Objective To investigate the relationship between serum 25- hydroxyvitamin D(25(OH) D3)level and lung function of bronchial asthma patients. Methods Thirty-nine bronchial asthma patients with severe,moderate,mild stage(each for 13 cases)in respiratory department of the First People's Hospital of Jining from Jan. to Oct. 2013 were selected as our subjects. Fifth healthy people were selected as control group. Serum 25(OH)D3 and pulmonary function indexes were detected,and the percentage of forced expiratory volume in one second(FEV)in predicted value(FEV1% pred)was calculated. Results The FEV1% pred of patients with mild,moderate and severe stage bronchial asthma were(86. 62 ± 10. 80)% ,(67. 23 ± 11. 30)% and(31. 26 ± 12. 80)% pespectively,and there were significant between groups(P < 0. 01). The level of 25(OH)D3 in patients with mild,moderate and severe bronchial asthma were(14. 33 ± 6. 82),(10. 28 ± 5. 51),(5. 68 ± 3. 26)μg/ L respectively,lower than that in control group((17. 28 ± 7. 12)μg/ L),and the differences were statistically significant(P < 0. 01 or 0. 05). There was a positive correlation between serum 25(OH)D3 and pulmonary function,and the linear regression equation was:y = - 0. 0115 + 0. 167x. Conclusion The deficiency of Vitamin D relate to the occrrence and degreed of bronchial asthmaisease,and suppliment of vitamin D should also be used as a therapy in patients with bronchial asthma.

Objective Probing into the primary healthcare capabilities of healthcare clinics in the four provinces in China's west,in order to recommend the government in making relevant policies.Results It is found that among those village doctOrs under 45 years of age,76.0%have senior high school diploma/secondary technical school education,89.6%have rural doctor certificates;those above 45 years old,59.5%have middle school education,96.9%have rural doctor certificates,and 1.6%have licensed assistant doctor certificates.x2check is statistically significant,as the village doctors born in different eras have different composition of education and different percentage of qualification certificates.44.44% of the village clinics have less than three rooms,and 41.11%occupy less than 40 square meters.Only 19.44%of the clinics receive funding for their medieal facilities from higher authorities.Conclusion It is imperative to enhance resources input tO the staff and facilities of village clinics in the west,to cater to the primary healthcare needs of the local people.

Objective To evaluated the renal hemodynamic changes in early diabetic nephropathy rats by color Doppler ultrasound and its correlation with podocyte damage.Methods Twenty male SD rats were randomly divided into 2 groups:,control group and diabetic nephropathy group.After 8 weeks,the systolic peak velocity (Vmax),diastolic minimum velocity (Vmin) and resistance index (RI) were measured by color Doppler ultrasound,the pathological changes in kidney tissues were obseved by HE staining,nephrin deposits were observed by immunofluorescence,and the nephrin mRNA expression in the renal cortex were detected by RT-PCR method.The difference of those results between two groups were compared,and the relationship between nephrin mRNA expression and index of renal hemodynamic were analysed.Results Compared with rats in control group,the Vmax and Vmin was lower among rats in diabetic nephropathy group [(16.63 ± 2.85)cm/s vs (24.16 ± 3.35)cm/s,P ＜0.001 and (5.41 ± 1.11)cm/s vs (9.87 ± 2.26) cm/s,P ＜0.001].However,the RI was higher than that of control group (0.73 ± 0.14 vs 0.57 ± 0.12,P =0.034).Bigger glomerular volume,increased mesangial matrix,increased mesangial cells,and visible focal lymphocytic or mononuclear cell infiltrated were observed in diabetic nephropathy group.The expressions of nephrin were lower in the cortex of renal in diabetic nephropathy group compared to control group (0.276 ± 0.015 vs 0.507 ± 0.024,P ＜0.001).Correlation analysis suggested nephrin mRNA expression was positively correlated with the Vmax and Vmin (r =0.931 and r =0.944,all P ＜0.001),and negatively correlated with RI (r =0.786,P ＜0.001).Conclusions Renal hemodynamic changes assessed by color Doppler ultrasound associated with podocyte damage in diabetic nephropathy rat,which is a noninvasive method of evaluation of early kidney damage.

Objective To discuss the influence of the holistic nursing careng on clinical value in patients with advanced pancreatic cancer.Methods 70 patients with pancreatic cancer were randomly divided into the observation group and the control group,with 35 cases in each group.The control group was given routine nursing measures.The observation group received the holistic nursing careng on the basis of routine nursing measures.The hospitalization time,satisfaction degree,treatment compliance and mentality were observed.Results The SAS,SDS scores of the observation group after nursing were (56.87 ±6.01)points and (61.79 ±6.17)points,which were significantly lower than (39.11 ±5.68)points and (40.82 ±5.31)points of before nursing(t =9.136,8.561,all P <0.05).The hospi-talization time,exhaust time of the observation group were (32.9 ±6.6)days and (8.21 ±1.29)days,which were significantly lower than (45.1 ±10.2)days and (13.56 ±1.77)days of the control group(t =8.561,3.769,all P <0.05).The treatment satisfaction and treatment compliance in the observation group were also significantly better than the control group(χ2 =8.292,8.156,all P <0.05).Conclusion Hsystematic nursing intervention can significantly improve thepostoperative anxiety and depression,and improve the quality of life of patients with severe pneumonia.

Objective To compare the efficacy and safety of mirtazapine and fluoxetine in the treatment of somatoform disorders.Methods 82 patients were randomly divideded into mirtazapine group and fluoxetine group,all the patients were treated for 6 weeks.The efficacy was evaluated with Hamilton depression rating scale and symptom checklist,the side effects were evaluated with treatment emergent symptom scale.Results The total effective rate of the mirtazapine group was 88％.The total effective rate of the fluoxetine group was 80％.There was no difference between the two groups in efficacy (x2 =0.13,P ＞ 0.05).After the first week of treatment,by Symptom checklist,somatization,anxiety and total score of mirtazapine group were significantly lower than the fluoxetine group (t =2.97,3.01,3.73,all P ＜ 0.05).After the sixth week of treatment,somatization,interpersonal,depression,anxiety,fear and total score of mirtazapine group were significantly lower than the fluoxetine group (t =2.01,2.36,3.25,3.62,2.17,3.84,all P ＜ 0.05).Mirtazapine group had no significant adverse drug reactions.Fluoxetine group had four cases of adverse drug reactions.Conclusion Mirtazapine in the treatment of patients with somatoform disorders has more rapid onset and drug side effects is less than fluoxetine.

Objective To set up a novel clinical method for storage of oocytes by slowly freezing and successful pregnancy by intracytoplasmic sperm injection (ICSI). Methods The frozen oocytes (n=33) in metaphase Ⅱ (28),which were normal in morphology,were denuded of their cumulus-corona complex.The protective freezing solution contained 1,2-propanediol (1.5 mol/L) and sucrose (0.35 mol/L) and the process was slow for freezing and rapid for thawing.The recipients of these oocytes received hormone replacement therapy (HRT). Results A high survival rate of oocytes (32/33) was obtained when the sucrose concentration was 0.35 mol/L.ICSI induced a higher fertility rate (23/28),a good embryo cleavage rate (21/23) and a satisfactory embryo morphology for thawed oocytes.Embryo transfers were performed in 6 cycles/6 cases. Four cases got clinical pregnancy by demonstration of four gestation sacs on B ultrasonic examination 7 weeks after ICSI,1 fetal was first trimester spontaneous abortion,another 3 survival fetal were ongoing pregnancy and the first case gestation week is 17 weeks. Conclusions This study is the first successful application of human oocyte cryopreservation in China and this method can increase the survival rate of freezing oocytes.It’s easy to carry out,low in cost and high in the recovery rate of oocytes after thawing.

Objective To investigate the protective effects of angiotensin Ⅱ receptor antagonist losartan on diabetic nephropathy (DN).Methods 37 DN cases complicated by renal insufficiency were divided into two groups which were treated with losartan and enalapril,respectively.Blood pressure,plasma creatinine,blood urea nitrogen (BUN),uricemia,urinary protein and albumin were measured before and at 2,4,8,12 weeks after treatment.Results Losartan and enalapril lowered blood pressure remarkably (P0.05).Losartan decreased uricemia remarkably (P

Objective To analyse the associated clinical findings of newborn infants with HIE after intrauterine asphyxia with normal Apgar scores at birth and follow-up the neurologic sequelae. Methods 30 newborn infants admitted for HIE in Jan.to Dec. 2002 were analysed,they had :(1)intra-uterine asphyxia with Apgar scores of 8～10 at birth,(2)with neurological symptoms on the first day after birth,(3)diseases of infection,genetics and metabolism,and deformity were ruled out,(4)with characteristic findings of HIE on cranial ultrasound examinations and CT scans. Results All of 30 newborn infants had signs of depression from the first day after birth,22 infants of them sometimes were irritable.17 cases (56.7%) with mild encephalopathy and 13 cases (43.3%) with moderate encephalopathy,none of severe case,compared with the infants who had HIE with birth asphyxia,there were no statistical difference. Less than 40% cases had elevated BUN and CKMB,hyponatremia,hypocalcemia,hypoglycemia,acidosis,etc The incidence of them were the same as the infants who had HIE with birth asphyxia. The findings of cranial ultrasound examinations were different between the acute and chronic hypoxic injury of intrauterine asphyxia Follow-up 28 infants at the mean age of (11.7?3.8) months. Except 1 case of cerebral palsy,all of them are normal intelligent infants. There were 4 cases of dilated lateral ventricle and 1 case of dilated 3rd ventricle at birth; 6 cases of dilated ventricles found in follow-up and 1 of them had cerebral palsy,all of those infants recovered at 12～19 months of age. Conclusion Newborn infants who had intrauterine asphyxia without birth asphyxia might suffer from HIE and cerebral palsy later. Cranial ultrasound examinations showed some of them had fetal brain damages. Therefore,intensive care of such infants,preventing and treating intrauterine asphyxia could decrease the morbidity of HIE.

Objective: To investigate association between psychosocial factors and anxious and depressive disorders in patients with diabetes mellitus. Methods: 172 patients with type 2 diabetes were inquired with a self-administered questionnaire about their socio-demographic characteristics, perceived stress caused by the disease, coping styles, social support. At the same time, anxious and depressive disorders were assessed with HAD.Results:Among our sample, 35 (20.3%) patients with anxiety, 33 (19.2%) with depression. After adjusting for gender, age, marital status, educational level and income, multivariate logistic regression analysis found the following results. Perceived stress from "Worrying about to be harmed by the disease"(OR=1.76,95%CI 1.12~2.77),"Social/family crisis caused by the disease"(OR=1.85, 95%CI 1.18~2.92),"Worrying about declining in body/physical function"(OR=2.16, 95%CI 1.28~3.67), "Declined economic condition"(OR=2.03,95%CI 1.27~3.26)and "Negative coping styles"(OR=1.94,95%CI 1.26~2.97)were significantly associated with anxious disorders. The perceived stress from "Social/family crisis caused by disease"(OR=1.79, 95%CI 1.09~2.96), "Worrying about declining in body/physical function"(OR=2.89, 95%CI 1.59~5.24)and "Negative coping styles"(OR=1.95,95%CI 1.23~3.11)were significantly associated with depressive disorders, while patients "Taking avoidant measures"(OR=0.52, 95%CI 0.30~0.90)were less depressive disorders.Conclusion: Anxious and depressive disorders in patients with 2 type diabetes were significantly associated with patients' perceived stress from the disease and their coping styles.

OBJECTIVE To find out the changes of pathogens and their sensitivity to antibiotics in bile samples of patients with biliary tract infection of our hospital during last six years. METHODS The data of 359 strains of microbes found in 371 patients with positive bile culture from Jan 2001 to Dec 2006 and their sensitivity to antibiotics were statistically analyzed. RESULTS There were 84 and 188 positive samples respectively in 140 samples during the first half of this study (2001-2003)and 231 ones during the second half (2004-2006) as well as 105 and 254 strains cultured. Respectively, Gram-negative bacteria accounted for 60.0%, and 50.8% and Gram-positive cocci 34.3%, and 40.2% and fungi 5.7%, and 9.0%; Escherichia coli was the major one and accounted for 36.2%, and 31.1%, with the increasing incidence of the positive rates of its ESBLs (34.2% vs 60.8%, P