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:With the development of science and technology, large medical equipments have been universally applied in clinical diagnosis. It is important in hospital management to search for the way to obtain the maximum economic and social benefits by efficiently analyzing cost benefit of large medical equipment. Methods:To ascertain cost benefit of medical equipment by profit margin of investments and cost-redemption periods. Results:Proposals on purchase and management of department medical equipment were presented. Conclusion:Scientific evaluation and analysis on large medical equipment would play a positive role in purchase, use and economic returns of department medical equipment.

Chitinase (EC3.2.1.14) catalyses the reaction of hydrolyzing the chitin into N acetylglucosamine (GlcNac) and (GlcNac) n.With the in deep study of chitinase,more and more biological function of chitinase appeared obviously.Now,we introduce the actualities of chitinase research,including substrate specificity,physiological function,antifungi function and transgenics, et al .

Objective To evaluate the value of digital subtraction computed tomography angiography(DSCTA)in the diagnosis of intracranial small aneurysms.Methods 92 patients with intracranial aneurysms confirmed by digital subtraction angiography(DSA) or surgery were selected as the subjects of this study.Their clinical and CT imaging data were analyzed retrospectively.The diagnos-tic accuracy of DSCTA and conventional CTA for intracranial aneurysms was compared.Results A total of 102 aneurysms were con-firmed in the 92 patients,100 of them were detected by DSCTA and 89 by conventional CTA (χ2 =8.707,P =0.003).Two small aneurysms of less than 5.0 mm located respectively at the cavernous sinus and beneath the clinoid segments were missed by DSCTA, while 13 by conventional CTA.When aneurysms of less than 3.0 mm and 3.0-5.0 mm were combined with calculation,the sensi-tivity of DSCTA in detecting aneurysms of less than 5.0 mm was significantly higher than that of conventional CTA (χ2 =8.393,P =0.004).Conclusion DSCTA has more advantages than conventional CTA in the diagnosis of intracranial aneurysms,especially for the small aneurysms adjacent to the skull base.DSCTA can be used as a preferred technique in the screening and diagnosis of in-tracranial aneurysms.

OBJECTIVE:To explore regularity and characteristics of ADR in our hospital,and to provide reference for ratio-nal drug use in the clinic. METHODS:A total of 368 ADR collected from Zhengzhou People's Hospital during 2013-2014 were an-alyzed statistically in respects of patient's gender,age,drug types,route of administration,dosage form,organs or systems in-volved in ADR,clinical manifestations,ADR outcome,etc. RESULTS:Of 368 ADR reports,female was more than male (52.99% vs. 47.01%);the number of patients aged more than 50 years was the most(36.14%);most of ADR cases were induced by antibiotics and TCM preparations,accounting for 40.22%,21.47%,respectively;among route of administration,most of ADR cases were induced by intravenous administration (85.60%);main clinical manifestations were lesion of skin and its appendants (39.95%),followed by digestive system (21.47%). After treatment,all patients were cured or improved,no death case was found. CONCLUSIONS:Clinic should strengthen ADR monitoring and analysis and evaluarion,strengthen the rational use of anti-biotics and TCM injections and adopt measures to reduce drug risk.

Objective To explore the effect and mechanism of fluvastatin on the expression of fibronectin(FN) in human peritoneal mesothelial cells (HPMCs) induced by high-glucose peritoneal dialysate (HGPDS).Methods Cultured HPMCs were randomly divided into control,HGPDS,HGPDS plus GSK650394 10-5 mol/L (the competitive inhibitor of SGK1),different concentrations of fluvastatin,fluvastatin 10-6 mol/L and GSK650394 10-5 mol/L alone.The morphology change of HPMC was observed by light microscopy.The cellular viability was detected by MTT colorimetry.The mRNA and protein expressions of serum and glucocorticoid-inducible kinase 1 (SGK1) and FN were detected by RT-PCR,Western blotting or ELISA.Results After incubation with HGPDS,the cell morphology changed from typical cobblestone-like appearance to fibroblast-like appearance,and the cell viability was inhibited significantly (P＜0.05).Fluvastatin 10-6mol/L and GSK650394 could improved the cell morphology and the cell viability injured by HGPDS (P＜0.05).Compared with the normal control group,the mRNA and protein expressions of SGK1 and FN increased significantly in HPMC treated with HGPDS(P＜0.05).GSK650394 significantly decreased the high expression of SGK1 and FN (P＜0.05),also the fluvastatin had same effects as GSK650394 in dose-dependent manner (P＜0.05).Conclusions High-glucose peritoneal dialysate can increase FN expression in human peritoneal mesothelial cells,which can be attenuated by fluvastatin.The protective role of fluvastatin in HPMC may be partially achieved through the signal pathway of SGK1.

Objective To summarize the relationship between metabolic syndrome (MS),its components and T1 stage with high grade urothelial carcinoma (HGUC) of the Bladder.Methods The clinical data of 200 patients with T1 high grade bladder cancer who were admitted to our hospital from January 2010 to June 2014 were retrospectively analyzed,including 155 males and 45 females.Ages were 24 to 86 years old,average 66 years old.Based on the history or blood glucose levels,patients were divided into diabetic group (n =41) (20.5％) and non diabetes group 159 cases (79.5％);According to the body mass index (BMI) were divided into obese group (≥25 kg / m2) of 98 cases (49.0％) and non obese group (＜ 25 kg / m2) of 102 cases (51.0％).According to the blood pressure level,71 cases (35.5％) were divided into hypertension group and 129 cases of non hypertension group (64.5％).MS and its components and the relationship between the recurrence and progress of bladder cancer were analyzed.The Kaplan Meier method was used to assess MS and its components division of tumor progression free survival (progress-free survival,PFS) and recurrence free survival (recurrence-free survival,RFS) influence.Cox regression model of multi factor analysis were used to evaluate the PFS and RFs of MS and its components with bladder cancer.Results Of the 200 cases,16 cases (8.0％) were MS.Tumor recurrence occurred in 121 cases (60.5％),and 84 patients (42.0％) were in progress.Diabetes and non diabetes groups the average RFs were 21.7 and 29.3 months respectively,and the difference was statistically significant (x2 =10.115,P =0.001);The median PFS were 32.8 and 39.8 months respectively,the difference has statistical significance (x2 =14.760,P ＜0.001).Obese group and non obese group average RFs were 34.7 and 42.0 months respectively,and the difference were statistically significant (x2 =16.077,P ＜ 0.001);The median PFS were 22.8 and 32.6 months respectively,the difference was statistically significant (x2 =16.174,P＜0.001).The average RFS of MS group and non MS group were 21.5 and 28.4 months respectively,the difference was statistically significant (x2 =5.429,P =0.02);the average PFS was 35.1 and 38.7 months respectively,and the difference was statistically significant (x2 =3.854,P ＜ 0.05).Cox multivariate survival analysis showed that diabetes and obesity can increase the risk of recurrence and progression of T1 advanced stage bladder cancer (HR =1.792,P =0.013,HR =2.498,P ＜ 0.001;HR =0.559,P ＜ 0.001;HR =0.492,P ＜ 0.001).Conclusions Diabetes mellitus and obesity are high risk factors for the recurrence and progression of T1 advanced stage bladder cancer,but MS is not related to the prognosis of T1 patients with advanced bladder cancer.

Objective To observe the preventive and therapeutic effects of the new process extracts ofTangwang Mingmu Granule on rats with diabetic retinopathy.Methods The best preparation process technology of drug extraction was improved and selected based on the traditional water decoction of Chinese medicine. The active ingredient of two processes were detected and compared by HPLC. In vitro and in vivo pharmacodynamic evaluation models were used to evaluate the drug effects and analyze its mechanism. MTT assay was used to analyze the inhibitory effects of extracts in the two processes on EA.hy 926 cell proliferation in vitro. The effects of two extracts on STZ induced rat diabetic microvascular disease and its related factors were observed by retinal slice staining and ELISA.Results Compared with the traditional process, the active ingredients of the extracts were improved by the new technology ofTangwang Mingmu Granule. The preparation process ofTangwang Mingmu Granule could significantly improve the diabetic rat retinal microvascular pathological state, and reduce the protein expression levels of angiogenesis related factors.Conclusion The new preparation process could effectively improve the active ingredients in the herbal extract. The extract of new technology showed a significantly effect on the diabetic rats in retinal microvascular pathology state. The mechanism may be related to the regulation of vascular cell adhesion molecules and inflammatory factors.

Objective To investigate the effect of fluvastatin (FLV) on the expression of β1 integrin in puromycin aminonucleoside (PAN)-treated podocytes and its mechanism.Methods Cultured human podocytes were divided into PAN,different concentrations of fluvastatin (1 × 10-8 to 1 × 10-5 mol/L),SOD,H2O21 groups respectively.Expressions of β1 integrin and reactive oxygen species (ROS) in podocytes were detected by Western blotting and DCFHDA (2' 7'-Dichlorofluoresecein 3' 6'-diacetate) respectively.The viability of podocyte was determined by MTT colorimetry.Results PAN and H2O2 significantly decreased the expression of β1 integrin and increased the synthesis of ROS in podocytes (P＜0.05respectively).Lower concentration fluvastatin or SOD treatment up-regulated β1 integrin and downregulated ROS of podocytes induced by PAN (P＜0.05 respectively).MTT revealed that lower podocyte viability was found in higher concentration fluvastatin,PAN and H2O2 groups.Lower concentration fluvastatin and SOD could protect podocytes against PAN.Conclusion Fluvastatin attenuates the injury of podocyte induced by PAN and increases the expression of β1 integrin,whose mechanism may be associated with the inhibition of the ROS activity.

Objective Acute kidney injury (AKI) is common but usually under-diagnosed in hospitalized patients,of the impact of which on patients is still unclear.The paper was aimed to investigate the impact of delayed recognition of AKI on short-time prognosis of patients through a propensity score matched study.Methods From Oct 2013 to Sep 2014,1401 adult hospitalized patients with AKI in the First Affiliated Hospital of Nanjing Medical University were divided into delayed recognition group and timely-diagnosed group according to propensity score matching (1∶ 1) without replacement method.Primary endpoint was 30-day all-cause mortality,and secondary endpoints included recovery of kidney at discharge,length of hospitalization,length of intensive care unit stay and hospital costs.Results There were significant differences in age,department distribution,complications,stage of AKI,Charlson index,APACHE Ⅱ score,SOFA score between the two groups before matching.After matching,there were no significant difference in demographic data,department distribution,complications,stage of AKI,Charlson index,APACHE Ⅱ score,SOFA score between the two groups except in blood urea nitrogen (P=0.039) and use of diuretics (P=0.018).Delayed recognition of acute kidney injury was not associated with 30-day all-cause mortality in univariate (P=0.711) and multivariate Logistic regression analyses.The secondary endpoints did not differ in two groups.Conclusion Delayed acute kidney injury recognition did not associate with poor short-term outcomes in adult hospitalized patients.