was made, the virtual moving error of the center point of the plan was moved, and the maximum moving error was 5 mm by 1 mm step. After recalculating the dose, the corresponding data including the clinical target areas ( CT ) , CTV ( V50 ) , average heart volume, V20 of the affected lung and CTV volume were recorded. SPSS 19. 0 software was used for statistical analysis, and repeated measurement of variance analysis was used to analyze the changes of the actual dose in the target area after moving the center point. Linear regression analysis method was used to analyze the correlation between the CTV volume and the dose change after the CTV moving midline. Results The virtual set-up error had little influence on the axis direction of the approximate mammary tangent direction, while the vertical direction of the approximate mammary tangent direction had greater influence. After moving more than 3 mm on the vertical axis, the CTV ( V50 ) decreased to below 90％, which was lower than the general requirement for the target area of CTV. Statistical analysis of set-up errors in all directions showed that there was significant difference in dosimetric changes ( F=34. 182, 12. 877, 16. 443, 9. 846, 46. 829, 10. 122, 57. 931, P <0. 05) in all directions except the B direction of left breast set-up errors (P>0. 05). Between breast conserving surgery and modified radical mastectomy, there was little effect on target movement. Through correlation analysis, it was found that the volume of CTV in the target area of breast cancer patients was linearly related to the errors caused by the movement of B, C and B directions of left breast and right breast(F=5. 733, 18. 496, 6. 630, P<0. 05). Conclusions In postoperative radiotherapy for breast cancer, the errors perpendicular to the section of breast should be paid special attention to whether left or right breast. When the error of this direction exceeds 3 mm, CTV is obviously less than V50 below 83. 85％. The effect of set-up error on the dose of CTV was not related to the operation mode of breast cancer and there was no obvious correlation with the volume of the target area.

To compare with the effects of the GM-CSF and IL-2 used as adjuvants in the baculovirus vaccine, we used genetic engineering to construct the recombinant baculovirus rBV-LMI-F and with GM-CSF and IL-2 to immunized chickens. Then, we compared the concentration of the neutralizing antibody and cytokines to determine the immunostimulatory effects of GM-CSF and IL-2. GM-CSF induced higher levels of antibodies and cytokines in chickens at 28 d and 42 d post-vaccination. In conclusion, GM-CSF could elicit higher serum antibody and cytokines responses and improved the effects of Baculovirus vaccine.

Virtual simulation experiments use the virtual simulation technology to simulate the exper-imental process and experimental instrument,which is intuitive, sharing and cost-saving. Due to the single form of traditional experiment of sanitary chemicals in cosmetics testing and the limitation of experimental time, place and funding, this paper attempts to apply the virtual simulation experiment to sanitary chemicals in cosmetics testing experiment teaching. From the aspects of optimizing experimental items, organizing virtual simulation experiments and evaluating teaching effects, this paper discusses the application of virtual simulation experiment in sanitary chemicals in cosmetics testing experiment teaching.

Amisulpride,a kind of the second generation antipsychotics,was marketed in China in 2010.A series of clinical research and experience before and after listed,especially the data based on Chinese population,provided evidence for the generalization and application of amisulpride.In order to optimize the clinical application of amisulpride,and improve the prognosis of patients,Expert Advice on the Practical Use of Amisulpride in the Treatment of Schizophrenia is presented here.This advice is based on the recent evidence and clinical experience,for guiding the clinical medication of amisulpride.

Objective To explore the clinicopathological features and diagnosis of adenoid cystic carci noma of the breast (ACCB).Methods Clinical data of 3 cases of ACCB were collected and followed up to observe the clinical pathological features.Immunohistochemistry was used to determine the immune phenotype.Results All the 3 cases were female,aging from 55 to 72 years old (61 years old as the average).The tumors were found in subareolar region well-circumscribed.ACCB was characterized by the presence of a dual cell population of luminal and basaloid cells arranged in cribriform and tubular-trabecular patterns.On immunohistochemical staining,the myoepithelial cells expressed SMA,CK5/6,P63,CD117 and the glandular epithelium cells were mostly positive for CK18,EMA,CK7,while no expression of ER,PR,HER-2,CD10 was observed.Conclusions ACCB is a rare neoplasm with a triple-negative,basal-like phenotype,but exhibits an indolent clinical behavior.The diagnosis can be worked out by evaluation of clinical characterstics,histological and immunohistochemical features.

Purpose To explore the clinicopathological features,immunophenotype,differential diagnosis and prognosis of the composite pheochromocytoma (CP)-ganglioneuroma.Methods 3 cases of CP-ganglioneuroma were stained by immunohistochemical SP method,and the related literatures were reviewed.Results 3 cases of CP-ganglioneuroma were one male and 2 females,the age were 37-64.Case 3 were of primary mediastinal.Microscopically,the tumor tissues were composed of two components:one type of tumor cells were arranged in nests with a predominant Zellballen pattern,round or oval nuclei,fine granular cytoplasm and rare mitotic,another part of the neoplasm showed scattered and aggregated distributed ganglion cells in the background of neurofibromatosis which aligned bundles and interwoven,the edge of the tumor was still residual adrenal tissue.Immunohistochemically,components of pheochromocytoma were positive for CD56,CgA,Syn,vimentin and negative for SMA,Melan-A,α-inhibin NF with low Ki-67 proliferation index.S-100 was positive in supporting cells,ganglioneuroma components were positive for NF,S-100 with low Ki-67 proliferation index.CgA and Syn were weakly positive or negative in the ganglion cells.Conclusion CP is a relatively rare tumor,which can not be distinguished from pheochromocytoma in clinical and radiological diagnosis.The corresponding clinical treatment and follow-up management should be taken according to the different ingredients (benign or malignant).