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 study the clinical significance of lung function and allergen detection in the diagnosis of cough variant asthma (CVA) in children. Method Forty-three cases of chronic cough in children with bronchial provocation (diastolic) test and skin prick allergy test results were analyzed, CVA group was 23 cases and control group was 20 cases. Results The positive of bronchial provocation (diastolic) test in CVA group was 19 cases, significantly higher than that in control group (3 cases, χ2=14.745, P ＜ 0.01 ).The positive of skin prick allergy test in CVA group was 17 cases , significantly higher than that in control group (5 cases, χ2 = 10.243,P ＜0.05). The correlation analysis showed that bronchial provocation (diastolic) test and skin prick allergy test was significantly correlated (r =0.404,P＜0.01 ).Conclusion Bronchial provocation (diastolic) test has an important role in the diagnosis of CVA; skin prick allergy test has a supporting role on the CVA diagnosis;allergens affect on lung function, bronchial provocation (diastolic) test with the help of skin prick allergy test in children with cough variant asthma diagnosis.

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 raise the competition power of China's pharmaceutical enterprises,make them adapt to the principle of WTO better,and finally to build a safe,effective,and convenient pharmaceutical circulation channel.METHODS:To interview the pharmacy-related departments and enterprises in22provinces and cities to collect the firsthand materials,and consult a lot of literature.RESULTS&CONCLUSION:The government should enhance the macro-management for the purpose to build a fair,unified and ordered national market;enterprise should promote and enhance themselves to improve the core competition capacity;the trade association should play a role in micro-harmonization.

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 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.

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 determine the effect of age,body figure and risk framing in making treatment decision for female patients with breast cancer.Methods Two groups of healthy female:one group of 60 female ages 18-24 from undergraduate student and the other group of 60 female ages 35-60 from the university community.Healthy women imagined that they had been diagnosed with breast cancer and received information regarding lumpectomy versus mastectomy and recurrence rates.Participants indicated whether they would choose lumpectomy or mastectomy and reasons.Results The different concern levels of body appearance between younger and older women influences treatment selection of lumpectomy versus mastectomy.Facing the risk information,older women were unlikely to select the breast conserving operation.Conclusions The factors of age and the attention to body figure would effect the choice of breast conserving operation or mastectomy.Risk information on the selection of treatment would not affected directly,but the effects of risk information on younger and older female is different.Nurses should provide the age-appropriate information who recently have been diagnosed with breast cancer regarding treatment alternatives to ensure their active participation in the decision-making process,female who have different levels of investment in body figure also may have different concerns about treatment,and should be alert on empathetic of such concerns.