Objective To understand the clinical distribution and monitoring the change of resistance of Streptococcus pneumoni‐ae ,effective for clinical anti infection to provide reference .Methods Using VITEK 2 Compact to analyze the bacteria identification and drug sensitivity data ,and using WHONET5 .3 software and SPSS13 .0 software for statistical analysis .Results From 2008 to 2013 ,588 strains of Streptococcus pneumoniae were isolated ,mainly distributed in the intensive care unit (ICU) ,followed by respir‐atory department of internal medicine ,general pediatrics ;mainly from sputum samples ,followed by the throat swabs and blood samples .The highest resistant rate was erythromycin ,followed by penicillin and cotrimoxazole ;Streptococcus pneumoniae remains sensitive to ofloxacin ,levofloxacin ,vancomycin ,linezolid ,chloramphenicol .Conclusion The resistance rate of Streptococcus pneu‐moniae was rising ,and that great attention should be paid to the bacterial drug resistance so as to reasonably use a antibiotics based on the result of drug susceptibility testing .

Objective To investigate the relationships between glucokinase(GCK) gene 3 tag single‐nucleotide polymorphisms (tagSNPs)sites rs2971672 ,rs2268573 and rs2300587 polymorphisms with type 2 diabetes (T2DM ) .Methods A total of 499 south‐ern Han inpatients with T2DM (T2DM group) in our hospital and contemporaneous 499 Han individuals undergoing the physical examination(control group) in the Health and Fitness Protection Center of our hospital from August 2013 to December 2014 were chosen .The GCK gene 3 tagSNPs sites in all subjects were genotyped by adopting the improved multiple ligase detection reaction (iMLDR) ,and the genotype and allele frequency between the T2DM group and healthy controls were compared by the chi‐square test ,logistic regression analysis ,moreover the tagSNPs sites were performed the correlation analysis under three genetic modes (dominant ,recessive and additive) .The Haploview software was used to construct the haplotype of GCK gene 3 tagSNPs and the linkage disequilibrium(LD) and relationship between various GCK haplotype and T2DM susceptibility was analyzed .Results The differences of rs2268573 and rs2300587 genotypes(χ2 =3 .361 ,2 .076 ,P>0 .05) and allele frequency(χ2 =0 .222 ,1 .980 ,P>0 .05) between the T2DM group and the control group were not statistically significant .The difference of rs2971672 genotype(χ2 =6 .896 , P<0 .01) and allele distribution(χ2 =4 .708 ,P<0 .05) between the T2DM group and the control group was statistically signifi‐cant .Under the dominant genetic model and additive genetic model ,the genotype distribution of rs2971672 between the T2DM group and the control group was statistically significant(OR= 1 .74 ,95% CI:1 .17 -2 .57 ,P<0 .01 ;OR=1 .51 ,95% CI:1 .06-2 .14 ,P<0 .05) .Among 3 GCK gene sites ,rs2971672 and rs2300587 had the LD domain including 3 main haplotypes of TC ,TA and CA3 ,the TA and CA haplotypes all decreased the risk suffering from T2DM(OR=0 .81 ,95% CI:0 .66-1 .00 ,P<0 .05 ;OR=0 .78 ,95% CI:0 .62-0 .98 ,P<0 .05) .Conclusion In Han population ,GCK gene rs2971672 site is closely related with T2DM ge‐netic susceptibility ,while rs2268573 and rs2300587 sites have no obvious correlation with T2DM susceptibility .Haplotype TA and CA in rs2971672 and rs2300587 LD domain all reduce the individual risk suffering from T2DM .

Objective To understand the drug resistance of Neisseria gonorrhoeae in Foshan area and to detect the related drug resistant gene mutation situation.Methods 57 strains of Neisseria gonorrhoeae were collected.The drug susceptibility test was per-formed by adopting the agar dilution method.The related drug resistance genes were amplified by PCR and the PCR product se-quencing results were performed the homological searching in GenBank by the BLAST algorithm.Results The sensitive rates of Neisseria gonorrhoeae to penicillin,tetracycline,ciprooxacin,ceftriaxone and spectinomycin were 0.0%,8.8%,7.0%,61.4% and 100.0%,respectively.The rates of beta lactamase-producing Neisseria gonorrhoeae and tetracycline resistant Neisseria gonorrhoeae were 35.1% and 56.1%,respectively.The mutation rate of drug resistance genes were over 80%.Conclusion Ceftriaxone and spectinomycin can be used as the first choice drug for the treatment of Neisseria gonorrhoeae in Foshan region.The drug resistance mechanism of Neisseria gonorrhoeae is complex.The epidemiological monitoring of the Neisseria gonorrhoeae related drug resist-ance genes should be strengthened.

Objective To investigate the relationships between Glucokinase(GCK) gene 4 tag single‐nucleotide polymorphisms , tagSNPs)sites which named rs12702070 ,rs2268569 ,rs2268573 and rs1476891 polymorphisms and type 2 diabetes in Chinese South‐ern Han Population .Methods This study was designed as a case‐control .499 type 2 diabetes patients and 499 healthy controls were chosen .4 GCK tagSNPs sites were analyzed by improved multiple ligase detection reaction(iMLDR) ,and genotype and allele fre‐quency between T2D group and healthy controls could be determined by chi‐square test ,logistic regression analysis ,and tagSNPs were further analyzed under three genetic modes(dominant ,recessive and additive) .What′s more ,Haploview software was used to construct the haplotype of 4 GCK tagSNPs and the linkage disequilibrium(LD) and relationship between various GCK haplotype and T2D susceptibility could be analyzed .Results Genotype distribution of rs2268573 ,rs2268569 and rs1476891 and allele frequen‐cy in T2D group were no significant differences with health controls .Significant differences in genotype distribution of rs12702070 and allele frequency were observed between T2D group and health controls .Under dominant model and additive model ,genotype distribution of rs12702070 in T2D was significantly different from health controls .One LD domain was observed in 3 tagSNPs a‐mong those 4 sites of GCK gene .There are 4 main haplotypes(TAG ,TGG ,TAT ,CGG)in rs2268569 ,rs12702070 and rs1476891 , but all these haplotypes have no relevance to the individual risk of T2D(P>0 .05) .Conclusion The results indicated that the GCK gene tagSNPs site rs12702070 imparts susceptibility to T2D in Han Chinese ,but not rs2268573 ,rs2268569 and rs1476891 .Four main haplotypes in rs2268569 ,rs12702070 and rs1476891 have no relevance to T2D .

Objective To investigate the relationships between Glucokinase (GCK) gene 6 (tag single-nucleotide polymorphisms,tagSNPs)sites which named rs12702070,rs2971672,rs2268569,rs2268573,rs2300587 and rs1476891 polymorphisms and type 2 diabetes in Chinese Southern Han Population.Methods This study was designed as a case-control.499 type 2 diabetes patients and 499 healthy controls were chosen.All subjects were from August 2013 to December 2014 in Zhongshan Affiliated Hospital of Sun Yat-sen University.6 GCK tagSNPs sites were analyzed by improved multiple ligase detection reaction (iMLDR),and genotype and allele frequency between T2D group and healthy controls could be determined by chi-square test,logistic regression analysis,and tagSNPs were further analyzed under three genetic modes(dominant,recessive and additive).What's more,Haploview software was used to construct the haplotype of 6 GCK tagSNPs and the linkage disequilibrium (LD) and relationship between various GCK haplotype and T2D susceptibility could be analyzed.Results Genotype distribution of rs2268573,rs2300587,rs2268569 and rs1476891 (x2 were 3.361,2.076,0.582 and 0.918 respectively,all P ＞0.05) and allele frequency (x2 were 0.222,1.980,0.590 and 0.851 respectively,all P ＞ 0.05) in T2D group were no significant differences with health controls.Significant differences in genotype distribution of rs2971672 and rs12702070 (x2 were 6.896 and 7.990 respectively,all P ＜ 0.01) and allele frequency (x2 were 4.708 and 5.979,P ＜ 0.05 and P ＜ 0.01 respectively) were observed between T2D group and health controls.Under dominant model (rs2971672:OR =1.74,95％ CI =1.17-2.57,P ＜ 0.01;rs12702070:OR =1.54,95 ％ CI =1.17-2.04,P ＜ 0.01) and additive model (rs2971672:OR =1.51,95 ％ CI =1.06-2.14,P ＜ 0.05;rs12702070:OR =1.26,95％ CI =1.04-1.52,P ＜ 0.05),Genotype distribution of rs2971672 and rs2971672 in T2D were significantly different from health controls.There are two LD domains in 5 tagSNPs among those 6 sites of GCK gene.There are three main haplotypes(TC,TA,CA)in rs2971672 and rs2300587,and four main haplotypes (TAG,TGG,TAT,CGG) in Rs2268569,rs12702070 and rs1476891.Although TAG,TGG,TAT and CGG have no relevance to the individual risk of T2D (P ＞ 0.05),haplotype TA and CA reduce the individual risk of T2D with OR 0.81 (95％ CI:0.66-1.00,P＜0.05) and0.78 (95％ CI:0.62-0.98,P ＜0.01)respectively.Conclusions The results indicated that GCK gene 2 tagSNPs sites included rs2971672 and rs12702070 imparts susceptibility to T2D in Han Chinese,but not rs2268573,rs2300587,rs2268569 and rs1476891.Haplotype TA and CA in rs2971672 and rs2300587 reduce the individual risk of T2D and four main haplotypes (TAG,TGG,TAT,CGG) in rs2268569,rs12702070 and rs1476891 have no relevance to T2D.

Objective:To study the application of the best evidence of dysphagia recognition in acute stroke patients.Methods:The study was performed guided by JBI evidence-based continuous quality improvement pattern, including evidence acquisition, baseline audit, evidence implementation and re-audit. Data were collected by using field observation, questionnaire survey and review of nursing records. 80 patients and 18 nurses were recruited in the study. Barriers to evidence implementation and available solutions were analyzed. Before and after the application of evidence, the compliance of audit criterion, screening rate of swallowing disorder, screening accuracy, screening record rate and knowledge of nurses were compared.Results:Before and after the implementation of evidence, the compliance of all audit criterion was 0-33.3% and 95.0%-100.0%, and had a significant difference ( P<0.05). The dysphagia recognition knowledge score was improved from 40-80(60.56±10.69) to 60-100 (82.78±10.18) and had a significant difference ( t value was -6.39, P<0.05). The screening rate for dysphagia increased from 7.5% to 95.0%, with statistically significant difference ( χ2 value was 119.10, P<0.05). The screening accuracy was 100%, and the screening record rate was 97.4%, only 4 of the 24 patients at risk of dysphagia developed pulmonary infection. Conclusion:The application of the best evidence of dysphagia recognition in acute stroke patients can improve the nurses′ ability of dysphagia screening and improve nursing practice in dysphagia management.