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.

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 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.

Objective To study the relationship between cardioembolic stroke and plasma BNP by analyzing the plasma BNP level in cardioembolic stroke patients.Methods The clinical data of 81 patients with acute stroke were collected.According to the TOAST classification,all the patients were diagnosed as non-cardioembolic stroke,including atherothrombotic,lacunar,others etiology and undetermined etiology cardioembolic stroke.Blood samples were drawn on emergency department arrival( within 24 hours) to test BNP( assayed by ELISA).The plasma BNP level between non-cardioembolic stroke and cardioembolic stroke was compared.Results Cardiogenic stroke patients with plasma BNP level( 147.5 ±7.8 ) ng/L,atherosclerotic stroke patients level(51.2 ± 5.8) ng/L,lacunar stroke( 39.5 ±10.0)ng/L.Higher levels of BNP were observed in patients with cardioembolic stroke than other stroke subtypes(t =67.8,23.6,17.6,all P ＜ 0.01 ).Conclusion The plasma BNP could be used for distinguishing cardioembolic stroke from other stroke subtypes and has great clinical significance in etiologic diagnosis of ischemic stroke subtypes.

Objective To determine the bacterial composition and resistance of wound infections in China. Methods Disc diffusion test,MIC test and E-test were used to detect the antimicrohial resistance of bacterial isolates from wound secretions.WHONET 5.4 was applied for analysis of the bacterial sensitive data from 86 domestic tertiary hospitals from June 1,2006 to May 31,2007. Results (1)2125 bacterial strains were coileeted in the survey period,which included 994 strains (46.8%) of Gram positive and 1131 strains (53.2%) of Gram negative bacteria,Staphylococcus(780 strains,36.7%),E.coli(338 strains,15.9%) and Pseudomonas aeruginosa (231 strains,10.9%)were the most common isolates.(2)38.2% and 84.1% of Staphylococcus aureus and Staphylococcus epidermidis were methicillin-resistant.respectively.No Staphylococcus strain was resistant to vancomycin or teicoplanin.(3)ESBLs positive rate of E.coli was about 60%,while the resistant rate to quinolones Was about 70%.(4)The resistant rates of Staphylococci and E.coli isolated from adults to aminoglyeoside and quinolones were higher than those from children.(5)The resistant rates of Staphylococei to cephalosporin,aminoglyeoside and quinolones from inpatients were higher than those from out-patients. Conclusion Staphylococci,E.coli and Pseudomonas aeriginoso were among the most common organisms isolated from wound infections.The ESBLs positive rate of E.coli from wound infections was higher than that from all specimen bacteria found in other surveys performed during the same period and the methicillin resistant Staphylococci were less than that.

Objective To study the incidence of pelvic adhesions in endometriosis(EM) and the relationship between pelvic adhesions and pain symptoms. Methods The incidence of pelvic adhesions, dysmenorrhea, chronic pelvic pain, dyspareunia, dyschizia in 480 patients with EM were studied retrospectively to evaluate the correlation between pelvic adhesions and the degree of pain symptoms. In accordance with the revised American Fertility Society classification (r-AFS), it was observed that 155 cases were in Stage Ⅰ,33 cases were in stage Ⅱ,108 cases were in stage Ⅲ and 184 were cases in stage Ⅳ. Results (1) Among 480 cases with EM, 72.3% (347/480) of patients have pelvic adhesions simultaneously, of which 25.2% (39/155) patients were in Stage Ⅰ, 78.8% (26/33) patients were in Stage Ⅱ, 90.7% (98/108) patients were in Stage Ⅲ and 100.0% (184/184) patients were in Stage Ⅳ. It was found that positive correlation existed between the degree of pelvic adhesions and clinical staging of EM(rs=0.870,P<0.01).(2) 61.0%(293/480) of patients presented dysmenorrhoea, of which the percentages of mild, moderate and severe dysmenorrhea were 52.2%(153/293), 26.6%(78/293), 21.2% (62/293), respectively. The rate of patients presenting chronic pelvic pain (CPP), dyspareunia and dyschezia were 23.8% (114/480), 15.4% (74/480) and 7.1% (34/480), respectively. (3) Ovarian adhesions was positively correlated with dysmenorrhea and CPP(rs=0.367 and 0.267,P<0.01). Adhesion of the bottom and posterior wall of uterus was positively correlated with dysmenorrhea and CPP (rs=0.336, 0.164,P<0.01); adhesions of fallopian tubes were positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.283, 0.225 and 0.159, P<0.01). Adhesions of rectum was positively correlated with dysmenorrhea (rs=0.101,P<0.05). In addition to dyspareunia, the degree of pelvic adhesions was positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.470, 0.273, 0.132, P<0.01). Conclusion Pelvic adhesions are characteristic lesions of endometriosis, the site and degree pelvic adhesions are closely correlated with pain symptoms.

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.