Objective To probe into the burden of caregivers of patients with Alzheimer' s disease (AD) ,coping styles and the correlation. Methods A survey involving 143 caregivers of patients with AD was conducted with Caregivers' Burden Scale and a simple Coping Style Questionnaire to analyze the burden of caregivers of AD and the characteristics of their coping styles and discuss the correlation. Results The burden of the caregivers of patients with AD was at intermediate level the score was 46. 96 ±7. 28. 78. 32% of the caregivers had intermediate burden. Both the grade of the positive coping and that of the negative coping of the caregivers of patients with AD were higher than the domestic norm (P < 0.01); the positive coping styles of the caregivers of patients with AD were negatively related with their burden while nursing; their negative coping styles were positively related with their burden while nursing (P < 0.01). Conclusion The burdens while nursing are related with their coping styles. In the aspect of nursing activity, caregivers should be encouraged to adopt positive coping styles.

OBJECTIVE To investigate the phlegm etiology and the prevention measures of respiratory tract infection in 89 cases with heavy type hepatitis in hospital.METHODS From Jan 2004 to May 2007,the phlegm from respiratory tract hospital infection patients were studied retrospectively.RESULTS The main respiratory tract pathogens were the G-bacillui(44.5%),G+ cocci(23.2%),Candida albicans(16.8%),Aspergillus(9.0%) and yeast-like fungi(4.5%).CONCLUSIONS The investigation of the etiology suggests that the prevention of respiratory tract infection be the main measure to decrease hospital infection in heavy type hepatitis patients.

Objective To study the effect of bisphenol A (BPA) and dibutyphthlate (DBP) treated with Rat Liver S9 on proliferation MCF-7 cells. Methods Added the positive control 17?-estradiol (E2) and compounds of BPA and DBP with the effect of Rat Liver S9 to MCF-7 cells proliferation respectively and determinated the quantity of MCF-7 cells with MTT assay. Results The activity of E2 and DBP stimulated MCF-7 cells decreasing significantly with the effect of Liver S9 than without the effect of Liver S9, while BPA stimulated MCF-7 cells increasing significantly with the effect of Liver S9 than that without the effect of Liver S9. Conclusion E2 and DBP have a lower estrogenic activity with the effect of S9 than without the effect of S9. BPA shows a higher estrogenic activity with the effect of S9 than without the effect of S9.

Objective To investigate the association between nonalcoholic fatty liver disease (NAFLD) and metabolism or carotid intima-media thickness (CIMT) in Type 2 diabetic(T2DM). Methods According to the liver B-ultrasonography, a total of 321 T2DM patients were divided into two groups, with or without NAFLD. Metabolic indexes such as BMI, BP, blood glucose, blood lipid, uric acid ( UA ), insulin, C-peptipe,insulin resistance index(HOMA-IR) between the two groups were compared, and the relationships between alanine aminotransferase (ALT) and the above indexes were analyzed. Furthermore,the CIMT of the two groups were compared, and the relationships between NAFLD, ALT and CIMT were investigated by correlation and regression analysis. Results Compared with the group without NAFLD, the patients with NAFLD had higher level of BMI, triglyceride ( TG ), UA, fasting blood glucose ( FBG ), fasting insulin ( FIns ), fasting C peptide (FCP) ,HOMA-IR,and lower level of high density lipoprotein ( HDL-C ) significantly; BMI ( OR = 1.25, P ＜0. 001 ), TG ( OR = 1.74, P = 0. 008 ) and HOMA-IR ( OR = 2. 33, P = 0.010) were independent risk factors of NAFLD while H DL-C was independent protective factor; ALT was positively correlated with BMI (r = 0. 255, P ＜0. 001 ) ,TG(r =0. 156,P ＜0. 018) ,UA(r =0. 239,P ＜0. 001 ) ,FIns(r =0. 213,P =0. 001) ,FCP(r =0. 199,P ＜0. 003), HOMA-IR ( r = 0. 247, P ＜ 0. 001 ) and negatively correlated with HDL-C ( r = - 0. 199, P =0. 002) ,and BMI (β =0. 456,P =0. 048) ,UA (β =0. 021 ,P =0. 025) and HOMA-IR(β =3.634 ,P =0. 004)were independent associated facrors. The difference of CIMT between the two groups didn't reach statistical significance, while mutiple regression analysis revealed that ALT was independently associated with CIMT(β =0. 002,P = 0. 013). Conclusion T2DM patients with NAFLD show more serious disorder of metabolism and insulin resistance. ALT is an independent risk factor of CIMT in T2DM patients.

Objective To evaluate the effects and toxicities of the hyperthermic peritoneal peffusion with oxaliplatin (L-OHP) and interleukin-2 (IL-2) combined with chemotherapy for treatment malignant asci-tes. Methods 42 patients with malignant aacites from assimilation system tumor were catheterized,drained and flushed with L-OHP 85 mg/m2 in 2 000 ～2 500 ml of 5 % glucose and IL-2(2 MU),NRL-001 Double RF tumor hyperthermia system was applied to heat the abdominal part for 60 ～ 120 minutes at an intraperitoneal temperature of 41 -43 ℃ ,next day,all the patients were treated with calcium folinate(CF)0. 2 g/m2 by 2 hours intravenous infusion,5-fluorouracil (5-FU) 0. 4 g/m2 intravenously, followed by 46 hours continuous infusion of 5-FU (1 600 mg/m2), 2 weeks a cycle. Results The overall response rate was 66. 67%, including CR : 6 cases, PR:22 cases, NC:6 cases, and PD:8 cases. MST is 5.6 months. The main toxicity was impatient abdomen ache,paralysis intestinal obstruction. Conclusion Hyperthermic peritoneal perfusion with oxaliplatin and inter-leukin-2 combined with chemotherapy is efficient and safe in the treatment malignant ascites and can improve the quality of life. It is worthing wildly using and research.

Objective To explore the impact of the systematic social skills training on recovery of chronic schizophrenia patients with negative symptom and social skills defects.Methods A total of 82 cases of long -term hospitalized patients with chronic schizophrenia were randomly divided into intervention group and control group by digital table,41 cases in each group.The two groups received psychiatric routine therapy and nursing,and general entertainment therapy,and systemic social skills training was conducted in the intervention group for 12 weeks.PANSS and SSC were respectively used to evaluate the two groups before and after the intervention.Results After 12 weeks of systematic social skills training,the total score of SSC[(24.5 ±4.5)points]in the intervention group was apparently lower than that in the control group[(29.2 ±5.2)points],and the difference was statistically significant(t =3.212, P <0.01).Compared with the control group[(20.5 ±4.3)points,(27.2 ±4.2)points,(59.1 ±9.5)points],in the intervention group the score of negative symptom mental pathology and total score of PANSS were (14.9 ± 3.7)points,(24.5 ±3.5)points,(52.8 ±7.1)points.The differences of total score between the two groups were sta-tistically significant(t =5.199,3.317,3.239,all P <0.01),while the positive symptoms score was not statistically significant(P >0.05).Compared with before intervention,in the negative symptom table,the differences of total score N2,N3,N4,N6 had statistically significant differences(t =4.533,5.413,4.501,4.668,all P <0.01).Conclusion The systematic social skills training can greatly promote chronic schizophrenia patients with negative symptom and social skills defects,improve their social skills and life qualities.

Objective To investigate the precision, trueness, and accuracy of self-developed detection system in clinical chemistry.Methods This was a methodological evaluation.Take serum creatine kinase( CK) for instance, 6 serum sampleswith different leves ( on the upper or lower limit of the reference range or close to the medicine decide levels ( MDLs) , were collected for within-run precision( repeatability) and within-laboratory precision ( intermediate precision ) experiments.5 proficiency testing ( PT ) samples, 5 samples assigned value by reference method, and 40 fresh-frozen serums were measured and compared with reference method for trueness verification.Drawing method evaluation decision chart, calculating total errors and sigma level evaluation experiment based on the CV, bias, and allowed total errors(TEa)were used to evaluate the accuracy performance.The precision, trueness, and accuracy were compared with the quality indicators.Results The within-run precision and within-laboratory precision were less than the highest requirement of Chinese industrial standard.The mean bias was -8.96%, didn′t reachthe required standard (5.5%).After taking corrective actions, all samples but one ( -5.8%) met the required standard. Compared with the reference method, the mean bias on the MDLs was less than TEa.The performance points of the method evaluation decision chart indicated excellence performance.The total errors on MDLs were 14.2%, 10.4% and 7.6%, less than 15%.The sigma levels on MDLs were 5.9, 7.5 and 15, also achieved excellent level. Conclusions The precision, trueness, and accuracy performance of CK measured by self-developed detection system achieved excellent level of the Chinese industry standard, and the same results were found from different evaluation methods.

OBJECTIVE:To explore the effect of nifedipine combined with losartan on the blood pressure and renal function of hypertension complicated with coronary heart disease. METHODS:150 patients with hypertension complicated with coronary heart disease were randomly divided into observation group and control group. Control group was orally treated with Nifedipine sustained release tablet 30 mg,once a day;observation group was additionally treated with Losartan potassium capsules 50 mg,once a day. The treatment course for both groups was 1 month. Systolic blood pressure,diastolic blood pressure,renal function indicators be-fore and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,systolic blood pressure and diastolic blood pressure after 3 months was lower than 1 month and lower than before treatment in same group,renal function indicators were significantly lower than before treatment,and observation group was lower than control group,the differ-ences were statistically significant(P<0.05);the incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Nifedipine combined with losartan can well control the blood pressure of hypertension complicated with coronary heart disease,protect renal functions,with good safety.

Objective To explore the impact of the systematic social skills training on recovery of in -patients with chronic schizophrenia.Methods A total of 78 cases of long -term hospitalized patients with chronic schizophrenia were randomly divided into intervention group and control group on the basis of random number table. The two groups received psychiatric routine therapy and nursing,and general entertainment therapy,and the patients in the intervention group received group social skills training for 12 weeks.IPROS and SSSI were respectively used to evaluate two groups before the intervention,trained for 12 weeks.Results After 12 weeks'of systematic social skills training,social function defect levels SSSI score in the intervention group was apparently higher than that in the control group,and the difference was significant (χ2 =8.952,P <0.05 ).Compared with the control group (19.4 ± 4.5)points,(16.5 ±4.7 )points,(13.6 ±4.1 )points,(5.5 ±3.1 )points,(18.2 ±4.2 )points,(73.2 ± 16.3)points,in the intervention group public medical situation (10.3 ±5.5)points,life ability(12.1 ±5.7)points, social ability(6.2 ±3.5)points,antiseptic ability (3.3 ±3.3)points,concern and interest (9.6 ±4.5)points as well as the total score of IPROS (44.6 ±20.4),the differences were significant(t =7.760,6,188,8.165,2.568, 6.632,8.259,all P <0.05).Compared with before intervention,each factor in IPROS and the total score in the inter-vention group had statistically significant differences (t =8.890,7.923,8.321,3.195,8.21,9.852,all P <0.01). Conclusion The systematic social skills training can greatly promote the recovery of in -patients with chronic schiz-ophrenia,improve their social skills and life qualities.Compared with control group,the social function of patients in the intervention group has recovered positively.

Objective To investigate drug resistance and clinical efficacy of second-line anti-tuberculosis drugs in patients with multidrug-resistant pulmonary tuberculosis.Methods A total of 183 multi-drug resistant pulmonary tuberculosis (MDR-PTB) patients received standard anti-tuberculosis treatment in Zhejiang Provincial Center for Diagnosis and Treatment of Tuberculosis during March 2011 and March 2013.Patients were divided into four groups according to the results of first-line anti-tuberculosis drugs susceptibility test:group A (n =30) resistant to isoniazid (H) and rifamipicin (R) ; group B (n =28) resistant to HR and ethambutol (E) ; group C (n =53) resistant to HR and streptomycin (S) ; groups D (n =72) resistant to HRES.Drug susceptibility tests of second-line drugs kanamycin (Km),protionamide (Pto),paraaminosalicylic acid (PAS) and levofloxacin (Lfx) were performed.Negative conversion rates of mycobacterium tuberculosis in sputum culture were also observed and compared among different groups with x2 test.Results Among 183 MDR-PTB patients,49 cases (26.8％) were resistant to Lfx,which was significantly higher than that of Km (8.7％,n =16),Pto (13.1％,n =24) and PAS (6.6％,n=12) (x2 =37.983,P＜0.05).The resistant rate to Lfx in group D was 45.8％ (33/72),which was higher than that in group A (2/30,6.7％),group B (6/28,21.4％) and group C (8/53,15.1％) (x2 =14.413,5.047 and 13.087,P ＜0.05).The occurrence of pre-extensively drug resistance (Pre-XDR) in group D was 34.7％ (25/72),which was higher than that in group A (3/30,10.0％) and group C (9/53,17.0％) (x2 =6.499 and 4.852,P ＜ 0.05).Among 157 MDR-PTB patients who received standard anti-tuberculosis treatment for one year,the negative conversion rate of mycobacterium tuberculosis in sputum culture was 87.3％ (137/157).The negative conversion rate in group D was lower than that in other groups,but the difference was not of statistical significance (x2 =1.899,P ＞ 0.05).Conclusions The efficacies of second-line anti-tuberculosis drugs vary among MDR-TB patients resistant to different firstline anti-tuberculosis drugs.The sensitivity tests results of the first-line drugs may serve as reference for MDR chemotherapy regimen in lack of test results of second-line drugs.