Objective To observe and explore the risk factors of nonalcoholic fatty liver diseas(NAFLD) complicated with hypertension in the enterprise retirees .Methods A total of 209 NAFLD patients diagnosed by ultrasound combined with questionnaire were collected in the enterprise retirees,and they were divided into the NAFLD with hypertension group(100 cases)and NAFLD without hypertension group (109 cases)after combined with physical examination results and past medical history.The relevant data of the two groups were retrospectively analyzed,and the risk factors of NAFLD complicated with hypertension disease were analyzed.Results The levels of age(t =1.69,P <0.05),body mass index(BMI)(t =0.36,P <0.05),waist circumference(t =0.64,P <0.05), total cholesterol(TC)(t =2.31,P <0.05),total bilirubin(TBS)(t =6.83,P <0.05),serum creatinine(Scr)(t =2. 20,P <0.05)in NAFLD complicated with hypertension group were higher than those in NAFLD group,and the differ-ences were statistically significant(P <0.01 or P <0.05).The logistic regression analysis showed that TC(OR =4.2)was the independent influencing factor of NAFLD with hypertension.Conclusion NAFLD is closely associated with hypertension,NAFLD can be incorporated into chronic disease management system with high blood pressure in order to improve the value of the disease in the elderly,and it is conducive to the further study of NAFLD and the management of other chronic disease.

Objective To study the diagnosis and treatment of spontaneous perirenal hemorrhage(SPH). Methods The clinical data of 31 cases of SPH were reviewed retrospectively.In the 31 cases,flank pain,flank mass,shock,gross hematuria,abdominal bleeding occured in 31,10,8,3 and 3 cases,respectively.The final diagnosis was established on CT scan,B-ultrasonography and IVU were 18,22 and 7 cases. Results In 31 cases,nephrectomy were performed in 18,radical nephrectomy in 1 case,nephron spare surgery in 4,renal artery embolization in 2,inspiration and drainage of hemorrage in 1 and careful watching in 5 cases.There were 11 cases of angiomyolipoma,6 renal cyst,4 of renal cell carcinoma,3 infectious diseases,2 aneurysm of renal artery and 2 hydronephrosis. Conclusions The clinical presentation may vary greatly depending on the degree and duration of bleeding,and the severe pain in the upper abdomen of abrupt onset is the common sign and symptom.The spontaneous rupture of renal cell carcinoma and angiomyolipoma are the most common cause of SPH.CT scan and B-ultrasonography are the most valuable in the diagnosis of SPH.It is demanded that management of SPH depends on the histopathology and the degree of bleeding.

[Objective] To discuss the effect of the community chronic disease management mode which combines physical identification and“preventive treatment”in control of GLU and TG of diabetes. [Method] 300 patients with T2 DM were randomly divided into the control group and intervention group with 150 patients in each group. The intervention group were physical y identified, and the management mode based on theories of“preventive treatment”including health education, diet control, exercise and medication used in the intervention group according to the result of physical identification, while the general management was used in the control group. 1 year later, changes of patients ’GLU and TG were observed. [Result] The community chronic disease management mode which combines physical identification and “preventive treatment”can improve T2 DM patients’GLU and TG, and reduce the GLU and TG of patients with QiXu, YangXu, and ShiRe types of physique. [Conclusion] The community chronic disease management mode which combines physical identification and“preventive treatment”is proved to be effective, and it improves the management of diabetes in communities.

[Objective] To explore the relativity between sPG and gastritis of H.pylori. [Method] Select 73 cases of chronic gastritis correctly diagnosed by gastric microscope and pathology, among which, 36 were chronic atrophic gastritis and 36 chronic superficial gastritis. 49 cases of positive H.pylori were administered with Lizhu Weisanlian tablets, measure the sPG before and after treatment. [Result] In the infected cases of H.pylori, PG Ⅰ was similar between atrophic gastritis and superficial gastritis; for PG Ⅱ value, atrophic gastritis group was more than superficial gastritis group, positive H.pylori patients higher than negative ones; PGR(PG Ⅰ/PG Ⅱ) was lower in atrophic gastritis group than superficial one, so was in positive H.pylori than negative one. After anti-H.pylori treatment, 87.75% patients were removed H.pylori, where the PG Ⅰ rose, PG Ⅱ lowered, PGR rose in atrophic gastritis group; in the superficial one where the H.pylori was not removed, no changes happened to PG Ⅰ, PG Ⅱ and PGR. In superficial gastritis group where the H.pylori was not removed, PGR rose. [Conclusion] H.pylori infection is correlated with sPG. Serum PG Ⅰ, PG Ⅱ and PGR have definite value in early diagnosing H.pylori concerned atrophic gastritis. PGR can be an index to evaluate the removal efficacy of H.pylori.

Objective To find out the living condition of the elderly adults and their needs for community bealthcare services so as to provide evidence-based guidance for our govemment. Methods A total of 925 participants aged ＞ 60 years were personally interviewed for questionnaire and ADL scale evaluation. Chi-square test and Kmskal-Wallis H test were used for data analysis. Results The subjects showed relatively lower education level and the illiteracy rate was high. Their marriage was stable and a decreased divorce rate was found. The economic situation was satisfactory. Their life satisfaction was farbeyond the health satisfaction. Most of the elderly did not live with their offspring,although 21.8% could not take care of themselves. The prevalence rate of chronic diseases was 81.5% ,which resulted in more demands for social activities, health consultation, rehabilitation nursing, and home healtheare services in the community. Conclusion They need to pay more attention to physical and mental health of the elderly. A community healthcare system that could provide services in an-all-round way,including medical care, should be established and improved.

By morpometric and immunohistochemical methods, it is observed that the volume density, the numerical density on area and the numerical density of specific granules in the perinuclear region of the atrial myocytes in the aging rats ars significantly less than that in the young groups (p

OBJECTIVE:To provide reference for the establishment of clinical skills evaluation system in students majored in clinical pharmacy and pharmacy of China. METHODS:Retrieved from pharmacy OSCE literatures and the related websites,phar-macy OSCE contents and evaluation in the United States,the United Kingdom,Canada,Japan,Malaysia and other countries were introduced to provide suggestions for clinical skills evaluation system in students majored in clinical pharmacy and pharmacy of Chi-na. RESULTS & CONCLUSIONS:OSCE had widely applied in medicine,nursing and other professional clinical skills,the United States,the United Kingdom and other countries had applied OSCE into pharmacy,and confirmed its important role in assessment of clinical competence in pharmacy students. There was no uniform standard in OSCE,and OSCE examinations were slightly different in different countries and different schools. Pharmacy OSCE usually based on school courses such as pharmacotherapy,clinical pharmacokinetics,medicine information,pharmaceutical care,doctor-patient communication,identification and solving ability of clinical drug-related issues. Numerous college of pharmacy in domestic colleges and universities has added the practice-based cours-es,but evaluation system and assessment methods are poor. Almost no OSCE is applied for the assessment of pharmacy students. OSCE has short application time in pharmacy education and relatively less study,therefore,pharmacy OSCE in foreign countries should be learnt to assess clinical skills of pharmacy students,establish and improve the pharmacy OSCE that is suitable for China by combining with the pharmacy education status.

ObjectiveTo present 4 cases of primary c ar cinoid tumor of urinary bladder and to discuss the characteristics,diagnosis,tre atment and prognosis.MethodsA retrospective study of p athological and clinical data of 4 cases of primary bladder carcinoid tumor was made.Three were male patients and 1 female with an average age of 58.Two cases w ere considered as benign carcinoid tumor whereas the other 2 carcinoid of high malignancy.All of them presented macroscopic or microscopic hematuria but with no carcinoid syndrome noted.ResultsOne case of maligna nt carcinoid tumor with deep muscle invasion underwent radical cystoprostatectom y and adjurvent chemotherapy,but the prognosis was poor (died 5 months after the operation).Transurethral resection were performed for 2 cases of benign carcino id tumor and 1 case of focal malignant carcinoid with good prognosis.ConclusionsThe primary carcinoid tumor of urinary bladder has no specific symptoms,and should be diagnosised on histopathologic studies.Surgical intervention is the mainstay to treat the disease but the prognosis is hard to b e predicted.

Cancer malnutrition observed in 31%~87% patients with cancer can reduce the tolerance and compliance to radiotherapy ,interrupt or delay the treatment ,and significantly affect the prognosis .The malnu-trition may be aggravated when the duration of radiotherapy is prolonged and chemotherapy is applied concurrent -ly.PG-SGA is the most suitable method for nutritional risk screening in patients with malignant tumor .According to the result of nutrition assessment ,giving the adaptive nutrition support can improve the nutritional status of pa-tients and the curative effect in the early stage of radiotherapy ,as wells as post radiotherapy .

Objective To evaluate the value of spiral CT and 3D reconstruction in diagnosis and treatment of tibial plateau fractures.Methods 25 cases with tibial plateau fractures were examined with plain radiograhs,spiral CT and 3D reconstruction during July,1998 to December,2000.The tibial plateau fractures were classified according to Schatzker′s classification on the X-rays and 3D reconstruction images.On the superior view the tibial plateau fractures were divided into anterior lateral,posterior lateral,anterior medial and posterior medial fractures.Results 3D reconstruction images of 25 plateau fractures were the same as what arthroendoscopy were.25 fractures(including 23 arthroscopic management fractures)were operated under 3D reconstruction guide.No one case was infected.The treatment was valid.Conclusion Spiral CT and 3D reconstruction can offer more accurate classification and complement to new spatial classification of fractures.Also can provide better planning and management for the tibial plateau fractures.