Objective To investigate the relationship between Alzheimer disease(AD) and plasma homocysteine (HCY) level. Methods Rate of mini mental state examination(MMSE) and levels of plasma homocysteine and folate and vitamin B12 were determined in 68 AD patients, which were compared with 60 healthy older. Results The mean plasma level of HCY was higher in AD patients than that in contrast group,and the very reverse of plasma level of folate and vitamin B12(P15?mol/L,the odd ratio(OR) was 4.3(95% CI 1.89～7.43). Plasma level of HCY was negatively correlated with that of folate and vitamin B12 and rate of MMSE in two groups. Conclusion The high level of plasma HCY is an important risky factor to AD patients. The lack of nutrition elements of folate and vitamin B12 et al can result in the rising of plasma HCY.

OBJECTIVE To investigate the relevant factors and drug sensitivity of Candida in nosocomial infection from a class A comprehensive hospital in Hangzhou in order to prevent and control nosocomial infection.METHODS We collected and identified clinic samples from inpatients during from Jan 2004 to Dec 2006 and drug resistance test was performed for Candida strains.The CHROMagar candida color medium and the Analytic Products Inc(API)20CAUX identification system were used to isolate and identify Candida strains from inpatients.The Etest was used to study the antifungal sensitivity.The data were analyzed by WHONET-5 software and were determined by the Clinical and Laboratory Standard Institute(CLSI)method.RESULTS Totally 264 strains of Candida were detected in the three years.The detection ratio in each year was 78 strains(29.5%),87 strains(32.9%),and 99 strains(37.5%),respectively.The C.albicans was the most commonly isolated species(65.5%)and then was C.tropicalis(15.1%)in all Candida species.The detection ratio was the highest in sputum samples(108 strains,40.9%)and the patients with respiratory tract infection(58 strains,22%).The results of antifungal drug sensitivity test showed that Candida were the most susceptive to amphotericin B,followed by fluconazole.The results of change showed that Candida remained stable susceptive to amphotericin B,but susceptive ratio to fluconazole was descent in the three years.CONCLUSIONS Candida in nosocomial infection are an increasing tendency and C.albicans is the commonest.Sensitivity of Candida to various antifungal drugs is different and there is a developing change in susceptive ratio to antifungal drugs.Strengthening supervising relevant factors and improving the immunity of organism are the main measures to prevent Candida in nosocomial infection.Antifungal drug should be used reasonably based on drug sensitive test.

Objective To investigate the early risk factors for stroke-associated pneumonia (SAP) in acute stroke patients with dysphagia.Methods The modified Mann assessment of swallowing ability (MMASA) was used to screen dysphagia in patients with acute stroke admitted to hospital within 24 hours after symptom onset.The patients with dysphagia were used as research subjects.They were divided into either a SAP group or a non-SAP group according to whether they had SAP or not within one week of symptom onset.Univariate and multivariate logistic recession analyses were used to analyze the data of demography,past history,clinical practice,and laboratory.The early risk factors for the occurrence of SAP in patients with dysphagia were identified.The independent risk factors were analyzed with receiver operating characteristic (ROC) curves in order to assess their predictive value for SAP.Results Of the 113 patients with acute stroke,55 had dysphagia,and 30 of them (54.54％ ) had SAP.Univariate analysis showed that the National Institutes of Health Stroke Scale (NIHSS) score (median,[ interquartile range] 16,[ 13 - 21 ] vs.3,[ 1 - 7 ] ; P =0.000),neut rophil counts ([ 8.22 ± 3.75 ] × 109/L vs.[ 5.39 ± 2.56 ] × 109/L; t =3.198; P =0.002),proportion of hemorrhagic stroke (96.00％ vs.4.00％ ;x2 =7.333; P =0.007),and proportion of mechanical ventilation (20.00％ vs. 0.00％;x2=5.612; P=0.018) in the SAP group (n=30) were significantly higher than those in the non-SAP group (n =25),while the MMASA score (median,[ interquartile range ] 53,[ 27 - 84 ] vs.88,[ 66 - 92 ] ; P =0.002),Glasgow Coma sCale (GCS) score (median,[ interquartile range] 10,[7-13] vs.15,[11-15];P=0.001),lymphocytecounts([1.17±0.54] ×109/L vs.[1.75±0.81 ] × 109/L; t =-3.563,P =0.001),CD3+ T lymphocyte counts ([0.73 ± 0.42] × 109/L vs.[ 1.14 ±0.85] × 109/L; t=-2.307; P=0.025),and CD4+ T lymphocyte counts ([0.38± 0.22] × 109/L vs.[ 0.69 ±0.57] × 109/L; t =-2.761; P =0.008) were significantly lower than those in the non-SAP group.Multivariate logistic regression analysis showed that the NIHSS score was higher at admission (odds ratio [ OR ],1.206,95％ confidence interval [ CI ] 1.076- 1.351; P=0.001) and the CD4+ T lymphocyte counts decreased ( OR,0.974,95％ CI 0.952 - 0.997; P =0.025) were the independent risk factors for SAP in stroke patients with dysphagia.The NIHSS score ≥ 10.5 had good predictive value for SAP,and its sensitivity and specificity were 86.7％ and 72.0％ respectively (P =0.000).Conclusions More than half of the acute stroke patients with dysphagia occurred SAP.The NIHSS score at admission,neutrophil counts,stroke types,mechanical ventilation,MMASA score,GCS score,lymphocyte counts,CD3+ T lymphocyte counts,CD4+ Tlymphocyte counts,and other factors were associated with occurrenee of SAP in patients with dysphagia,in which a higher NIHSS score and a decreased CD4+ T lymphocyte counts were independent risk factors for the occurrence of SAP in stroke patients with dysphagia.The NIHSS score ≥ 10.5 at admission had higher predictive value.

Objective To study the inhibitory effect of recombinant adenoviruses carrying the mouse endostatin gene on the therapy of endometriosis in nude mice.Methods Animal endometriosis models were established by inoculating human endometrial fragments.Mice were randomly divided into three groups(10 each):PBS control group,Ad-lacZ group and Ad-mEndo therapy group when ectopic lesion diameter reached 5-10mm.The ectopic lesion size was measured every day.The expression of endostatin in ectopic lesion was detected by immunohistochemical stainining.The microvessel density(MVD) of ectopic lesion was traced by CD34 immunohistological labeling.Meanwhile,the contents of steroid hormone and histological changes in mice uterus and ovary were detected.Results The titer of the recombinant adenovirus was about 5.0?109pfu/ml.The endostatin gene was transferred into mice successfully and expressed effectively.The lesion volume was significantly less in Ad-mEndo group(34.3?11.2mm3) than that in Ad-lacZ group(93.3?10.7mm3) and PBS group(90.4?18.7mm3,P

Ojective To investigate therapeutic results of conservative operation with laparoscopy for all kinds of patients with tube pregnancy. Methods 62 patients with tube pregnancy were performed the conservative surgery, fenestration on the position of tube pregnancy or take out embryos from the tube crevice combined with injection of MTX under laparoscopy. Results all of 61 patients' tube were retained successfully. no complications occurred, urine HCG recovered to normal levels two weeks after operation. Only one patient continue to pregnancy and completely recovered after intramuscular injection MTX. 18 patients were carried out HSG 1～4 months after operations. 15 patients' tube among them were unobstructed. Opening rate was 88.3%. Within postopeative four years, 12 patients were repregnant. Pregnancy rate was 66.7%. Conclusions Tube pregnancy conservative treatments under laparoscopy not only is safe and minimal invasion, but also had less complications, therefore it is a more suitable method for retaining the fertile females' tubes.

Objective: To understand the effects of remuneration incentive and their influences on job satis-faction in county public hospital. Methods: Stratified random sampling was adopted. Six county public hospitals in county level in Heilongjiang province were selected as the sample. Exploratory factor analysis was used to ana-lyze the remuneration incentives, descriptive statistical analysis and logistic regression analysis were used to ana-lyze the effects and their influences on work satisfaction. Results: remuneration incentives are divided into four dimensions that comprised a total of 16 items, which including direct material rewards, indirect material re-wards, occupational rewards and social rewards. The surgeon’s job satisfaction is higher than the physician, and is lower than the obstetrics and gynecology and pediatrics. Technician and nurses’ satisfaction is lower than the general practitioner. The medical staff who worked less than5 years has the lowest satisfaction. Authorized staff’s satisfaction is lower than off-staff. Direct material rewards and occupational rewards are related to job satisfac-tion. Conclusions:Material rewards were in low level, and non-economic incentive was insufficient. The salary incentive for highly educated talents should be strengthened.

Sunscreen products have been widely used with the increase in public awareness of sun protection. As sunscreens are structurally stable and resistant to degradation, the concern for their biotoxicity and impact on marine environment has been heightened increasingly, and several countries and regions have successively issued bans on relevant sunscreen products. However, these bans have not yet affected the key international rules and regulations related to sunscreen products. The risks of different sunscreens to marine ecosystems and potential risks to human themselves still need to be evaluated through further multidisciplinary researches.

The incidence of dysphagia after stroke is high.It may affect the rehabilitation of patients and increase mortality.The assessment is of great significance for early objective examination of dysphagia,in which the bedside screening tests are the most common assessment methods in the routine clinical work.This article reviews the advances in research on the commonly used bedside screening tests of dysphagia.

Objective To analyze the utilization of Chinese medicines in outpatients of our hospital for the rational use of Chinese medicines in clinic. Methods Drug consumption data during 2010-2012 were collected from the hospital information system database,and drug daily dosages(DDDs)and consumption sum were statistically analyzed. Results The amount of Chinese medicines was 33.07%-36.29%of all drugs costs in the outpatients from 2010-2012. From DDDs’top 10 Chinese medicines during 2010-2012, medicine for cardiovascular medications and urinary system had a great percentage, and the doctors used Chinese medicines reasonably. Conclusion The Chinese medicines uses in outpatients of our hospital is generally rational.

Objective To investigate the consistency of gene amplification and its expression at protein level of human epidermal growth factor receptor 2 (HER2) in gastric carcinoma.Methods From 2010 to 2012,120 gastric cancer specimens of patients with gastric cancer were collected,of which 100 were surgical specimens and 20 were specimens from biopsy under gastroscope.The protein expression of HER2 in 120 specimens was detected by immunohistochemistry (IHC).According to the results of IHC,the positive parts of HER2 expression of IHC slices were developed into tissue microarrays for fluorescence in situ hybridization (FISH) to test the gene amplification of HER2.The different parts with different color intensity of focal (+ + +) (≤ 10％ tumor cell strongly staining) specimens detected by IHC detection were compared with the results of FISH.Kappa test was performed for statistical analysis.Results Among 120 gastric cancer specimens,the results of IHC indicated that 77 specimens were positive with different staining intensity including 16 strong positive (+++),six focal positive (+++),37 moderate positive (++) and 18 weak positive (+).The positive rate of HER2 protein expression detected by IHC was 18.3％ (22/120).The results of FISH showed 41 specimens were positive and the rate of gene amplification was 34.2％.Among which,21 were moderate positive (++) detected by IHC,15 were strong positive (+ + +) and five were focal positive (+ ++).The positive rate of HER2 was 35.0％ (42/120) with IHC and FISH combined detection.The consistent rate of IHC and FISH was 91.6 ％ (76/83).Kappa coefficient was 0.960 (P＜0.01).In five positive specimens detected by FISH and which were focal positive (+ + +) by IHC,the different parts with different color intensity were compared with the results of FISH and gene amplification was found in all specimens.Conclusion Tissue microarray technology is consistent with IHC in HER2 detection in gastric cancer specimens and could help to improve the detection rate.