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 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 observe the clinical efficacy of extemal application of Chinese medicine following tapping using a plum-blossom needle for allergic rhinitis.Methods:All 328 cases were randomized into an observation group of 206 cases,Chinese medicine group of 70 cases and point application group of 52 cases.Results:The differences between the observation and Chinese medicine groups (P＜0.01) and between the observation and point application group (P＜0.05) were both of statistical meaning.The cases in the observation obtained the best effect,the point application group obtained a moderate effect and the Chinese medicine group obtained the least effect.A younger age and an increased number of treatments contributed to a better effect.Conclusion:External application of Chinese medicine following tapping using a plum-blossom needle is safe and effective for allergic rhinitis.

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.

Objective To investigate the relationships between Glucokinase (GCK) gene 6 (tag single-nucleotide polymorphisms,tagSNPs)sites which named rs12702070,rs2971672,rs2268569,rs2268573,rs2300587 and rs1476891 polymorphisms and type 2 diabetes in Chinese Southern Han Population.Methods This study was designed as a case-control.499 type 2 diabetes patients and 499 healthy controls were chosen.All subjects were from August 2013 to December 2014 in Zhongshan Affiliated Hospital of Sun Yat-sen University.6 GCK tagSNPs sites were analyzed by improved multiple ligase detection reaction (iMLDR),and genotype and allele frequency 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 6 GCK tagSNPs and the linkage disequilibrium (LD) and relationship between various GCK haplotype and T2D susceptibility could be analyzed.Results Genotype distribution of rs2268573,rs2300587,rs2268569 and rs1476891 (x2 were 3.361,2.076,0.582 and 0.918 respectively,all P ＞0.05) and allele frequency (x2 were 0.222,1.980,0.590 and 0.851 respectively,all P ＞ 0.05) in T2D group were no significant differences with health controls.Significant differences in genotype distribution of rs2971672 and rs12702070 (x2 were 6.896 and 7.990 respectively,all P ＜ 0.01) and allele frequency (x2 were 4.708 and 5.979,P ＜ 0.05 and P ＜ 0.01 respectively) were observed between T2D group and health controls.Under dominant model (rs2971672:OR =1.74,95％ CI =1.17-2.57,P ＜ 0.01;rs12702070:OR =1.54,95 ％ CI =1.17-2.04,P ＜ 0.01) and additive model (rs2971672:OR =1.51,95 ％ CI =1.06-2.14,P ＜ 0.05;rs12702070:OR =1.26,95％ CI =1.04-1.52,P ＜ 0.05),Genotype distribution of rs2971672 and rs2971672 in T2D were significantly different from health controls.There are two LD domains in 5 tagSNPs among those 6 sites of GCK gene.There are three main haplotypes(TC,TA,CA)in rs2971672 and rs2300587,and four main haplotypes (TAG,TGG,TAT,CGG) in Rs2268569,rs12702070 and rs1476891.Although TAG,TGG,TAT and CGG have no relevance to the individual risk of T2D (P ＞ 0.05),haplotype TA and CA reduce the individual risk of T2D with OR 0.81 (95％ CI:0.66-1.00,P＜0.05) and0.78 (95％ CI:0.62-0.98,P ＜0.01)respectively.Conclusions The results indicated that GCK gene 2 tagSNPs sites included rs2971672 and rs12702070 imparts susceptibility to T2D in Han Chinese,but not rs2268573,rs2300587,rs2268569 and rs1476891.Haplotype TA and CA in rs2971672 and rs2300587 reduce the individual risk of T2D and four main haplotypes (TAG,TGG,TAT,CGG) in rs2268569,rs12702070 and rs1476891 have no relevance to T2D.

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 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 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 .