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.

OBJECTIVE:To establish a pharmacy online to offline (O2O) platform service quality evaluation model,and to provide reference for platform operators to improve the service quality. METHODS:Using SERVQUAL scale,combining the situa-tion of pharmacy O2O platform development in China,the reliability,safety and aspects of O2O platform were analyzed to sum up primary evaluation index of pharmacy O2O platform service quality. Based on this,the expert interviews questionnaire was de-signed. According to the questionnaire results,indicators were modified and empowered to construct the pharmacy O2O platform service quality evaluation model;the reliability and validity of model were validated. RESULTS & CONCLUSIONS:According to the connotations of each dimension analysis in the SERVQUAL scale and expert interview results of pharmacy O2O platform ser-vice quality,pharmacy O2O platform service quality evaluation model is constructed,including five indicators as“reliability”“se-curity”,and 18 secondary indexes as the“number of platform pharmacy”“pharmacy qualification show”“pharmacy type”. The re-sults of model index reliability and validity verification show that model construction is reasonable and can provide reference for platform operators improving service quality. Follow-up research should give full consideration to the Chinese consumer behavior habits,personal preferences and other factors to build more suitable pharmacy O2O platform service quality evaluation model in China.

Objective To investigate the effects of eye movement desensitization and reprocessing (EMDR) versus cognitive behavior therapy (CBT) for treating adult posttraumatic stress disorder (PTSD) .Methods A total of 81 patients with PTSD con‐forming to the including standard were randomly allocated to the EMDR group ,CBT group ,and control group ,27 cases per group . The PTSD symptoms ,anxiety and depression moods in 3 groups were assessed before and after treatment by adopting the Clinician‐administered PTSD Scale (CAPS) ,Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) .Results The drop‐out rates were 29 .63% for the EMDR group ,7 .41% for the CBT group and 7 .41% for the control group respectively ;the re‐experience symptoms score of CAPS in the EMDR group was lower than that in the CBT group with statistical difference (P=0 . 036) .Conclusion Both EMDR and CBT are the effective psychological therapeutic method ,EMDR has more effective than CBT in the reproving the re‐experience symptoms of PTSD .The future studies should pay more attention to the application of stabilization technologies for reducing the dropout rate of EMDR .

Objective To comprae the difference of Sex hormone,serum and follicular fluid anti Mullerian hormone (AMH) level tube,number of retrieved egg,the number of cleavage rate,fertilization oocytes,the number of available embryos and total embryo on in vitro fertilization and embryo transfer (IVF-ET) of different reaction groups,to explore the relationship between AMH and pregnancy outcome of IVF-EH.Methods Eighty-one cases of IVF-ET assisted pregnancy were divided into low ovarian response group,normal ovarian response group and high ovarian response group according to the response of the super ovulation.Serum sex hormone and AMH of all patients were detected on the third day of menstruation,on the day of HCG injection,oocyte pick-up (OPU) and embryo transfer (ET),AMH in FF were detected too.The difference of oocytes,cleavage rate,embryo quality and the indicators mentioned above among the three groups were compared.All of the above indicators were compared between pregnancy group and unpregnancy group.Results (1) The level of AMH on the third day of menstruation ((1.76 ± 0.47) μg/L,(3.45 ± 1.01) μg/L,(6.34 ± 1.29) μg/L,F =2.435,P＜0.001),HCG injection ((1.09±0.13)μg/L,(1.29±0.29)μg/L,(2.64±0.51)μg/L,F=1.542,P=0.001) and embryo planting((1.32±0.33) μg/L,(1.62±0.39) μg/L,(1o 91±0.41) μg/L,F =1.573,P ＜0.001) all were statistically significant in three groups.On day of OPU,the levels of serum AMH ((0.95±0.21)μg/L,(1.15±0.29) μg/L,(1.74±0.41) μg/L,F =12.573,P＜0.001) and AMH in FF((5.82±1.19) μg/L,(6.92±1.05) μg/L,(7.79±1.39) μg/L,F =9.83,P＜0.001) were statistically differences in the three groups.(2)The number of oocytes were positively correlated with AFC,based AMH,levels of E2,P and AMH on the day of HCG injection and OPU,E2 and AMH on the day of ET and AMH in FF(P＜0.05).(3)AMH in FF in pregnancy group was (6.22±0.82)μ g/L,significantly higher than those without pregnancy group ((5.31 ±0.71)μg/L,P =0.037).Conclusions Levels of AMH in serum and follicular fluid are good predictors of ovarian response in IVF-ET.The level of serum AMH can only predict ovarian response,but can not effectively predict pregnancy outcome.The level of AMH in FF is a good predictor of pregnancy outcome.