Objective:To evaluate the effect of inhaled medication compliance intervention in elderly patients with chronic obstructive pulmonary disease (COPD) based on integrated theory of health behavior change.Methods:A total of 117 elderly COPD patients who visited Respiratory Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University from July to December 2021 were selected by the convenient sampling method. According to the random number table method, they were divided into the experimental group and the control group. 7 cases fell off during follow-up, and a total of 110 cases were finally included in the study, of which 55 cases were in the experimental group and 55 cases in the control group. The control group adopted the conventional health education method, while the experimental group adopted the intervention plan of inhalation medication compliance of elderly COPD patients based on the integrated theory of health behavior change. The accuracy of inhalation device use, inhalant medication compliance, forced expiratory volume in the first second (FEV 1) and Chronic Obstructive Pulmonary Diseases Assessment Test (CAT) scores were compared between the two groups before intervention and 3 months after intervention. Results:After 3 months of intervention, the inhalation device use accuracy, inhalation medication compliance in experimental group were higher than those in the control group, the score of CAT in experimental group was lower than that in the control group, the differences were statistically significant ( P<0.05). There was no statistically significant difference in FEV 1 between two groups ( P>0.05) . Conclusions:The intervention plan for inhalation medication compliance in elderly patients with chronic obstructive pulmonary disease based on the integrated theory of health behavior changes can improve their inhalation medication compliance and improve their quality of life.

Objective:To explore the main management points and ethical considerations of diabetic subjects involved in hypoglycemic drug clinical trials.Methods:Taking the subject management of a hypoglycemic drug clinical trial in Yuncheng Central Hospital as an example, the problems and measures in the subject management of diabetic patients were systematically discussed.Results:In hypoglycemic drug clinical trial that involving diabetic patients, ethical considerations regarding to the subjects' rights, safety and health should take into account in the whole process of subjects' recruitment, screening, enrollment and follow-up.Conclusions:Subject management taking into account of ethical consideration can better protect the safety and rights of subjects, enhance the compliance of subjects and improve the quality of drug clinical trials.

Total 1 452 newborns were home visited within 28 d after birth during January 2016 to December 2016,and 27 cases of skin infections were found.Umbilical inflammation was more common (11 cases),followed by folliculitis (9 cases) and impetigo (7 cases).Samples were collected for bacterial culture and identification from the skin of infected newborns,the hands and nasal cavity of family baby caretakers,and household articles,including faucets,mobile phones,toilet buttons and so on.The pathogens identified were Staphylococcus aureus in 20 cases (including 2 methicillin-resistant strains) and Escherichia coli in 7 cases.The isolation of Staphylococcus aureus in household articles was significantly correlated with newborns infected with Staphylococcus aureus (x2=678.808,P＜0.01);and the isolation of Staphylococcus aureus from family baby caretakers was also significantly associated with neonatal Staphylococcus aureus infection (x2=820.396,P＜0.01).In 7 cases of Escherichia coli infection,the Escherichia coli were detected from samples of baby caretakers or household articles.The study suggests that the awareness of baby caretakers and home hygiene are important to reduce neonatal skin infections.

Objective To investigate the expression of different inflammatory variables,such as procalcitonin(PCT),C-reactive protein (CRP),D-dimer (DD),fibrinogen (FIB),white blood cell (WBC),neutrophils and platelet(PLT)in septic elderly female patients with bacterial bloodstream infection,in order to assess the early diagnostic value of these variables.Methods A total of 308 elderly female patients with systemic inflammatory response syndrome(SIRS)were enrolled for this prospective study in Beijing Hospital between January 2014 and December 2015.Patients were divided into the sepsis group(n=210)and non-sepsis group(n=98)based on the diagnostic criteria of sepsis.The early inflammatory variables in blood,including PCT,CRP,DD,FIB,WBC,neutrophils and PLT,were detected within 6 hours of bloodstream infection,and their correlations were analyzed.The receiver operating characteristic(ROC)curve of inflammatory variables for the diagnosis of bloodstream infection was plotted,and the area under ROC curve (AUC)was calculated and used to evaluate diagnostic value for bloodstream infection.The best diagnostic cut-off points were identified based on the best(largest)AUC and the best sensitivity and specificity of inflammatory variables for bloodstream infection.Results The levels of all the inflammatory variables were significantly higher in the sepsis group than in non-sepsis group(all P＜0.05).Additionally,PCT and CRP were independent factors for diagnosis of blood stream infection.AUC of the combination of two biomarkers of PCT and CRP was 0.694 for diagnosis of sepsis,which was higher than the either biomarkers alone with AUC of 0.628 for PCT and 0.627 for CRP.The combination group of PCT and CRP showed better values of sensitivity,specificity,positive predictive,and negative predictive (86.2 ％,59.1％,65.1 ％,81.3 ％),as compared with those used individually(63.4％,58.2％,60.3％,61.4％ for PCT;and 62.4％,58.2％,59.9％,60.7％ for CRP,respectively).Conclusions The combination assay of PCT and CRP enhances the diagnostic ability for bacterial bloodstream infection.

Swabbing samples were routinely collected from health care workers ( HCW) contacting newborns in Obstetrics Department of our hospital on every Wednesday during January to December 2015. Total 495 samples from nasal vestibule and 483 samples from hands of HCW were collected for bacterial culture.The carrying status of methicillin-resistant staphylococccus aureus ( MRSA) was analyzed.The results showed that the average carrying rate of MRSA in the nasal vestibule was 8.1%(40/495) and that in hands was 5.0(24/483)(χ2 =3.871, P<0.05).The MRSA detection rate of nasal vestibular samples in the second quarter was the highest [12.2%(17/139)], while that of hands samples was highest in the first quarter [ 15.3%( 15/98 ) ] . The study indicates that carrying rate of MRSA in health care workers contacting newborns of our hospital is high , and the training and monitoring should be strengthened among health workers to reduce the MRSA carrying rate .

This study was aimed to evaluate the clinical effect and safety of Qing-Fei Tong-Luo (QFTL) ointment for treating children with pneumonia.Randomized controlled trial (RCT) was conducted among 460 cases of children with pneumonia.The observation group was given QFTL ointment combined with basic treatment.And the control group was only treated by basic treatment.Evaluation was given on the total clinical efficacy,disappeared time of fever,cough,expectoration,shortness of breath,and medication safety.The incidence of respiratory diseases was followed up on the 30th days after drug withdrawal.The results showed that in the aspect of clinical efficacy between two groups,the cure rate of the observation group was 98.26％,and that of the control group was 93.89％,with statistic significance (P ＜ 0.05).The cure rate of the observation group was better than that of the control group.There was statistical difference on expectoration disappeared time (P ＜ 0.05).There was no statistical difference on disappeared time of fever,cough and shortness of breath (P ＞ 0.05).There was statistical difference on the incidence of respiratory diseases on the 30th days followed-up after drug withdrawal (P ＜ 0.05).There was no statistical difference on the incidence of upper respiratory tract infection,pneumonia and asthma (P ＞ 0.05).No adverse reactions occurred in the observation group.It was concluded that QFTL ointment combined with basic therapy on the treatment of pneumonia in children was significantly better than the control group in the aspect of clinical efficacy,expectoration disappeared time and the incidence of bronchitis.It is safe and effective.The prognosis is good and worthy of promotion in the clinical practice.

Objective To explore the influence of elderly waist-hip ratio ( WHpR) on adiposity and vascular elasticity. Methods A total of 120 healthy middle aged and elderly people aged 40-60 years old were selected between February, 2015 and December, 2015. A number of 60 patients with normal ratio of WHpR were treated as a control group, while another 60 patients with higher ratio of WHpR as study group. Adiposity, arterial blood vessel elasticity, blood pressure, blood fat and blood glucose of two groups were compared. Results Normal rate of body fat and arterial blood vessel of the study group were lower than those of the control group. Adiposity, pulse wave velocity(PWV), body mass index of the study group were significantly higher than those of the control group. Systolic blood pressure, diastolic blood pressure, pulse pressure, blood glucose, uric acid, three acyl glycerin, total cholesterol, low-density lipoprotein cholesterol of the study group were higher than those of the control group, high density lipoprotein cholesterol was lower than that of the control group( P<0.05) . WHpR was positively associated with Adiposity, degree of elastic stiffness of blood vessels and body mass index (r=0.135, P=0.011;r=0.189, P=0.013;r=0.146, P=0.014). Degree of elastic stiffness of blood vessels was positively related with WHpR, adiposity, body mass index ( r=0. 189, P=0. 013;r=0. 123, P=0. 009;r=0.097,P=0.021) . Conclusions WHpR can be used as an early evaluation index of Adiposity and blood vessel elasticity for middle aged and elderly people.

Objective This study is designed to determine whether an association exists between single nucleotide polymorphism (SNP) variant rs2252673 of insulin receptor(INSR) gene and polycystic ovarian syndrome (PCOS) in Han Chinese in order to identify INSR as a genetic susceptibility factor for PCOS.Methods A total of 224 women with PCOS,192 controls and 672 participants consisting of 224 trios (mother,father and offspring with PCOS) were recruited from the Hospital for Reproductive Medicine Affiliated to Shandong University,from July 2007 to April 2013.Genomic DNA was extracted according to the manufacturer' s protocol.SNP rs2252673 of INSR gene was amplified by PCR and then sequenced on an automated sequencer.Moreover,clinical and metabolic features of the patients with PCOS were compared according to the genotypes.The subjects were divided into twot groups according to body mass index (BMI),and then the results were compared between two groups.And the transmitted disequilibrium test (TDT) was applied for data analysis.Results (1) There were three kinds of genotype of CC,CG and GG.Genotype frequencies of rs2252673 were 8.0％,38.8％,53.1％ and 14.6％,42.2％,43.2％ in the PCOS group and the control group,respectively.The allele frequencies of C and G were 27.5％,72.5％ and 35.7％,64.3％ in the PCOS group and the control group,respectively.There were statistical differences in genotype frequencies and allele frequencies between two groups (all P＜0.05).(2)No significant differences were observed in the different genotype according to clinical and metabolic characteristics of women with PCOS (P＞0.05).But when merging the genotype CG and GG,carriers of the CG and GG genotypes in women with PCOS were slightly associated with total cholesterol (TC) levels (t=2.072,P=0.048) and lower high-density lipoprotein (HDL) levels (t=2.274,P=0.026).Although statistical significance was not achieved,there was an increased tendency in fasting blood glucose (FBG) and fasting insulin (FINS) levels in CG and GG genotypes in PCOS cases.(3)Between the obesity and the non-obesity with PCOS,there was no statistical significance in the genotype and allele frequencies (x2=0.054,P=0.974; x2=0.022,P=0.883).(4)The results of families based analysis shown that genotype distribution of the SNP rs2252673 was in Hardy-Weinberg equilibrium (P＞0.05).After the TDT,the G allele in SNP rs2252673 was over transmitted in families (transmitted∶ non-transmitted=120∶ 88; x2=4.923,P=0.027).There was a transmitted disequilibrium in rs2252673,which implies the association of INSR and PCOS were independent of population stratification.Conclusions There were a association between the SNP variant rs2252673 of INSR gene and the susceptibility to PCOS in Han Chinese women,which was independently of body mass index.The carrier of G allele frequency of rs2252673 may have higher risk of PCOS.

Objective To observe the effect of comprehensive rehabilitation combined with home-based direction on spastic cerebral palsy.Methods 42 children with spastic cerebral palsy were divided into treatment group (n=21) and control group (n=21). The treatment group accepted comprehensive rehabilitation and home adjusted. Their parents participated in the rehabilitation and received home-based direction.The control group resigned the rehabilitation for poverty or other reasons, without home adjusted. They were assessed with Gross Motor Function Measure (GMFM-88) and Activities of Daily Living of Cerebral Palsy before and 6 months after treatment. Results The scores of GMFM-88 and Activities of Daily Living of Cerebral Palsy improved in the treatment group after treatment (P<0.05), and improved more in the treatment group than in the control group (P<0.05). Conclusion Rehabilitation training combined with home-based direction could improve the gross motor function and activities of daily living in children with spastic cerebral palsy.

Objective To investigate the pathogens and their drug resistance of neonatal skin infection in Maternal-Neonatal Unit to provide evidence for rational selection of antibiotics.Methods Secretions of skin lesions from newborns with skin infections delivered in Maternal-Neonatal Unit,Department of Obstetrics of Beijing Daxing People's Hospital from Jan.2009 to Dec.2010 were collected,cultured and identified for bacterial serotype.Antibiotic resistances of pathogens were determined.Enumeration data was presented by frequency and rate.The difference between groups was compared with Chi-square test.Results Two hundred and six newborn skin infection cases were diagnosed,which accounted for 2.3％ of all newborns (n=9131) delivered in the hospital during the study period.Two types of skin infection were identified,impetigo (n=192,93.2％) and omphalitis (n=14,6.8％).Totally 154 pathogens were found,including 95 (61.7％) Gram-positive cocci and 59 (38.3 ％) Gram-negative bacilli.The major pathogens among Gram-positive cocci were Staphylococcus aureus (45/154, 29.2％), followed by Staphylococcus epidermidis and Staphylococcus haemolyticus.Staphylococcus was sensitive to Cefazolin,Amoxicillin/clavulanic acid and Piperacillin/tazobactam,while resistant to Penicillin,Ampicillin and Erythromycin.The major pathogens among Gram-negative bacilli were Enterobacter cloacae (19/154,12.3％),followed by Escherichia coli and Klebsiella pneumoniae.Drug resistance rate of Gram-negative bacilli was high in penicillin,aminoglycosides and cephalosporins,while they were sensitive to piperacillin/tazobactam,Ampicillin/sulbactam,carbapenems and Quinolones.Conclusions Gram-positive cocci are the main pathogens of neonatal skin infection in the Maternal-Neonatal Unit,and among which Staphylococcus aureus is the major pathogen.Multi-drug resistance is common in the identified pathogens.Attentions should be paid to use antibiotics reasonably according to drug sensitivity test.