Objective To investigate the risk factors of adverse pregnancy outcome of women in China by Meta analysis.Methods Meta analysis was used to analyze the influencing factors of adverse pregnancy outcomes from January 2010 to January 2015.According to the inclusion and exclusion criteria,124 articles were retrieved,and 38 articles were excluded.14 papers were included in this study.Results There was strong correlation between fetal abnormalities and adverse pregnancy outcomes.And the maternal history of abortion and adverse pregnancy outcomes were not related.There was strong association between multiple pregnancy,syphilis infection and adverse pregnancy outcome,and there was moderate correlation between the high blood pressure in pregnancy and adverse pregnancy outcome.Abnormal fetal position,the OR value was 3.48 (2.70 -4.43),history of abortion OR value was 1.14 (0.90 -91.44),gestational hypertension OR value was 2.88 (1.69 -4.92),multiple births OR value was 6.40 (2.05 -20.01),syphilis OR value was 5.54 (1.64 -18.64).Conclusion The risk factors of adverse pregnancy outcomes from strong to weak are as follows:multifetal pregnancy,syphilis infection,abnormal fetal position and hyper-tensive disorder complicating pregnancy.

Objective To investigate the carriage and homology of carbapenemase genes of multidrug-resistant Acinetobacterbaumannii (MDRAB)in Wujiang area.Methods A total of 44 non-duplicated MDRAB isolated from patients in 3 general hospitals in Wujiang area from January 2010 to December 2013 were collected. Minimum inhibitory concentrations (MICs)were detected,carbapenemase genes OXA-51,OXA-23,OXA-24,OXA-58, IMP,TEM,SHV,and GES were amplified with polymerase chain reaction(PCR),homology of strains was detec-ted with pulsed-field gel electrophoresis (PFGE).Results 44 MDRAB strains were mainly collected from sputum (93.18% ),mainly distributed in intensive care unit (ICU),department of respiratory diseases,and department of neurosurgery,accounting for 45.45% ,27.27% ,and 13.64% respectively;MDRAB were both sensitive to minocy-cline and polymyxin B,resistance rates to piperacillin,ampicillin/sulbactam,ceftazidime,gentamicin,amikacin, and ciprofloxacin were all 100.00% ,resistance rates to imipenem and meropenem were both 97.73% . 44 MDRAB strains were all detected OXA-51,OXA-23 and TEM genes,12 strains were positive for GES gene,1 strain was positive for OXA-58 and SHV respectively,OXA-24 and IMP genes were not found ;MDRAB were divided into 7 types of G-A,which included 19,3,9,3,1,4,and 5 strains respectively,type A was mainly from two large gen-eral hospitals in Wujiang area (Wujiang First People’s Hospital and Shengze Hospital),type B,D and E strains were not detected in Wujiang First People’s Hospital,type E strain was only 1 isolate and was from Yongding Hos-pital,the other types were sporadically distributed.Conclusion Multidrug resistance of clinically isolated Acineto-bacterbaumannii is serious in Wujiang area,OXA-23 and TEM genes are major causes of multidrug resistance in Acinetobacterbaumannii,the main types are A and C,which present clonal spread.

Objective:To produce monoclonal antibodies(McAb) against aspergillus fumigatus and to establish rapid assay for the measurement of aspergillus fumigatus antigen.Methods:Recombinant galactomannoprotein of aspergillus fumigatus(AFMP1) was used to immune BALB/c mice.Monoclonal antibodies against AFMP1 were produced from hybridoma.Results:Three hybridomas producing antibodies against AFMP1 were obtained.IgG isotypes of three McAb were IgG1,IgG2a and IgG2b.The affinity constants(K) were 1.2?10 10 ,4.56?10 9 and 1.81?10 10 mol/L.The antibodies were proved to be specific for aspergillus fumigatus by Western blot and recognized different epitopes on AFMP1 by the additivity assay.An sandwich enzyme-linked immunosorbent assay(ELISA) to detect AFMP1 was established to produce standard curve which showed linearity between 0.1～60.0 ng/ml with a sensitivity of 0.1 ng/ml.Conclusion:These results show three hybridomas producing high specificity and affinity monoclonal antibodies against AFMP1 and can provide for rapid assay for the measurement of aspergillus fumigatus antigen.

Objective To determine whether focal adhesion kinase (FAK) signal pathway was involved in migration of hepatocarcinoma cells by inhibiting focal adhesion kinase (FAK) phosphorylation in HepG2 cells with focal adhesion related nonkinase (FRNK). Methods The recombinant of FRNK and pEGFP-C2, an endogenous inhibitor of FAK activation,was transfected into HepG2 cells. HepG2 migration was examined by transmembrane assay. FAK and phosphatinositol 3-kinase (PI3-K) phosphorylation were detected by immunoprecipitation method. Confocal scanning microscopy was used to verify nuclear translocation of nuclear factor-kappa B (NF-?B). Results The transfection of FRNK recombinant plasmid could inhibit HepG2 migration, FAK and PI3-K phosphorylation decreased by 50.2 percent and 39.5 percent respectively. Furthermore, NF-?B translocation was down-regulated from 3.495?0.227 to 1.182?0.106. Conclusion These results suggested FAK was a main signal pathway in mediating HepG2 migration. Over expression of FRNK might inhibit signal transduction of FAK via depression of the phosphorylation of PI3-K and NF-?b activation, resulting in the decrease in migration of hepatocarcinoma cell.

Objective To investigate the clinical value of echocardiography combined with genetic testing in the fetal cardiac rhabdomyoma. Methods Thirty-three fetal cardiac rhabdomyoma cases diagnosed by fetal echocardiogram in Beijing Anzhen Hospital from Jan. 2011 to Oct. 2015 were enrolled in a retrospective analysis. The results of other examination and pregnancy outcomes of them were followed up, the genetic characteristics of cardiac rhabdomyoma were summarized on the basis of pathology and genetics examination results. Results The pregnancy outcomes:24 cases were terminated pregnancy, 4 cases were born and 5 cases were lost. The results of ultrasound, pathology and genetic examination were detailed in 8 cases. Pathological examination: the typical characteristics of cardiac rhabdomyoma were found in the 8 cases with cardiac rhabdomyoma. The tumor tissue was composed of irregular and swelling shape of cardiomyocytes, and the cytoplasm was vacuole like, which was characteristic of“spider like cells”through microscopic observation. The geneticdetection results: 7 cases had tuberous sclerosis complex (TSC) gene mutation, TSC gene abnormalities were not detected in 1 case. Among the 7 cases with TSC gene mutations, 6 cases were with TSC2 gene mutation and the other 1 case was with TSC1 gene mutation. The family gene was investigated in the 5 cases, which including 3 cases of TSC gene mutation in mother passed on to the fetus (1 case with family of three generations of genetic) and 2 cases of spontaneous TSC gene mutation in the fetus. Conclusions Prenatal echocardiography combined with genetic detection have important clinical significance, which not only can clear if cardiac rhabdomyomas were associated with TSC, but also can clear the TSC gene mutation source. So as to further guide the perinatal management.

ObjectiveTo explore the effect of nursing management emergency project in the treatment of batches of wounded persons in sudden disasters.Method The overall emergency system was set up,the emergency project on nursing management was made including non-stop nosocomial transmission mode,standardization of nursing management in the wards,specialized nursing and individualized nursing for critically ill patients.Result All 139 injured were successfully rescued and discharged after a quick pre-hospital care and effective in-hospital care,with effective rescue time (33.5±19.6)min and the rescue success rate 100.0%. Conclusion The nursing management emergency project for sudden disasters is effective for rescuing batches of wounded persons and improving the success rate of rescue.

Objective To investigate the effect of vitamin D supplementation on biochemical imdexes and compliations in patients with type 2 diabetes(T2DM).Methods Two hundred and ten patients with type 2 diabetes of the People's Hospital of Chongli County were selected from January 2001 to January 2002.According to the envelope sampling method they were divided into vitamin D supplementation group of 105 people and not supplemented group of 105 people,and 105 healthy people at the same period as control group.Compared the biochemical baseline indicators differences.After 10 years of follow-up,the biochemical indexes and the complications were detected and compared again.Results After ten years follow-up,82 cases of supplementation group were followed up,78 cases of not supplemented group were followed up.The level of FPG and HbA1c of supplementation group and not supplementation group were higher than that of control group,the differernce was significant(P＜0.05).In supplement group,TG levels,25(OH) D3 concentrations and BMD values were (2.11±0.41) mmol/L,(16.88±5.02) μg/L and-1.15±(-0.25) respectively,and equal to the control group ((2.12 ± 0.38) mmol/L,(44.83 ± 21.25) mmol/L,-0.94 ± (-0.21)),and TG levels were lower than not supplemented group,25 (OH) D3 concentrations and high bone density higher than not supplemented group((24.53±15.61) mmol/L,-3.15±(-0.33),P＜0.05).FPG,Cr,BUN,UA,FIB,and BNP in supplement group were(10.00±2.32) mmol/L,(64.77±9.31) μmol/L,(6.41± 1.24) mmol/L,(339.83±43.74) mmol/L,(2.41±0.46) g/L and (588.92±73.69) ng/L,in not supplemented group were (15.60±2.51) mmol/L,(92.69±11.68).μmol/L,(8.70±2.35) mmol/L,(398.94±49.13) mmol/L,(2.89±0.54) g/L and (761.09±91.52) ng/L,all higher than those in control group ((5.01 ±0.59) mmol/L,(57.81±6.61) μmol/L,(4.52±1.11) mmol/L,(311.83±49.51) mmol/L,(2.00±0.31) g/L,(434.31 ± ±71.03) ng/L),and those indexes in supplement group all higher than in not supplemented group(P＜0.05).The level of HbA1c of supplement group and not supplemented group both higher than control group((11.32 ± ±2.03) ％,(13.22±4.17) ％ and (5.34±1.99) ％,P＜0.05).There were 45 cases in supplement group occurred diabetic nephropathy and cardiovascular complications,and 65 cases of not supplemented group (x2 =15.07,P＜0.05).Conclusion The relationship of Vitamin D and various complications of diabetes mellitus are closely,and supplementing vitamin D can reduce the complications of diabetes.

Objective To investigate the relationship between the genetic polymorphisms of glutathione S-Transferase M1,T1 and the susceptibility to sporadic colorectal adenocarcinoma(SCRAC) and smoking and alcohol consumption in Chinese Hans.Methods Multiplex polymerase chain reaction (M-PCR) was used in the study of genetic polymorphisms of GSTM 1,T1 gene.Logistic analysis was performed to elucidate the roles of GSTM1,GST1,smoking and alcohol.Results The null GSTM1,T1 genotypes could increase the susceptibility to SCRAC(OR=1.711,95% CI:1.043～2.805;OR=1.734,95% CI:1.057～2.843),but smoking and alcohol consumption made no significant effect on SCRAC(OR=0.584,95% CI:0.356～0.958;OR=0.378.95% CI:0.217～0.657).Further stratification of the SCRAC patients by chnical features showed that there were no relationship between the GST M1,T1 genotype and the age of the SCRAC patients.But the frequency of null GSTM1 genotype was significantly associated with distal colon adenocarcinoma (P=0.021),colorectal adenocarcinoma of Dukes C classification (P=0.003) and poor difierentiation (P=0.020),respectively.The frequency of null GSTF1 genotype was only higher in colorectal adenocarcinoma of Dukes C classification(P=0.041).No relationship was found between the location,the degree of differentiation and the frequency of null GSTF1 genotype(P＞0.05).Furthermore,the frequencies of homozygous deletion in GSTM1,T1 genes were found to be significantly increased in SCRAC patients than those in healthy controls(38.9%VS25.7%.P=0.023).Conclusion The GST genotype is strongly correlated with SCRAC incidence in Chinese Hans.The null GSTM1,T1 genotypes can enhance the genetic susceptibility to SCRAC.while smoking and alcohol consumption have no significant effect on the susceptibility to SCRAC.

Background Vitreous amyloidosis is an autosomal dominant hereditary disease,often leads to reduction of visual acuity and affects life quality of patients.Vitrectomy is the main treatment for vitreous amyloidosis,but the analysis of curative efficacy in China is rarely reported.Objective The study was to observe and analyze the efficacy of vitrectomy for vitreous amyloidosis.Methods The clinical data of 11 eyes from 6 patients with vitreous amyloidosis who received vitrectomy from March 2011 to February 2013 in Affiliated Hospital of Guizhou Medical University.The best corrected visual acuity (BCVA),intraocular pressure (IOP),manifestations under the slit lamp microscope,findings of ocular fundus and results of fundus fluorescence angiography (FFA) were observed after surgery.Pathological examination for vitreous samples was carried by Congo red staining.Results Before surgery,the visual acuity was counting fingers for 30 cm in 5 eyes and hand movement for 30 cm in 6 eyes,and the mean IOP was (13.09±2.12)mmHg (1 mmHg=0.133 kPa).Fixed white flocks in vitreous and white membrane on the posterior lens capsule were seen under the slit lamp microscope.The BCVA remained 1.0 in 7 eyes and 0.8 in 4 eyes 1 week,6 months and 2 years after vitrectomy,and the mean IOP was (13.32±2.07),(14.09±2.47),(12.32±1.87)mmHg at 1 week,6 months and 2 years after vitrectomy,respectively.FFA showed a little fluorescein leakage at peripheral retinal vessel in all eyes at 1 week after vitrectomy but the leakage disappeared at 6 months after vitrectomy.The white flocks increased at peripheral retina in 4 eyes at 2 years after vitrectomy,but the BCVA remained the same in the eyes.Pathological examination of vitreous specimens comfirmed the diagnosis of vitreous amyloidosis.Conclusions Vitrectomy is an effective method for the treatment of vitreous amyloidosis,which can effectively improve the visual acuity of patients.Postoperative recurrence of vitreous amyloidosis appear in parts of patients,but the BCVA is unaffected.

The classification of diagnosis and treatment is based on the classification of disease, and medical institutions at different levels bear different diseases to achieve the first contact care in primary hospitals and two-way referral.As one of the common chronic diseases, diabetes is a serious threat to human health.The classification of diagnosis and treatment model is beneficial to controlling blood sugar and promoting the integrated management of chronic diseases.Clinical pharmacists as medical and pharmaceutical professionals can provide pharmacy services to promote rational drug use in the diagnosis and treatment of diabetes.The article summarized the current methods for the classification of diagnosis and treatment model (diabetes mellitus) and the participation ways of clinical pharmacists in the model in order to provide new ideas for the comprehensive management of diabetes mellitus.