Objective To explore the influence of psycho-behavioral intervention on psychological status and quality of life in patients with gastroesophageal reflux disease (GERD). Methods 62 patients with GERD were divided into intervention group (n=30) and control group (n=32). Both groups received routine treatment, and the intervention group received psychological care applying cognitive, emotional,behavioral, social support intervention in addition. They were assessed with Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Generic Quality of Life Inventory (GQOLI) before and 6 weeks after intervention. Results The scores of SAS, SDS, and GQOLI (all the dimensions and total) improved in the intervention group compared with the control group after intervention (P<0.05). Conclusion Psycho-behavioral intervention can reduce the anxiety and depression, and improve the quality of life for patients with GERD.

Objective To investigate the effect and mechanism of the icaritin on the human cronic myeloid leukemia K562 cells. Methods The K562 cells at logarithmic growth phase were divided into the control group and the icaritin group. The cells in the control group were normally treated and the cells in the icaritin group were incubated with 8 μmol/L icaritin. Methyl thiazolyl tetrazolium (MTT) method and flow cytometry were used to examine the proliferation and apoptotic changes in the two groups after incubation for 72 h, respectively. Gene expression of p85 and Akt were detected by RT-PCR. The protein changes of p85, Akt, p-p85, p-Akt cleavage-caspase-3 and caspase-3 were detected by Western blot. Results Compared with the control group, the proliferation rate of K562 cells in the icaritin group was significantly decreased (P<0.05), however the apoptotic rate of K562 cells and the expressions of p-p85, p-Akt, cleavage-caspase-3 in the icaritin group were significantly increased (all P< 0.05), but the expressions of p85 mRNA, Akt mRNA and caspase-3 protein had no difference (all P> 0.05). Conclusion Icaritin could induce the proliferation and promote the apoptosis of K562 cell, and its mechanism may be achieved through activating the PI3K-Akt signal transduction pathway.

ObjectiveStudy on the effect of nasal decontamination hefor aerosol inhalation in elderly patients with general anesthesia postoperation.Methods130 elderly patients with general anesthesia postoperation were randomly divided into routine treatment group and nasal decontamination group.The time of first sputum,the time of postoperative sputum changing characters,respiratoty-related indicators,sputum cuhure positive rate of bacterial,the incidence of postoperative pulmonary complications was examined.ResultsCompared with routine group,nasal decontamination group obviously shorten sputum character changing time ( P ＜ 0.05 ).Postoperative nasal decontamination group and conventional group sputum Staphylococcus aureus positive rate were 7.7％ (5 cases) and 20.0％ ( 13 cases) respectively,the difference was significant(x2 =4.13,P ＜0.05).ConclusionGiven nasal decontamination before aerosol inhalation could improve character of sputum and reduce sputum bacterial culture positive rate,and had good efficacy and safety.

Objective To investigate the influence of sufentanial in postoperative patient controlled epidural analgesia(PCEA) in hemorheology after total hip replacement and its inhibitory effect on thrombosis.Methods Fifty patients,ASA Ⅰ-Ⅱ,undergone total hip replacement were randomly divided into PCEA group (n=25) and control group (n=25), and received continuous epidural anesthesia.After operation,5 mL 0.2% ropivacaine was administered in PCEA group,and then PCEA pump was used,analgesia liquid included 0.4 mg?L-1 sufentanial,0.2% ropivacaine and saline.Petidine was administered intramuscuarly according to pain in control group.VAS scores 1,12,24 and 48 h after operation and changes of various parameters of hemorheology at diffenent time after anesthesia were observed.Results ①The VAS scores 1,12,24,48 h after operation were lower than those in control group (P

Objective To evaluate the diagnosis and treatment of left renal vein entrapment syndrome. Methods The clinical data of 10 cases of left renal vein entrapment syndrome were retrospectively analyzed.Their mean age was 24 years (range,14-37 years).Of them 7 cases presented with non-glomerular origin hematuria;2,with orthostatic proteinuria;1 with hematuria accompanied by proteinuria.Color Doppler sonography showed that the dilated segment of the left vein was three-fold than the strictured segment in diameter,and magnetic resonance angiography (MRA) showed that the left renal vein was compressed in 9 cases. Results Stent placement across the left renal vein was performed in 7 cases.Superior mesenteric arteriectomy and replantation were performed in 3 cases.The operations were all successful.Follow-up of 1-5 years showed that the clinical symptoms were improved and urine tests were normal. Conclusions Non-glomerular hematuria or orthostatic proteinuria is frequently found in left renal vein entrapment syndrome.Left renal vein entrapment syndrome can be diagnosed by Doppler sonography,MRA and cystoscopy in the presence of hematuria or proteinuria.Generally,conservative treatment and careful follow-up are conducted in these patients.Surgical and radiologic interventional procedures are effective alternatives for those with glomerular dysfunction and complications.

OBJECTIVE To look into and analyze the application of antibacterial used in our hospital in order to enhance the rationality of clinical usage. METHODS We conducted the survey by means of picking out examples in numbers within a definite range,looking back at the records with regard to it from Jan 2004 to Dec 2004. RESULTS Altogether there were 5 302 medical records.The percentage of using antibacterial was 70.24%,from which 45.22-36.68% were used two kinds and 8.54% were used more than two kinds.As to the basis,preventive use taken up a large proportion,accounted for 48.93%;the main route was by intravenous injection,which added up to 74.03%.Of the antibacterials applied,the first three were penicillins;aminoglycosides;cephalosporins.The percentage for surgical application was 94.49%,from them 57.14% used 2 or more kinds for treatment of incision of type Ⅰ. CONCLUSIONS It is very necessary and urgent to supervise the management of the rational application of antibacterial.

目的了解中年男性晚期肿瘤患者家属的心理状态及影响因素。方法对50例中年男性晚期肿瘤患者的100名直系家属进行问卷调查。结果中年男性晚期肿瘤患者家属的焦虑自评量表（SAS）及抑郁自评量表（SDS）评分明显高于国内常模（P<0.01），且父母与配偶得分明显高于子女与兄弟姐妹（P<0.01），其影响因素主要有：患者的病痛、家庭人员照顾、家庭经济等。结论护士在照顾中年男性晚期肿瘤患者的同时，应充分关心其直系家属，尤其是其配偶与父母的心理。

Objective To discuss the distributions and drug resistance of gram-positive cocci and provide scientific basis for reasonable use of antimicrobial drugs.Methods One hundred and twenty-five strains were isolated and cultured in our department from January 2009 to December 2011.The drug susceptibility was tested by K-B method and the results were judged by the criteria guideline of CLSI 2009.Results The main strains of separated cocci were Staphylococcus aureus (68,54.4％),Enterococcus faecium (22,17.6％),coagulase-negative staphylococcus (CNS) (20,16.0％),Enterococcus faecalis (6,4.8％),Staphylococcus haemolyticus(7,5.6％)and other gram-positive cocci (2,1.6％).Methicillin-resistant S.aureus (MRSA) and Methicillin-susceptible S.aureus (MSSA) detected were 40 and 28 strains(accounted for 58.8％ and 41.1％ of S.aureaus).The results of drug susceptibility tests showed that the drug resistant rate of MRSA to Gentamicin,Clidamycin,Erythromycin and Ciprofloxacin was up to 87.5％-95.0％,and the drug resistant rate of coagulasenegative staphylococcus to Penicillin,Erythromycin,Clidamycin and Gentamicin was up to 65.0％-95.0％,besides,the drug resistant rate of E.faecalis and E.faecium to Erythromycin,high level Gentamicin and Ciprofloxacin were 86.4％-100％ and 50.0％-66.7％,respectively.No strains with drug resistant to Vancomycin,Teicoplanin and Linezolid were detected.Conclusion S.aureus was the main strains of nosocomial infection of gram cocci.The resistance of gram-positive cocci is severe,so clinicians should attaches great importance to high drug resistance of gram-positive cocci.

Background:Intestinal ischemia-reperfusion( I/R)is a surgical abdomen,which not only leads to intestinal tissue necrosis,but also induces systemic inflammatory response,resulting in a serious impact on other organs and tissues. Aims:To investigate the role and mechanism of rosiglitazone( ROS)on intestinal I/R injury. Methods:Eighteen male C57BL/6 mice were randomly divided into three groups:sham operation group,I/R injury group and ROS pretreatment group. Mice in ROS pretreatment group received ROS(0. 3 mg/kg,IV)30 minutes before I/R injury. I/R injury model was established by clamping superior mesenteric artery for 30 minutes,followed by 4 hours reperfusion. All the mice were sacrificed. The pathology of intestinal tissue was examined by HE staining. The mRNA expressions of tumor necrosis factor( TNF )-α, interferon(IFN)-γ,interleukin( IL)-1β,transforming growth factor( TGF)-β and Smad3 were measured by real-time quantitative PCR. The protein expressions of TGF-βand Smad3 were measured by Western blotting. Serum levels of TNF-α, IFN-γand IL-1βwere measured by ELISA. Results:Compared with the sham operation group,pathological score of small intestinal mucosa in I/R injury group was significantly increased(P<0. 05),and the mRNA expressions of TNF-α,IFN-γand IL-1β were significantly increased( P < 0. 05 ),the mRNA and protein expressions of TGF-β and Smad3 were significantly increased(P<0. 05),the serum levels of TNF-α,IFN-γand IL-1β were significantly increased(P<0. 05). With the pretreatment of ROS,all the above-mentioned indices were significantly ameliorated(P<0. 05). Conclusions:ROS pretreatment can attenuate intestinal I/R injury by inhibiting TGF-β/Smad3 signal pathway to reduce inflammation.

Objective To investigate the mechanism of brain derived neurotrophic factor (BDNF) regulated by differ-ent isoforms of tyrosine kinase receptor B (TrkB) in epileptic hippocampal neurons. Methods Primary hippocampal neu-rons were cultured in vitro for 7 days, and divided into two groups, ALLN (calcineurin inhibitor) group and Anisomycin (trans-lation inhibitor) group. ALLN group included control group, control+BDNF group, epilepsy group, epilepsy+BDNF group, control+ALLN group, epilepsy+ALLN group and epilepsy+ALLN+BDNF group. Anisomycin group was sub-divided into con-trol group, control+BDNF group, epilepsy group, epilepsy+BDNF group, control+Anisomycin group, epilepsy+Anisomycin group and epilepsy+Anisomycin+BDNF group. The immunofluorescent technique was used to identificate the hippocampal neurons. Epileptiform discharges were detected by electrophysiological techniques. Western blot assay was used to deter-mine the protein expression of TrkB and phosphorylated TrkB (p-TrkB) in all cell groups. Results (1) In ALLN group, the gray value of p-TrkB/TrkB was higher in control+BDNF group compared with that of control group, the value was higher in epilepsy+BDNF group than that of epilepsy group but was lower than that of control+BDNF group. The gray value of p-TrkB/TrkB was lower in epilepsy+ALLN+BDNF group than that of epilepsy+BDNF group, but no significant difference compared with that of epilepsy+ALLN group. (2) In Anisomycin group:the gray value of p-TrkB/TrkB was higher in control+BDNF group than that of control group. The gray value of p-TrkB/TrkB was higher in epilepsy+BDNF group than that of epilepsy group, but which was lower than that of control+BDNF group. The gray value of p-TrkB/TrkB was higher in epilepsy+Aniso-mycin+BDNF group than that of epilepsy+BDNF group and epilepsy+Anisomycin group. Conclusion The decreased ex-pression of TrkB.T can improve the inhibition of BDNF/TrkB signaling, and BDNF can activate BDNF/TrkB signal pathway in epileptic hippocampal neurons. The increased TrkB.FL protein level by ALLN can’t improve the inhibition of BDNF/TrkB signal pathway.