Objective To investigate the rehabilitation role of family-community-hospital rehabilitation management for communityschizophrenics. Methods 110 schizophrenic patients were divided into the control group (n=60) and the training group (n=50). The controlgroup were followed up once a month, while the training group participated in the family-community-hospital rehabilitation care. They wereassessed with Social Disability Screening Schedule (SDSS), General Well-Being Schedule (GWB), Self-Esteem Scale (SES) before and afterthe treatment, as well as the compliance and management of medcine questionnaire. Results No significant difference was found betweenthese groups with SDSS, happiness, self-esteem, compliance and management of medcine before the training(P>0.05), but were significantlyhigher in the training group(P<0.01). Conclusion Family-community-hospital rehabilitation management can significantly improvethe social function, the happiness, the self-esteem, the medication compliance and self-management of schizophrenia patients.

objective To compare the technical survival between Tenckhoff double-cuffed straight catheter (TC)and swan-neck curled tip catheter (SNC) in peritoneal dialysis (PD). Methods Clinical data of 208 patients received PD in the Peritoneal Dialysis Center of Peking Union Medical College Hospital from January 1999 to December 2007 were analyzed retrospectively. All the patients were divided into two groups according to indwelling catheter. Technical survival and complications associated with the catheter between two groups were compared. Results Demographics and basic information were similar in both groups. The exit-site infection (ESI) rates of TC and SNC were 22.1% and 19.8% (P=0.786), and peritonitis rates of TC and SNC were 31.1% and 22.1% (P=0.159), which were slightly lower in SNC group, but the difference was not significant. Removal of the catheter was found in 27 (13.0%)patients, including 17 cases in TC group (13.9%) and 10 cases in SNC group (11.6%)(P=0.680).The median survival times of catheter in TC group and SNC group were 25 months and 22 months respectively without significant difference (P=0.103). Conclusions There are no significant differences of ESI rate, peritonitis rate and catheter survival between these two catheters in PD. The expensive swan-neck catheter offers no additional advantage. Doctors should choose the catheter according to the economic status of patients.

Objective To analyze the characteristics of lethal peritoneal dialysis related peritonitis and to define the risk factors.Methods All patients who developed PD related peritonitis between Jan.1999 and May 2015 in PUMCH were included.Clinical profiles were collected.Patients were divided into mortality group(n=16) and non-mortality group(n=182) according to whether peritonitis causing mortality.Baseline clinical profiles were compared between two groups.Cox regression analysis was used to define the risk factors for mortality.Results White blood cells [(10.2±6.3)×109/L vs (5.8±1.8)×109/L,P<0.05] increased,but serum albumin[(25.2±8.5)g/L vs (34.0±6.3)g/L,P<0.05] and potassium concentration [(3.5±0.9)mmol/L vs (4.5±1.0)mmol/L,P<0.05] decreased at the time of lethal peritonitis bacteria and fungus cultures were positive in half of the patients as bacteria (31.2%),fungus (12.5%)and mycobacterium tuberculosis (6.25%).Multiple cox regression analysis identified cardiovascular disease as the independent risk factor for peritonitis related mortality (HR 9.318,95% CI 1.875~46.305,P<0.01).Conclusions Peritonitis of patients with cardiovascular disease may cause death.

Objective To observe the clinical parameters, self-management, and compliance in peritoneal dialysis (PD) patients before and during Spring Festival, and to describe holiday syndrome in PD patients.Methods We prospectively observed PD patients with regular follow-up in our center before Chinese Spring Festival (January 8-February 7, 2016) and during Chinese Spring Festival (February 8-March 8, 2016).Demographic and clinical characteristics, self-management, and compliance with its influencing factors were collected by face-to-face method in outpatient care.Results Totally 130 PD patients were enrolled.The average age was (58.5±15.4) years, and women accounted for 53.1％.The primary diagnosis was diabetic kidney disease (32.3％), followed by primary glomerulonephritis (26.2％).Fourteen patients (10.8％) received automated peritoneal dialysis (APD), and most of the remaining patients chose continuous ambulatory peritoneal dialysis (CAPD,73.8％), with a median dialysis age of 34 months.During the 4-week followed-up, the appetite was stable, while the serum phosphate and pre-albumin increased [(1.5±0.4)mmol/L vs.(1.6±0.4)mmol/L, P=0.025;325.3 (272.2,355.1)mmol/L vs.326.0(284.2,376.5)mmol/L, P<0.01, respectively].No difference was observed in edema, dyspnea, and nighttime lying flat.However, the weight elevated significantly [(61.3±13.9)kg vs.(63.4±13.0)kg, P=0.002], with the median peritoneal ultrafiltration volume increased from 783.3 ml to 900.0 ml (P=0.005).During the holiday, the incidences of dialysis-related infections were unchanged, while the incidences of digestive system comorbidities increased significantly (5.4％ vs.13.8％, P=0.021).As for the compliance, 8 patients reduced their PD cycles during the holiday, which was more frequent than before holiday (P=0.018).One patient changed his PD pattern, and 6 patients did not follow the medication orders.Demographic characteristics such as gender, age, and marriage conditions were not associated with the compliance.Conclusions Holiday syndrome remarkably affects PD patient''s volume load, metabolism, and compliance.Poor self-management of PD patients during holidays needs further concern.

Objective To explore the effects of the community-based rehabilitation on schizophrenia. Methods 100 patients with schizophrenia from 4 communities were assigned to intervention group (n=50) and control group (n=50). The intervention group accepted comprehensive intervention for 6 months. All the patients were followed up for 12 months, and assessed with the Positive and Negative Symptoms Scale (PANSS), Personal and Social Function Scale (PSP), the General Quality of Life Inventory (GQOLI-74). Results 48 cases of the intervention group and 44 of the control group finished the study. The scores of negative symptoms and general spirit pathology were less in the intervention group than in the control group (P<0.01). The score of PSP was more in the intervention group than in the control group (P<0.01), as well as the total score and score of dimensions of physical function, mental health and social function (P<0.05). Conclusion Community-based rehabilitation can control the mental symptoms, and improve the social function and the quality of life of patients with schizophrenia.

Objective To explore the clinical curative effect of pre cut type perforated patellar needle combined with tension band steel wire internal fixation minimally invasive in the treatment of patellar transverse fracture. Methods A total of 67 cases of patients with patellar transverse fracture were treated with pre cut with holes patellar needles com-bined with tension band wire fixation of minimally invasive, the fracture degree,joint activity,knee functional score and incidence of complications were observed and analysised. Results Postoperative knee function score, the excellent and good rate was 92.5%was significantly higher than the preoperative 9.0%,postoperative knee activity, excellent rate was 90.0% significantly higher than the preoperative 6.0%,postoperative X piece shows the alignment score the excellent rate of 100%was significantly higher than the preoperative 11.0%fractures ,the differences were statistically significant (P<0.05),the incidence of complications of patients was 9.0%. Conclusion Pre cut type perforated patellar needle combined with tension band steel wire internal fixation minimally invasive in the treatment of patellar transverse frac-ture is be conducive to the fracture and recover the function of knee joint,the incidence of complications of patients is low, witch is the practical operation in treatment of patella fracture.

Objective: To analyze the clinical data of the elderly peritoneal dialysis (PD) patients in Peking Union Medical College Hospital (PUMCH), and to find the risk factors for the long-term survival. Methods: Baseline data and the outcome of maintenance PD patients from 1996-03 to 2015-09-30 were collected for a retrospective cohort study. Patients were divided into the non-elderly group (<65 years old), the 65-79 years old group and the ≥80 years old group, and were follow to 2016-09-30. The survival rate was calculated by Kaplan-Meier method and the risk factors of outcome were analyzed by the Cox's regression model. Results: Among 577 PD patients, about 243(42.1%) were elderly patients, including 207 patients aged between 65 and 79 years (35.9%) and 36 patients aged 80 or more (6.2%). The most common primary disease causing PD was diabetic nephropathy (DN) for both elderly and non-elderly patients. The 1-year, 3-year, 5-year survival rate of patients aged between 65 and 79 years were 87.0%, 61.9%, 32.4% respectively, and 72.5%, 48.5%, 27.3% for the ≥80 years old group. The dominating reasons of death were cardiovascular events and infection. There was no difference of technical survival rates among three groups, and the most common reason for technical failure was peritonitis. For elderly patients, diabetes (HR=2.193, 95% CI 1.445-3.328, P<0.001) and lower baseline serum albumin (HR=0.968, 95%CI 0.940-0.996, P=0.026) were independent risk factors for death. However, for non-elderly patients, diabetes (HR=3.746, 95%CI 2.149-6.529, P<0.001) was the only independent risk factor for death. Conclusions Cardiovascular diseases and infection are the main reasons for death among the elderly PD patients in PUMCH. Diabetes and lower baseline serum albumin may predict the mortality of elderly PD patients independently. Better management of nutrition might improve survival in elderly PD patients.

At present, the cats play a more and more important role in medical experiments as an experimental animal,especially for the studies of neurology,physiology and toxicology. Compared with rodent animals,the physiological characteristics, anatomical features, pathological and biochemical reactions of cats are closer to human beings, and compared with the primate animals,they have advantages of economy,abundant resources and so on. Therefore,cat has an extensive application prospect in animal models of human diseases. This article mainly reviews and summarizes the establishing method and research status of cats as an animal model of human diseases in ophthalmology, nervous system, tumor and other fields in recent years.

Objective Explore differences in the cognitive abilities of socially different Labradors.Methods The dog mentality assessment(DMA)test created by the Swedish Working Dog Association was modified to employ 12 behavioral variables from five subtests of the DMA test,social contact,play Ⅰ,distance-play,ghosts and play Ⅱ,to assess sociability of the dogs.In accordance with the scoring criteria,49 labradors provided by the China Guide Dog Training Centre in Dalian were scored on the social behavioral variables and classified into high(n=15)and low(n=34)sociability groups by cluster analysis.A new system to test canine cognitive ability was developed using the dog cognitive development battery,which tests various domains of cognitive ability such as social cue use,unsolvable task,inhibitory control,cognitive flexibility,working memory,and multistep problem solving task.The dogs'behavioral performance and duration of the test were also recorded.Statistical analysis was performed to determine assess differences in the cognitive abilities of socially diverse dogs.Results Dogs in the high and low social subgroups differed significantly in behavioral variables of the unsolvable task,inhibitory control test,and multistep problem solving task.In the unsolvable task,dogs in the high social group looked at people for significantly longer than dogs in the low social grouping(P=0.008)and looked at people with significantly less latency time than dogs in the low social group(P=0.0001).In the inhibitory control,dogs in the high social group chose significantly more correctly than dogs in the low social group(P=0.034)and chose for significantly less time than dogs in the low social group(P=0.039).In the multistep problem solving task,for dogs in the high social group.successfully completed number of stakes was significantly higher than for dogs in the low social group(P=0.044).The percentage of operation pale time was significantly lower than for dogs in the low social group(P=0.05).The average latency time to solve the bone task was significantly higher than for dogs in the low social group(P=0.037).Moreover,the percentage of operation bone time was significantly lower than for dogs in the low social group(P=0.038).In tests involving a manipulable apparatus,dogs in the high social group spent more time looking at people than dogs in the low social group and less time manipulating the apparatus than dogs in the low subgroup,but no statistically significant differences were observed(P＞0.05).Conclusions Highly sociable labradors have a greater cognitive ability,they are more able to suppress impulses during tests,more able to complete the multistep problem solving task,and more inclined to change strategies to seek new cues from people rather than obsessing over manipulating the apparatus when they are unable to solve a problem.

Renal replacement therapy and perioperative management have difficulties in hemophilia patients with end-stage renal disease. The paper summarized the diagnosis and treatment experience of six hemophilia patients complicated with end-stage renal disease from January 1, 2000 to March 31, 2023 in Peking Union Medical College Hospital. Among 6 patients treated with peritoneal dialysis, 3 were treated with hemodialysis or continuous venous-venous hemodialysis. Altogether 11 dialysis access procedures were conducted successfully, and no serious bleeding or thrombotic events. In further conjunction with literature review, the paper summarized the key points of dialysis access appliance relevant to such patients, to provide reference for renal replacement treatment paths.