Objective To investigate the situation and demands of the nursing services for both urban and rural elderly people with chronic diseases in China,so as to provide basis of establishing the new elderly care mode. Methods 1902 urban and rural elderly with chronic diseases in almost 29 provinces had been enrolled by the convenience and stratified sampling method to complete the investigation. Results The utilization of relevant nursing care and the demand of psychological counseling and hospice care in cities and towns were higher than those of villages.The demand of common chronic diseases in towns were all higher than that in cities and villages.The demand of pain management in cities wee lower than that in towns and villages.73.3％ of elderly in the survey will choose community to subsequent recovery after discharge.The physical,psychological health and economic status might be the pivotal factors. Conclusions At present,endowment in community becomes an inevitable trend in China.Meanwhile,there are still lots of problems in our community health care services,so it remind relevant staffs that some measures should be taken to change such situations.

Objective To investigate the etiology, diagnosis and treatment of pneumocystis cari-nii pneumonia (PCP) at early stage after orthotopic liver transplantation (OLT). Method The clinical data of 276 patients undergoing OLT were retrospectively analyzed and those of 6 cases complicated with PCP were summarized from January 2005 to December 2005. Results The morbidity of PCP in our group was 2.17% and occurred in early stage after OLT. The average time on set was (11.17?2.50) days and uneasily controlled hypoxemia was the main manifestation. The diagnosis of PCP was established by clinical symptoms, chest X-ray, chest CT, pneumocystis carinii PCR detection and visualization of PC encysts from sputum samples under a microscope. SMZco was the initial choice of treatment combined with immunosuppressive regimen regulation. Five cases were cured and 1 case died from septic shock. Conclusion PCP can occur among OLT patients in the early stage, and aggressive early diagnosis and treatment were critical to improve the prognosis.

Objective To improve the performance of triazene reagent, the synthesis of benzothiazolyl_2_aminoazo_4_methyphenyl (BTDAPMP) and its color reaction with titanium were studied in this paper. Methods BTDAPMP was applied to determination of trace titanium in human hair by spectrophotometry. Results In the presence of cetylpyridiniumbromid (CPB), Ti(Ⅳ) reacted with BTDAPMP to form a stable complex in a HAc_NaAc buffer solution at pH 5.5. The ratio of the amount of Ti(Ⅳ): BTDAPMP in the complex was found to 1∶2. The chromogenic reaction was completed within 5 min, and a steady color reaction was maintained for at least 4 h. In the color reaction, the apparent molar absorptivity was 1.21?10 5 L/(mol?cm) at 625 nm wavelength, Beers law was obeyed in the concentration range of 0～0.24 mg/L for Ti(Ⅳ). In the determination of trace Ti(Ⅳ) in human hair, the relative standard deviation (RSD) was less than 5% (n=7), the detection limit was 1.06?10-9 g/ml. Conclusion This method was highly sensitive and selective in determination of trace Ti(Ⅳ) in human hair.

OBJECTIVE: To observe the effects of Kangfengshi Granules (KFSG) on expressions of the mRNAs of osteoprotegerin (OPG), receptor activator of nuclear factor-kappaB ligand (RANKL) and macrophage colony stimulating factor (M-CSF) in bone tissues of rats with collagen-induced arthritis. METHODS: Forty SD rats were randomly divided into four groups: normal control group, untreated group, cyclosporine A (CsA)-treated group and KFSG-treated group. Except the rats in the normal control group, all the other rats received subcutaneous injection of collagen II to establish collagen-induced arthritis (CIA) models. Then the rats in each group were fed normal saline or corresponding drugs for four weeks. Total RNA was extracted from carpal and digital bones. The expressions of OPG, RANKL and M-CSF mRNAs were examined by real-time PCR. RESULTS: The total incidence of arthritis induced by collagen II in the rats was approximately 90%. The expression levels of RANKL and M-CSF mRNAs and the RANKL mRNA/OPG mRNA ratio in the untreated group, KFSG-treated group and CsA-treated group were all significantly higher than those in the normal control group, while the expression levels of OPG mRNA in those three groups were significantly lower than that in the normal control group. The expression level of OPG mRNA in the KFSG-treated group was obviously higher while the expression level of M-CSF mRNA and the RANKL mRNA/OPG mRNA ratio in the same group were both lower as compared with those in the untreated group. CONCLUSION: The molecular mechanism of effects of KFSG on bone erosion and destruction induced by rheumatoid arthritis is closely correlated with up-regulating the expression of OPG mRNA, down-regulating the expression of M-CSF mRNA and RANKL mRNA/OPG mRNA ratio.

Objective To explore the efficacy of tigecycline combined with cefoperazone/sulbactam in the treatment of infections due to multiple drug resistant strains and pandrug-resistant acinetobacter baumannii, so as to guide the reasonable clinical medication.Methods A total of 16 cases of ventilator associated pneumonia caused by multiple drug resistant strains and pandrug-resistant acinetobacter baumannii treated in the First Hospital of Shijiazhuang from November 2012 to November 2014 were retrospectively analyzed, and the severity of the infection, clinical efficacy and mortality were observed.Results The multiple drug resistant strains and pandrugresistant acinetobacter baumannii were frequently detected in the 16 patients.Fifteen cases had been used other antibiotics before tigecycline, such as imipenem, cefoperazone/Shubatan, minocycline etc.The severity of underlying disease was assessed with the acute physiology and chronic health score(APACHE Ⅱ sore) within 24 h of admission, on the first day of tigecycline (TGC) therapy and after 7 days of TGC therapy.It showed that the average APACHE Ⅱ score were (25±6.0), (24.2±6.4) and (17.8±6.6) within 24 hours of admission(P＜0.01), on the first day of TGC therapy and after 7 days of TGC therapy.Thirty days after application of the TGC, the bacterial eradication rate was 56.25％ (9/16).The effective rate was 87.5％ (14/16).The failure rate was 12.5％ (2/16).Conclusion The effect of the tigecycline combined with cefoperazone/sulbactam on the clearance of the multiple drug resistant strains and pandrug-resistant acinetobacter baumanniiis is satisfied.

Objective To analyze the mutations in keratin 1 (KRT1), KRT9 and KRT10 genes in a Chinese family with epidermolytic palmoplantar keratoderma (EPPK). Methods Clinical data were collected from a family with EPPK. Genomic DNA was extracted from the peripheral blood of 12 family members, including 6 patients and 6 unaffected members, as well as from 50 unrelated normal human controls. PCR was performed to amplify all the exons and flanking sequences of KRT1, KRT9 and KRT10 genes followed by DNA sequencing.Results A missense mutation C.1436T > C was found in the highly conserved helix termination motif of KRT1 gene of all the patients, resulting in a substitution of isoleucine by threonine at position 479 of the KRT1 protein. No mutation was found in the unaffected members or unrelated controls. Conclusions The missense mutation C.1436T > C in K.RT1 gene is likely to be the main cause of the phenotype of EPPK in this family.This is the first report of a pedigree with KRT1 gene mutation-induced EPPK in China.

Objective To detect the steroid sulfatase (STS) gene mutation in a Chinese pedigree with X-linked ichthyosis (XLI). Methods Genomic DNA was extracted from the peripheral blood of 3 affected patients and unaffected members in this family and 50 unrelated healthy volunteers followed by the amplification of the exon 1 and exon 10 of STS gene by PCR. Results Complete deletion of the exon 1 to 10 of STS gene was detected in all the patients in this pedigree with XLI, while no mutation was found in this gene in unaffected members of this family or normal human controls. Conclusion The complete deletion of STS gene is likely to be the main cause of the phenotype of XLI in this family.

OBJECTIVE: To introduce the research progression of fMRI in brain functional localization in China or abroad in the recent 15 years, so as to further comprehend the effect and value of fMRI.DATA SOURCES: A computer-based online search of Medline database was undertaken to identify English articles about fMRI published from 1990 to 2005 with the keywords "functional magnetic resonance imaging (fMRI), brain".STUDY SELECTION: The articles about experimental studies of fMRI articles irrelative to motor function, sensory function, hearing function, visuEnglish title.DATA EXTRACTION: Totally 6 144 relevant articles were collected, 18 articles were involved according to the inclusive criteria, and the others were excluded. cles about sensory function, including 1 about simple tactile stimulation,ry function, including 2 about simple visual stimulation, and 1 about binoction, including about hearing stimulation by various methods, and 1 about comparison between normal and abnormal subjects by the same stimulation.language function, 1 about visual language function, and 1 about listening basic principle.CONCLUSION: fMRI was more accurate, convenient and direct than other methods. It can not only show localization, size and dimension of the activated areas in different cerebral regions, but also show accurate anatomical position. Many aspects still need to be consummated, for example, exploration of the stimulating method, design of advanced hardware, post processing of the image and the effect of visualization. With the development of hardware, software and the endless endeavor of scientists, fMRI dooms to play an important role in illustrating the function of human brain.

Background and purpose:Primary malignant melanomas of the uterine cervix and vagina are rare neoplasms with very poor prognosis. This article aimed at investigating the clinicopathologic characteristics, treatment and prognosis of primary malignant melanomas of the cervix and vagina. Methods:The clinical data of 51 patients with primary malignant melanomas of the cervix and vagina treated at Fudan University Shanghai Cancer Center from Dec.1998 to Jul. 2011 were reviewed. Results:The 2-and 4-year progression-free survival (PFS) rates were 32.8%and 13.1%, respectively. The 2-and 4-year overall survival (OS) rates were 67.2%and 39.8%, respectively. Three patients survived more than 5 years. Twenty-nine (56.9%) patients had a recurrence. The common sites were vaginal stump/pelvis (10 patients, 34.5%), liver (4 patients, 13.9%), lung (3 patients, 10.3%), bone (3 patients, 10.3%) and vulva (3 patients, 10.3%). Larger tumor size and lymphovascular space invasion were the independent predictors of poor OS (P<0.05). Pelvic lymph nodes metastases were associated with shorter PFS (P=0.05). Among them, those who received combined immunotherapy and chemoradiotherapy achieved longer median time to progression (TTP) (17 months) compared with patients who had chemotherapy alone (9 months) or immunotherapy alone (11 months). Conclusion:Primary melanomas of cervix and vagina have a very poor prognosis. The multidisciplinary treatment of combining surgery, chemoradiotherapy, and immunotherapy can improve the patients’ prognosis.

Aim To study the biotransformation of gly-cyrrhizin in rat intestine-liver. Methods The in situ vascularly perfused rat intestine-liver model was estab-lished with a validated LC-MS/MS method for assay of the model perfusate glycyrrhizin and glycyrrhetinic acid. Results The steady state intestinal and liver ex-traction ratios in the once-through perfused rat intes-tine-liver model for glycyrrhizin were ( 4. 2 ± 0. 6 )%and (28. 0 ± 3. 0)%, respectively; the first-order ab-sorption rate constant for glycyrrhizin in the recircula-tion of perfusate to the intestine model was ( 0. 33 ± 0. 06 ) min-1;after intraduodenal administration of gly-cyrrhizin,the main active metabolite in was the perfu-sate glycyrrhetinic acid, which was also found in intes-tinal luminal fluids. Conclusions The first-pass effi-cacy of glycyrrhizin is obvious and there is only a small amount of metabolite in the intestinal mucosa cells;gly-cyrrhizin is metabolized by gut bacteria or liver cells af-ter oral administration;the in situ vascularly perfused rat intestine-liver model can be used in glycyrrhizin pharmacokinetic studies.