Objective To get a more comprehensive view of caregiving experiences, and describe the caregiver burden and the positive aspects of caregiving of family caregivers of senile dementia patients in community and to explore the relationship between the caregiver burden and the positive aspects of caregiving. Methods Totally 80 family community-dwelling caregivers of senile dementia patients in community were investigated by Caregiver Burden Inventory (CBI) and Positive Aspects of Caregiving (PAC) questionnaires. Results The score of CBI was 54.73 ± 13.15 and the score of PAC was 28.53 ± 5.37. The score of PAC was negatively correlated with the caregiver burden (r=-0.243, P<0.05). Conclusions The caregiver burden of the family community-dwelling caregivers of dementia patients is high and the positive aspects of caregiving is at middle level. Professional help and support should be provided to the family caregivers of dementia patients by the community health service centers on the premise that the caregiving experience is fully understood. Our aim is to reduce their burden, strengthen the caregiving skills and improve the positive aspects of caregiving simultaneously.

Objective To get informed of the parents' oral health behaviors,children's oral hygiene habits and the correlation between the two,to lay the foundation of building up joint educational pattern of the oral health between pre-school children and their parents.Methods The questionnaire between preschool children and their parents was applied.By cluster sampling,124 pre-school children from 5 kindergartens in the local community were selected to participate the survey.The oral health behaviors of parents and their kids were investigated and the results underwent analysis.Results Parents’ oral health behaviors were closely related to children's,which was embodied by three parts,such as the starting age of brushing teeth,the duration of brushing and the habits of gargling after meals.As to parents,the knowledge sources of oral health mainly came from TV and broadcast programs (82.3％),newspapers and periodicals,magazines and popular science readings (51.6％),relatives and friends (27.4％),but the anticipated knowledge sources were from medical personnel (90.3％),TV and broadcast programs (53.2％),community activities on health education (51.6％).Conclusions Pre-school children's oral health behaviors are currently good; more emphasis should be laid on the effect of parents' behaviors to their children's oral health; it's necessary to hold more community activities on health education.

Objective To explore the impacts of natural ovulation cycles and stimulation cycles on the outcome of intrauterine insemination (IUI) in order to improve the clinical effects of IUI. Methods 176 women received 384 stimulation cycles. According to different ovulation stimulation protocols , the women were divided into six groups including natural cycle (NC) group, clomiphene citrate (CC) group, letrozole (LE) group;human menopausal gonadotrophin (HMG ) group, CC + HMG group, and LE + HMG group. The pregnancy rate between nature cycles and ovarian hyperstimulation cycles was compared. Results The pregnancy rate was 9.33%in the nature cycle group and 13.27% in the stimulation cycle group, with a significant difference (P < 0.05);and it dif not differ significantly among the stimulation cycle groups (P > 0.05). Conclusions Use of ovulation-induction medications is one of the important factors affecting the pregnancy rate of intrauterine insemination. There are no differences in the outcome of IUI among different ovulation stimulation protocols.

Objective To evaluate the association between vitamin D deficiency and diabetic nephropathy in type 2 diabetic patients.Methods A total of 594 patients with type 2 diabetes were enrolled from the inpatients of the Nanjing Medical University Affiliated Nanjing Hospital.Fasting serum lipid profile,25-hydroxycalciferol vitamin D and urinary albumin excretion rate were investigated.The relationship between nephropathy and vitamin D deficiency (＜ 20 μg/L) or insufficiency (20-＜ 30 μg/L) was analyzed.Results Nephropathy was found in 177 subjects (29.8％) with albuminuria in 141 and proteinuria in 36 subjects.Vitamin D deficiency was found in 180 subjects and insufficiency in 157 subjects.The proportion of vitamin D deficiency was higher in the individuals with nephropathy than those without nephropathy (36.2％ vs 27.8％,P ＜0.05).The urinary albumin excretion rate was significantly higher in the patients with vitamin D deficiency than those with normal vitamin D concentration [(123.0 ± 299.2)mg/24h vs (47.6 ±97.1) mg/24h,P ＜0.01].The prevalence of nephropathy was higher in the patientswith vitamin D deficiency than those with normal vitamin D concentration (35.6％ vs 26.1％,P ＜ 0.05),while the prevalence of proteinuria was higher in patients with vitamin D deficency (12.2％ vs 3.1％,P ＜0.01).Logistic regression analysis demonstrated that vitamin D deficiency was associated with nephropathy (OR 1.57,95％ CI 1.04-2.37),even after the adjustment for age,gender,hypertension,dyslipidemia,smoking status,use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (OR 1.78,95％ CI 1.12-2.81).The Vitamin D concentration was significantly negatively correlated with urinaryalbumin excretion rate (r =-1.783,P ＜ 0.001).Conclusions Type 2 diabetic patients have a high prevalence of vitamin D deficiency.Vitamin D deficiency is independently associated with diabetic nephropathy.

This paper was designed to study metabonomic characters of the osteoporosis induced by high dose of hydrocortisone and the protective effects of Drynariae Rhizoma, which can replenish the kidney and strengthen the bones. A urinary metabonomics method based on ultra-performance liquid chromatography coupled with mass spectrometry (UPLC-MS/MS) was developed. Clear separation of healthy control group, model group and treatment group was achieved by using the principal components analysis (PCA) and 9 significantly changed metabolites were identified as potential biomarkers of osteoporosis. Compared with the health control group, the model group rats showed lower levels of creatinine, citric acid, azelaic acid, hippurate, tryptophan and indoxyl sulfate together with higher levels of phenylalanine, cresol sulfate and phenaceturic acid. These changes in urinary metabolites suggest that the disorders of amino acid metabolism, energy metabolism, gut microflora and anti-oxidative damage are related to osteoporosis induced by high dose of hydrocortisone and the potential effect of Drynariae Rhizoma on all the four metabolic pathways.
Animals ; Chromatography, High Pressure Liquid ; Male ; Metabolomics ; Osteoporosis ; prevention & control ; urine ; Plant Extracts ; pharmacology ; Polypodiaceae ; Rats ; Rats, Wistar ; Tandem Mass Spectrometry

Objective:To put forward relevant policy recommendations for strengthening the quality control of clinical trial drug production in China. Methods:The objective differences of clinical trials and marketing drugs in the production and management as-pects were in-depth analyzed, and the lessons in clinical trial drug production quality supervision and management experience were drawn from the FDA and the European Union EMA. Results and Conclusion:Based on the particularity of clinical trial drug produc-tion management,it is suggested to formulate the administrative rules and technical standards for the quality control of clinical trial drug production and amend relevant laws and regulations timely so as to achieve the purpose of strengthening the quality supervision of drug production in clinical trials.

Objective To explore the influence of the self-efficacy nursing on compliance behavior of patients with cervical cancer.Methods Totals of 153 patients from November 2012 to November 2013 diagnosed as uterine cervical neoplasms and treated by surgical procedure were selected, within which 86 patients joined the research and were divided into observation group and control group, 43 cases in each group. The control group was given the routine nursing care, and the observation group was given the self-efficacy nursing intervention on the basis of conventional nursing.The self-efficacy and compliance behavior were surveyed before and after the intervention.Results The scores of self-efficacy before the intervention had no statistically significant difference (t=0.158,P>0.05).After the intervention, the score of the observation group was (35.15 ±5.21), which was significantly higher than (21.26 ±8.26) of the control group ( t=15.684,P<0.01) .The score of self-efficacy of the observation group before and after the intervention were statistically significant (t=15.124,P<0.01), while the self-efficacy in the control group before and after the intervention had no statistically significant difference (t=1.245,P>0.05).After the intervention, the scores of compliance of medication, reasonable break, regular examination, healthy diet, abstain from tobacco and drink, reasonable exercise, prevention of infection and the total score were (2.85 ±0.41), (2.92 ±0.56), (2.81 ±0.44), (2.75 ±0.46), (1.87 ±0.41), (2.79 ±0.54), (2.88 ±0.39) and (18.75 ±1.65), which were significantly higher than those of the control group ( t=5.124, 6.235, 5.842, 4.963, 4.698, 5.148, 6.398, 5.458, respectively;P<0.01).Conclusions Self-efficacy nursing intervention can improve the self-efficacy of uterine cervical neoplasms patients, enhance patients’ self-management level, and enhance confidence on health compliance behavior.

Objective To investigate the impaction of health education with PDCA model combined with ABC management on compliance and quality of life in patients with ovarian cancer chemotherapy . Methods Totals of 124 ovarian cancer patients were selected from May 2011 to December 2013 in our hospital . Patients were randomly divided into observation group and control group , with 62 cases in each group .The control group was given general health education , and the observation group was treated by PDCA model combined with ABC management .The compliance , quality of life and treatment satisfaction were compared between the two groups .Results In the observation group , the medication compliance , nutritional support , functional training and rehabilitation of compliance were significantly better than those in the control group (χ2 =8.382, 7.225, 7.314, 10.098, respectively;P<0.01).The difference of quality of life at admission was not significant (P>0.05).After one-year treatment, the score of quality of life was (66.75 ±5.42) in the observation group and (49.55 ±5.17) in the control group.The difference was statistically significant (t=9.251,P<0.05).The satisfaction score in the observation group was (91.35 ±3.48) and (63.53 ±4.12) in the control group.The difference was statistically significant (t=11.521,P<0.05).Conclusions The health education with PDCA model combined with ABC management can improve the quality of life in patients with ovarian cancer .It can also strengthen the cooperation between nurses and patients , so that patients′satisfaction is improved.

OBJECTIVEMucopolysaccharidosis(MPS) is a congenital hereditary disease. Only a few patients with this disease can be controlled by enzyme replacement therapy. Most of them are short of effective interference. To exploit the effect of treatment with allogenic hematopoietic stem cell transplantation, two children were treated with the transplantation.

METHODSThe two patients included a 23 month MPS-IH and an 18 month old MPS-VI at the time of transplantation. Busulfan of 20 mg/kg plus 200 mg of Cyclophosphamide were used as the conditioning regimen. Peripheral stem cells were collected from a 9/10 high resolution matched unrelated donor and a matched sibling carrier donor, respectively. The heart and lung were affected in the patient with MPS-IH. Medium obstructed pulmonary impairment was found by pulmonary function test at the time of transplantation. Medium mitral valve countercurrent and patent ductus arteriosis(PDA) were found by Doppla examination.

RESULTSThe number of hematopoietic stem cells was comparative between the two donors with total nucleated cells and CD34+ cells of 11 x 10(8)/kg and 17 x 10(8)/kg, and 7.6 x 10(6)/kg and 7.2x 10(6)/kg respectively. Neutrophil engrafted at day 11. The process of transplantation in the MPS-VI patient went smoothly with grade II graft versus host disease(GVHD) briefly and only 1 U RBC and 2 U platelet were transfused. For the MPS-IH patient, the process of transplantation was tough with platelet reaching to 20 x 10(9)/L till day 40 and 5 U RBC and 7 U platelet were transfused during transplantation. Grade III GVHD was resolved by steroid, mycophenolate mofetil (MMF) and CD25 antibody. Pneumonia recurred 3 times with 2 times rescued by trachea intubation and mechanical ventilation because of accompanying acute heart failure. At day 14 the lymphocytes in both patients were 100% from donors as evidenced by short tandem repeat-PCR(STR-PCR). MPS associated enzyme activity was increased to 70 nmol/h.mg and 66 nmol/h.mg at 3 month and still remained 50.9 nmol/h.mg and 44.5 nmol/h.mg at 2 years post transplantation. Till now the 2 patients have been followed up for 25 months and 28 months with good general condition. The cardiac and pulmonary functions have improved obviously in the MPS-IH patient. The cornea became clear in this patient.

CONCLUSIONAllogeneic hematopoietic stem cell transplantation is an effective measure to treat patient with MPS-IH and MPS-VI. Transplantation at earlier stage of age can decrease transplant related complications. It requires longer time follow up for observing the clinical effects for these patients.

Female ; Follow-Up Studies ; Graft vs Host Disease ; drug therapy ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Infant ; Intraoperative Complications ; drug therapy ; etiology ; Male ; Mucopolysaccharidoses ; enzymology ; pathology ; physiopathology ; surgery ; Recovery of Function ; Transplantation, Homologous

Objective To investigate the efficacy of leflunomide combined with prednisone in the induction therapy of proliferative lupus nephritis (LN).Methods A prospective,multicenter,randomized controlled clinical trial was conducted in patients with biopsy-proved proliferative lupus nephritis recruited from 15 renal centers from 2013 to 2015.Patients were randomized to two groups.Oral leflunomide or intravenous cyclophosphamide was given to patients in each group.Both groups received a tapering course of oral prednisone therapy.All patients were followed up for 24 weeks.The blood biochemistry,urine index,clinical curative effect and adverse reaction were recorded and analyzed statistically.Results A total of 100 patients were enrolled in this clinical trial,including 48 patients in leflunomide group and 52 patients in cyclophosphamide group.After 24 weeks,the overall response rate was 79％ (95％ CI 67％-90％) in the leflunomide group and 69％ (95％ CI 56％-82％) in the cyclophosphamide group.23％ (95％CI 11％-35％) of patients in leflunomide group showed complete remission compared with 27％ (95％CI 24％-30％) in cyclophosphamide group (P=0.35).The levels of 24-hr urine protein excretion,SLEDAI and anti-dsDNA antibody titers were decreased in patients treated with leflunomide group after 24-weeks treatment.And the levels of serum albumin and complement 3 after treatment were significantly higher compared with these before treatment.There was also no significant difference in changes of 24-hr urine protein excretion,SLEDAI score,anti-dsDNA antibody titers,serum albumin and complement C3 levels after treatment between two groups.Incidence of adverse events did not differ between the leflunomide and cyclophosphamide group.Conclusions Leflunomide combined with prednisone showed same efficacy compared with cyclophosphamide as induction therapy for lupus nephritis.Leflunomide might be an useful medicine in the induction therapy of lupus nephritis.