Objective To observe the effect of anti-Helicobacter pylori (H.pylori) treatment on patients with idiopathic thrombocytopenic purpura (ITP) and its effect on blood platelet. Methods From April 2006 to April 2008, a total of 31 patients diagnosed as having ITP and H.pylori infection were collected. These patients were given standard antibiotic therapy for H.pylori eradication (omeprazole 20 mg, clarithromycin 0.5 g, and amoxicillin 1.0 g, twice per day for 1 week). The effect of anti-H.pylori treatment was analyzed, and the blood platelets were counted before the treatment and on day 7, 14, and 28 after the treatment. Results Of the 31 ITP patients with H.pylori infection, 21 were cured and 10 were not effective, with the effective rate 67.74 %. Blood platelet increased in the cured group but did not change in the no-effect group. Conclusion Anti-H.pylori treatment could increase the blood platelet, and H.pylori infection may be related to the reduction of blood platelet in ITP patients.

Objective To explore the prevalence and related risk factors of thyroid nodule in elderly patients(age ≥ 60 years old) with type 2 diabetes mellitus(T2DM)) in Xinjiang region.Methods Two hundreds and two elderly patients with T2DM were selected,including 91 cases of thyroid nodule(thyroid nodule group) and111 cases of non-thyroid nodule (control group).The disease history,body mass index(BMI),fasting blood-glucose (FBG),2-h postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),cholesterol(TC),high-density lipoprotein(HDL-C) and low density lipoprotein(LDL-C) were collected for statistical analysis.Results The age,gender,BMI,TC and HbA1c had statistical difference between the two groups (P<0.05);the disease course,pulse pressure,systolic pressure,abdominal perimeter,smoking history,HDL,TG,FBG and 2 h PBG had no statistical differences netween the thyroid nodule group and non-thyroid nodule group (P>0.05).The multivariable Logistic regression analysis showed that the age,gender,TC,HbA1c and BMI were the risk factors of thyroid nodule occurrence.Conclusion Conducting the thyroid nodule related imaging examination has an important clinical significance for diabetic elderly women patients with obesity and cholesterol increase.

Objective A preliminary study on the etiology , the gene typing , the PCR-ribotyping and the clinical features of Clostridium difficile from clinical isolates at Xiangya Hospital could improve the isolation rate and provide the basis for effectively prevention of C.difficile.Methods A prospective observational study was performed.A total of 452 stool samples were collected during June to December 2012 at Xiangya Hospital.All stools were anaerobic cultured by selective medium and identified by API 20A for C.difficile.The positive isolates were detected the toxin genes ( tcdA, tcdB, cdtA, cdtB ) and ribotyping (16S-23S internal spacer region ) by PCR.The clinical data of all patients were collected and analyzed through Logistic regression to discover the risk factors for the development of C.difficile infection ( CDI ) . Results The rate of CDI occurrence was 13.94%(63/452), among them, 42.86%(36/63) were A-B+strains and only 14.29%(9/63) were obtained from community acquired-CDI.No binary toxin was detected in any of the isolates.Eleven different PCR ribotypes were identified , the dominant ribotype CD017 accounted for 22.22%(14/63).Logistic regression analysis showed that the risk factors for CDI included age>55(P=0.016;OR=4.45;95%CI:1.33-14.91), diarrhea frequency(P=0.007, OR=0.03;95%CI:0.002 -0.38 ) and the duration of diarrhea ( P =0.015; OR =7.86; 95%CI: 1.50 -41.16 ) . Conclusions C.difficile is the main pathogens of diarrhea patients and is mainly from hospital infections with higher detection rate of A -B+ in Xiangya Hospital.Ribotyping exist comparative advantages type CD017.No evidence suggests outbreak of C.difficile infection.

objective To compare the technical survival between Tenckhoff double-cuffed straight catheter (TC)and swan-neck curled tip catheter (SNC) in peritoneal dialysis (PD). Methods Clinical data of 208 patients received PD in the Peritoneal Dialysis Center of Peking Union Medical College Hospital from January 1999 to December 2007 were analyzed retrospectively. All the patients were divided into two groups according to indwelling catheter. Technical survival and complications associated with the catheter between two groups were compared. Results Demographics and basic information were similar in both groups. The exit-site infection (ESI) rates of TC and SNC were 22.1% and 19.8% (P=0.786), and peritonitis rates of TC and SNC were 31.1% and 22.1% (P=0.159), which were slightly lower in SNC group, but the difference was not significant. Removal of the catheter was found in 27 (13.0%)patients, including 17 cases in TC group (13.9%) and 10 cases in SNC group (11.6%)(P=0.680).The median survival times of catheter in TC group and SNC group were 25 months and 22 months respectively without significant difference (P=0.103). Conclusions There are no significant differences of ESI rate, peritonitis rate and catheter survival between these two catheters in PD. The expensive swan-neck catheter offers no additional advantage. Doctors should choose the catheter according to the economic status of patients.

Objective To observe the clinical parameters, self-management, and compliance in peritoneal dialysis (PD) patients before and during Spring Festival, and to describe holiday syndrome in PD patients.Methods We prospectively observed PD patients with regular follow-up in our center before Chinese Spring Festival (January 8-February 7, 2016) and during Chinese Spring Festival (February 8-March 8, 2016).Demographic and clinical characteristics, self-management, and compliance with its influencing factors were collected by face-to-face method in outpatient care.Results Totally 130 PD patients were enrolled.The average age was (58.5±15.4) years, and women accounted for 53.1％.The primary diagnosis was diabetic kidney disease (32.3％), followed by primary glomerulonephritis (26.2％).Fourteen patients (10.8％) received automated peritoneal dialysis (APD), and most of the remaining patients chose continuous ambulatory peritoneal dialysis (CAPD,73.8％), with a median dialysis age of 34 months.During the 4-week followed-up, the appetite was stable, while the serum phosphate and pre-albumin increased [(1.5±0.4)mmol/L vs.(1.6±0.4)mmol/L, P=0.025;325.3 (272.2,355.1)mmol/L vs.326.0(284.2,376.5)mmol/L, P<0.01, respectively].No difference was observed in edema, dyspnea, and nighttime lying flat.However, the weight elevated significantly [(61.3±13.9)kg vs.(63.4±13.0)kg, P=0.002], with the median peritoneal ultrafiltration volume increased from 783.3 ml to 900.0 ml (P=0.005).During the holiday, the incidences of dialysis-related infections were unchanged, while the incidences of digestive system comorbidities increased significantly (5.4％ vs.13.8％, P=0.021).As for the compliance, 8 patients reduced their PD cycles during the holiday, which was more frequent than before holiday (P=0.018).One patient changed his PD pattern, and 6 patients did not follow the medication orders.Demographic characteristics such as gender, age, and marriage conditions were not associated with the compliance.Conclusions Holiday syndrome remarkably affects PD patient''s volume load, metabolism, and compliance.Poor self-management of PD patients during holidays needs further concern.

Objective To analyze the characteristics of lethal peritoneal dialysis related peritonitis and to define the risk factors.Methods All patients who developed PD related peritonitis between Jan.1999 and May 2015 in PUMCH were included.Clinical profiles were collected.Patients were divided into mortality group(n=16) and non-mortality group(n=182) according to whether peritonitis causing mortality.Baseline clinical profiles were compared between two groups.Cox regression analysis was used to define the risk factors for mortality.Results White blood cells [(10.2±6.3)×109/L vs (5.8±1.8)×109/L,P<0.05] increased,but serum albumin[(25.2±8.5)g/L vs (34.0±6.3)g/L,P<0.05] and potassium concentration [(3.5±0.9)mmol/L vs (4.5±1.0)mmol/L,P<0.05] decreased at the time of lethal peritonitis bacteria and fungus cultures were positive in half of the patients as bacteria (31.2%),fungus (12.5%)and mycobacterium tuberculosis (6.25%).Multiple cox regression analysis identified cardiovascular disease as the independent risk factor for peritonitis related mortality (HR 9.318,95% CI 1.875~46.305,P<0.01).Conclusions Peritonitis of patients with cardiovascular disease may cause death.

Objective To test the effect of an APP in the adherence of inhalation medicines for children with asthma,improve the rate of inhalation medicines compliance,self management ability and the quality of life of children with asthma.Methods The research use self-control study.We use Medication Adherence Report Scale for Asthma (MARS-A) to test the adherence of inhalation medicines for children with asthma in outpatient department.After 2 months using the APP,the children with asthma may be re-tested by the MARS-A to compare the differences in medication adherence,asthma knowledge,use method and pulmonary function,etc.Finally,data analysis using paired t test.Results After using the APP,the inhalation medicines adherence rate is increased from 25.78 ％ to 68.75 ％,the awareness rate of patients and their caregivers are increased from 25 ％ to 65 ％,and the APP usage rate is 42.18％,there was significant difference (P＜0.01).Conclusion The APP can effectively improve the adherence of inhalation drugs,standardized medication management,guarantee treatment effect and improve the quality of life of children with asthma.It could also reducing medical costs and improving work efficiency and service quality,thus deserves promotion.

Objective To explore the effects of the community-based rehabilitation on schizophrenia. Methods 100 patients with schizophrenia from 4 communities were assigned to intervention group (n=50) and control group (n=50). The intervention group accepted comprehensive intervention for 6 months. All the patients were followed up for 12 months, and assessed with the Positive and Negative Symptoms Scale (PANSS), Personal and Social Function Scale (PSP), the General Quality of Life Inventory (GQOLI-74). Results 48 cases of the intervention group and 44 of the control group finished the study. The scores of negative symptoms and general spirit pathology were less in the intervention group than in the control group (P<0.01). The score of PSP was more in the intervention group than in the control group (P<0.01), as well as the total score and score of dimensions of physical function, mental health and social function (P<0.05). Conclusion Community-based rehabilitation can control the mental symptoms, and improve the social function and the quality of life of patients with schizophrenia.

Objective To translate the English version of Northwick Park Dependency Score (NPDS) and to investigate the reliability and validity of the Chinese version of NPDS as a nursing dependency instrument for stroke patients. Methods The NPDS was Chinesized according to the Brislin's translation model. The expert evaluation method and the pilot investigation were implemented for cross-cultural research. The reliability and validity of the Chinese version of NPDS were tested in a cohort of 259 stroke patients. SPSS 17.0 was used to analyze the data. Results The Chinese version of NPDS consisted of 17 items, and 4 factors were extracted by exploratory factor analysis, which could explain 64.598% of the total variance. The content validity index (CVI) was 0.926. The criterion-related validity of NPDS with nursing hours per patient day and activity of daily life were 0.541,0.624 respectively (P<0.001). The Cronbach's coefficient was 0.852, and the inter-rater reliability was 0.975. Conclusions The Chinese version of NPDS has high reliability and validity, and is a valuable nursing dependency instrument for Chinese stroke patients.

Objective: To study the influence of community mental rehabilitation based on Deming Cycle(PDCA) management model on the quality of life of patients with chronic schizophrenia. Methods: From January 2016 to June 2017, 100 patients with chronic schizophrenia who agreed to community management in Wuxi were randomly divided into study group(n=50) and control group(n=50). Both two groups received traditional community mental health services, meanwhile, the study group was provided with community mental rehabilitation based on PDCA model.All the patients were followed up for 1 year.The quality of life scales(SQLS), social disability screening schedule(SDSS) and family care index(APGAR) were assessed before and after one-year intervention. Results: At the end of one year after intervention, the scores of total quality of life, psychosocial dimension, motive and energy dimension, symptom and side effects in the observation group were (41.27±10.54)points, (38.37±10.84)points, (35.43±7.46)points, (20.71±7.34)points, respectively, which were lower than those in the control group[(51.98±7.43)points, (48.73±8.72)points, (47.67±6.98)points, (29.79±8.64)points] and before intervention[(54.37±5.87)points, (49.78±4.73)points, (48.57±6.87)points, (33.17±10.42)points](t=5.87, 5.27, 8.47, 5.66, 7.68, 6.82, 9.16, 6.91, all P<0.05). At the end of one year after intervention, the social function score[(6.78±2.84)points] of the observation group was significantly lower than that of the control group[(8.83±2.73)points]and before intervention[(8.97±2.18)points](t=3.68, 4.33, all P<0.05), and the family social care index score[(8.75±2.04)points]was significantly higher than that of the control group[(7.04±2.36)points] and before intervention[(6.76±2.14)points](t=-3.88, -4.76, all P<0.05). There was a positive correlation between SDSS score and SQLS score(r=0.41, P<0.05). There was a negative correlation between SQLS score and SDSS score(r=-0.35, P<0.05). Conclusion The community mental rehabilitation strategy based on PDCA model can improve the social function and family social care, effectively improve the quality of life of schizophrenic patients, while positively promote the rehabilitation of patients.