Objective To investigate the caregivers' difficulty in taking care of the elderly and the related factors. Method A self-designed questionnaire was used to investigate the difficulties in care giving among 1,517 caregivers. Results The total score on the difficulties was (16.16 ±5.79). The preventive factors were good care-related knowledge and family income and the risk factors were advanced age, poor health condition of the patients ( all P<0.01). Conclusions The difficulty in caring the elderly are varied. We should attach importance to those caregivers of advanced age, with lower income and lack of care-related knowledge. Meanwhile, we should provide consultation, education and training for caregivers according to their different situation, and carry out targeted and multi-level support services so as to solve their problems in care to the patients.

OBJECTIVE:The dissolution rates of baicalin in Gonglaoquhuo tablets were determined to provide a basis for evaluating and controlling the drug quality METHODS:The dissolution rates of Gonglaoquhuo tablets with different batch num_bers were determined by HPLC,using water as dissolution medium RESULTS:The T50 of Gonglaoquhuo tablets was 106min～220min and there were significant differences in dissolution parameters(T50,Td,m) between the tablets tested(P

Objective In order to provide information for the health administration and the price authorities to establish the reasonable price,the practical cost of special nursing of the chronic wound be analyzed,and be compared with the present charge,and the deviation be studied.Methods The cost of nursing care for all items was measured,recorded and collected,then calculating the special nursing cost for chronic wound using the method of ladder sharing the project cost.Rusults The true cost on a single special care for chronic wound was (29.42±9.29)yuan,and it reached 2.5 times of present charge ( 12 yuan).Conclusions The present charge on the special care for chronic wound was seriously deviated from the practical cost,and the labor value of special care of nurses could not be embodied.

Objective To investigate the current treatment of childhood bronchiolitis and wheezy bronchitis in the outpatient clinic.Methods The medication treatments of the children under 2 years old with bronchiolitis were retrospectively analyzed in the outpatient department of the Children's Hospital Affiliated to the Capital Institute of Pediatrics,during the 2 periods from November to December 2010 and July to August 2011.These children were divided into 3 groups according to age,1-6 months old group,＞ 6 months to 1 year old group and ＞ 1-2 year old group.The medications prescribed,including antibiotics,steroid,β2 agonists and anticholinergic drugs were analyzed.Results Altogether 6 198 patient visits were included.Among them,4 764 (76.86％) visits received antibiotics,4 078 (65.80％) visits received intravenous antibiotics,3 018 (48.69％) visits received systemic glucocorticoids,2 980 (48.08％) visits received intravenous steroid,3 400 (54.86％) visits received nebulization treatment,3 381 (54.55％) visits received nebulized steroid,3 417 (55.13％) visits received inhaled bronchodilators,among them,3 384 (99.03％) visits received combined nebulization of β2 agonists and anticholinergic drugs;and 826 (13.33％)visits received oral bronchodilators.In the 3 age groups,the older the age group the higher the oral bronchodilators prescription rate (6.77％,11.50％ and 18.77％,respectively).While the prescription rate of intravenous steroid,inhaled steroid and inhaled bronchodilators were lowest in the oldest(＞ 1-2 year old) group (43.65％,49.64％ and 50.00％,respectively).The average cost was 166.08 Yuan per visit,and 69.06％ was spend on drug cost.Conclusions There is a wide spread use of antibiotics,glucosteroids and bronchodilators in the treatment of bronchiolitis and wheezy bronchitis.There is a need for national guideline of bronchiolitis to standardize the management of childhood bronchiolitis in outpatient clinic.

Objective To investigate the incidence of AKI and its relationship to mortality of inpatients by analyzing the changes of serum creatinine(SCr). Methods We collected the data of SCr in Peking Union Medical College Hospital through Jun 2006 to May 2007 and then selected the patients who were subjected to SCr determination more than one time. The relationship between the frequency of SCr determination and gender, age was analyzed. The relationship of increased SCr to gender, age, frequency of determination was also analyzed. The risk stratification based on SCr was investigated. In our study, we investigated the incidence of AKI in different diagnostic groups. The relationship between AKI and mortality in ICU and MICU unit was analyzed. Results There were 36 855 patients in one year, 16 934 patients were subjected to SCr determination only one time, 15 233 patients were subjected to SCr determination at least two times. Elder men were subjected to SCr determination more frequently (P<0.01). Along with the increase of SCr concentration, the frequency of SCr determination were increased significantly (P<0.01). Using the increasing of SCr exceeding 50% as the criteria for diagnosis of AKI, the incidence of hospital-acquired AKI was 8.46%, and it was higher in patients with injury and poisoning (16.7%), infection (16.0%), hematological system diseases (16.1%), neoplasms (12.7%). The incidence of AKI was 27.7% and 55.2% in ICU and MICU, respectively. Mortality of patients in MICU was increased along with the increasing of SCr level Mortality of patients with AKI in ICU was 23.3%, that was significant higher than patients without AKI, the adjust OR was 2.7 (P<0.01). Conclusions The incidence of AKI evaluated by analyzing SCr changing is significantly higher than that using experienced clinical diagnosis. This method is convenient in clinic for early diagnosis of AKI.

The prescription of antibiotics for children with upper respiratory infections (URIs) in outpatient department of our hospital from November to December 2010 and from July to August 2011 were retrospectively analyzed.In 37 211 patient visits (prescriptions) with suppurative tonsillitis,laryngitis and other URIs,the antibiotic prescription rates were 90.45％ (3 626/4 009),78.77％ (2 642/3 354)and 52.25％ (15 596/29 848),respectively;the intravenous antibiotics rates were 78.22％ (3 136/4 009),60.58％ (2 032/3 354) and 16.47％ (4 915/29 848),respectively for above three conditions.For suppurative tonsillitis,the 3rd generation cephalosporins were the most commonly prescribed antibiotics (orally:51.07％,715/1 400) and(intravenously:54.88％,1 721/3 136),followed by the 2nd and first generation cephalosporins and macrolides.For laryngitis and other URIs,the 2nd generation cephalosporins were most frequently prescribed(orally:48.78％,538/1 103 and 39.16％,4 433/11 320,respectively) and (intravenously:54.38％,1 105/2 032 and 42.75％,2 101/4 915,respectively),followed by macrolides,3rd generation cephalosporins and first generation cephalosporins.No intravenous penicillin were prescribed.Oral penicillin were prescribed for 0-0.22％ of these children.The results indicate that antibiotics prescription rates are high for children with upper respiratory infections,particularly the prescription of broad spectrum antibiotics and intravenous antibiotics,while penicillin is seldom prescribed.

Objective To study the protective effect of hydrogen-rich saline (HRS) on apoptosis in skin flap after ischemia/reperfusion injury.Methods Total 18 Sprague-Dawley rats were randomly divided into three groups:a HRS treated group and two physiological saline treated groups (controls 1,2).The rats were anesthetized and an extended abdominal skin flap (6 cm × 9 cm) was elevated in each animal.Ischemia was induced by clamping the left right pedicle for 3 h,then HRS was administered intraperitoneally 10 min before reperfusion,and physiological saline was injected in control groups 1 and 2.In the control group 2,the flaps were elevated without occluding the artery and vein.Five days postoperation,apoptosis,TNF-α level in flap were measured with ELISA,NF-κB in nucleus was determined by Westernblot.Results Apoptotic rate represented (39.72±8.09) ％in HRS group and (69.43±13.27) ％ in control group 1,respectively.Treatment with HRS resulted in a marked reduction in apoptotic rate.TNF-α level was (516.408±38.674) pg/ml in the control group 1,a significant reduced TNF-α was measured in HRS group,accounting for (269.136 ±24.530) pg/ml.Moreover,NF-κB activation was significantly down-regulated by HRS.In control group 2,no significant apoptosis was observed because of non-blood occlusion,and there was no marked elevation of TNF-α and NF-κB.Conclusions HRS can protect skin from ischemia/reperfusion injury,attenuate apoptosis in flaps,which may be associated with the inhibition of TNF-α and NF-kb elevation.

OBJECTIVE:To discuss the correlation between antibacterial drug use and the bacterial drug resistance in the hospital where the authors work.METHODS:The DDDs of antibacterials during the period from2002to2004were counted,and the correlation between DDDs and bacterial drug resistance was analyzed.RESULTS:The total DDD of the antibacterials increased by47.14%in this period.To2004,the resistance rates of4major pathogens to9commonly used categories of antibacterials were more than44%.The DDDs of amoxicillin/clavulanate potassium,ampicillin sodium/sulbactam sodium,cefoperazone sodium/sulbactam sodium increased by4,19.8and7times,respectively in the3years,the resistance rates of pathogens to which also evidently increased,among which staphylococcus aureus increased by over22%.CONCLU_ SION:The hospital should strengthen the administration of antibacterial drug use in many ways to reduce the bacterial drug resistance.

Objective To evaluate the benefits and potential adverse effects of Cordyceps sinensis as an adjuvant immunosuppressive treatment in acute kidney injury.Methods English language database ( including MEDLINE, EMBASE and CENTRAL) in systematic review searched, using search terms relevant to this review.Chinese language databases ( including CNKI, CBM, WanFang and other resources) in systematic review also searched.It included all randomised controlled trials ( RCTs) and quasi-RCTs evaluating the benefits and potential side effects of Cordyceps sinensis for acute kidney injury, irrespective of blinding or publication language.An inclusion criterion was that immunosuppressive therapy baseline must be the same across arms in each study.Data were collected and analyzed by RevMan 5.0.Methodological risk of bias was assessed using the Cochrane risk of bias tool. Results This review included 7 RCTs (representing a total of 601 patients with acute kidney injury) that assessed the use of Cordyceps.Reporting of methods was incomplete in most studies.It conducted comparisons of Cordyceps versus no treatments on the base of same conventional treatment in both groups.Cordyceps for patients showed a favorable trends toward improving patient survival and reducing renal replace treatment, but the difference did not reach significance.However, Cordyceps significantly reduce the level of serum creatinine shorten the period of oliguria, and increase the osmotic pressure of urine.Conclusion On the base of same conventional treatment in both groups, compared with no treatment, Cordyceps significantly improves the functions of renal tubule and glomerulus.But long-term studies are needed to clarify any benefit-harm trade-off.Future studies also need to be appropriately sized and powered.

Objeetive:To investigate the epidemiology of EBV in adenoidal hypertrophy and chronic tonsillitis and discuss the effection of EBV on the nosogenesis of adenoidal hypertrophy and tonsillitis of children.Method:Fifty-two children with chronic tonsillitis and/or adenoidal hypertrophy had the operations of the tonsillectomy and/or the adenoidectomy.These tissues reseeted and plasma of all cases were detected to find EBV-DNA by RQPCR.Result:The infection rate of EBV in the tissues of adenoidal hypertrophy and tonsillitis of childen was 51.9%.The boys'infection rate of EBV was 50.0%,and the girls'infection rate of EBV was 55.6%,which had not significantly different.The EBV infection rate in the tissues of tonsillitis was 40.4%,The EBV infection rate in the tissues of adenoidal hypertrophy was 48.9%,which had not significant difference.The school age group(7to 14 years old)presented higher infection rate of EBV in the tissues of adenoid and tonsil(65.5%)than the preschool children group(2 to 6 years old)(34.8%).Comparing the copies numbers of BV-DNA in the different degrees of adenoidal hypertrophy,we found that the copies numbers of EBV-DNA in the severe hypertrophy group were higher than the midrange and slight hypertrophy groups(P＜0.05).Meanwhile we detected EBV-DNA in these childrens'blood plasma by RQ-PCR.No blood plasma was detected EBV-DNA copies higher than normal(＜1×10~3 copies/ml).Conclusion:The tissues of adenoidal hypertrophy and tonsillitis had same sensitivity to EBV.There was not significant difference between the infection rates of the boys and girls with adenoidal hypertrophy and/or tonsillitis.With these children growing up and the course of diseases prolonging,the infection rate of EBV increased correspondingly.There was a certain correlation between the hypertrophy of adenoid and EBV.There were NO EBV-DNA fragments in blood plasma of the children with adenoidal hypertrophy and/or tonsillitis.So there were essential different between benign hyperplasy and nasopharyngeal carcinoma.