Human immunodeficiency virus ( HIV) is commonly transmitted through blood transfu-sion, sexual contact and mother-to-child transmission. The number of patients with HIV infection has kept growing in the last three decades. Although the wide application of antiretroviral therapy ( ART) has effec-tively suppressed the replication of HIV, the emergence of drug resistant mutants compromises the efficacy of ART. What is worse is that there has been transmission of drug resistance strains in ART-na?ve HIV-infected individuals. This review describes the distribution of transmitted drug resistance strains in different regions and high risk population as well as the factors associated with the transmission in recent years.

Objective: To study review the experience of the preparation method of total nutrient admixture(TNA).Methods: 273 patients receive TNA in 2005.More than 4 200 bags of TNA were prepared.Results: There were no infusion reaction and complication in clinical application because of unsuitable preparation.100 bags of TNA were detected for bacteris and all were negative.Conclusion: The ingredients of parenteral nutrition are various and the preparation is important.Strict aseptic technique and preparation procession are wanted.

At present, immune checkpoint inhibitors (ICIs) are widely used in clinical, and the common adverse reactions include adverse reactions of skin, gastrointestinal tract, endocrine and liver. Adverse reactions to the lungs and heart are relatively rare, but can be fatal. Systemic steroid therapy is the main treatment for immune related adverse events (irAEs). If there is no response to steroid therapy, an immunomodulator may be considered. Understanding the incidence, pathogenesis, common types and treatment strategies of irAEs can provide theoretical basis for the safe application of ICIs in clinical practice.

Traditional Chinese medicine exercise therapy has a long history in rehabilitation and keep in good health, which pays attention to integration of body and spirit.There are many clinical studies proving that it can improve heart function and quality of life in patients with cardiovascular diseases, and it is suitable for vigorously generalizing.

OBJECTIVE To investigate drug-resistance status of Gram-positive cocci in the local region and offer scientific basis for reasonable usage of antibiotics.METHODS 336 strains of Gram-positive cocci were isolated from all kinds of specimens from Jan 2003 to Dec 2007 in the local hospital.Organisms were cultivated and identified complying with National Operation Procedure of the Clinical Laboratory.Drug sensitivity test was performed with K-B methods.RESULTS Among the 336 strains,Staphylococcus aureus(SAU) ranked the top,accounting for 45.8%;then the coagulase-negative Staphylococcus(CNS) accounting for 23.2%;Enterococcus faecalis ranked the third,accounting for 18.2%;the detection rate of meticillin-resistant Staphylococcus aureus(MRSA) was 31.8%;that of meticillin-resistant coagulase-negative Staphylococcus(MRCNS) was 35.9%.The results of drug sensitivity test showed the Gram-positive cocci were resistant to the many antibiotics in different degrees except for 100% sensitive to vancomycin.CONCLUSIONS Hospital should attach importance to supervise the drug-resistance of Gram-positive cocci and prevent the dissemination and epidemic of drug resistant strains.

Standardized patients for interview has been widely used in medical education and examinations.Nevertheless the standard training of SP is still not widely used in China up to the present.Referring to the character of SP working as "the people providing case history","the assessor" and"the teacher",we have described how to write scenarioes,establish the score criteria,institute the training steps,form the measures of examination and supervision in detail in this article,and resummarized the experiences we got during the training period.

This paper discussed the methods of developing clinical thinking ability and the key emphasis on the related main medical and teaching activity.

Objective To understand the influence of HBsAg+ pregnant woman on the persistence of hepatitis B surface antibody(HBsAb)of neonates in three years after the first"0,1,6"immunization,and the influences of regular examination every half-year and revaceination in time on maintaining the immune effect. Methods Twenty neonates born from HBsAg-mothers and 24 from HBsAg+ mothers were followed up for 3 years.And children whose HBsAb's titer faded or disappeared(unstable)received recombinate yeast-derived hepatitis B gene vaccine.The proportion of children with unstable HBsAb and the positive rate of HBsAb on 7 month-old and 3 year-old were compared. Results The unstable rate of HBsAb in HBsAg- and HBsAg+ groups were 20.0%(4/20)and 79.2%(19/24),respectively(P<0.05).The rate of revaccination in these two groups were significantly different.The positive rate of HBsAb in 7 month-old children of HBsAg-mothers was 100.0%(20/20)and 62.5%(15/24)in those of the HBsAg+ group(P<0.05).No statistically difference was detected between the two groups when followed up at 3 years of age[85.0%(17/20)vs 91.7%(22/24),P>0.05]. Conclusions HBsAg+ mothers would reduce the stability of HBsAb in their neonates within three years after the first"0,1,6"immunization,but the immune effect of vaccination against hepatitis B can be maintained through regular examination every half or one year and revaccination.

Objecitive The research was in order to explore the roles of MMP-2,MMP-3 and MMP 9 which played in the gastric cancer cell metastasis,and make a further study of the clinical signifance.Methods Both SGC-7901 and GES-1 were cultured in vivo.The migra-tion were examined by Wound-healing and the Transwell assay.The expression of MMP-2,MMP-3 and MMP 9 in the medium were detected by ELISA.The positive rate of MMP-3 in the gastric cancer,gastritis and normal was used the IHC,and the serum of MMP-2,MMP-3 and MMP-9 were also examined by ELISA.Results Both Wound-healing and Transwell assay showed that the migration of SGC-7901 cells was more quicker than the GES-1.Comparing to GES-1,the MMP-2,MMP-3 and MMP-9 were higher in the SGC-7901.The immunohistochemical results showed that the positive rate of MMP-3 in the gastric cancer patients was 84.4%,it was higher than the latter.The serum levels of MMP-2 MMP-3 and MMP-9 were also significantly higher than others.Conclusion The migration of gastric cancer cells was depended on the MMP-2,MMP-3 and MMP-9.The 3 proteins can be used for the diagnosis of gastric cancer patients,and it also avail to make the judgment the prognosis of patients with gastric carcinoma.

Over-expression of P-glycoprotein (Pgp) is associated with the development of multi-drug resistance ( MDR). Pgp has been focused on as the main target in designing chemotherapy strategy. In this article we review some of the latest advancement in designing and evaluation methods of P- glycoprotein inhibitors.