Objective To observe and explore the risk factors of nonalcoholic fatty liver diseas(NAFLD) complicated with hypertension in the enterprise retirees .Methods A total of 209 NAFLD patients diagnosed by ultrasound combined with questionnaire were collected in the enterprise retirees,and they were divided into the NAFLD with hypertension group(100 cases)and NAFLD without hypertension group (109 cases)after combined with physical examination results and past medical history.The relevant data of the two groups were retrospectively analyzed,and the risk factors of NAFLD complicated with hypertension disease were analyzed.Results The levels of age(t =1.69,P <0.05),body mass index(BMI)(t =0.36,P <0.05),waist circumference(t =0.64,P <0.05), total cholesterol(TC)(t =2.31,P <0.05),total bilirubin(TBS)(t =6.83,P <0.05),serum creatinine(Scr)(t =2. 20,P <0.05)in NAFLD complicated with hypertension group were higher than those in NAFLD group,and the differ-ences were statistically significant(P <0.01 or P <0.05).The logistic regression analysis showed that TC(OR =4.2)was the independent influencing factor of NAFLD with hypertension.Conclusion NAFLD is closely associated with hypertension,NAFLD can be incorporated into chronic disease management system with high blood pressure in order to improve the value of the disease in the elderly,and it is conducive to the further study of NAFLD and the management of other chronic disease.

[Objective] To discuss the effect of the community chronic disease management mode which combines physical identification and“preventive treatment”in control of GLU and TG of diabetes. [Method] 300 patients with T2 DM were randomly divided into the control group and intervention group with 150 patients in each group. The intervention group were physical y identified, and the management mode based on theories of“preventive treatment”including health education, diet control, exercise and medication used in the intervention group according to the result of physical identification, while the general management was used in the control group. 1 year later, changes of patients ’GLU and TG were observed. [Result] The community chronic disease management mode which combines physical identification and “preventive treatment”can improve T2 DM patients’GLU and TG, and reduce the GLU and TG of patients with QiXu, YangXu, and ShiRe types of physique. [Conclusion] The community chronic disease management mode which combines physical identification and“preventive treatment”is proved to be effective, and it improves the management of diabetes in communities.

[Objective] To explore the relativity between sPG and gastritis of H.pylori. [Method] Select 73 cases of chronic gastritis correctly diagnosed by gastric microscope and pathology, among which, 36 were chronic atrophic gastritis and 36 chronic superficial gastritis. 49 cases of positive H.pylori were administered with Lizhu Weisanlian tablets, measure the sPG before and after treatment. [Result] In the infected cases of H.pylori, PG Ⅰ was similar between atrophic gastritis and superficial gastritis; for PG Ⅱ value, atrophic gastritis group was more than superficial gastritis group, positive H.pylori patients higher than negative ones; PGR(PG Ⅰ/PG Ⅱ) was lower in atrophic gastritis group than superficial one, so was in positive H.pylori than negative one. After anti-H.pylori treatment, 87.75% patients were removed H.pylori, where the PG Ⅰ rose, PG Ⅱ lowered, PGR rose in atrophic gastritis group; in the superficial one where the H.pylori was not removed, no changes happened to PG Ⅰ, PG Ⅱ and PGR. In superficial gastritis group where the H.pylori was not removed, PGR rose. [Conclusion] H.pylori infection is correlated with sPG. Serum PG Ⅰ, PG Ⅱ and PGR have definite value in early diagnosing H.pylori concerned atrophic gastritis. PGR can be an index to evaluate the removal efficacy of H.pylori.

Objective To study the diagnosis and treatment of spontaneous perirenal hemorrhage(SPH). Methods The clinical data of 31 cases of SPH were reviewed retrospectively.In the 31 cases,flank pain,flank mass,shock,gross hematuria,abdominal bleeding occured in 31,10,8,3 and 3 cases,respectively.The final diagnosis was established on CT scan,B-ultrasonography and IVU were 18,22 and 7 cases. Results In 31 cases,nephrectomy were performed in 18,radical nephrectomy in 1 case,nephron spare surgery in 4,renal artery embolization in 2,inspiration and drainage of hemorrage in 1 and careful watching in 5 cases.There were 11 cases of angiomyolipoma,6 renal cyst,4 of renal cell carcinoma,3 infectious diseases,2 aneurysm of renal artery and 2 hydronephrosis. Conclusions The clinical presentation may vary greatly depending on the degree and duration of bleeding,and the severe pain in the upper abdomen of abrupt onset is the common sign and symptom.The spontaneous rupture of renal cell carcinoma and angiomyolipoma are the most common cause of SPH.CT scan and B-ultrasonography are the most valuable in the diagnosis of SPH.It is demanded that management of SPH depends on the histopathology and the degree of bleeding.

Objective To find out the living condition of the elderly adults and their needs for community bealthcare services so as to provide evidence-based guidance for our govemment. Methods A total of 925 participants aged ＞ 60 years were personally interviewed for questionnaire and ADL scale evaluation. Chi-square test and Kmskal-Wallis H test were used for data analysis. Results The subjects showed relatively lower education level and the illiteracy rate was high. Their marriage was stable and a decreased divorce rate was found. The economic situation was satisfactory. Their life satisfaction was farbeyond the health satisfaction. Most of the elderly did not live with their offspring,although 21.8% could not take care of themselves. The prevalence rate of chronic diseases was 81.5% ,which resulted in more demands for social activities, health consultation, rehabilitation nursing, and home healtheare services in the community. Conclusion They need to pay more attention to physical and mental health of the elderly. A community healthcare system that could provide services in an-all-round way,including medical care, should be established and improved.

Objective To discuss the effectiveness of community-based intensified health management on type Ⅱ diabetes patients.Metbods From June 2010 to December 2011,1 024 type Ⅱ diabetes patients in Mishi Lane community were enrolled and assigned to the intervention group (n=501,obtaining intensive health management) and the control group (n=523,obtaining routine community health management).Fastingbloodglucose (FBG),2-hour postprandial blood glucose (PBG2h),HbA1c,blood pressure (BP),triglyceride (TG) and body mass index (BMI) were tested and recorded before and after the intervention.Student's t test or Chi-square test were used for data analysis.Results Differences of age (t=0.124,P＞0.05) and gender (x2=2.0,P＞0.05) were not statistically significant (both P＞0.05).Following the intensive health management,the control rates of HbA1c,BP,TG and BMI were increased to 75.4％,30.4％,85.6％ and 49.0％,respectively (x2 values were 4.54,4.71,6.54 and 3.67; all P＜0.05).TG,FBG and PBG2h of the intervention group were (1.5 ± 0.9),(6.2 ± 1.3) and (8.3 ± 2.4) mmol/L,respectively,which were significantly lower than those of the control group (all P＜0.05).Conclusion Community-based intensive health management could be effective for diabetes patients.

Objective To investigate the mecA gene expression lvevl in clinically isolated Staphylococcus aureus (SA) strains and its correlation with drug resistance .Methods Clinically isolated 186 SA strains were collected .The K-P method was adopted to conduct the durg sensitivity test .Then DNA of these strains was extracted and the mecA gene was amplified by using PCR .Results The detection rate of methicillin-resistant SA(MRSA) was 30 .65% (57/186) ,the positive mecA gene was detected in 56 strains of MRSA and 10 strains of methicillin susceptible S .aureus(MSSA) among 129 strains of MSSA ;except susceptible to vancomycin and linezolid ,the resistance rate of MRSA to ther antibacterial durgs were higher than that of MSSA ,the resistance rate to antibac-terial durgs in the strains carrying mecA gene was higher than that in the strains without carrying mecA gene ,ther difference be-tween them had statistical significance (P<0 .05) .Conclusion Clinically isolated SA strains carrying mecA gene are resistant to multiple antibacterial drugs ,which indicating that mecA gene play an important role in SA drug-resistance mechanism .

OBJECTIVE:To provide reference for the establishment of clinical skills evaluation system in students majored in clinical pharmacy and pharmacy of China. METHODS:Retrieved from pharmacy OSCE literatures and the related websites,phar-macy OSCE contents and evaluation in the United States,the United Kingdom,Canada,Japan,Malaysia and other countries were introduced to provide suggestions for clinical skills evaluation system in students majored in clinical pharmacy and pharmacy of Chi-na. RESULTS & CONCLUSIONS:OSCE had widely applied in medicine,nursing and other professional clinical skills,the United States,the United Kingdom and other countries had applied OSCE into pharmacy,and confirmed its important role in assessment of clinical competence in pharmacy students. There was no uniform standard in OSCE,and OSCE examinations were slightly different in different countries and different schools. Pharmacy OSCE usually based on school courses such as pharmacotherapy,clinical pharmacokinetics,medicine information,pharmaceutical care,doctor-patient communication,identification and solving ability of clinical drug-related issues. Numerous college of pharmacy in domestic colleges and universities has added the practice-based cours-es,but evaluation system and assessment methods are poor. Almost no OSCE is applied for the assessment of pharmacy students. OSCE has short application time in pharmacy education and relatively less study,therefore,pharmacy OSCE in foreign countries should be learnt to assess clinical skills of pharmacy students,establish and improve the pharmacy OSCE that is suitable for China by combining with the pharmacy education status.

ObjectiveTo present 4 cases of primary c ar cinoid tumor of urinary bladder and to discuss the characteristics,diagnosis,tre atment and prognosis.MethodsA retrospective study of p athological and clinical data of 4 cases of primary bladder carcinoid tumor was made.Three were male patients and 1 female with an average age of 58.Two cases w ere considered as benign carcinoid tumor whereas the other 2 carcinoid of high malignancy.All of them presented macroscopic or microscopic hematuria but with no carcinoid syndrome noted.ResultsOne case of maligna nt carcinoid tumor with deep muscle invasion underwent radical cystoprostatectom y and adjurvent chemotherapy,but the prognosis was poor (died 5 months after the operation).Transurethral resection were performed for 2 cases of benign carcino id tumor and 1 case of focal malignant carcinoid with good prognosis.ConclusionsThe primary carcinoid tumor of urinary bladder has no specific symptoms,and should be diagnosised on histopathologic studies.Surgical intervention is the mainstay to treat the disease but the prognosis is hard to b e predicted.

Objective To discuss the effectiveness of knowledge-attitude-practice(KAP)-based health management on type 2 diabetes in community residents.Methods From June 2010 to December 2011,930 type 2 diabetes patients living in Mishi Lane Community were enrolled and assigned to the intervention group(n=494) and the control group(n=436).The KAP mode was used for the intervention group,and the routine management mode was applied to the control group.Fasting blood glucose(FBG),PBG2 h,HbAlc,blood pressure(BP),triglyceride(TG) and body mass index(BMI) were tested and recorded.Student's t test or Chi-square test was used for data analysis.Results Age(t=0.124,P＞0.05),gender(x2=2.0,P＞0.05) and other demographics showed no statistically significant difference between the two groups(all P＞0.05).After one-year KAP-based health management,HbA 1 c of the intervention group reduced to(6.1 ± 1.2)％,FBG and PBG2 h reduced by 1.7 and 3.23 mmol/L,respectively(t=4.926,P＜0.05; t=4.306,P＜0.05; t=4.523,P＜ 0.05).Diet,physical exercises,medication,regular inspection,unhealthy habits and questionare test awaveness of the intervention group were improved(86.03％,82.19％,85.63％,70.45％ 76.11％ and 88.46％,respectively.Drinking,dietary structure,overweight and physical exercises of the intervention group were also improved(14.17％,15.79％,70.65％ and 68.83％,respectively; all P＜0.001).Conclusion The KAPbased health management is proved to be effective in the control of community diabetic patients.