Objective To analyze the risk factors of Gram‐negative bacterial blood‐stream infection in ICU for conducting the risk evaluation and guiding medication .Methods The inpatients were diagnosed with Gram‐negative bacterial blood‐stream infec‐tion in ICU of the Renmin Hospital of Wuhan University from January 2013 to December 2014 were retrospectively surveyed and analyzed .The risk factors of blood‐stream infection caused by Gram‐negative bacteria were analyzed and screened by the Logistic re‐gression analysis method .Results A total of 172 case‐times of blood‐stream infection occurred in ICU during this period ,including 93 case‐times of Gram‐negative bacterial infection .The Gram‐negative pathogenic bacteria were Acinetobacter baumanii ,Klebsiella pneumoniae ,Acinetobacter calcoaceticus baumanii ,E .coli ,pseudomonas aeruginosa ,etc .Except E .coli was mainly originated from community acquired infection ,other bacteria were mainly originated from nosocomial infection .In order to differing from other pathogenic bacterial blood stream infection ,the Logistic regression analysis results showed that the independent risk factors of G‐negative bacterial blood‐stream infection in ICU had serum PCT levels over 10 .0 ng/mL (OR= 60 .52 ,P= 0 .001) ,receiving the therapy of carbapenem and third generation cephalosporins (OR=16 .09 ,P=0 .03) ,hospitalization duration less than 2 weeks be‐fore suffering from disease (OR=13 .79 ,P=0 .03) and digestive system basic disease(OR=12 .94 ,P=0 .01) .Conclusion Gram‐negative bacterial blood‐stream infection in ICU of the Renmin Hospital of Wuhan University is mainly caused by multi‐drug resist‐ant bacteria .Serum PCT level over 10 .0 ng/mL ,hospitalization duration less than 2 weeks before infection ,receiving the therapy of carbapenem and third generation cephalosporin and basic diseases of digestive system are the independent risk factors influencing the occurrence and diagnosis of blood‐stream infection .

Objective To identify major factors which affect the completion quality of projects and build predictive models,and to propose strategies and suggestions for total process quality management of clinical research projects of the hospital.Methods Collect relevant literatures from home and abroad;consult completion reports of various research projects completed from 2003 to 2010 and sum up problems found in such projects.Carry out in-depth interviews with principal investigators,supervisors of scientific research of the hospital as well as administrators of sponsor institutions.A questionnaire survey was made on completed clinical research projects undertaken from 2003 to 2010.Results Six key factors affecting implementation of such projects were derived from factor analysis,which are research technology and external environment,project teamwork,research subject availability,project organization,manpower input,and research design.A multiple logistic regression analysis found project internal management and manpower input as two leading predictive factors for project completion outcomes,while the former has a greater impact than the latter.Conclusion Project management should focus on the 6 key factors affecting project quality.The two main predictive factors should attract greater attention and resources in both supervision and management.

Objective To explore the application and efficacy of autogenous septal cartilage in the correction of cleft lip nasal deformity.Methods A total of 31 patients with secondary nasal deformity of cleft lip were involved in this study.After autologous nasal cartilage was released,the dislocation of nasal cartilage was corrected,nasal septum cartilage was used as substitute to raise the alar collapse,to reshape the nasal tip cartilage structure and correct the nasal deformity.Results Postoperative incision was primarily healing.For cartilage donor area there was no serious complications,and incision scar was concealed and unobvious; after 6 months to 2 years follow-up,there was no cartilage absorption deformation,the tip of the nose was flat,crack side nosewing collapses,and nasal columella skew was totally corrected,with stable rhinoplasty effects.Conclusions For secondary nasal deformity of cleft lip,the use of nasal septum cartilage to repair nose deformity can not only solve the cartilage source,but also give septal straightening and at the same time the correction effect of external nasal deformity is good.

Objective To study influences of magnetic field on behavior of depressive rats under chronic unpredictable mild stress,and possible mechanisms under such phenomena.Methods Thirty-six Wistar rats were divided into model group,magnetic field group and control group (n =12 in each group) according to random number table.The model group and the magnetic field group received CUMS stimulation daily for 5 weeks,while the control group received no any treatment.At the end of the fifth week,rats in the magnetic field group were placed in the center of a magnetic machine (400 mT),and the model group was raised freely for4 weeks.The severity of depressive behaviors,cortisol levels and contents of C-reactive protein in blood and urine sample were tested pre-treatment,at the end of 5 weeks and 9 weeks.Results After 5 weeks,consumption of glucose solution of the control group was higher than the other two groups (P ＜ 0.05).After 5 and 9 weeks,body weights of the magnetic group and the model group were lower than the control group (P ＜ 0.05).At the end of 9 weeks,performance of the magnetic group as indicated by frequency of grid crossing,grooming time and suspending tail test were improved to a significantly greater extent than the other two groups (P ＜ 0.05).In addition,the urine content of cortisol in 24 hours in magnetic field and model groups was higher than the control group at the end of 5 weeks,and the serum level of cortisol in the magnetic field group were significantly higher than the model group at the end of 9 weeks (P ＜ 0.05).Conclusion The 400mT magnetic field can reduce the severity of behavior changes of rats with CUMS-induced depression,which might be attributable to its influence on the cortisol levels in blood and urine.

This paper combines the concept,advancement and application of minimally invasive technique to investigate the methods and procedure in the cultivation of clinical graduate students.

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 establish a method for the content determination of chlorogenic acid,protocatechuic acid and total phenolics in Chaenomeles sinensis,compare the content of total phenolics and 2 phenolic acids from different areas. METHODS:Wavelength switching HPLC method was conducted to determine the chlorogenic acid and protocatechuic acid. The column was Shim-pack CLC-ODS(M)with the mobile phase of acetonitrile-0.1% phoephoric acid(15∶85,V/V),the detection wavelength was 259 nm(for protocatechuic acid)and 325 nm(for chlorogenic acid)and the switching time was 14 min. With the index of proto-catechuic acid,Folin-Ciocalteau colorimetric method was conducted to determine the total phenolics. RESULTS:The 2 methods of quantitative analysis showed that the precision,repeatability,recoveries and standard curves were all validated by methodology. The mass fraction of total phenolics was 0.87%-3.77% with the average of 2.16%;the chlorogenic acid was 0.053%-0.387% with the average of 0.192% and the protocatechuic acid was 0.024%-0.541% with the average of 0.087%. The order of total phenolics content in C. sinensis from different areas was Yunnan>Anhui Xuancheng>Sichuan>Hubei and the order of total amount of chlo-rogenic acid and protocatechuic acid from different areas was the same as the total phenolics. There were differences among the con-tents of C. sinensis from different areas,however,the positive correlation was found between the content of total phenolics and the total amount of chlorogenic acid and protocatechuic acid with the pearson correlation coefficient of 0.719(P<0.01).CONCLU-SIONS:The established method is simple,accurate and reproducible and can be used for the content determination of chlorogenic acid,protocatechuic acid and total phenolics in chaenomelis fructus.

AIM To observe the anti-inflammatory effects of total flavones from Xueli Formula (Violae Herba,Serissa japonica,Plantaginis Herba and Salvia plebeia,TFXL) on LPS-stimulated RAW264.7 macrophages.METHODS The effects of different concentrations of TFXL on RAW264.7 cell viability were examined by MTT assay.The NO kit assay was adopted to detect the NO release amount of TFXL on LPS-stimulated RAW264.7 cells.The secretions of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) and interleukin-10 (IL-10) were tested by enzyme linked immunosorbent assay (ELISA).Reverse transcriptase-polymerase chain reaction (RTPCR) was used to determine the expressions of inducible nitric oxide synthase (iNOS),TNF-α,IL6 and IL10 mRNA.The protein expressions of IκB-α and p65 were tested by Western blot.RESULTS Compared with the LPS model group,TFXL could significantly reduce the secretions of NO,TNF-α and IL-6;increase the secretion of IL-10;inhibit the expressions of iNOS,TNF-α and IL6 mRNA;promote the expression of IL10 mRNA;inhibit the phosphorylations of IκB-α and p65.The TFXL high-dose group could inhibit the degradation of IκB-α.CONCLUSION This study preliminarily proves the protective effects of TFXL on LPS-stimulated RAW264.7 cell inflammation,whose action mechanism may be related to NF-κB signal pathway.

Objective To observe the effects of telmisartan and valsartan on insulin resistance in obese hypertensive patients. Methods Sixty-eight patients with essential hypertension and body mass index ( BMI) ≥25 kg · ( m2 ) -1 were randomly divided into the telmisartan group (33 cases) and valsartan group (35 cases). Blood pressure, fasting serum glucose, fasting insulin (Fins) and insulin resistance (HOMA-IR) were measured before and after 16 weeks treatment. Results Compared with basal levels, SBP and DBP were significantly decreased in both group ( P<0. 01). Fins and HOMA-IR were significantly decreased in telmisartan group [(12. 9±2. 9) mU·L-1 vs. (10. 9±2. 2) mU·L-1 (P<0. 01); (3. 1±0. 7) vs. (2. 7±0. 6) (P<0. 01), respectively], while no such changes were found in valsartan group [(12. 9 ±3. 0) mU·L-1 vs. (12. 7±2. 7) mU·L-1 ( P > 0. 05);( 3. 0 ± 0. 7) vs. (3. 0 ± 0. 7) ( P > 0. 05), respectively]. Conclusion In obese hypertensive patients, telmisartan and valsartan exert similar antihypertensive effect, but telmisartan may have a benefit in insulin resistance in comparison to valsartan.

Objective To observe the effects of selfmade Lifeihuayu decotion in the treatment of patients with bronchial asthma.Methods 102 patients with bronchial asthma were randomly divided into the observation group and the control group,each group had 51 cases.The patients in the control group were treated with the conven-tional treatment,while the patients in the observation group were treated with the conventional treatment plus selfmade Lifeihuayu decotion.They were treated for 8 weeks.The patients of the two groups were determined with lung function and blood gas analysis, including forced expiratory volume in one second ( FEV1 ) , forced inspiratory vital capacity ( FVC) ,peak expiratory flow( PEF) ,pH value,the partial pressure of oxygen( PaO2 ) and carbon dioxide partial pres-sure(PaCO2).Results The total effective rate were 98.0% in the observation group and 90.2% in the control group,the total efficiency of the observation group was significantly higher(χ2 =5.78,P<0.05).After treatment,the FEV1,FVC and PEF of the patient's in the two groups were significantly increased(t=5.325,4.821,2.761,all P<0.05),and compared with the control group,the FEV1,FVC and PEF of patients in the observation group improved more significantly(t=2.068,2.771,3.013,all P<0.05).After treatment,the PaO2 of the patient's in the two groups were significantly higher,which more obviously increased in the observation group than those in the control group( t=2.925,P<0.05).After treatment,the PaCO2 of the patient's in the two groups were significantly decreased,PaCO2 in the observation group significantly decreased more than that in the control group(t=3.063,P<0.05).Conclusion Selfmade Lifeihuayu decotion in the treatment of patients with bronchial asthma has curative effect,and can signifi-cantly improve lung function and blood gas analysis of patients.