OBJECTIVE To investigate the characteristics of female genital opportunistic infection patients who infected with human immunodeficiency virus(HIV) and to provide reference for early diagnosis and treatment of HIV infection.METHODS The clinical data of 116 patients with HIV,including female genital symptoms and general condition collected from Jan 2007 to Dec 2008 were analyzed retrospectvely.These patients were all from the Central African Republic.RESULTS Among these 116 patients with HIV,89 patients(76.72%)had infective changes in the female genitals,and 68 patients(58.62%) had two to four diseases simultaneously.Among these infections,the most infection was chronic infection in the basin behaved chronic ache in the basin and infertility,then were vulvovaginal candidiasis,acute pelvic inflammatory disease,and trichomonal vaginitis and cervicitis.The CD4+ cell counts of 67 patients decreased,and the CD8+ cell counts of 31 patients decreased,of which 35 patients were accompanied with chronic dissipative symptoms among these patients.CONCLUSIONS HIV can descend human immunity,the patients can suffer with female genital oppprtunistic infection easily and should be paid more attention to in the eary stage.

Objective To discuss the application effect of task-driven basic nursing probation based on the action research. Methods Using the frame of Lewin's action research, with random sampling, we selected a class for the study, for the first time in the traditional training model, and the second time in the task-driven model based on the action research. and information was collected according to the interviews and diary records, narrative description was used for records of the results. Results Action research promoted changes in basic nursing probation model, constructed knowledge, ability and improved various kinds of ability of nursing students. Conclusions The task-driven probation model improved the quality of clinic practice, which proved to be effective.

Objective To study the relationship between efflux pump MexAB‐OprM and carbapenem resistance of Pseudomonas aerginosa strains .Methods The minimum inhibitory concentrations of imipenem and meropenem were determined by agar dilution method for 75 strains of P .aerginosa in the absence or presence of MC207110 to screen the phenotypes of active efflux pump .Reverse transcriptase‐polymerase chain reaction (RT‐PCR) method was used to determine the mRNA expression level of mexA which encodes the membrane fusion protein in active efflux pump MexAB‐OprM and the reference (housekeeping) gene rpoD .PCR method was used to amplify the regulatory genes mexR ,nalC ,and nalD of active efflux pump MexAB‐OprM in the strains overexpressing the efflux pump . The PCR products were subject to DNA sequencing and BLAST analysis . Results Of the 75 P .aeruginosa strains ,13 (17 .3% ) were positive for efflux pump MexAB‐OprM .Overexpression of the efflux pump was identified in 10 of the 13 strains and associated with positive regulatory genes mexR ,nalC and nalD .A Gly71→Glu mutation in nalC was found in 9 strains ,and a Ser209→Arg mutation in nalC was identified in 8 strains .Only one strain had a Thr158→Ile mutation in nalD .Eight strains had mutation in mexR .Conclusions Overexpression of multidrug efflux pump MexAB‐OprM plays an important role in carbapenem resistance of P .aeruginosa .High level expression of MexAB‐OprM is related to the mutations of its regulatory genes .

Objective To investigate the clinical value of the duodenum double lumen cannula suction in duodenal rupture repair.Methods According to the operation methods,60 patients with duodenal rupture undergoing duodenal repair were divided into the surgical drainage alone group(26 cases)and double sets attract tube group (34 cases).The surgery effect and complications were observed.Results The difference of traffic flow 7 days after the operation between the two groups was statistically significant(t =7.564,P <0.05).The length of stay and hospital costs of the surgical drainage alone group were more than those of the double sets attract tube group,the differences were statistically significant(t =3.567,4.123,all P <0.05).The fistula,intra -abdominal infections,wound infec-tions,pulmonary infection rates of the surgical drainage alone group were 30.77%,42.31%,46.15%,26.92%, which were higher than 2.94%,11.76%,8.82%,2.94%,5.88% of the double sets attract tube group,the differ-ences were statistically significant(χ2 =8.949,7.330,10.950,2.986,5.116,all P <0.05).Conclusion Applica-tion of the double lumen cannula duodenal suction in duodenal rupture repair can significantly reduce the incidence of postoperative complications,has certain security,it is recommended in clinical practice.

Commonly, the interbacterial transfer of circular plasmids is initiated by nicking at an internal sequence, oriT, followed by transferring one strand as single-stranded DNA through a type Ⅳ secretion channel on cell membrane. In contrast, Streptomyces conjugative linear plasmids, containing a free 3'-end but a protein-capped 5'-end, can potentially undergo cell-to-cell transfer by transfer of non-nicked DNA. It was reported that circular derivatives of the Streptomyces lividans linear plasmid SLP2, as well as the parental linear plasmid itself can transfer efficiently. And the genetic requirements for such transfer was described. Efficient transfer of plasmid requires six co-transcribed SLP2 genes, encoding a Tra-like DNA translocase, cell wall hydrolase, two cell membrane proteins that interact with an ATP binding protein, and a protein of unknown function. Reduced transfer efficiency of plasmid from SalⅠ R-/M-to Sal Ⅰ R/M hosts argues that transfer of both the circular and linear forms of the plasmid involves double-stranded DNA. These results suggest that conjugal transfer occurs by a similar mechanism for SLP2-derived linear and circular plasmids, and cellular membrane/wall functions in the transfer process.

Objective To explore the effect of fluoxetine on the brain function of bulimia nervosa (BN) patients.Methods Seven female BN patients,who met criteria of the 3rd version Chinese Criteria of Mental Diseases (CCMD-3),accepted functional magnetic resonance imaging (fMRI) examinations before and after the antidepressant treatment (fluoxetine (20 mg/day)) for three months.Seven normal controls accepted the same fMRI examination only at baseline.fMRI imaging was block-design.Blocks of food or non-food stimulus containing pictures selected from International Affective Picture System (IAPS) which were shown by computer automatically.All subjects were evaluated by Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD17) and Likert Scale-likelihood evaluation to the same pictures in the fMRI imaging blocks.Results The average intensity and volume activated in BN before treatment were both significantly lower than that in the control (P＜0.05).But under stimulus of food pictures,bilateral prefrontal cortex and left amygdala of BN patients were significantly activated.After fluoxetine treatment,the intensity and volume activated both increased significantly (P＜0.01) and the main areas being activated were right temporal,cerebellum and bilateral prefrontal cortex.Conclusion Fluoxetine improves the bulimic symptoms of BN patients and decreases abnormal activation of prefrontal and limbic in these areas.The underline mechanism may be related to functions of serotonin system in prefrontal-limbic path.

Objective To explore the optimal acupuncture scheme in intervening hypermyotonia of the affected limbs in stroke.Method Eighty eligible stroke patients were randomly grouped by using the orthogonal experimental design, by adopting electroacupuncture (A), daily acupuncture frequency (B), and acupoint (C) as three factors, and two levels. A total of 20 treatment sessions were conducted. Each group was scored by using the Modified Ashworth Scale (MAS) before and after the treatment, and the safety was also evaluated.Result There was a significant difference in comparing the MAS score between the two different levels of factor A (P<0.05), while there were no significant differences in comparing the MAS scores between different levels of factor B and factor C (P<0.05). Concerning the improvement of the MAS scores of wrist, elbow, knee, and ankle joints, A2B1C1(i.e. electroacupuncture twice a day with acupoints from yin meridians) was the optimal treatment scheme.Conclusion Electroacupuncture twice a day is the optimal treatment scheme for hypermyotonia of the affected limbs in stroke, as it can effectively ease the hypermyotonia, improve the function and symptoms of the limbs, and has a satisfactory security evaluation.

Objective:To measure the serum levels of 25-hydroxyvitamin D in children with asthma, and to investigate the relationship between the serum levels of 25-hydroxyvitamin D and total immunoglobulin E (TIgE).Methods:From October 2013 to September 2014, 48 children with bronchial asthma were selected as asthma group, and 35 healthy children were selected as control group.Double-antibody radioimmunoassay(RIA) was used to detect the levels of serum 25-hydroxyvitamin D and TIgE.Results:The serum level of 25-hydroxyvitamin D in the asthma group was (35.86±14.31)nmol/L, which was significantly lower than that in the control group[(53.91±22.71)nmol/L], and IgE level in the asthma group was (331.66±223.67)IU/mL, which was significantly higher than that in the control group [(99.33±86.50)IU/mL], the differences were statistically significant( t=4.32, 2.36, all P<0.05). There was a negative correlation between serum 25-hydroxyvitamin D and IgE in the asthma group( r=-0.400, P<0.05). Conclusion:The serum levels of 25-hydroxyvitamin D may be associated with childhood asthma.The significant negative correlation between the levels of 25-hydroxyvitamin D and TIgE in children who had bronchial asthma indicates that asthma has a close relationship with allergy.Through increasing the concentration of 25-hydroxyvitamin D may prevent or treat child-hood asthma.

Five hundred and nineteen patients with essential hypertension from 6 community health centers in Baoshan Distract of Shanghai were enrolled in the program,all patients received direct or indirect comprehensive interventions.These interventions were conducted by doctors from tertiary hospitals and community health serwice centers.Among these hyperpietic,462 patients were followed-up for 1 year.After interventions,the awareness rate of hypertension was significantly increased,unhealthy life styles were changed; blood pressure control rate and risk factors control rate were also increased; carotid-femoral artery pulse wave velocity and carotid-radial artery pulse wave velocity were decreased (P ＜ 0.01 or P ＜ 0.05).The results indicate that comprehensive interventions organized by tertiary hospitals with community health centers are effectivc in managcmcnt of hypcrtension.

Objective To develop the clinical practice guidelines for the management of medication adherence to highly active antiretroviral therapy (HAART) in China. Methods The development methods included qualitative interview of 31 stakeholders, questionnaire survey of 423 PLHIV, adaptation of 30 clinical practice guidelines related to AIDS care, and overviews of reviews of 44 systematic reviews/Meta-analysis. Results 10 clinical practice guidelines and 10 systematic reviews/Meta-analysis were included. The clinical practice guidelines for the management of HAART were formed. Conclusions The formed clinical practice guidelines showed better applicability and higher general quality. It is recommended to use the guidelines in AIDS care.