Objective The purpose of this trial was to appraise the effects of both recognition-insight therapy and family education on rehabilitation of patients with schizophrenia. Methods 140 outpatients with schizophrenia were randomly divided into two groups (70 patients in each group). The family group was trained with recognion-insight therapy and family education while the control group only received services at outpatient department. During a three-year follow-up period, both groups were conformed with the schizophrenic diagnostic criteria of BPRS, CGI, SDSS and the self-made gauge. Results Both at the end of the 1st and the 3rd year, the family group was lower than the control group on scores of every gauge (P <0.01 ). On the other hand, the therapy compliance of the family group was significantly higher than the control group (P<0.01 ). Both relapse rates of the end of the Ist year and 3rd year (19.4%, 32.2%) were excessively lower than the control group (46.9%, 74.5%) (P<0.Ol ), while the family group's social function fine rate (73.1% , 62.7% ) was significantly higher than that of the control group (39.1% , 20.0%) (P<0.01). Conclusion The recognion-insight therapy and family education performed pivotal role in the rehabilitation of patients with schizophrenia.

Objective:To explore influence of walking training on pulmonary function and blood glucose in aged pa‐tients with type 2 diabetes mellitus (T2DM) .Methods :A total of 163 T2DM patients treated in our department were selected .According to number table ,they were randomly divided into routine group (n= 80 ,performed DM diet and routine insulin therapy strictly ,and lived as usual) and intensive group (n=83 ,received intensive walking train‐ing based on strict DM diet and routine insulin therapy ,namely walking ≥10000 steps/d for eight weeks) .Pulmona‐ry function and blood glucose indexes were compared between two groups before and after intervention .Results:Compared with before treatment ,after treatment ,there was significant rise in pulmonary function and significant reductions in blood glucose indexes in intensive group , P<0.01 all;compared with routine group after treatment , there were significant rise in vital volume [(2622.0 ± 323.3)ml vs .(2987.0 ± 405.6)ml] ,forced expiratory volume in one second [(2003.0 ± 279.7)ml比(2392.0 ± 323.6)ml]and vital volume/body weight [(44.0 ± 4.2) ml/kg vs . (47.0 ± 4.7) ml/kg] ,and significant reductions in levels of glycosylated hemoglobin A1c [(5.63 ± 2.63)mmol/L vs . (3.82 ± 1.41) mmol/L] ,fasting blood glucose [(7.90 ± 1.41) mmol/L vs .(5.28 ± 1.18) mmol/L]and 2h postpran‐dial blood glucose [(10.48 ± 1.43) mmol/L vs .(8.09 ± 1.68) mmol/L]in intensive group , P<0.01 all .Compared with before treatment ,there were no significant changes in above indexes in routine group after treatment , P>0.05 .Conclusion:As a low intensity aerobic exercise ,walking training can effectively improve pulmonary function , glucose metabolism in aged patients with type 2 diabetes mellitus ,it is help to improve quality of life .

Objective To evaluate the clinical value and safety of radiotherapy combined with tyrosine kinase inhibitors (TKI) in non-small cell lung cancer (NSCLC) with brain metastasis driven by epidermal growth factor receptor (EGFR) mutation.Methods A retrospective cohort of 21 non-small cell lung cancer (NSCLC) patients with EGFR mutation-driven brain metastasis was recruited.10 patients (treatment group) were randomly selected for radiotherapy combined with TKI treatment,and 11 patients (control group) were treated with radiotherapy.Tumor size was measured and clinical efficacy was evaluated by MRI in the four weeks after radiotherapy.Since then,a clinical response was evaluated every three months until disease progression,and the median overall survival time was calculated.Results The objective remission was 8 cases in treatment group and 4 cases in control group.The disease control was 9 cases in treatment group and 8 cases in control group.The median overall survival time of treatment and control groups was 11.2 months and 6.4 months,respectively.Adverse reactions in treatment group mainly contained nausea,diarrhea and rash,which all were tolerated.Conclusion Radiotherapy combined with TKI is superior to radiotherapy alone in effect and safety for treatment of NSCLC with EGFR mutation-driven brain metastasis.

BACKGROUND: With wide application of biotechnological substitute materials, pelvic repair and reconstruction develop to a certain degree. Biomaterial patch is a major substitute for repairing injured pelvic fascia tissue, so it is widely used for pelvic reconstruction.OBJECTIVE: To investigate the feasibility, efficacy, and clinical value of biomaterial patch to pelvic reconstruction in the females.METHODS: Articles related to pelvic functional disorder, pelvic reconstruction, and application of patch implant were retrieved from PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and (http://www.wanfangdata.com.cn) with the key words of "reconstruction of whole pelvic floor, mesh, synthetic mesh implants" in both Chinese and English between 1990 and 2008. Duplication studies were excluded. A total of 54 articles were initially retrieved, and 17 ones were included in the final analysis.RESULTS AND CONCLUSION:Pelvic organ prohpse, which was a major symptom of pelvic disorder in the females, caused by defect of pelvic supporting structure, injury, and functional disorder. Traditional operation could not solve fundamental question.At present, substitute materials for pelvic repair and reconstruction mainly include biomaterial patch (self-substitute materials, homogeneity substitute materials, and heterogeneity substitute materials) and artificial patch. All of them could substitute the injured pelvic fascia tissue; therefore, they were major substitute materials of pelvic tissue and widely used for pelvic reconstruction. Patch which was used for pelvic reconstruction realized the recovery of anatomic structure and caused functional recovery, with simple and easy processing. Additionally, patch application did not prolong operative time and cause complication, but induced well tolerance, security and reliability, and remarkable short-term effect on patients. However, the long-term efficacy should be further studied. The modified pelvic reconstruction is clinically valuable for patients with varying prolapsed sites.

OBJECTIVE To investigate the antibacterial resistance of clinical isolates from inpatients of non-ICU departments in China in 2006-2007.METHODS Clinical isolates were collected by member hospitals of Mohnarin according to unified protocol.Bacterial susceptibility testing was carried out using Kirby-Bauer(KB),MIC or E-test methods according to CLSI 2006.The data were analyzed by WHONET 5.4 software.RESULTS A total of 77253 clinical isolates from inpatients of non-ICU departments in Mohnarin member hospitals were collected from Jun 2006 to May 2007,of which Gram-negative bacteria accounted for 53549(69.3%),and Gram-positive cocci for 23704(30.7%).Meticillin-resistant Staphylococcus aureus(MRSA) and coagulase-negative Staphylococcus(MRCNS) strains accounted for 57.6% and 83.3%,respectively.There was no glycopeptide-resistant Staphylococcus to be found,but small part of coagulase-negative Staphylococcus was teicoplanin intermediate or resistant.50.9% Of Enterococcus faecalis and 69.9% of E.faecium strains were resistant to high concentration gentamicin.1.1% And 2.7% of E.faecalis and E.faecium isolates were resistant to vancomycin,0.8% and 2.7% resistant to teicoplanin.There were 9.9% isolates of Streptococcus pneumoniae were penicillin-nonsusceptible.About 34.5% Escherichia coli and 23.5% Klebsiella pneumoniae isolates were ESBLs-producing strains.Isolates of Enterobacteriaceae were still highly sensitive to imipenem and meropenem,the average resistant rate was less than 2%.There were about 70% E.coli isolates resistant to quinolones,and 20-60% of non-fermentative Gram-negative bacilli were resistant to antibacterials.CONCLUSIONS Bacterial resistance is severe in inpatients in our country,and the resistant rates are increasing.More effective measures should be taken

Objective To explore the perioperative nursing method and effect of doing minimal invasive occlusion to children with congenital heart disease via subaxillary incision.Methods The data of 86 children patients with congenital heart disease underwent minimally invasive occlusion via right subaxillary incision were retrospectively analyzed and summarized nursing points including preoperative and postoperative mental nursing,postoperative postural care and sedative care,observing whether the occluder moved or detached and mechanical hemolysis,monitoring ECG and blood pressure,and preventing hemorrhage and thrombogenesis.Results One case of infracristal ventricular septal defect with frequent premature ventricular beat after occlusion was converted to thoracotomy surgery;one case of mixed atrial septal defect with heart rate increasing and dyspnea after 12 hours of occlusion was found occluder detached and immediately converted to remove the occluder and fix the atrial septal defect;The other children were successfully recovered and been discharged.Conclusions Full understanding and strengthened perioperative nursing care of complications of children with congenital heart disease after surgical minimally-invasive surgical closure is the key point to avoid the occurrence of fatal complications and ensure the children recover safely and smoothly.

Objective To investigate the effect of high glucose on the expression of transforming growth factor-?1(TGF-?1),?-SMA,E-Cadherin in renal proximal tubular epithelial cells(HKCs)and role of AG490,an antagonist of Janus kinase.Methods Cultured HKCs cells were divided into four groups:low glucose group(LG),high glucose group(HG),high mannitol group(LG+M),and HG+AG490 group(AG).Immunoprecipitation and Western blot analysis were used to measure the expressions of tryosine phosphorylated Janus kinase 2(p-JAK2),STAT1,STAT3,p-STAT1,p-STAT3 and ?-SMA,E-Cadherin.The contents of TGF-?1 and type I collagen in the supernatants of the cultured HKCs were detected by ELISA.TGF-?1 mRNA were measured by RT-PCR.ResultsCompared with low glucose control group,the expressions of JAK2,p-STAT1,p-STAT3 and TGF-?1 mRNA were significantly increased in HG group from 6 to 72 h.Meanwhile,the contents of TGF-?1 and collagen I in the supernatants and the expression of ?-SMA were increased,the expression of E-Cadherin was decreased.The expression of JAK2,p-STAT1,p-STAT3 and TGF-?1 mRNA and the level of TGF-?1,collagen I in the supernatant s in HG+AG490 group were obviously lower than those of the HG group.The expression of ?-SMA and E-Cadherinwas also decreased in HG+AG490 group.Conclusion Activation of JAK/STAT signaling pathway seems to be involved in the high glucos induced overproduction of TGF-?1 and ECM proteins in HKCs.

Functional dizziness is one of the most frequent functional disorders in adult patients.The termfunctional dizziness is not a nosological entity,but comprises several diagnoses.This study is aim to summarize the typical symptoms of functional dizziness and signs and symptoms of non-functional dizziness.

Objective To investigate the bacteriological features and the epidemiology of methicillin－ resistant Staphylococcus aureus (MRSA) in patients with impetigo, and provide evidence for selection of appropriate agents for treating impetigo and its complications. Methods Two hundred and forty－ six out- patients with impetigo were surveyed. Cultures were obtained from impetiginous lesions. Antibiotic susceptibility tests on 212 S.aureus isolates were performed by standard agar dilution testing (MIC). Results In a total of 246 isolates, 87.0％ yielded S.aureus alone, 2.0％ S.aureus and Group A beta－ hemolytic streptococcus (GABHS), 1.6％ GABHS alone, 4.1％ Staphylococcus epidermidis. Fifteen antimicrobial agents were used in the susceptibility tests. One hundred percent of S. aureus isolates were resistant to penicillin, 87.7％ were resistant to erythromycin, followed by clindamycin (75.5％ ), tetracycline (63.2％ ), chloramphenicol (54.2％ ), ampicillin－ sulbactam (44.8％ ), oxacillin (30.2％ ), ciprofloxacin (12.8％ ), cefotaxime (0.9％ ), fusidic acid (0.9％ ) and gentamicin (0.9％ ). None of the S.aureus isolates was resistant to vancomycin, cefazolin, cefuroxime and mupirocin. Sixty- four MRSA strains were isolated. No vancomycin resistant S.aureus strain was found. Conclusions Penicillin, erythromycin, clindamycin, tetracycline, chloramphenicol and ampicillin－ sulbactam prove to be no longer the appropriate therapeutic agents. Cephalosporin, mupirocin and fusidic acid might be the good choice for treatment of impetigo in our region.

BACKGROUND: Many factors can lead to a large area of skin defects, and tissue-engineered artificial skil transplantation composed by seeding cel s and scaffold materials can be used for skin defect repair. OBJECTIVE: To construct the skin implantation scaffold based on human epidermal stem cel s combined with acel ular dermal matrix in nude mice. METHODS: Human epidermal stem cel s from children’s foreskin were isolated and cultured, and the skin of nude mice was obtained to prepare acel ular dermal matrix scaffold. Then, the human epidermal stem cel s were cultured on the acel ular dermal matrix scaffold to construct artificial skin. Ten Sprague-Dawley rats were equivalently randomly divided into two groups: rats treated by human epidermal stem cel s combined with acel ular dermal matrix scaffold as combined group, and those treated by simple acel ular dermal scaffold as acel ular dermal scaffold group after skin defect models were prepared. RESULTS AND CONCLUSION: The artificial skin was milky white, soft and elastic, not easy to break, and has good flexibility, and good plasticity, and could be processed into different shapes. No obvious exudation appeared in the rat wound of two groups after repair. At 2 weeks after modeling, the transplanted skin showed good growth and skin wound healed gradual y in the combined group. In contrast, scar healing and two animals with transplant failure occurred in the acel ular dermal scaffold group. These results show that human epidermal stem cel s combined with acel ular dermal materials in nude mice can construct the tissue-engineered skin, which exerts good repair effects for skin defects in animals.