Objective To assess stress degree of osteosarcoma caregivers and explore the impact factors of stress response. Methods We used CRA scale to investigate stress state of the primary caregivers of osteosarcoma patients, the demographic characteristics, status of patients, the objective amount of care and scores for each latitude underwent multiple regression analysis. Results The pressure of caregivers from the city was relatively light, annual income more than 50 thousand yuan and with help from the families to take care patients could effectively alleviate the pressure. The caregivers came from rural areas, household income less than 20 thousand yuan, caregivers were the patients' parents, had their own job presently, with no one to help were high - pressure groups. Conclusions Caregivers of osteosarcoma patients with high-pressure need focused intervention, more help and support should be given to these population.

BACKGROUND: The application of biological response modifiers (BRMs) has become the fourth cancer treatment following surgery, chemotherapy and radiotherapy. Polysaccharide-peptide (PSP) is a biological response modifier substance playing a special role in cancer treatment, which has been used in the treatment of gastric cancer, lung cancer, esophagual can cer, etc. With good results. OBJECTIVE: To observe the effect of PSP on the immune function and quality of life (QOL) in patients receiving chemotherapy for gynecological malignancies. DESIGN: A comparative observation. SETTING: Department of Obstetrics and Gynecology, Shanghai Jiaotong University Affiliated First People's Hospital. PARTICIPANTS: Forty patients who had been operated on for gyneco logical malignancies were selected from the Department of Obstetrics and Gynecology, Shanghai Jiaotong University Affiliated First People's Hospital from June 1999 to December 2002, including 36 cases of ovarian cancer with an average age of 52 years and 4 cases of endometrial cancer with an average age of 54 years. Patients with ovarian or endometrial cancer suffered from no contraindication in chemotherapy postoperatively were enrolled, otherwise were excluded.METHODS: The 40 patients were divided into study group (n=20) and control group (n=20) by matching according to stage and age. In the study group, the patients were treated with PSP capsules in addition to chemotherapy, whereas those in the control group were treated with chemotherapy only. PAC (phenacetin, spirin, caffeine) and MFP (melphalan, 5-fluorouracil, medroxyprogesterone acetate) regimens were adopted for the ovarian cancers and endometrial cancer respectively. The experiment lasted for two months from the beginning of the second course of chemotherapy to the beginning of the fourth one.MAIN OUTCOME MEASURES: The indexes of blood immune function and QOL were observed before and after treatment.RESULTS: All the 40 patients were involved in the analysis of results. ①The average Karnofkky's scores before and after treatment were (84±9.6)and (90±8.6) in the study group (P ＜ 0.05), and (83±9.2), (80±12.8) in the control group (P ＞ 0.05). The average Karnofkky's score was 10 credits higher in the study group than in the control group (P ＜ 0.05). ② The CD4+,CD4+/CD8+ and natural killer cells after treatment in the study group were all obviously higher than those in the control group (28.14±4.10, 0.96±0.17,23.80±4.90; 23.12±3.97, 0.75±0.21, 5.32±3.90) (P ＜ 0.05, 0.01).CONCLUSION: PSP can improve the cellular immunity and QOL of patients with ovarian or endometrial cancers.

ve To explore the sanitary quality of swimming pool water of public places. Methods The sanitary quality of swimming pool water of 7 public places was monitored, and the sanitory facilities equiped in swim-ming pools were investigated in Jiangyin. Results The pH values, the levels of turbidity and urea in swimming pool water all accorded with the related sanitary standards, and their related qualified rates were 93.9% , 98.5% and 98.5% respectively. For water temperature and residual chlorine, the qualified rates were lower, 3.0% and 19.7% respectively. Both the levels of turbidity and urea were positively correlated with the openning durations of swimming pools (P

Objective To observe the characteristics of obesity in rats with metabolic syndrome (MS) and to study the role of ERK1/2 and p38MAPK in the production of adipose tissues. Methods The metabolic parameters, weight of adipose tissue, waist circumference (WC), Lee's index, distribution area of adipocytes and the number of big adipocytes in the rats were measured. Adipose tissues and liver were histopathologically observed. ERK1/2 and p38MAPK of adipose tissue were determined using Western blot. Results (1) The blood pressure, fasting insulin level, LDL-C, TG and FFA in rats with MS were markedly higher than that in control rats (P

Objective To investigate the changes of serum and urinary adiponectin (ADPN) levels and insulin resis-tance (IR) states in patients with chronic kidney disease (CKD), and to explore their relationship thereof. Methods A total of 487 patients with CKD stages 2-5 were enrolled in this study, and 30 healthy subjects were served as control group. The se-rum ADPN levels in urine samples were examined by ELISA. The level of fasting insulin (FINS) was detected by radioimmu-noassay. Blood routine test, liver and kidney functions, blood glucose, serum lipids, 24 h urinary protein excretion and endoge-nous creatinine clearance rate (Ccr) and body mass index (BMI) were observed and calculated. The differences of ADPN lev-els in serum and urine samples and homeostasis model assessment for insulin resistance (Homa-IR) were compared between groups. Results The serum and urine ADPN levels and Homa-IR were higher in CKD patients than those of controls (P＜0.05). With the decline in renal function, the ADPN and Homa-IR levels were increased gradually (P＜0.05). The value of se-rum ADPN was significantly higher in patients with CKD stages 3-5 and high Homa-IR. The ADPN levels and Homa-IR were positively related to lipid parameters and 24 h urinary protein, and negatively correlated with hemoglobin and serum al-bumin in patients with CKD (P ＜ 0.05). Conclusion CKD patients had higher ADPN level and more significant IR. The ADPN and IR were correlated with serum lipids, hemoglobin, albumin and urinary protein. Dynamic monitor of ADPN level may have clinical significance in judging metabolic disorders in CKD patients.

Objective:To identify the differentially expressed genes and pathways of minimal change disease (MCD) by bioinformatics analysis, and to explore the pathogenesis of MCD.Methods:The gene expression omnibus (GEO) under the National Center for Biotechnology Information (NCBI) platform of the United States was used, and the data chips GSE104948 and GSE104954 containing MCD information were selected. The data set contained the gene expression array data of 19 cases of MCD renal biopsy tissue and 36 cases of normal renal tissue. The online tool GEO2R was used to analyze data and screen differentially expressed genes, and DAVID 6.8 database was used to perform GO and KEGG functional enrichment analysis of differentially expressed genes and network analysis of genes involved in metabolic pathways. The String 11.0 database and Cytoscape 3.7.2 software were used to analyze the relationship between MCD differentially expressed genes and perform visual analysis. At the same time, the CytoHubba plug-in was used to analyze the degree of association of protein interaction networks and screen key expressed genes.Results:A total of 302 highly expressed differentially expressed genes were identified by online tool GEO2R. GO analysis showed that the products of these differential genes were mostly located in the extracellular matrix, exosomes, pernucleus and other regions, exerting cell adhesion molecule binding, deoxycytidine deaminase activity, protein homodimerization activity, 2'-5'-oligoadenylic acid synthase activity and other functions, as well as participating in the formation of extracellular matrix, cell lysis, cell apoptosis, inflammatory response, immune response and other biological processes. KEGG analysis showed that differentially expressed genes were enriched in local adhesion, NOD-like receptor and other signal pathways. Combining the results of GO analysis and Cyto Hubba analysis, the PYCARD gene was screened out as the key gene that induced the inflammatory response in MCD kidney. Conclusions:The inflammatory response may be involved in the occurrence and development of MCD, and the PYCARD gene may be a key gene in the induction of inflammatory response in MCD.

Objective To analysis the reliability of the examination of Introduction of Nursing by using the methods of generalizability theory and to give advice on how to modify examination paper.Methods Estimation value of variance component from different variations and precision indexes were calculated by applying the principle of generalizability theory.Results The generalizability coefficient and index of dependability were greater than 0.4 in choice question and terminology explanation,the generalizability coefficient of short-answer question was also greater than 0.4.Short-answer question's index of dependability and generalizability coefficient and index of dependability of comprehensive problem were less than 0.4.Conclusions Generalizability theory can be used in analysis the reliability of the examination of Introduction of Nursing.Its result is helpful to improve the framework of examination papers and the reliability of examination.

Objective To investigate the value of otolith-repositioning maneuver combined with medical treatment on benign paroxysmal positional vertigo in the elderly patients.Methods 176 elderly people who suffered from benign paroxysmal positional vertigo were randomly divided into observation group and control group (n=88,each).All patients were treated with basal medicine treatment and compulsive position for 21 days,and patients in the observation group were treated with otolith repositioning maneuver added on the basis.The clinical efficacy and adverse reactions were observed and compared between the two groups after treatment.Results The curative rate and effective rate were higher in observation group than in control group at 2,3 weeks after treatment [50.0％ (44/88) vs.11.4％ (10/88),70.5％ (62/88) vs.47.7％ (42/88),77.3％ (68/88) vs.29.5％ (26/88),93.2％ (82/88) vs.86.4％ (76/88),x2 =37.32,73.32,37.32,53.43,respectively,all P＜0.05].Dizziness combined with nausea and vomiting,and walking instability were both found in the two groups,which had no statistical difference (x2 =3.25,P＞0.05).Patients in observation group developed arrhythmia and Tumarkin otolith crisis after treatment.The transfer rate of surgery was lower in observation group than in control group (x2 =45.43,P＜0.01).Conclusions Otolith-repositioning maneuver combined with medical treatment have good clinical effect and safety on benign paroxysmal positional vertigo in the elderly.

Objective To investigate the ability level of institutionalized elderly people and its correlation with pension service demand.Methods Ability assessment for older adults and a self-designed questionnaire about pension service demand were used to survey the ability level and service demand of 332elderly people in 7 institutions of Yancheng city in Jiangsu province in July 2014.The influence factors of pension service demand were analyzed by the binary classification Logistic regression.Results 67.8％ (225/332),14.8％(48/332) and 15.7％(52/332) institutionalized elderly's ability level were mild,moderate and severe impairment.The impairment of ability levels of the elderly had positive impact on helping eating,bath,cleaning,medical service and other services agency and negative impact on culture and entertainment.Conclusions The ability of institutionalized elderly were poor in Yancheng city in Jiangsu Province.We should provide service according to their abilities and demand,in order to ensure the rational use of the limited resources.