Objective To evaluate the clinical application of disk diffusion method(ROSCO company of Denmark) for testing the susceptibility of candida species isolated from patients with cancer with the using broth microdilution method ((NCCLS) M27-A of America Committee for clinical laboratory standards) as the gold standard in order to find the better method for clinical laboratory.Methods Antifungal susceptibility (5-flucytosine,amphotericin B,fluconazole and itraconazole) of 78 strains of Candida species were tested both by ROSCO disk diffusion method and ATB FUNGUR2 broth microdilution method.The microdilution method NCCLS as the gold standard.The sensitivity,specificity,positive and negative predictive values of two methods was calculated.Results The Kappa value was reached to 0.89 in term of disk diffusion method for detecting susceptibility of candida to 5-flucytosine,amphotericin B,fluconazole and itraconazole,suggesting that no serious errors was seen in terms of sensitive and resistant another method.Of 78 strains of candida,they had the high susceptibility to 5-flucytosine,amphotericin B,which were 88.20％ and 89.17 ％.The lower susceptibility of 78 strains of candida was fluconazole and itraconazole (56.34％ and 52.12％).Candida glabrata and candida krusei were proved to suspect to four kinds of antifungal agents(90.95％,85.71％).And the lowest positivity was 67.50％ and 41.67％ regarding of candida glabrata and candida krusei.Conclusion The higher consistency was seen in terms of detecting candida susceptibility to antibiotics by disk diffusion method and microdilution method,suggesting disk diffusion method can replace microdilution method.In bur hospital,candida species are susceptibility to amphotericin B at the highest sensitivity and courtyard albicans at lower sensitivity.Antifungal agents works to candida albicans and lower inhibition rate to candida kruse.

Objective To evaluate the effect of low-dose omeprazole in the treatment of functional dyspepsia(FD).Methods A total of 260 FD patients were diagnosed clearly and divided into two groups randomly:148 cases(observation group)were treated with low-dose omeprazole(10 mg/d),while 112 cases(control group)were treated with esomeprazole(20 mg/d)and domperidone(each 10 mg,three times per day).Two groups were all treated for 2 weeks.The clinical symptoms such as heartburn,postprandial distenstion,epigastric pain and eructation were observed.Results Compared with symptoms in two groups before treatment,the scores of heartburn and epigastric pain were decreased evidently after treatment in two groups(P

ObjectiveTo investigate the characteristics of the ambulatory blood pressure of acute cerebral infarction patients in the first 24 hours from onset and to study the relationship between their neurological deficit and characteristics of blood pressure.MethodsBlood pressure in 31 acute cerebral infarction patients (within 24 h) was measured serially during the first 24 hours in hospital with ambulatory blood pressure monitoring. Their neurological deficit was assessed with the National Institutes of Health stroke scale (NIHSS) on the first and the fifth day. Results83.87% nocturnal blood pressures decreased less than 10%. In multiple linear regression analysis, 24 h diastolic blood pressure (DBP) becomes the only and the most important factor to NIHSS on the first day. The patients with improved NIHSS on the fifth day showed lower nocturnal DBP and mean arterial pressure (MAP) than those of patients with unimproved NIHSS.ConclusionNot only the level but also the circadian of ambulatory blood pressure in acute cerebral infarction patients is significantly abnormal, especially for the reduction of nocturnal blood pressure decrease. On the first day, the neuroulogical deficit and blood pressure influence each other. The patients with higher nDBP and nMAP on the first day may be associated with poor early neurological function outcomes.

This article summarizes LI Shimao's academic view of tracing the origin and differentiating the pulse and syndrome in six aspects.1) Emphasizing pulse in diagnosis:he put forward the new theories of pulse diagnosis such as differentiating syndrome by pulse diagnosis outline theory,deficiency and excess pulse diagnosis outline theory and interpreting pulse mechanism with Qi and blood outline theory.2) Emphasizing sweat promotion method in the three methods (including sweat promotion,emetic method and purgative method):he promoted sweat with acrid-warm drugs not only in the treatment of excess cold syndrome,but also in the treatment of deficiency cold syndrome.3) Emphasizing Yang deficiency in cold damage syndrome:he regarded Yang deficiency as an important reason for the attack of externally-contracted wind-cold.4) Emphasizing fire constraint in warm disease:he was the first to pinpointed that the nature of warm disease is stagnated heat,he was good at treating warm disease with clearing,venting and enriching methods of which venting is the core and he invented Xinjia Shengjiang San (新加升降散) to treat stagnated heat;5) Emphasizing treating phlegm and stasis in the complicated diseases:he thought the difficult and complicated diseases in modem medicine were similar to the phlegm syndrome and stasis syndrome in Chinese medicine,so he liked modifying Daotan Tang (导痰汤),ZHANG Zhongjing's formulae,WANG Qingren's formulae for removing blood stasis and Taohong Siwu Tang (桃红四物汤) to treat phlegm and stasis syndromes;6) Emphasizing emergencies in rescue period:he thought Chinese medicine did a great work in treating emergencies,and modern scientific and technological methods should be used in studying emergencies in Chinese medicine.

Application of a number of philosophical ideas is instructive in eliminating the opposition on the doctors'right to inform and the patients right to being informed,building a harmonious relations between doctors and patients and correctly understanding and carrying out the informed consent.

Objective To explore the occupational stressors and the coping strategies in the newly-employed nurses and to explore their relationships. Method The survey was done among 193 registered nurses with less than 3 years working experience using the occupational stressor scale for Chinese nurses, the simplified coping strategies questionnaire and a self-designed general demography form. Results The total score on occupational stressors was 2.27 ± 0.56, which was at a common level. Postive and negative coping style were 1.88 ± 0.44 and 1.04 ± 0.51. The stressors together with the dimensions were positively correlated with negative coping strategies (P<0.05). Conclusion Nursing administration should improve work environment, provide enough manpower for patient care, carry out training system to focus on education for newly employed nurses, and provide advice and help for them when they need.

Objective To investigate the association between the three single nucleotide polymorphisms (SNP) in angiotensin Ⅱ type one receptor (AT1R) gene with coronary artery disease (CAD) in Chinese Han nationality.Methods Extracted DNA and RNA samples of peripheral blood white cells from 192 CAD patients and 189 healthy individuals in Jan 2011 to Oct 2013 from the general hospital of the PLA Rocket Force.Designed primes and the three SNPs as rs6801836,rs2675511 and rs5182 of AT1R gene were analyzed with allele-specific fluorogenic oligonucleotide probes in an assay combining extension and hybridization.Results The genotype and allele frequencies of the three SNPs were not significantly different between the control group and CAD group (x2 =0.047～2.226,all P＞0.05).The major haplotype constructed with linkaged rs6801836 and rs5182 was TT.The frequency of every haplotypes showed no significantly difference between the two groups (x2 =0.025～1.020,all P＞0.05).Conclusion The three polymorphisms of AT1R gene studied in this work showed no association with CAD susceptibility.

Objective To explore the community elderly depression effect on quality of life and provide the basis for the elderly mental health intervention. Methods Adopting stratified random sampling method, using the SF-12,CES-D and psychological capital questiennaire of elder to survey among 500 community elderly people and established the structural equation model. Results The age, degree of education, income situation, depression and the old psychological capital of the community elderly can be used to predict the quality of life, can explain 88.6%variance of life quality(P<0.05);depression on quality of life has a direct effect of-0.21(P < 0.05); depression through psychological capital indirect effect on quality of life for-0.64(P<0.05). Conclusions The elderly depression through psychological capital intermediary effect on the quality of life.

Objective To evaluate the risk clinic factors of severe community-acquired pneumonia in older adults,and to provide examples for its clinic application.Methods Sixty-four case patients who were admitted for a diagnosis of severe community-acquired pneumonia in older adults in Beijing Haidian Hospital from January 2013 to July 2015 were selected as observation group.One hundred cases patients also admitted for a diagnosis of community-acquired pneumonia were selected as control group.Within 24 h of admission,the clinical data were collected,medical history were collected,and the serum biochemistry,coagulation index fibrin degradation product,D-dimer and inflammatory factor procalcitonin were detected.The data were analyzed by univariate analysis,and logistic regression analysis was used to analyze the variables with significant difference in single factor analysis.Results Single factor analysis showed that the percentage of severe pneumonia with central nervous system disorders,severe pneumonia with aspiration,severe pneumonia with two or more comorbidities,aspiration and severe pneumonia with bedridden patient in observation group were obviously higher than the control group,the difference between two groups have remarkable statistical significance((82.21％ (53/64) vs.32％(32/100),60.93％(39/64) vs.1％(1/100),(84.37％,54/64) vs.54％(54/100),90.62％(58/ 64) vs.28％ (28/100),59.37％ (38/64) vs.11％ (11/100);P＜0.01 or P＜0.05).The mortality of observation group was higher than the control group,the difference between two groups have remarkable statistical significance(56.62％ (36/64)] vs.3％ (3/100),P=0.001).Albumin of severe pneumonia was obviously lower than the control group,the difference between two groups have remarkable statistical significance ((27.79 ±8.53) g/L vs.(33.66±9.63) g/L,P=0.011).Fibrin degradation product of severe pneumonia was obviously lower than the control group,the difference between two groups have remarkable statistical significance ((i0.98 ± ± 1.32) ng/L vs.(3.61±0.98) ng/L,P=0.002).D-dimer of severe pneumonia was obviously higher than the control group,the difference between two groups have remarkable statistical significance ((2.68± 0.56) mg/L vs.(0.42±0.12) mg/L,P=0.001).Procalcitonin of severe pneumonia was obviously higher than the control group,the difference between two groups have remarkable statistical significance ((1.63±0.32) ng/L vs.(0.13 ± ±0.21) ng/L,P =0.015).The result of multiple factors logistic regression analysis showed the aspiration,hypoproteinemia,D-dimer were severe community-acquired pneumonia in older adults's independent risks (OR =1.782,1.208,1.356,P＜0.05).Conclusion Aspiration,hypoproteinemia,D-dimer are the factors of risking suffering severe community-acquired pneumonia in older adults.D-dimer could be the detection index of severe community-acquired pneumonia in older adults.