Major changes and updates of Clinical and Laboratory Standards Institute (CLSI) document M100-S22 for performance standards for antimicrobial susceptibility testing were introduced in the article,which includes ( 1 ) general changes; (2) changes of drugs recommended for testing and reporting;( 3 ) changes of interpretive criteria ( breakpoints ) and comments ; ( 4 ) changes of quality control and others; and (5) changes of appendixes and glossaries.

Objective To investigate the genetic association of HLA class II DRB1,DQB1,DQA2 and DQB2 locus with schizophrenia in the Han people of Northern China.Methods The polymerase chain reaction(PCR)and restrictive fragment length polymorphism(RELP) were applied to detect the gene types in the 195 Han family trios including patients with schizophrenia and their healthy parents in the north of China.The chi-square(?2) test,transmission disequilibrium test(TDT) and the haplotype relative risk(HRR) analysis were used to process the genotyping data statistically.Results The genotypic frequency of four genes did not deviate from Hardy-Weinberg equilibrium in both case and control groups;The SNP rs2239800,a G to A base change,presented in the DQA2 locus.Its allelic frequencies showed significant difference between case and control(?2=5.021,P=0.025).And the AA genotype of rs2239800 showed associations with schizophrenia.Conclusion The polymorphism of rs2239800 in the DQA2 gene may be associated with schizophrenia.

In this double-blind,double-dummy,non-inferiority study,144 cases of newly diagnosed acute gouty arthritis were reassigned to Chuanhu anti-gout mixture group (CH,n =72) and colchicine group (Col,n =72).After treatment for 10 days,the total efficiency rates of CH and Col groups were 93.02％ and 95.35％,respectively,showing no difference between two groups.Three months later,the overall recurrence rates in CH and Col groups were 12.50％ and 13.89％ respectively (P＜0.05).The incidence of adverse reactions in colchicine group was significantly higher than CH group (34.72％ vs 2.78％,P ＜ 0.01).Blood uric acid,alanine aminotransferase,aspartate aminotransferase,and creatinine in CH group were decreased significantly compared with Col group (P＜0.05 or P＜0.01).The results suggest that the clinical efficacy of Chuanhu anti-gout mixture in the treatment of acute gouty arthritis was not inferior to colchicine,but with higher safety.

The clinical features of 172 female and 1 067 male residents with gout in the coastal regions of Shandong province were analyzed.The results showed that as compared with male patients the onset of gout occurred at an older age in the female patients,and there were less obesity and tophi as well as less alcohol consumption and medication needed in the female patients.However,comorbidity with diabetes mellitus and coronary heart disease,as well as involvement of upper limb and other metatarsophalangeal joints were more prevalent in the female patients.

Objective To explore the applications and effect of experience-based health education in maternal nursing in community.Methods According to the random number table,150 women pregnant for the first time were divided into control group and observation group with 75 in each group. In the control group,the traditional method for health education was used and in the observation group the experience-based teaching based on traditional health education.The two groups were compared in terms of the awareness rate of knowledge about maternal and infant health care and the incidence of postpartum depression.Result The awareness of knowledge about maternal and infant health care in the observation group was significantly higher than that of the control group and the incidence of postpartum depression in the observation group was significantly lower than that of the control group(P<0.01).Conclusion Experience-based health education can improve the level of knowledge about maternal and infant health care and reduce the incidence of maternal postpartum depression.

OBJECTIVE To investigate the distribution and the drug resistance of Klebsiella pneumoniae in our hospital,and provide reference for the rational use of antimicrobial agents in clinic.METHODS The strains of K.pneumoniae isolated from clinical samples were identified by the VITEK-32 system.Extended spectrum ?-lactamases(ESBLs) were determined by phenotypic confirmatory test.Susceptibility test to antimicrobial agents was performed by disk diffusion methods and analyzed by WHONET 5.3.RESULTS 93.6% Of total 256 strains of K.pneumoniae were isolated from urine,sputum,blood and secretion samples,and 54.3% of them were isolated from sputum.81.6% Of infections caused by K.pneumoniae were frequently occurred in patients in intensive care units(ICU),departments of respiratory medicine and gastroenterology,departments of hematology and endocrinology,cadred wards and department of nephrology.The isolated ratio of ESBLs producing K.pneumoniae were 39.8%.The rates of resistance to piperacillin,cefuroxime,ceftazidime, cefotaxime,ceftriaxone,aztreonam,gentamicin,ciprofloxacin,and sulfamethoxazole/trimethoprim were between 32.4% and 50% in all strains;and the resistance rate to cefoperazone/sulbactam,piperacillin/tazobactam,cefepime,cefoxitin,and amikacin was less than 22.7%.There were isolates producing ESBLs,which showed much higher resistance to antimicrobial agents tested(but susceptible to imipenem and meropenem) than that of non-ESBLs-producing K. pneumoniae(P

Objective To explore the method of Oncomelania hupensis snail surveillance in transmission?interrupted re?gions of schistosomiasis,so as to provide a new pattern for the surveillance of snail status in the transmission?interrupted areas. Methods In Dongtai County,north of Jiangsu Province where the transmission of schistosomiasis was interrupted,the surveil?lance of snail status was performed by means of the village?level general survey,village?level sampling survey,snail survey in key settings of township and county,and snail reporting by residents. In addition,quality?control snail sites were set up for quali?ty control. The effectiveness and cost of the four methods of snail surveillance was compared. Results A total of 163 079 set?tings and 22 785.62 hm2 were surveyed in Dongtai County from 2008 to 2013,and 89 residual snail breeding sites were found, with a snail area of 1.48 hm2. The patterns of village?level general survey,village?level sampling survey,and snail survey in key settings of township and county were employed for investigation of 94 550,45 033 and 23 496 settings,consisting of 57.98%, 27.61%and 14.41%of total settings,and 2,0 and 6 settings were found with snails,with 0.021/thousand,0,and 0.255/thou?sand detection rates of settings with snail breading sites,respectively. The pattern of snail survey in key settings of township and county was more effective than that of village?level survey to detect snail breeding sites(χ2 =19.158,P=0). The recovery rate of quality?control snail breeding sites was 52.56%,38.27%and 73.62%for the three patterns of snail survey,respectively,and the pattern of snail survey in key settings of township and county showed a higher quality for snail survey than that of village?lev?el survey(χ2 =111.597 and 85.991,both P=0). During the period from 2008 to 2013,289 person?times reported 279 sus?pected snail habitats and 1 501 living snails,and no Oncomelania snails were found. During the 6?year period,there were 1617.5,964.7 and 527.7 thousand RMB invested for village?level general survey,village?level sampling survey,and snail sur?vey in key settings of township and county,and the cost of snail survey per hm2 was 129.88,133.6 and 162.57 RMB/hm2,re?spectively. The cost of village?level general survey and snail survey in key settings of township and county to detect a snail?breed?ing site was 808 800 and 88 000 RMB,respectively(t=12.850,P=0.000),and the cost of snail survey in key settings of town?ship and county was 10.88%of that of village?level general survey. Conclusion The snail survey in key settings of township and county is a highly effective and high?quality method for snail surveillance,which may serve as a prior way for the surveil?lance of snail status in the transmission?interrupted areas of schistosomiasis.

Objective To analyze the clinical characteristics of familial and sporadic gout patients to provide information for the classification,individual treatment and prognosis of gout.Methods The clinical and biochemical characteristies of 431 patients with familial gout and 1899 patients with sporadic gout were compared and analyzed.T test and X2 test were used for statistical analysis.Results The age at onset [(47±13) years ] and the serum uric acid level [ (472±125) μmol/L] of the familial gout patients in the acute phase were significantly lower than those of the sporadic gout patients (P＜0.05).The percentage of patients whose attack were induced by purine-rich food (67.7％ vs 88.2％),drinking (31.3％ vs 44.5％) and the first metatarsophalangeal joint involvement (69.1％ vs 77.4％ ) were significantly lower in the familial gout patients than those in the sporadic group of patients.The percentage of female was lower in the familial gout (9.7％) than in the sporadic patients(6.6％,P＜0.05).The percentage of patients with ankle joint (18.1％ vs 11.3％) and no obvious predisposing causes (25.2％ vs 2.5％ ) were higher in the familial gout patients than in the sporadic patients (P＜0.05).The percentage of patients with complicated lipid metabolism disorders was significantly higher in the familial gout patients than in the sporadic patients (P＜0.05).Conclusion The familial gout patients in Shandong coastal regions are early in disease onset,with lower serum uric acid level and more frequent in women.Detailed family history should be collected,and early prevention and appropriate treatment should be emphasized.

Objective To evaluate the performance of Carba NP test (CNP) for detection of carbapenemases in carbapenem-non-susceptive Enterobacteriaceae.Methods Carbapenemases in Enterobacteriaceae strains isolated from clinical specimens in the 117th hospital of PLA from January 2010 to December 2014 were detected by both CNP and modified Hodge test (MHT),and corresponding results were analyzed and compared by Chi-square using SPSS version 19.0.Data acquired from PCR were used as the standard.Results Of the 253 carbapenem-non-susceptive Enterobacteriaceae strains,188 positive strains and 65 negative strains were detected by MHT,and 175 positive strains,77 negative strains and 1 undetectable strain were detected by CNP,while 177 positive strains and 76 negative strains were detected by PCR.Sensitivities of two tests were comparable [CNP,98.9％ (175/177),versus MHT,98.3％ (174/177);x2 =0.5,P =0.48],but CNP was more specific [100.0％ (76/76) versus 81.6％ (62/76);x2 =12.1,P ＜ 0.05].Positive result in the CNP was emerged earliest in a KPC-producing strain.Conclusion The CNP is rapid and simple,which have good sensitivity and specificity.Yet further perfection is still needed in the future.

Objective To investigate the correlation between the cerebrocardiac syndrome (CCS) of severe type and prediction of prognosis of patients with neurosurgery .Methods Myocardial zymogram levels were measured in course of development of 120 ca‐ses of Acute Stroke(AS) that were confirmed diagnosis by brain computerized tomography (CT) .ultrasoundcardiogram(UCG)and electrocardiogram(ECG)were used to dectect Segmental Wall Motio Abnormalities (SWMA) .Results For 120 patients with AS , the specimens include 38 cases(76 .0% )of T‐wave change and 12 cases(24 .0% )of ST‐segment depression in 50 cases of ST‐T seg‐ment change ,7 cases of arrhythmia and adnormal cardiac electrical conduction .24 cases of SWM A ,32 cases(26 .7% ) of raised CK‐MB ,35 patients could be recovered to normal of ECG after active treatment .17cases of ECG improve markedly ,18 cases of ECG un‐improved ,15 cases of myocardial enzymes normally ,8 cases of myocardial enzymes improve markedly20 cases of death .Conclusion Hypertension is a risk factor of CCS ,correlation between ST‐T segment and SWMA as well as myocardial enzymes and myocardial damagein CCS was statistically analyed .