Exploring the type of social support available to aged male hypertensive clients in Ghana

Objective: To explores the social support available to aged hypertensive male clients in a municipality in Ghana.Methods: The inclusion criteria were as follows: age ≥60 years and are known hypertensive patients. Data were collected from 186 selected aged male hypertensive patients for 3 months. The questionnaire was self-developed and open-ended. The data were processed and analyzed using SPSS version 23. Some of the variables were subjected to statistical tests and ranks in the order of impor tance to respondents. The enrolled respondents were allowed to par ticipate in the study after their informed consent was obtained. It was evident that respondents do not obtain much support or help in taking care of their condition.Results: The result revealed that the repondents has no support to help take care of their condition as evident by the responses in the study. The scores on average mean for some variables are(AM = 2.25, SD = 0.381) more than the test value of 2.50. Some of these supports were on feeding support(M = 3.97, SD = 0.278, n = 186), health support(M = 2.87, SD = 0.167, n = 186), and cleaning support(M = 2.59, SD = 0.868, n = 186). Supports such as clothing, socialization, medication, washing, transportation, and financial support were lacking.Conclusions: Based on the finding that certain forms of support were lacking, the study concludes that steps undertaken by the government, community, religious bodies, and family toward improving these supports can be of immense help for aged male hypertensive patients living in the Ejura-Sekyedumase municipality.

Correlation between social support and depression in elderly stroke patients in the sequelae stage from five communities of Shanghai, China

Using a convenience sampling method, 81 aged patients who were between 6 and 24 months post-stroke were selected from five communities of Shanghai, China. The correlations between social support and depression, as well as other influential factors, were investigated. Results revealed that 46% （37/81） of the stroke patients suffered from depression. Depression was correlated with social support total scores and the two domains of subjective support and utilization. Older age, male gender, low income, absence of spouse and cerebral hemorrhage were risk factors for depression and identify more vulnerable groups.

Roles of mutual help of local community networks in community health activities: Improvement for the quality of life of older people in Thailand

Objectives: This study aimed to describe work and activities of community networks focusing on the improvement of the quality of life (QOL) of older people in Thailand.The understanding of the work can help enhancing the community development and strengthening of local communities and their networks.Methods: Qualitative methods including in-depth interview,observation,and focus group discussion were employed to the study.64 participants participated to the study and were recruited from 4 key actors within the community.Content analysis was used to analyze the obtained data.This study was conducted in 6 local administrative organizations (LAOs) which selected from the outstanding areas of the project.Each LAO represents one sub-district of the regions of Thailand namely;(1) the upper north,(2) the lower north,(3)the upper eastern,(4) the lower eastern,(5) the central and (6) the south.Results: The findings of this study were categorized into three main themes: (1) Social capital including people in the community,social groups,and organizations,(2) Mutual help/collaboration activities composed of six sets of activities related to social capitals working on the improvement of QOL of older people,and (3) Impacts of the mutual help/collaboration activities on older people and local communities who help to improve of QOL of older people.Conclusion: The findings are important features for the community development.These themes should be recommended for community nurses,health related groups and organizations for the improvement of QOL of older people in the community.

Reduction of the incidence and mortality of rectal cancer bypolypectomy:a prospective cohort study in Haining County

AIM: To reduce the incidence and mortality of rectal cancer and address the hypothesis that colorectal cancer often arise from precursor lesion(s), either adenomas or non-adenomatous polyps, by conducting a population-based mass screening for colorectal cancer in Haining County, Zhejiang, PRC. METHODS: From 1977 to 1980, physicians screened the population of Haining County using 15 cm rigid endoscopy. Of over 240000 participants, 4076 of them were diagnosed with precursor lesions, either adenomas or non-adenomatous polyps, which were then removed surgically. All individuals with precursor lesions were followed up and reexamined by endoscopy every two to five years up to 1998. RESULTS: After the initial screening, 953 metachronous adenomas and 417 non-adenomatous polyps were detected and removed from the members of this cohort. Further, 27 cases of colorectal cancer were detected and treated. Log-rank tests showed that the survival time among those cancer patients who under went mass screening increased significantly compared to that of other colorectal cancer patients (P【0.0001). According to the population-based cancer registry in Haining County, age-adjusted incidence and mortality of rectal cancer decreased by 41% and 29% from 1977-1981 to 1992-1996, respectively. Observed cumulative 20-year rectal cancer incidence was 31% lower than the expected in the screened group; the mortality due to rectal cancer was 18% lower than the expected in the screened group. CONCLUSION:Mass screening for rectal cancer and precursor lesions with protocoscopy in the general population and periodical following-up with routine endoscopy for high-risk patients may decrease both the incidence and mortality of rectal cancer.

Glutathione S-transferases M1,T1 genotypes and the risk of gastric cancer:A case-control study

AIM: Glutathione S-transferases (GSTs) are involved in the detoxification of many potential carcinogens and appear to play a critical role in the protection from the effects of carcinogens. The contribution of glutathione S-transferases M1 and T1 genotypes to susceptibility to the risk of gastric cancer and their interaction with cigarette smoking are still unclear. The aim of this study was to determine whether there was any relationship between genetic polymorphisms of GSTT1 and GSTT1 and gastric cancer. METHODS: A population based case-control study was carried out in a high-risk area, Changle County, Fujian Province, China. The epidemiological data were collected by a standard questionnaire and blood samples were obtained from 95 incidence gastric cancer cases and 94 healthy controls. A polymerase chain reaction method was used to detect the presence or absence of the GSTT1 and GSTT1 genes in genomic DNA. Logistic regression model was employed in the data analysis. RESULTS: An increase in risk for gastric cancer was found among carriers of GSTT1 null genotype. The adjusted odds ratio (OR) was 2.63 95% Confidence Interval (95% CI) 1.17-5.88, after controlling for age, gender, cigarette smoking, alcohol drinking, and fish sauce intake. The frequency of GSTT1 null genotype in cancer cases (43.16%) was not significantly different from that in controls (50.00%). However, the risk for gastric cancer in those with GSTT1 null and GSTT1 non-null genotype was significantly higher than in those with both GSTT1 and GSTT1 non-null genotype (OR = 2.77, 95% CI 1.15-6.77). Compared with those subjects who never smoked and had normal GSTT1 genotype, ORs were 1.60 (95% CI:0.62-4.19) for never smokers with GSTT1 null type, 2.33 (95% CI 0.88-6.28) for smokers with normal GSTT1, and 8.06 (95% CI 2.83-23.67) for smokers with GSTT1 null type. CONCLUSIONS: GSTT1 gene polymorphisms may be associated with genetic susceptibility of stomach cancer and may modulate tobacco-related carcinogenesis of gastric cancer.

High level of deoxycholic acid in human bile does not promote cholesterol gallstone formation

AIM:To study whether patients with excess deoxycholic acid (DCA) differ from those with normal percentage of DCA with respect to biliary lipid composition and cholesterol saturation of gallbladder bile. METHODS:Bile was collected during operation through puncturing into the gallbladder from 122 cholesterol gallstone patients and 46 gallstone-free subjects undergoing cholecystectomy.Clinical data,biliary lipids,bile add composition, presence of crystals and nucleation time were analyzed. RESULTS:A subgroup of gallstone patients displayed a higher proportion of DCA in bile than gallstone free subjects. By choosing a cut-off level of the 90th percentile,a group of 13 gallstone patients with high DCA levels (mean 50 percent of total bile acids) and a large group of 109 patients with normal DCA levels (mean 21 percent of total bile acids) were obtained.The mean age of the patients with high DCA levels was higher than that of the group with normal levels (mean age:62 years vs45 years) and so was the mean BMI (28.3 vs.24.7).Plasma levels of cholesterol and triglycerides were slightly higher in the DCA excess groups compared with those in the normal DCA group.There was no difference in biliary lipid composition,cholesterol saturation,nucleation time or occurrence of cholesterol crystals in bile between patients with high and normal levels of DCA. CONCLUSION:Gallstone patients with excess DCA were of older age and had higher BMI than patients with normal DCA.The two groups of patients did not differ with respect to biliary lipid composition,cholesterol saturation,nucleation time or occurrence of cholesterol crystals.It is concluded that DCA in bile does not seem to contribute to gallstone formation in cholesterol gallstone patients.

Can ultrasound predict the severity of acute pancreatitis early by observing acute fluid collection?

INTRODUCTIONThe spectrum of acute pancreatitis (AP) ranges from a mild spontaneously resolved disorder to severe disease with mortality up to 20%-48.4%[1-3]. sAP is defined as the AP with organ failure and /or local complications which developed form acute fluid collection (AFC) including necrosis ,abscess , pseudocyst formation into or around the pancreas [4].

Function of apoptosis and expression of the proteins Bcl-2,p53 and C-myc in the development of gastric cancer

INTRODUCTIONIn China ,the incidence and mortality of gastric cancer rank the second among all cancers. Recent development of cancer [1-20].The aim of this study was investigat the insight of apoptosis and bcl-2, p53 and C-myc protein expression in the development of gastric cancer .

Neither gastric topological distribution nor principle virulence genes of Helicobacter pylori contributes to clinical outcomes

AIM: Studies on Helicobacter pylori (H pylon) and gastroduodenal diseases have focused mainly on the distal sites of the stomach, but relationship with the gastric cardia is lacking. The aim of this study is to determine if the gastric topology and genotypic distribution of Hpyloriwere associated with different upper gastrointestinal pathologies in a multiethnic Asian population. METHODS: Gastric biopsies from the cardia, body/corpus and antrum were endoscoped from a total of 155 patients with dyspepsia and/or reflux symptoms, with informed consent. H pylori isolates obtained were tested for the presence of 26kDa, ureC, cagA, vacA, iceA1, iceA2 and babA2 genes using PCR while DNA fingerprints were generated using random amplification polymorphic DNA (RAPD). RESULTS: Hpyloriwas present in 51/155 (33%) of patients studied. Of these, 16, 15 and 20 were isolated from patients with peptic ulcer diseases, gastroesophageal reflux diseases and non-ulcer dyspepsia, respectively. Of the Hpyloripositive patients, 75% (38/51) had Hpyloriin all three gastric sites. The prevalence of various genes in the H pylori isolates was shown to be similar irrespective of their colonization sites as well as among the same site of different patients. The RAPD profiles of H pylori isolates from different gastric sites were highly similar among intra-patients but varied greatly between different patients. CONCLUSION: Topographic colonization of H pylori and the virulence genes harboured by these isolates have no direct bearing to the clinical state of the patients. In multiethnic Singapore, the stomach of each patient is colonized by a predominant strain of H pylori，irrespective of the clinical diagnosis.

TECA hybrid artificial liver support system in treatment of acute liver failure

AIM: To assess the efficacy and safety of TECA type hybrid artificial liver support system (TECA-HALSS) in providing liver function of detoxification, metabolism and physiology by treating the patients with acute liver failure (ALF). METHODS: The porcine liver cells (1-2) x 10(10) were separated from the Chinese small swine and cultured in the bioreactor of TECA-BALSS at 37.0 degrees C and circulated through the outer space of the hollow fiber tubes in BALSS. The six liver failure patients with various degree of hepatic coma were treated by TECA-HALSS and with conventional medicines. The venous plasma of the patients was separated by a plasma separator and treated by charcoal adsorbent or plasma exchange. The plasma circulated through the inner space of the hollow fiber tubes of BALSS and mixed with the patients' blood cells and flew back to their blood circulation. Some small molecular weight substances were exchanged between the plasma and porcine liver cells. Each treatment lasted 6.0-7.0 h. Physiological and biochemical parameters were measured before,during and after the treatment. RESULTS: The average of porcine liver cells was (1.0-3.0) x 10(10) obtained from each swine liver using our modified enzymatic digestion method. The survival rate of the cells was 85%-93% by trypan blue stain and AO/PI fluorescent stain. After cultured in TECA-BALSS bioreactor for 6 h, the survival rate of cells still remained 70%-85%. At the end of TECA-HALSS treatment, the levels of plasma NH(3), ALT, TB and DB were significantly decreased. The patients who were in the state of drowsiness or coma before the treatment improved their appetite significantly and regained consciousness, some patients resumed light physical work on a short period after the treatment.One to two days after the treatment, the ratio of PTA increased warkedly. During the treatment, the heart rates, blood pressure, respiration condition and serum electrolytes (K(+), Na(+) and Cl(-)) were stable without thrombosis and bleeding in all the six patients. CONCLUSION: TECA-HALSS treatment could be a rapid, safe and efficacious method to provide temporary liver support for patients with ALF.

Seasonal variation in the onset of acute pancreatitis

AIM:A drcannual variation in the onset of several acute diseases, mostly dealing with cardiovascular system,has been reported. The present study was to verify the possible existence of a seasonal variability in the onset of acute pancreatitis. METHODS:All patients consecutively admitted to the Hospital of Ferrara,Italy,between January 1998 to December 2002, whose discharge diagnosis was acute pancreatitis,were considered.According to the time of admission,cases were categorized into twelve 1-mo intervals and in four periods by season.x^2 test for goodness of fit and partial Fourier series were used for statistical analysis. RESULTS:During the study period,549 cases of acute pancreatitis were observed.A significant peak of higher incidence was found in March-May,both for total population, males and subgroups with and without cholelithiasis or alcoholism.Fourier analysis showed the existence of a circannual rhythmic pattern with its main peak in March(95% CL.:February-April,P=0.005),and a secondary one in September.Death occurred more frequently in December- February,compared to the other periods(P=0.029),and chronobiologic analysis yielded a seasonal peak in November- December(P<0.001). CONCLUSION:This study shows the existence of a circannual variation in the onset of acute pancreatitis,with a significantly higher frequency of events in the spring,especially for patients with cholelithiasis or alcoholism.Moreover,events occurring during the colder months seem to be characterized by a higher mortality rate.

Azithromycin in a triple therapy for H.pylori eradication in active duodenal ulcer

AIM:To assess and compare the efficacy and safety of two triple regimes:A)metronidazole,amoxicillin and omeprazole, which is still widely used in Russia,and B)azithromycin, amoxicillin and omeprazole in healing active duodenal ulcer and H.pylori eradication. METHODS:100 patients with active duodenal ulcer were included in the open,multicentre,randomized study with comparative groups.Patients were randomly assigned to one of the following one-week triple regimes:A) metronidazole 500 mg bid,amoxicillin I g bid and omeprazole 20 mg bid(OAM,n=50)and B)azithromycin 1 god for the first 3 days(total dose 3 g),amoxicillin 1 g bid and omeprazole 20 mg bid(OAA,n=50).Omeprazole 20 mg od was given after the eradication course as a monotherapy for three weeks.The control endoscopy was performed 8 weeks after the entry.H.pyloriinfection was determined in the entry of the study and four weeks after the cessation of treatment by means of histology and CLO-test. RESULTS:97 patients completed the study according to the protocol(1 patient of the OAM group did not come to the control endoscopy,2 patients of the OAA group stopped the treatment because of mild allergic urticaria).Duodenal ulcers were healed in 48 patients of the OAM group(96 %, C190.5-100 %)and in 46 patients of the OAA group(92 %, CI 89.5-94.5 %)(p=ns).H.pyloHinfection was eradicated in 15 out of 50 patients with OAM(30 %,CI 17-43 %)and in 36 out of 50 patients treated with OAA(72 %;CI 59-85 %) (P<0.001)-ITT analysis.CONCLUSION: The triple therapy with omeprazole, amoxicillin and metronidazole failed to eradicate H.pylori'vc\ the majority of patients, which is an essential argument to withdraw this regimen out of the national recommendations. Macrolide with amoxicillin are preferable to achieve higher eradication rates. Azithromycin (1 g od for the first 3 days) can be considered as a successful component of the triple PPI-based regimen.

基于“The all-on-3 concept”以不同角度植入远中倾斜种植体的种植固定全口义齿修复模型各部件应力峰值

目的分析不同植入角度“The all-on-3 concept”远中倾斜种植体两种加载条件下模型各部件的应力分布。方法建立种植固定全口义齿修复模型,其中“The all-on-3 concept”模型3组(分别记为3-17°、3-30°、3-45°组)及“All-on-4”模型1组(4-30°组),3-17°组、3-30°组、3-45°组、4-30°组种植体数量分别为3、3、3、4颗,远中倾斜种植体植入角度分别为17°、30°、45°、30°,修复体远中悬臂长度为14.7、12.8、9.6、12.8 mm,近中种植体与远中种植体间距分别为15.3、17.2、20.9、6.8 mm,使用有限元软件对4组模型进行垂直以及倾斜加载,分析两种加载模式下各组模型各部件(下颌骨、种植体、基台、修复螺丝、氧化锆桥)的应力峰值。结果在两种加载模式下,3-45°组各部件最大应力峰值出现次数最多、应力分布最不均匀,其次为3-17°组和3-30°组,4-30°组在对比中未出现最大应力峰值。结论“The all-on-3 concept”远中种植体植入角度为30°时各部件应力分布情况最佳,其次为17°,最差为45°,但“The all-on-3 concept”应力分布情况略差于“All-on-4”。

Optimized Modeling Method for Unbalanced Data in High-Level Visual Semantic Concept Classification

To solve the unbalanced data problems of learning models for semantic concepts, an optimized modeling method based on the posterior probability support vector machine （PPSVM） is presented. A neighborbased posterior probability estimator for visual concepts is provided. The proposed method has been applied in a high-level visual semantic concept classification system and the experiment results show that it results in enhanced performance over the baseline SVM models, as well as in improved robustness with respect to high-level visual semantic concept classification.

Reform in Old Age Support

China is presently undergoing a drastic transition fram a tra-ditional to modern society in which large families are grad-ually disintegrating.while nuclear families are on the rise.The function of family for supporting old folks is losing its tradi-tional importance.China's population is aging rapidly.The per-centage of the elderly is on the increase and the average life ex pectancy of China s population has reached 70.8 years present-ly.However。a growing number of old peqple are being left unattended.due to some reasons.by their familes,particularly in rural areas.

深基坑支护理念演进和设计方法改进剖析

基于我国30多年建设实践,分析现有深基坑支护临时性理念、与主体结构相结合理念实施的优点和不足,提出促进基坑支护工程高质量发展的永久化理念。结合济南某基坑工程,阐释三个理念的逐次提升和相应支护结构的计算内容,定义适应与主体结构相结合理念、永久化理念的结构岩土化、岩土结构化设计方法;重点分析土钉墙与抗浮锚杆相结合的复合土钉墙的设计,以及抗浮锚杆与外伸支撑、水平楼板永久支护结构中抗浮锚杆的力学性状与耐久性,分析了永久支护对于地下室外墙受力机制的影响,阐释深基坑支护理念演化方向和与之适应的设计改进内容。对于反思我国岩土与结构设计管理体制,促进基坑与基础设计理论和方法进步,推动“新发展理念”在基坑工程的实践具有导向价值。

养老保险对老年人养老选择的影响——基于CLASS数据的证据

积极老龄化背景下,多样化养老选择已成为提升老年生活质量、改变传统家庭养老方式的重要举措,而养老保险的完善为丰富老年人养老选择、建立多元养老格局奠定基础。本文利用中国老年社会追踪调查数据,采用多元线性回归模型和工具变量法,实证分析养老保险参与对老年人养老选择的影响。研究发现,参与养老保险能够有效促进老年人做出养老选择。机制检验表明,养老保险通过改变养老观念、提高政府信任程度对养老选择产生影响。异质性检验表明,养老保险参与对老年人养老选择的影响效应在地区、户籍及参保类型方面存在明显差异。为推进积极老龄化战略实施,实现“老有所养”目标提供重要的参考价值。

父母受教育程度对青年生育意愿的影响——基于中国家庭追踪调查(CFPS)数据的分析

青年生育意愿减弱是造成当前“超低生育率”问题的重要原因,而青年生育意愿的形成深受父母个人特征的影响。基于此,运用2018年中国家庭追踪调查(CFPS)数据,考察了父母受教育程度对青年生育意愿的影响机制。研究发现,父母受教育程度越高,青年的生育意愿越低;照料支持和“传宗接代”观念在父母受教育程度对青年生育意愿的影响过程中发挥了中介作用;经济帮助并非父母受教育程度对青年生育意愿产生代际影响的有效方式;相比于男性,女性的生育意愿更容易受到父母受教育程度的影响。在当前父母受教育程度不断提升的背景下,加强公共托幼服务,提供隔代照料津贴,培育积极生育观念和完善女性生育保障是提升青年生育意愿的有效政策措施。

“土地换社保”能改变老年人的传统养老观念和养老行为吗?——来自征地养老保险政策实验的证据

“养儿防老”和“土地是命根子”塑造了中国农村社会千百年来不变的传统观念和养老模式,也构成了现代化转型的瓶颈。着眼于破解后者的“土地换社保”政策能否“一石两鸟”,既冲击“养儿防老”的传统观念,又能改变养老行为呢?本文从征地养老保险的政策实验安排出发,使用2011—2018年CHARLS数据,考察征地养老保险对传统养老观念和养老行为的影响。研究结果表明,征地养老保险使得农村老年人“养儿防老”的概率显著降低28.7%,减少了来自子女的代际经济支持,增加了对子女的经济支持力度,促进了社交活动参与,而对居住方式、劳动参与和孙子女照料没有显著影响。而一次性征地货币补偿等替代方案均不具备类似功能。本文还进行了异质性分析和稳健性检验,发现征地养老保险对老年人养老观念和养老行为的影响在高水平的征地养老保险地区和三个以上子女的家庭的影响更大。本文的结果表明,提供高水平稳定收入流的征地养老保险不但能弥补征地对农民造成的损失,还能改变农村传统养老观念和养老行为。