A randomized, open-label, multicentre study to evaluate plasma atherosclerotic biomarkers in patients with type 2 diabetes mellitus and arteriosclerosis obliterans when treated with Probucol and Cilostazol

Objectives To evaluate the plasma atherosclerotic biomarkers in patients with type 2 diabetes mellitus （T2DM） and arteriosclerosis obliteran （ASO） when treated with Probucol plus Cilostazol in combination and individually. Methods In this open-label study, patients aged 40-75 years were randomized to receive conventional therapy alone, or with Cilostazol 100 mg bid, or with Probucol 250 mg bid, or with both in combination. Endpoints included changes in plasma biomarker and safety at 12 weeks. Results Of the 200 randomized pati- ents, 165 for per-protocol and 160 for the safety （QTc intervals） were set, respectively. Probucol significantly reduced total cholesterol （P 〈 0.001）, low-density lipoprotein cholesterol （LDL-C）, （P = 0.01）, and high-density lipoprotein cholesterol （HDL-C） （P 〈 0.001） compared with conventional therapy. Cilostazol was effective in increasing HDL-C （P = 0.002） and reducing triglycerides levels （P 〈 0.01） compared with conventional therapy. A trend towards significance was observed for the difference between conventional therapy alone and Probucol plus Cilostazol group for the change in oxidized low-density lipoprotein （Ox-LDL, P = 0.065）. No significant effects on the majority of the remaining biomarkers were found across the treatment groups. Conclusions We have confirmed that Ox-LDL could be a possible plasma atherosclerotic biomarker among the evaluated biomarkers, which reflected the synergetic effect of Cilostazol plus Probucol in patients with T2DM and ASO shown previously in preclinical studies.

Self-endangering:A qualitative study on psychological mechanisms underlying nurses’burnout in long-term care

Objectives To develop a more specific understanding of psychological mechanisms in the development of burnout in long-term care as a basis for potential new intervention strategies aiming at improving nurses’mental health.Methods Two qualitative studies with thematic analysis were conducted.In Study 1,we conducted eight group interviews with 110 nurses from May–July 2019 in the context of workshops at eight nursing homes in Germany.In Study 2,we supplemented these with semi-structured interviews with 14 executives at German nursing homes in December 2019.Results The thematic analysis in Study 1 identified three main themes:causes of challenges,employees’opportunities for change,and organisational opportunities for change.Thematic analysis in Study 2 identified three main themes:job motives,reasons for filling in for others,and employee self-care.Further,our results show that the need to stand in for colleagues,in particular,is one of the greatest challenges for geriatric caregivers.In dealing with these challenges we found that self-endangering behaviour—a diminished ability to say no when asked to fill in or to do work overtime—was an important antecedent of nurses’burnout.Further,high levels of altruistic motivation and identification with the team or organisation were associated with self-endangering behaviour in the presence of adverse working conditions.Low levels of self-worth are a further risk factor for self-endangering.Conclusions Our findings are at odds with some core tenets of classic models of job demands and burnout that construe motivation and identification as resources.Our results show the need of a holistic intervention program in nursing including individual coaching,team-based interventions and organisational development processes.Employees themselves should be sensitized to this issue and supported in the long term,and politicians should create structures that do not encourage this behaviour any further.

Application of stilamin on advanced gastrointestinal carcinoma patients complicated with malignant bowel obstruction

Objective： To investigate the effectiveness of stilamin in malignant bowel obstruction （MBO） due to advanced gastrointestinal carcinoma patients. Methods： 62 patients with MBO due to gastrointestinal carcinoma were randomly divided into two groups： routine therapy group （control group 30 patients） and stilamin group （32 patients）. Stilamin group received routine therapy combined with stilamin （6 rag/d） by 24 hours continuous infusion for three to twelve days. The curative effectiveness was observed and compared between the two groups. Results： After treatment, the clinical symptoms of abdominal distention and abdominal pain were relieved significantly in stilamin group compared with the control group （84.4% vs 57.6%; P 〈 0.05）. The exhaust of anus was more earlier （62.1% vs 25.6%; P 〈 0.05）, and the average volume of gastrointestinal decompression reduced more rapidly in stilamin group compared with the control group [（216 ± 158） mL/d vs （522 ± 184） mL/d; P 〈 0.001）, smaller and less fluid-air in the intestinal and in the colon at the 81.3% of patients plain abdominal radiography were observed in stilamin group. Quality of life, evaluated with Karnofsky score （57 ±7 vs 45 ±9; P 〈 0.01）, was improved significantly. Conclusion： The administration of stilamin, in combination with routine treatment can be very effective in the management of MBO. It can effectively relieve the symptoms of MBO and improve the quality of life in patients.

Do Small Family Firms Outperform Non-family Firms？ A Research Agenda Based on Agency and Stewardship Theories＊

The aim of this study is to examine the effects of family involvement and altruism on agency costs of equity and debt, as well on the performance of small family businesses. To achieve this objective, the authors reviewed the literature on family business. Drawing from agency theory and stewardship theory, the authors also proposed a research model that highlights the links among the variables. In so doing, this paper makes some contributions to the literature in three ways. Firstly, it takes an integrative framework that may help to explain behaviors oriented towards maximizing potential performance within a context in which pro-organizational attitudes co-exist with self-serving motivations. Secondly, it advances the understanding of corporate governance mechanisms in small family businesses, and finally, it deepens the discussion of prior research by advancing a set of propositions based on two theoretical approaches. Thus, the authors believe that a systematic comparison of different contexts provides new insights into small family business governance. The implications and directions for future research are in the last section.

With the dragon as a foil： American imagining of China and the construction of America＇s national identity

Throughout the period from the late eighteenth to the mid-twentieth century, China was invariably ＂the other＂ contrasted with the US in the latter＇s imagination. Imagining this ＂other＂ reflected the fears, aspirations and yearnings of Americans, and helped define American identity and its position in the world in different historical periods. It was a w^iy for the US to reflect on and conceive of itself, and was therefore profoundly autobiographical. Americans should give up their manner of understanding and imagining China within the framework of their own values and interests and obtain a clear understanding of the feelings, desires and aspirations of the Chinese people, so as to lay a sound emotional foundation for the stable development of Sino-US relations.