OBJECTIVE To investigate the susceptible factors and the methods of prevention and treatment of nosocomial deep fungal infection in intensive care unit(ICU).METHODS The clinical information of 798 patients in ICU was investigated from Jul 2005 to Jun 2007.The risk factors,species,drug-resistance and the methods of prevention of fungal infection were analyzed.RESULTS Fungal infections were found in 137 cases(17.2%).The lower respiratory tract accounted for 72.3% in 137 cases with fungal infection.A total of 180 strains of fungi were isolated,Candida albicans,C.tropicalis and C.glabrata accounted for 43.3%,25.6% and 23.3%.The resistance characteristics to fluconazole,itraconazole,5-fluorocytosine and amphotericin B were relatively weak.The factors related to nosocomial fungal infection were the severity of the underlying disease,long-term use of antibiotics and glucocorticoid and invasive procedure.CONCLUSIONS Proper use of antibiotics and immuno-depressor,reduction of unnecessary operation and early diagnosis are the keys in prevention of systemic fungal infection.

OBJECTIVE To investigate the distribution and tendency towards drug resistance of Candida albicans which causing clinical deep infection and to supply data to clinical treatment. METHODS The distribution and tendency towards drug resistance of C. albicans isolates from infected patients from Jan 2007 to Dec 2007 were analyzed retrospectively.RESULTS All 1698 strains of Candida were isolated from patients sputum,urine,blood,secretion,etc. From 1075 cases with C. albicans,965(89.8%) strains were isolated from sputum. The resistance rate to nyststin,fluconazole,itraconazole,5-fluorocytosine and amphotericin B were 3.9%,3.6%,2.5%,0.5% and 0,respectively. The factors related to nosocomial C. albicans infection were the use of antibiotics and condition,invasive procedure,physical fitness,age,basic state of patients,etc.CONCLUSIONS The incidence and resistance of C. albicans infection in a hospital have increasing by years. Proper use of antibiotics and immunodepressors,reduction of unnecessary operation,and early diagnosis and treatment are the keys in preventing from systemic C. albicans infection.

Objective To observe the effect of small dosage of perphenazine(2～6 mg)on psychotic symptoms of senile dementia.Methods 31 senile cases with psychotic symptoms after dementia(Alzheimer disease or vascular dementia)accepted small dosage of perphenazine in addition of the conventional therapy.They were assessed with Sadoz Clinical Assessment Geriatric(SCAG)and Treatment Emergent Symptom Scale(TESS).Results The score decreased 50%～75%(markedly improved)in 2 cases,25%～50%(improved)in 22 cases,lower than 25%(no improved)in 7 cases.Some mild emergent symptoms have been observed.Conclusion Small dosage of perphenazine is safe and effective in treating psychotic symptoms of senile dementia.

Objective To explore the treatment effect and comfort of colostomy surgery with fecal water der-matitis around stoma after application of multilayer soft silicone dressings.Methods Approved by the Hospital Ethics Committee and the patients'informed consent,120 patients were divided into the hydrocolloid dressings group ( the control group) and multi-layer soft silicone dressing group (the treatment group),60 cases in each group.Before treatment,after treatment 24h and 36h,DET score,GCO score and the treatment effect were evaluated.Results After treated for 24h,the DET,GCO scores and treatment effects ( in the control group,cured in 3 cases,effective 45 cases, in the treatment group 5 patients were cured,effective in 46 cases) had no significant differences between the two groups (t=-2.624,P>0.05,t=-0.429,P>0.05,χ2 =0.519,P>0.05).After treated for 36h,the DET,GCO scores and treatment effects ( in the control group:cured in 29 cases,effective in 25 cases,in the treatment group:51 patients were cured,effective in 9 cases) had significant differences between the two groups ( t=-5.022,P<0.01,t=12.784,P<0.01,χ2 =6.316,P<0.05).Conclusion Colostomy fecal water dermatitis around stoma after application of multilayer soft silicone dressings can significantly improve the patients'comfort.

Objective To evaluate the validity, reliability and feasibility of Chinese version of Aggressive Behavior-Teacher' s Checklist (TCL) among preschool children. Methods TCL was translated and administered with Child Behavior Checklist (CBCI)-aggressive subscale to 148 preschool children in Shanghai. Validity and reliability of TCL was evaluated using standard psychometric analyses. Results Each item of Chinese version of TCL was significantly correlated with the subscale it belonged to(P<0. 01). The criterion validities of reactive aggressive subscale and proactive aggressive subscale among boys and girls were from 0.491 to 0. 733. The construct validity was also confirmed by factor analysis with 78.489% variance explained by two factors. Cronbach's alpha of TCL and its two subscales were 0. 891,0. 814, and 0. 880 respectively. The test-retest reliability and the inter-rater reliability coefficients of reactive aggressive subscale and proactive aggressive subscale were all above 0. 7. Conclusion Chinese version of Aggressive Behavior-Teachers Checklist has good validity and reliability among preschool children in Shanghai, and can be applied in kindergartens and schools to evaluate and deal with aggressive behavior among these children.

Objective To explore the epidemiological characteristics of nonalcoholic fatty liver disease (NAFL)and relationship with main chronic diseases in Xuanwu district community of the elderly.Methods 6 779in the elderly physical examination,unified health questionnaire,physical examination,measurement of body mass index,blood pressure,fasting blood glucose,liver function,blood lipids,abdominal B-ultrasound to calculate prevalence of NAFL rate,and its related factors were analyzed.Results NAFL prealence was 38.7％,NAFL group of overweight and obesity,diabetes,high blood pressure,dyslipidemia was significantly higher than the control group.Conclusion NAFL rate was high,and it has close relationship with the metabolic syndrome,NAFL should be placed in community mainly chronic diseases of prevention and control category.

Abstract BACKGROUND: Large amounts of data have shown that Chinese herbal monomer has a neuroprotective effect, and can improve the quality of life in stroke patients with cerebral nervous system injury. Nuclear-factor-erythroid 2-related (Nrf2) factor has neuroprotective effect on hemorrhagic stroke and ischemic stroke, which is an important way to reverse the damage of nervous system through the natural non-toxic Chinese herbs or composition, but it is rarely reported systemicaly. OBJECTIVE:To summarize the neuroprotective effect of Chinese herbal monomersvia the Nrf2 signal pathway in stroke patients. METHODS:The first author retrieved the CNKI, VIP, Medline, and PubMed databases by computer. The keywords were “Nrf2, ARE, stroke, traditional Chinese medicine, neuroprotection” in Chinese and English,respectively. Articles concerning the neuroprotective role of Chinese herbal monomervia Nrf2 were analyzed and discussed. RESULTS AND CONCLUSION: Totaly 85 articles were retrieved. According to the inclusion and exclusion criteria, 46 articles were included in result analysis. The results show that a variety of monomers can exert neuroprotective effectsvia the Nrf2 pathway. Chinese herbal monomers include organic acids, phenols, saponins, terpenes, flavonoids, alkaloids, and other single or composite components. Traditional Chinese medicine has the clear neuroprotective effect after stroke, but it is lack of regularity, and it is stil need to expand the data and further research as the basis.

OBJECTIVE:To optimize the extraction technology of polysaccharides from antlion and explore its effect on im-mune functions of mice. METHODS:Using content of polysaccharides as investigation index,the effects of extracting polysaccha-rides from antlion by water extraction method protease hydrolysis extraction(optimized by orthogonal test using extraction tempera-ture,enzyme dosage,extraction time as indexes),and diluted alkali extraction(optimized by orthogonal test using alkali concentra-tion,extraction temperature,extraction time as indexes)were compared. 128 KM mice were randomly divided into 4 groups,then randomly divided into control group(normal saline),polysaccharides low-dose,medium-dose,high-dose groups(20,40,80 mg/kg),8 in each group,iv in tail vein,0.2 mL/10 g,once a day,for 1 week,which were respectively used to determine the phago-cytosis percentage and phagocytic index of peritoneal macrophages,spleen and thymus index,lymphocyte transformation rate and serum hemolysin levels. RESULTS:The contents of polysaccharides by 3 methods were 14.48%,38.66%,30.62%,respectively. The content of polysaccharides by protease hydrolysis extraction was the highest,the optimal extraction technology were as follows as using 100 μg/g papain extracting 3 h under 40 ℃. Compared with control group,phagocytosis percentage,phagocytic index, spleen index in polysaccharides low-dose,medium-dose,high-dose groups were significantly increased (P<0.05),thymus index was significantly decreased(P<0.05),while lymphocyte transformation rate had no significant changes(P>0.05);serum hemoly-sin in polysaccharides medium-dose group was significantly increased (P<0.05). CONCLUSIONS:Protease hydrolysis extraction is suitable for the extraction of polysaccharides from antlion,the optimal technology is reliable. Polysaccharides from antlion show activity in enhancing mice non-specific immunity and humoral immunity.

Objective:To explore social support and personality characteristic of patients with clinically chronic pains to provide a new idea for clinical psycho-intervention.Method:45 patients with clinically chronic pains were evaluated by the Symptom Checklist(SCL-90),EPQ and SSRS,and compared with the control group.Results:Somatization,interpersonal sensitivity,anxiety,fear and psychotic factors have significant differences from those of the control group when being compared(p

Objective To evaluate the effect of integrated service platform of extensional care based on the combined internet and extensional care model in the orthopedics nurse care. Methods Two hundred and eighty six hospitalized patients in the orthopedic department were randomly divided into two groups including experimental group (144 cases) and control group (142 cases) according to the random number table method. Patients in the control group received extensional care by traditional telephone follow-up, patients in the experimental group received extensional care by using the integrated service platform combing internet and extensional care. All the patients were evaluated using the self-made extensional care satisfaction questionnaire and Short Form 36 Questionnaire. Results The extensional care satisfaction scores of experimental group using internet plus extended care mode were respectively ( 74.4 ± 5.3) points and (76.2 ± 8.1) points at the time points of 3 months and 6 months after discharge from hospital;The extensional care satisfaction scores of control group were respectively (69.4±9.9) points and (70.1±12.2) points at the time points of 3 months and 6 months after discharge from hospital;The two groups had statistically comparative difference (t=7.40, 6.37, P<0.01). There was a statistically significant improvement of extensional care satisfaction and physical function score and role-physical score and social function score in the experimental group compared with the control group both at the time points of 3 months and 6 months after discharge from hospital. There was a statistically significant improvement of vitality score and role-emotion score in the experimental group compared with the control group both at the time points of 1 month and 3 months after discharge from hospital (t=2.366-8.211, P<0.05). Conclusions The effect of integrated service platform of extensional care based on the combined internet and extensional care model is better than traditional telephone follow-up, patients′satisfaction is higher. This new mode of service platform could greatly deepen the connotation of quality nursing, intensify the effect of extensional care, and reduce the working strength of nurse who did extensional care as while.