Objective To study the clinical efficay of the therapy adefovir dipivoxil combined with reduced glutathione in the treatment of decompensated hepatitis B cirrhosis .Methods 76 cases of decompensated hepatitis B cirrhosis were divided into the treatment group and the control group ,38 cases in each group .Both groups take symptomatic and supportive treatment ,the obser-vation group plus adefovir dipivoxil combined with glutathione therapy .After 3 months treatment ,we observed liver function ,hepa-titis B virus DNA quantification and assessed the clinical efficacy .Results After treatment ,the treatment group liver function im-proved was significantly better than the control group (P<0 .05) ,the total effective rate was higher than the control group (P<0 .05) ,the rate of hepatitis B virus DNA turn to negative was significantly higher than the control group (P<0 .01) .Conclusion Adefovir dipivoxil combined with reduced glutathione therapy for decompensated hepatitis B cirrhosis can effectively improve liver function ,suppress hepatitis B virus DNA undetectable ,reduce the incidence of the complication ,and worthy of promote in our clini-cal practice .

Objective To analyze the drug resistance status of mycobacterium tuberculosis in patients with double immunization of human immunodeficiency virus (HIV) and tuberculosis (TB) by phage bioassay (PhaB),and to optimize the control strategy.Methods One hundred and twelve cases of HIV/TB infected patients.in Chongqing Ninth People's Hospital were treated with PhaB method,and the drug susceptibility testing results were compared with 208 cases of simple pulmonary tuberculosis patients.Results The anti-tuberculosis drug resistance rate of HIV/TB patients was lower than that of simple pulmonary tuberculosis patients.The resistance rates of 5 common anti-tuberculosis drugs in HIV/TB patients were 7.14％ of isoniazid (INH),7.14％ of pyrazinamide (PZA),5.36 ％ of rifampicin(RFP) streptomycin(SM),and 4.46 ％ of ethambutol (EMB),compared with simple pulmonary tuberculosis(resistance rates of RFP were 17.31％,IN H 13.46 ％,PZA 11.54 ％,EMB 10.58 ％,SM 9.62 ％),RFP resistance rate of HIV/TB infected patients was lower(P＜0.05).There was no significant difference between two groups in the other four anti-tuberculosis drug(P＞0.05).The coincidence rate with the absolute concentration method were INH 96.4％,RFP 98.2％,PZA 96.4％,EMB 93.8％ and SM 96.4％,respectively.Conclusion The resistance rate of mycobacterium tuberculosis to RFP in patients with HIV/TB infection in this region is lower than that in patients with common pulmonary tuberculosis,which is related to the good medication compliance of these patients.PhaB has the characteristic of fast,simple,without special equipment,it can be used as a rapid screening of mycobacterium tuberculosis drug resistance method.

Objective To explore the effects of stress management intervention for companions of patients with AIDS on psychological status,quality of life and anti-viral treatment of patients with AIDS.Methods Totally 92 patients with AIDS and their companions were randomly divided into the experimental group and the control group,each with 46 cases.Both groups received routine nursing,the experimental group received stress management intervention for 4 months.Before and after intervention was complete,the GHQ-12 was used to assess the psychological status of companions in both groups.Morisky questionnaire,SF-12 and stigma scale were used to evaluate anti-viral treatment compliance,quality of life and stigma of patients in both groups.Results The differences in general health scores of two groups after 4 months were statistically significant.There were significant differences in scores of stigma,quality of life scores,anti-viral treatment adherence and anti-viral treatment between AIDS patients in two groups.Conclusion Stress management intervention for companions of patients with AIDS can significantly improve psychological status of companions,reduce the stigma of AIDS patients,improve the quality of life and anti-viral treatment adherence and the effects of anti-viral treatment for patients.

Objective To explore methods to measure the management level of Chinese hospitals in natural conditions of Chinese hospitals, for improvement of their operation efficiency. Methods The methodology of World Management Survey( WMS) was introduced, and the questionnaire was localized using expert consultation method. Double-blind telephone interviews were conducted to investigate the management level of Chinese hospitals in the four dimensions of standardized operation, performance monitoring, target setting and talent management. Results The management level of hospitals in China varied greatly from places. Among them, the hospital management scoring was found to range from 2. 50 to 2. 75 in most cases, averaging 2. 55. These hospitals scored relatively poor at the four specific management practices of hospital layout(2.48), performance communication(2.27), talents retention, and clarity and comparability of objectives(2. 45). Management level of a hospital was correlated to such factors as its history, ownership form, human capital and hospital size. Conclusions This study uses WMS methodology to quantify Chinese hospital management. The overall management level of Chinese hospitals is expected to improve with much gaps to cover. At this stage, it is imperative to solve the unbalanced and inadequate development of hospital management levels, among regions, hospital grades and forms of ownership.