OBJECTIVE To investigate the susceptible factors and the methods of prevention and treatment of nosocomial deep fungal infection in intensive care unit(ICU).METHODS The clinical information of 798 patients in ICU was investigated from Jul 2005 to Jun 2007.The risk factors,species,drug-resistance and the methods of prevention of fungal infection were analyzed.RESULTS Fungal infections were found in 137 cases(17.2%).The lower respiratory tract accounted for 72.3% in 137 cases with fungal infection.A total of 180 strains of fungi were isolated,Candida albicans,C.tropicalis and C.glabrata accounted for 43.3%,25.6% and 23.3%.The resistance characteristics to fluconazole,itraconazole,5-fluorocytosine and amphotericin B were relatively weak.The factors related to nosocomial fungal infection were the severity of the underlying disease,long-term use of antibiotics and glucocorticoid and invasive procedure.CONCLUSIONS Proper use of antibiotics and immuno-depressor,reduction of unnecessary operation and early diagnosis are the keys in prevention of systemic fungal infection.

OBJECTIVE To investigate the distribution and tendency towards drug resistance of Candida albicans which causing clinical deep infection and to supply data to clinical treatment. METHODS The distribution and tendency towards drug resistance of C. albicans isolates from infected patients from Jan 2007 to Dec 2007 were analyzed retrospectively.RESULTS All 1698 strains of Candida were isolated from patients sputum,urine,blood,secretion,etc. From 1075 cases with C. albicans,965(89.8%) strains were isolated from sputum. The resistance rate to nyststin,fluconazole,itraconazole,5-fluorocytosine and amphotericin B were 3.9%,3.6%,2.5%,0.5% and 0,respectively. The factors related to nosocomial C. albicans infection were the use of antibiotics and condition,invasive procedure,physical fitness,age,basic state of patients,etc.CONCLUSIONS The incidence and resistance of C. albicans infection in a hospital have increasing by years. Proper use of antibiotics and immunodepressors,reduction of unnecessary operation,and early diagnosis and treatment are the keys in preventing from systemic C. albicans infection.

Objective To observe the effect of small dosage of perphenazine(2～6 mg)on psychotic symptoms of senile dementia.Methods 31 senile cases with psychotic symptoms after dementia(Alzheimer disease or vascular dementia)accepted small dosage of perphenazine in addition of the conventional therapy.They were assessed with Sadoz Clinical Assessment Geriatric(SCAG)and Treatment Emergent Symptom Scale(TESS).Results The score decreased 50%～75%(markedly improved)in 2 cases,25%～50%(improved)in 22 cases,lower than 25%(no improved)in 7 cases.Some mild emergent symptoms have been observed.Conclusion Small dosage of perphenazine is safe and effective in treating psychotic symptoms of senile dementia.

Objective To explore the treatment effect and comfort of colostomy surgery with fecal water der-matitis around stoma after application of multilayer soft silicone dressings.Methods Approved by the Hospital Ethics Committee and the patients'informed consent,120 patients were divided into the hydrocolloid dressings group ( the control group) and multi-layer soft silicone dressing group (the treatment group),60 cases in each group.Before treatment,after treatment 24h and 36h,DET score,GCO score and the treatment effect were evaluated.Results After treated for 24h,the DET,GCO scores and treatment effects ( in the control group,cured in 3 cases,effective 45 cases, in the treatment group 5 patients were cured,effective in 46 cases) had no significant differences between the two groups (t=-2.624,P>0.05,t=-0.429,P>0.05,χ2 =0.519,P>0.05).After treated for 36h,the DET,GCO scores and treatment effects ( in the control group:cured in 29 cases,effective in 25 cases,in the treatment group:51 patients were cured,effective in 9 cases) had significant differences between the two groups ( t=-5.022,P<0.01,t=12.784,P<0.01,χ2 =6.316,P<0.05).Conclusion Colostomy fecal water dermatitis around stoma after application of multilayer soft silicone dressings can significantly improve the patients'comfort.

Objective To evaluate the validity, reliability and feasibility of Chinese version of Aggressive Behavior-Teacher' s Checklist (TCL) among preschool children. Methods TCL was translated and administered with Child Behavior Checklist (CBCI)-aggressive subscale to 148 preschool children in Shanghai. Validity and reliability of TCL was evaluated using standard psychometric analyses. Results Each item of Chinese version of TCL was significantly correlated with the subscale it belonged to(P<0. 01). The criterion validities of reactive aggressive subscale and proactive aggressive subscale among boys and girls were from 0.491 to 0. 733. The construct validity was also confirmed by factor analysis with 78.489% variance explained by two factors. Cronbach's alpha of TCL and its two subscales were 0. 891,0. 814, and 0. 880 respectively. The test-retest reliability and the inter-rater reliability coefficients of reactive aggressive subscale and proactive aggressive subscale were all above 0. 7. Conclusion Chinese version of Aggressive Behavior-Teachers Checklist has good validity and reliability among preschool children in Shanghai, and can be applied in kindergartens and schools to evaluate and deal with aggressive behavior among these children.

Objective To explore the epidemiological characteristics of nonalcoholic fatty liver disease (NAFL)and relationship with main chronic diseases in Xuanwu district community of the elderly.Methods 6 779in the elderly physical examination,unified health questionnaire,physical examination,measurement of body mass index,blood pressure,fasting blood glucose,liver function,blood lipids,abdominal B-ultrasound to calculate prevalence of NAFL rate,and its related factors were analyzed.Results NAFL prealence was 38.7％,NAFL group of overweight and obesity,diabetes,high blood pressure,dyslipidemia was significantly higher than the control group.Conclusion NAFL rate was high,and it has close relationship with the metabolic syndrome,NAFL should be placed in community mainly chronic diseases of prevention and control category.

Objective This study is to investigate cytokine pathway,Jak-Stat signal pathway,neuroactive ligand-receptor pathway gene expression pattern of peripheral blood mononuclear cell(PBMC) of primary sjgren syndrome patients.Methods The PBMC sample of 3 patients with sjgren syndrome and 3 healthy volunteers with consistent age were collected.The total RNAs was extracted from the PBMC samples,and reverse transcripted in vitro transcription(IVT),labeled with Cy5/Cy3 and hybridized on the gene chips.After scanning and data extraction with LuxScan 3.0,differentially expressed genes were analyzed with SAM method.The online tool of molecule analysis system(MAS) was used for biological knowledge mining.Results Statistical difference was calculated between the patient and control group in the following three pathways: cytokine pathway,Jak-Stat signal pathway,neuroactive ligand-receptor pathway.Among these,genes of IL-2RA,IL-10 were up-regulated and genes of PF4,GZMA were down-regulated.Conclusion Understanding of differently expressed genes should help us disclose the potential molecular mechanism underlying the development process of pathogenesis of primary Sjgren′s syndrome.And the research may provide new target therapy for SS.

Objective:To explore social support and personality characteristic of patients with clinically chronic pains to provide a new idea for clinical psycho-intervention.Method:45 patients with clinically chronic pains were evaluated by the Symptom Checklist(SCL-90),EPQ and SSRS,and compared with the control group.Results:Somatization,interpersonal sensitivity,anxiety,fear and psychotic factors have significant differences from those of the control group when being compared(p

Objective To evaluate the effect of integrated service platform of extensional care based on the combined internet and extensional care model in the orthopedics nurse care. Methods Two hundred and eighty six hospitalized patients in the orthopedic department were randomly divided into two groups including experimental group (144 cases) and control group (142 cases) according to the random number table method. Patients in the control group received extensional care by traditional telephone follow-up, patients in the experimental group received extensional care by using the integrated service platform combing internet and extensional care. All the patients were evaluated using the self-made extensional care satisfaction questionnaire and Short Form 36 Questionnaire. Results The extensional care satisfaction scores of experimental group using internet plus extended care mode were respectively ( 74.4 ± 5.3) points and (76.2 ± 8.1) points at the time points of 3 months and 6 months after discharge from hospital;The extensional care satisfaction scores of control group were respectively (69.4±9.9) points and (70.1±12.2) points at the time points of 3 months and 6 months after discharge from hospital;The two groups had statistically comparative difference (t=7.40, 6.37, P<0.01). There was a statistically significant improvement of extensional care satisfaction and physical function score and role-physical score and social function score in the experimental group compared with the control group both at the time points of 3 months and 6 months after discharge from hospital. There was a statistically significant improvement of vitality score and role-emotion score in the experimental group compared with the control group both at the time points of 1 month and 3 months after discharge from hospital (t=2.366-8.211, P<0.05). Conclusions The effect of integrated service platform of extensional care based on the combined internet and extensional care model is better than traditional telephone follow-up, patients′satisfaction is higher. This new mode of service platform could greatly deepen the connotation of quality nursing, intensify the effect of extensional care, and reduce the working strength of nurse who did extensional care as while.

OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in ICU,then instruct clinical application of antibiotics reasonably.METHODS The identification of bacteria,isolated from patients in ICU from Jan 2005 to Dec 2006,and antibiotic susceptibility by ATB expression were used.RESULTS A total of 1197 pathogens strains were isolated,Gram-negative bacilli,Gram-postive cocci and fungi accounted for 64.2%,19.6% and 15.8%,respectively.The most common pathogens of them were Pseudomonas aeruginosa(22.1%).Except Escherichia coli(40%),the rate of the ESBL-producing strains of Serratia marcescens,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae were higher than 70%.The most common pathogens of Gram-postive cocci were Staphylococcus.Meticillin-resistant strains of Staphylococcus aureus accounted for 93.8%.Mainly pathogenic bacteria were multi-resistant to some antibiotics.There were 189 strains fungi.And all the fungi were sensitive to amphotericin B,fluconazole and ketoconazole.CONCLUSIONS The infection and multi-drug resistance of pathogens are serious in ICU.It′s important and urgent to carry out surveillance of bacterial resistance for appropriately using antibiotics.