Objective To investigate the acute stroke patients with lower respiratory tract of multi drug resistant bacteria(MDR) infection risk factors.Methods The clinical data of 170 patients with acute stroke were retrospectively analyzed from January 2013 to December 2015.The MDR infection was divided into MDR infection group and non-MDR infection group.example.Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of MDR infection in patients with acute stroke.Results Univariate analysis: The relationship between COPD, coma, cerebral hemorrhage, cough, cough reflex, tracheal intubation, indwelling catheter, indwelling gastric tube, and combination of two or more antibiotics was more than 5 days and MDR infection(P<0.05).Multivariate logistic regression analysis: COPD, coma, tracheal intubation, cerebral hemorrhage, two or more antibiotics prophylactic use is an independent risk factor for MDR infection.Conclusion The acute stroke patients with lower respiratory tract infection in patients with MDR factors and iatrogenic factors, combined with COPD, coma, tracheal intubation, cerebral hemorrhage, irrational use of antibiotics are independent risk factors for its occurrence.

OBJECTIVETo identify the genetic etiology in a Chinese patient with neurofibromatosis type 1 (NF-1).

METHODSAll coding exons and the flanking sequences of neurofibromin 1 (NF1) gene from the patient were captured, individually barcoded and subjected to HiSeq2000 high-throughput sequencing. Suspected mutation was validated in the nuclear family members with Sanger sequencing.

RESULTSA novel indel mutation, c.789_790delAGinsT, was identified in the exon 8 of the NF1 gene in the patient but not in her asymptomatic parents. The mutation was predicted to have caused shifting of the reading frame and a premature downstream stop codon (p.K263Nfs*18). Two known polymorphisms, c.888+108 C>T (rs2953000) and c.888+118 G>T (rs2952999), was detected in the flanking of the indel mutation in the patient and her father. Sequencing chromatogram for the family indicates that above changes are located on the same chromosome.

CONCLUSIONThe c.789_790delAGinsT, as a de novo mutation occurring on the paternally derived chromosome, is most likely to be causative for the disease. Compared with Sanger sequencing, targeted next-generation sequencing is more efficient and can dramatically reduce the cost for the genetic testing of NF-1.

Adult ; Amino Acid Sequence ; Base Sequence ; Female ; Humans ; Molecular Sequence Data ; Neurofibromatosis 1 ; enzymology ; genetics ; Neurofibromin 1 ; genetics ; metabolism ; Point Mutation

Objective To explore the interaction between family history of diabetes and hyperlipidemia on the risk of diabetes in population with normotension.Methods A multistage stratified probability random sampling was conducted to select a representative sample of urban residents aged 20-74 years in Harbin.A total of 376 diabetes patients with normotension and 3 692 residents with normal blood pressure,normal fasting glucose,and normal 2 hours glucose from OGTT were surveyed.The interaction was evaluated by using crossover analysis and additive model.Results Multivariate logistic regression analysis indicated that there was a possible additive interaction between family history of diabetes and hyperlipidemia on the risk of diabetes.The relative excess risk due to the interaction,the attributable proportion due to the interaction,and the synergy index were 1.97 (95％CI:-0.32-4.26),0.30 (95％CI:0.03-0.57),and 1.54 (95％CI:0.96-2.47),respectively.There were significant combination effects between family history of diabetes and high both total cholesterol and triglyceride,isolated high total cholesterol,and isolated high triglyceride levels;the ORs were 10.55 (95％CI:5.62-19.80),7.81 (95％CI:3.65-16.71) and 5.13 (95％CI:3.22-8.16),respectively.Conclusion There might be synergistic effect between family history of diabetes and hyperlipidemia on the risk of diabetes in population with normotension.

Objective: To investigate the value of haemogobin A₁c(HbA₁c) for diagnosing various hyperglycemias in the Second Affiliated Hospital of Harbin Medical University. Methods: This study is based on the data randomly selected from patients without clinical intervention in the endocrinology department and admission office in the Second Affiliated Hospital of Harbin Medical University from January 1st of 2010 to December 31th of 2012. In this study, 2 853 patients aged 16-85 year were selected, who performed OGTT and HbA₁c on the same day. Their data of HbA₁c and OGTT were collected. Selection criteria: the OGTT and HbA₁c were performed simultaneously unless the patients had acidosis, and patients with past history of diabetes and oral hypoglycemic drugs or insulin treatment, or other basic combined diseases were included in this study. People in pregnancy were ruled out. Area under the receiver operating characteristics curve (ROC), sensitivity, and specificity were adopted to evaluate the diagnosis effect of HbA₁c using FPG and OGTT as golden standard for diabetes and pre-diabetes. Results: The area under the ROC were 0.902 (95% confidence interval 0.890-0.914) for HbA₁c alone and 0.915 (0.906-0.925) for FPG alone. The HbA₁c threshold of 6.5% showed the highest Youden index of 64.4% and significantly higher sensitivity 81.1% compared with FPG ≥ 7.0 mmol/L (69.8%, P < 0.01) in detecting diabetes. The optimal HbA₁c thresholds for diagnosing pre-diabetes was 5.6% (the area under the ROC: 0.725; sensitivity: 74.1%; specificity: 60.3%). Conclusions These findings suggest that HbA₁c 6.5% and 5.6% can be used as the diagnosing criterions for diabetes and pre-diabetes among the population who visit department of endocrinology.