Objective To study the detection of pathogens and drug resistance in the patients with diabetes mellitus associated urinary tract infection. Methods The clinical data of 256 patients with diabetes mellitus associated urinary tract infection were analyzed retrospectively,and the pathogens and drug resistance of all the patients were studied and analyzed. Results The 230 isolates out of 256 patients were detected,escherichia coli was 116 isolates,pseudomonas aeruginosa was 24 isolates,klebsiella pneumonia was 22 isolates,enterococcus faecalis was 20 isolates,proteus was 19 isolates,aureus was 17 isolates,other was 12 isolates,drug resistance of pathogenic bacteria for the penicillins and cephalothin were strong(21.5% ～ 50. 0% ). Conclusion The drug resistance of pathogenic bacteria in the patients with diabetes mellitus associated urinary tract infection were various, drug resistance of common antibiotics is high.

Objective To analyze the side effects of in-vitro amplification human leukocyte antigen (HLA)-haploidentical donor immune cell infusion(HDICI) in childhood malignant patients,and to provide the basis for how to nurse these patients.Methods From September 2011 to September 2012,twelve hospitalized childhood malignant patients were recruited in Cancer Center of Sun Yat-sen University,and they received a total of 92 times of HDICIs for immunotherapy.Side effects were carefully observed both during and 2 hours and 24 hours after each infusion,and we also provided psychological nursing,pre-infusion nursing,side effect analysis and corresponding care during infusion,post-infusion education and follow-up for every childhood patient.Results Among 92 times of HDICIs,fever occurred in 20 cases,of whom 6 cases were with chills,1 case with febrile convulsion,all achieved remission after receiving symptomatic treatment.5 cases were also recorded with a slight change of mood.Vital signs were all stable both during and after every HDICIs; and no nausea,vomiting,abdominal pain,diarrhea,rash,swelling or allergic reaction was observed.Neither change of the hemogram nor biochemical indexes was recorded before or after every course of HDICI.Conclusions Our study showed that HDICIs for immunotherapy in childhood malignant patients were safe,and during the whole infusions,much attention should be paid both for psychological nursing,pre-infusion anti-anaphylactic treatment,temperature monitoring,discovery of the precursor of febrile convulsion promptly,symptomatic treatment against corresponding side effects,and post-infusion education and follow-up,all those above are of great importance for childhood malignant patients who received HDICIs for immunotherapy successfully.

Objective: To observe the tolerability of Chinese melanoma patients to four-week high-dose interferon alfa-2b(INTRON A(R)，Schering-Plough)therapy. Methods:A total of 29 patients with high risk melanoma[American Joint Committee on Cancer Staging(AJCC)ⅡB-ⅢC]who received adjuvant interferon therapy in our hospital between September 2007 and May 2009 were retrospectively reviewed.Patients received 4 hours of intravenous infusion of interferon alfa-2b fdose range，22.00 million international unit(MIU)to 33.75 MIU]Ⅳ 5 days/week for 4 weeks.The adverse events were evaluated with National Cancer Institute Common Toxicity Criteria(NCI 2.0 version). Results: The average daily dose was 17.63 MIU/(m~2·d).The therapy was ended in two patients because of poor wound healing or intolerability to severe fatigue.The most common adverse events were myelosuppression.Grade 3/4 neutropenia was observed in 69% (20/29)patients and was rapidly reversed after conventional support interventions.Grade 1/2 abnormal hepatic function occurred in 18 cases(62%).Twenty-six patients were followed up for 3 to 22 months.Five patients developed early progression:one with local recurrence，two with regional lymph node metastasis one with in-transit metastasis in the affected limb,and one with distant metastasis. Conclusion: High-dose interferon alfa-2b regimen can be well tolerated by Chinese patients but cannot effectively inhibit subclinical lesions.

Objective To investigate the correlation between serum lipoprotein-associated phospholipase A2 (LP-PLA2) and homocysteine (Hcy) level change with cerebral infarction,and clinical value of combined detection of serum LP-PLA2,Hcy and blood lipid level in the diagnosis and differentiation diagnosis of cerebral infarction.Methods The serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in sixty-five cases of cerebral infarction(cerebral infarction group) and contemporaneous 64 healthy persons qualified in physical examination(health control group) were selected as the research subjects.The levels of serum LP-PLA2,TG,HDL,LDL,CHO and Hcy were detected.The differences were compared among various groups.Results The TG and LDL levels had no statistically significant difference between the health control group and cerebral infarction group(P>0.05),but the LP-PLA2 and Hcy levels in the cerebral infarction group were higher than those in the health control group(P<0.01),while serum HDL and CHO levels were lower than those in the health control group(P<0.01).Serum High Hcy and LP-PLA2 levels were the independent risk factors for cerebral infarction,however,high HDL was a protective factor for cerebral infarction.In the combined detection,the combined detection of LP-PLA2 and Hcy was superior to single index detection and other combined detection mode.Conclusion Serum LP-PLA2 and Hcy levels in the patients with cerebral infarction are significantly higher than those in the health control group,indicating that it may be involved in the occurrence of cerebral infarction,and may become an early biological marker for predicting cerebral infarction occurrence.The combined detection of serum LP-PLA2 and Hcy has highly clinical value in the diagnosis of cerebral infarction.

[Objective]To analyze the prognostic factors of resectable acral melanoma patients ,then develop a novel prognostic model and examined its prognostic value.[Methods]The study retrospectively analyzed clinicopathological characteristics and inflam?matory markers of 232 acral melanoma patients who underwent radical surgical resection between 2000 and 2011 at the Sun Yat-sen University Cancer Center. Kaplan-Meier curves were plotted to estimate overall survival. Significantly predictive factors were identified by multivariate Cox regression analyses and a prognostic model based on these variables was constructed to predict survival.[Results]Cox regression analysis revealed that age,lactic dehydrogenase(LDH),stage,globulin(GLB)and C-reactive protein (CRP)were independently related to survival. After computing these scores ,patients were classified into three risk groups. The new prognostic model identified three categories of patients with different prognoses(P<0.001)and significantly stratify patient prognosis in different tumor stages. The 5-year survival rate was 42.9%,25.7%,and 3.7%in groups 1,2,and 3,respectively. The AUC of new prognostic model is 0.664(95%CI:0.599-0.724).[Conclusion]Age,LDH,stage,GLB and CRP were independently related to survival in our study population,and the prognostic model is useful to stratify patients into different risk groups and it is a useful complement to AJCC staging for Asian patients with acral melanoma.

Objective To investigate the efficacy of different adding times,treatment courses and doses of bifidobacterium and lactobacillus triple live bacteria in Helicobacter pylori (Hp) eradication.Methods A total of 280 patients Hp-infected were enrolled and randomly assigned to five groups.Group A received lansoprazole 30 mg,clarithromycin 500 mg and amoxicillin 1,000 mg bid for 14 days;group B received bifidobacterium and lactobacillus triple live bacteria 2,000 mg tid for 14 days followed by regimen of group A for another 14 days;group C1 received regimen of group A with addition of bifidobacterium and lactobacillus triple live bacteria 2,000 mg bid for 14 days;group C2:regimen of group A with addition of bifidobacterium and lactobacillus triple livc bacteria 2,000 mg tid for 14 days;and group D received regimen of group C2 followed by bifidobacterium and lactobacillus triple live bacteria 2,000 mg tid for another 14 days.4 weeks after end of treatment,Hp eradication was assessed by 13C-urea breath test.Adverse effects during the courses of treatment were recorded.Results A total of 252 (90.0％) patients completed the treatment.The completion rate in group A,B,C1,C2,and D were 78.6％ (44/56),92.9％ (52/56),87.5％ (49/56),96.4％ (54/56),and 94.6％ (53/56) respectively;the completion rate was significantly higher in group B,C2 and D than in group A (P ＜ 0.05),but there were no differences among groups B,C2 and D (P ＞ 0.05).According to intention-to-trcat (ITT) analysis,the eradication rate was 62.5％,80.4％,69.6％,85.7％,and 87.5％ in groups A,B,C1,C2,and D respectively.The eradication rate in groups B,C2 and D was significantly higher than that in group A (x2 =4.375,P =0.036;x2 =7.864,P =0.005;x2 =9.333,P =0.002),and the eradication rate was higher in group C2 than in group C1 (x2 =4.171,P =0.041),but there were no differences among groups B,C2 and D (P ＞0.05).As for per-protocol (PP) analysis,the eradication rate was 79.5％,86.5％,79.6％,88.9％ and 92.5％ in groups A,B,C1,C2,and D respectively,but no significant statistical differences were found among the five groups (P ＞ 0.05).Adverse effects included nausea,bloating,taste distortion,anorexia and constipation.The rate of adverse effects in groups A,B,C1,C2 and D was 67.9％ (38/56),26.8％ (15/56),35.7％ (20/56),21.4％ (12/56),and 17.9％ (10/56) respectively.The incidence rate was significantly lower in groups B,C2 and D than in group A (P ＜ 0.05),but no significant statistical differences were found among groups B,C2,and D (P ＞ 0.05).Conclusions The triple therapy combined with bifidobacterium and lactobacillus triple live bacteria can obviously decrease the adverse effects and improve patient compliance,thereby increasing the rate of Hp eradication.14-day therapy with probiotics is the best regimen.

Objective:To examine the oncogenic mutations involved in melanoma in Southern China and to provide a theoretical basis for the development of melanoma molecular targeted therapy strategy. Methods:The Sequenom platform (OncoCarta Panel v1.0 and MassARRAY System) was used to determine the prevalence of oncogene mutations in 28 acral melanoma samples, 28 mucosal mel-anoma samples, and 30 non-chronic sun-induced-damage (no-CSD) melanoma samples from Southern China. Results:At least one mu-tation was detected in 33 of the 86 melanomas (38.4%) with mutations observed in BRAF (16.3%), NRAS (10.5%), KIT (5.8%), EGFR (4.7%), HRAS (2.3%), KRAS (2.3%), MET (2.3%), and PIK3CA (1.2%). In BRAF, the age of patients with mutations was significantly lower than those without BRAF mutation (45.7±15.3 vs. 55.9±12.7, P=0.01). Patients with mutations in NRAS were more likely to have ulceration compared with patients without NRAS mutations (88.9%vs. 48.1%, P=0.049). Conclusions:This study represents a compre-hensive and concurrent analysis of the major recurrent oncogenic mutations involved in melanoma cases from Southern China areas. The data have implications for both clinical trial designs and therapeutic strategies.

Objective To investigate the infection status of hepatitis B virus(HBV) and hepatitis C virus(HCV) in healthy adult in Xi′an ,in order to provide references for hepatitis prevention and health education .Methods A total of 1 052 healthy adults from 10 communities in Xi′an were collected by using multistage stratified random sampling method .HBV serum markers and anti‐HCV antibody were detected ,and characteristics of distribution of HBV and HCV infection were analysed .Results A total of 37 adults were observed with positive hepatitis B surface antigen(HBsAg) ,the total positive rate was 3 .52% ,and the positive rate of male and female was 4 .08% and 3 .07% respectively ,no statistically significant difference was found between male and female(P>0 .05) .Apart from male adults aged 30 - < 40 and 40 - < 50 ,there were no statistically significant differences between each age groups in male and female ,and between female and male in the same age groups(P> 0 .05) .A total of 31 adults were observed with HBsAg ,hepatitis B e antibody (HBeAg)and hepatitis B core antibody(HBcAb) positive ,the positive rate was 2 .95% .The positive rate of hepatitis B surface antibody(HBsAb) was 54 .18% .Serological patterns between different gender had no statistically signifi‐cant differences(P>0 .05) .A total of 9 adults(0 .86% ) were observed with positive anti‐HCV antibody ,and the positive rate of male and female was 0 .64% and 1 .02% respectively ,no statistically significant difference was found between male and female(P>0 .05) .Conclusion Healthy adults in Xi′an have relatively low infection rates of HBV and HCV ,while for the control of hepatitis B and hepatitis C ,further strengthening the health education ,improving awareness of prevention and routine monitoring infectious dis‐eases and vaccination may still be necessary .

Objective To investigate the serum levels of tumor markers CEA,CA724,PGⅠ,PGⅡ,PGI/PGII and SF in gas-tric cancer.Methods The serum levels of CEA,CA724,PGⅠ,PGⅡ,PGI/PGII and SF were detected in 46 healthy con-trols,45 atrophic gastritis patients and 39 gastric cancer patients.Serum levels of CEA,CA724 were measured by ELC meth-od,PGⅠ,PGⅡ by time resolved fluorescence immunoassay (TRFIA)and SF by immunoturbidimetry(ITM).Results ①Compared to the healthy controls,the statistical contrast of serum levels of CEA,CA724,PGⅠ,PGⅡ and PGI/PGII except SF was significant in gastric cancer patients(P<0.05),only PGⅠ,PGⅡ,SF had significant difference in atrophic gastritis patients (P<0.05).Compared to atrophic gastritis patients,the serum levels of CEA,CA724 were significantly higher,but PGⅠwas lower in gastric cancer patients(P<0.05).②When CEA,CA724,PGⅠ,PGⅡ,PGI/PGII and SF were used to di-agnose gastric cancer individually,the sequence of the area under ROC curve was CEA,SF,CA724,PGI/PGII,PGⅡ and PGⅠ.Only the areas of PGⅠ,PGⅡunder ROC curve had significant statistical difference (P<0.05).③The sensitivity,speci-ficity,PPV and NPV were different when these indexes were used to diagnize gastric cancer individually or incorporatedly. Conclusion The serum levels of tumor markers CEA,CA724,PGⅠ,PGⅡ,PGI/PGII and SF had important reference value for the diagnosis of gastric cancer although the diagnostic value was different individually or incorporatedly;the content of serum PG and the ratio of PGI/PGII were closely related to the gastric mucosa.

Objective To evaluate the outcome of ST-segment elevation myocardial infarction (STEMI) patients received different reperfusion therapies. Methods The 238 consecutive STEMI patients were enrolled from February 2012 to December 2012. According to the current guideline of PCI and the choice of patients, the patients were divided into the groups of percutaneous coronary intervention (PCI), ifbrinolysis, and conservative medication. The major adverse cardiac events (MACE) was analyzed in a follow up of 6 months. Results (1) The enrolled patients included the 210 patients received PCI (88.2%), 14 patients received fibrinolysis (5.9%) and 14 patients received conservative medication (5.9%).The Median time of D2B was 110minutes.(2) The rate of late stent thrombosis was signiifcant higher in BMS than DES (n=2, 2.8%vs 0, P < 0.05) . (3) The PCI group had a signiifcantly higher incidence of stroke than the ifbrinolysis group and the conservative medication group (1.0%vs 0, P < 0.05;1.0%vs 0, P<0.05). (4) The PCI group had a signiifcantly higher incidence of bleeding compared to the thrombolysis group and the medication group (1.0% vs 0, P < 0.05; 1.0% vs 0%, P < 0.05). Conclusions The majority of STEMI patients received PCI;The D2B time, which was required<90 minutes in guideline of PCI, was found delayed in our study;Compared to ifbrinolysis and conservative medication, PCI showed better clinical outcomes of STEMI patients.