Objective]To introduce professor Li Shuping's clinical experience by invigorating kidney and activating blood in treating recurrent spontaneous abortion prethrombotic state.[Method]By following professor Li Shuping's clinical diagnosis and treatment and organizing related cases ,to sum up professor Li Shuping's academic thoughts and clinical experience on the recurrent spontaneous abortion prethrombotic state ,and for proven cases.[Result] Professor Li Shuping thinks the disease of traditional Chinese medicine dialectical belongs to kidney deficiency and blood stasis ,so the basic principle of treatment is to invigorate kidney and activate blood.Professor Li Shuping is good at using invigorating kidney and promoting blood circulation to remove blood stasis,invigorating kidney and activating blood and tonifying qi,invigorating kidney and spleen,invigorating kidney and promoting blood circulation to remove heat.According to the pathogenesis treatment and flexible adjustment,the clinical curative effect is very good. And it is attached test cases of Shoutai Pills with the combination of Angelica Peony Powder treatment of kidney deficiency and blood stasis type recurrent spontaneous abortion. [Conclusion] Professor Li Shuping has unique clinical experience ,her clinical thought of invigorate kidney and activate blood is worthy our deep experiencing and study.

Objective To explore the effect of health education on medication compliance of middle-aged and elderly hypertensive patients in rural areas. Methods Outpatients aged 45 hypertensive patients were divided into two groups, the intervention group was given health education knowledge, intervention of bad habits and knowledge of drug by oral presentations, banner ads, TV screen publicity, publicity, newspaper, telephone follow-up and other forms of propaganda. Results Hypertension knowledge, dietary knowledge, living habits, medication knowledge, medication compliance of patients in the intervention group were increased significantly, and there were significant difference in the four survey in the observation group with statistical significance(P<0.05). Conclusion Health education has a great influence on drug compliance among middle-aged and elderly hypertensive patients in rural areas, and has great significance for controlling blood pressure.

Objective To investigate the risk factors,clinic charactertics and survival prognosis of pulmonary embolism (PE) in patients with lung cancer.Methods The clinic data of 28 lung cancer patients with PE,hospitalized in department of respiratory and critical care medicine of Tianjin Chest Hospital between June 2012 to June 2015,were retrospectively reviewed.Eleven of them were diagnosed with primary lung cancer and PE (symptomatic group),and 17 lung cancer patients were found PE accidentally (asymptomatic group).A total of 56 lung cancer patients without PE were used as control subjects (no PE group).Data of pathological types,clinical staging of lung cancer,systemic chemotherapy,white blood cell (WBC),hemoglobin (Hb),platelet (PLT),D-dimer (DD),albumin (ALB) and C-reactive protein (CRP) were analyzed by univariate analysis in the symptomatic group and asymptomatic group.Logistic regression analysis was carried out on the statistically significant indexes to observe the influencing factors.The morphology and location of the remobilization images were analyzed in lung cancer patients with PE.The median time to embolism and survival of PE patients were compared between symptomatic group and asymptomatic group.Results The proportion of adenocarcinoma,systemic chemotherapy and stage Ⅲ + Ⅳ were significantly higher in PE group than those in no PE group (P ＜ 0.01).The ratio of white blood cells (WBC)＞ 11× 109/L (hyperleukocytosis) and albumin (ALB) ＜30 g/L and D-dimer (DD)＞ 0.5 mg/L were significantly higher in PE group than those of no PE group (P ＜ 0.05).There were no statistical differences in other indicators including clinical symptoms between the two groups (P ＞ 0.05).The logistic regression analysis showed that adenocarcinoma,chemotherapy,WBC＞ 11× 109/L and DD＞0.5 mg/L were the risk factors of lung cancer with PE (P ＜ 0.05).There was higher ratio of asymptomatic PE in lung cancer patients with PE.There were no significant differences in morphology and location of the remobilization images in symptomatic group.The median time of embolization was 3.6 months (95％ CI:3.2-4.0) in the asymptomatic group,which was significantly earlier than that in the symptomatic group (10.5 months,95％ CI:8.88-12.12,P ＜ 0.01).The median survival time was 7.2 months (95％ CI:5.86-8.56) in the asymptomatic group,which was significantly longer than that of symptomatic group (2.8 months,95％ CI:2.48-3.12,P ＜ 0.05).Conclusion Lung adenocarcinom,systemic chemotherapy,hypoproteinemia and increased D-dimer are the independent risk factors in lung cancer patients with PE.PE in lung cancer is frequently asymptomatic in the early stage.Compared to symptomatic patients,asymptomatic cases have better prognosis.

Objective:To study the effect of alanyl-glutamine(Ala-Gln) on aged patients with severe pneumonia. Methods:The hospital acquired 56 cases of patients with severe pneumonia,who were randomized in two groups:Ala-Gln group in 30 cases and controlled group in 26 cases Both groups were cared with anti-infection,nutrition support and symptomatic treatment,during which Ala-Gln group was supplemented with 10g alanyl-glutamine amid 250ml amino acid intravenous drip in 14 days,two times each.Before and after the treatment,both groups were monitored over their intestinal functions and measured over their Alb,IgG,total lymphocytes count,C-reactive protein,nitrogen balance,blood routine,liver and kidney function examinations.Result:There were statistical differences between the groups involving intestinal function monitoring(P

0.05),and it shows that IL-4 does not play a major role in the occurrence of CAP.There is correlation between the serum level of IL-4 and the occurrence of CAP(r=0.48,P

Objective To determine the relationship between contraceptive or not after spontaneous abortion and the outcome of pregnancy in patients with polycystic ovary syndrome (PCOS). Methods One hundred and forty-one cases of women with PCOS who post-abortion were divided into two groups by random digits table,67 cases in non-contraception group and 74 cases in contraception group. The cycle cancelled rate, single dominant follicle development rate,pregnancy rate, spontaneous abortion rate were compared between two groups. Results The cycle cancelled rate was 1.49% (1/67),single dominant follicle development rate was 58.21% (39/67),pregnancy rate was 39.39% (26/66) in non-contraception group;13.51% ( 10/74 ), 20.27% ( 15/74 ), 18.75 % ( 12/64 ) in contraception group. There were significant difference between two groups (P ＜0.01). The spontaneous abortion rate was 7.69%(2/26)at pregnant 7 weeks in non-contraception group.The spontaneous abortion rate was 33.33%(4/12 ) in contraception group, 1 case in pregnant 6 weeks, 2 cases in pregnant 8 weeks, 1 case in pregnant 9 weeks. There was significant difference between two groups (P ＜ 0.05 ). Conclusion Patients with PCOS who are not contraceptive after abortion can obtain better outcome pregnancy with the low cycle cancelled rate, high safety and pregnancy rate, low spontaneous abortion rate.

Objective To investigate whether scores of epworth sleepiness scale (ESS) assessing daytime sleepiness were associated with sleep apnea syndrome(SAS)combined with cerebral vascular disease and ESS could be used to predict cerebral vascular disease occurrence.Methods A group of 62 SAS combined with transient ischemic attack(TIA), a group of 53 SAS with combined hypertension and the other group of 61 SAS combined without other diseases were monitored by polysomnography(PSG), daytime sleepiness of these SAS patients were assessed by ESS at the same time. Results Compared to SAS combined without other diseases, those SAS combined with TIA and hypertension patients had significant higher scores of ESS,apnea/hypopnea index (AHI) and micro-arousal index(MAI)(all P

Objective To explore the clinical features of hyperthyroidism combined with Moyamoya disease. Methods The manifestations of clinic and neuroimaging in 4 patients with hyperthyroidism combined with Moyamoya disease were retrospectively analyzed.Results 4 patients were young or middle-aged females and onset of the disease were acute or subacute. 2 cases had the history of hyperthyroidism for 4 and 1 years and other 2 cases were diagnosed of hyperthyroidism in the duration of hospital stay. All of them presented with focal neurologic deficit(3 of motor weakness or fatigue in the limbs, 2 of facial paralysis and 2 of aphasia). All of them had thyromegaly Ⅰ?～Ⅱ? and 1 of them had vascular murmur in thyroid region.Thyroid function tests revealed thyrotoxicosis, the level of fT3 was 10.1～30.8 pmol/L,the level of fT4 was 17.9～154.8 pmol/L, the level of TSH was 0.01～0.1 mU/L.DSA or MRA showed stenosis or occlusion of the terminal portions of the bilateral or unilateral internal carotid arteries and abnormal vascular network in the vicinity of the arterial occlusion. The patients recovered after the anti-thyroid therapy and treatments for the cerebral stroke. Then ,15 ～ 60 months were followed up respectively, there was no relapsed of cerebral stroke in them. Conclusion Hyperthyroidism combined with Moyamoya disease is only seen in females. Cerebral stroke is occurred during the presence of thyrotoxicosis. Anti-thyroid treatment is beneficial for recovery of the centre nervous system and prevention of recurrence.

OBJECTIVE To analyze the multi-drug resistant genes(genes encoding extended-spectrum ?-lactamases,outer membrane protein gene oprD2,aminoglycoside-modifying enzyme genes,sulfonamides and disinfectant-resistance gene and plasmid-mediated quinolone resistance gene) of Pseudomonas aeruginosa clinical strains.METHODS The drug-resistance to 15 antibiotics was detected by the disc agar diffusion(DAD) and microdilution broth method in 32 P.aeruginosa strains isolated from Jun to Dec 2006.Twenty-eight related drug-resistant genes and outer membrane protein gene oprD2 were examined by PCR method.RESULTS The resistance rate of 32 P.aeruginosa strains to amikacin,ceftazidime,ciprofloxacin,cefepime,cefoperazone/sulbactam,imipenem,meropenem,levofloxacin,piperacillin/tazobactam,aztreonam and piperacillin were 9.4%,25%,59.4%,68.7%,68.8%,78.1%,81.1%,81.3%,84.4% and 94.4%,respectively,and that to others antibiotics were 100%.The detective rate of aminoglycoside-modifying enzyme genes(aac(6′)-Ⅱ,aac(3)-Ⅱ,aac(6′)-Ⅰ,aph(3′)-Ⅵ,ant(3″)-Ⅰ and aac(3)-Ⅰ) were 68.8%,62.5%,21.9%,9.4%,9.4% and 6.3%,and the genes encoding extended-spectrum ?-lactamases(blaFOX,blaIMP,blaVIM and blaDHA) were 37.5% 15.6% 6.3% and 9.3%,respectively.Twenty-two(68.8%) of them were detected in oprD2 and 9(28.1%),but positive in qacE?-sul1 gene.CONCLUSIONS The detective rate of aminoglycoside-modifying enzyme genes,extended-spectrum ?-lactamases genes and the loss rate of outer membrane protein gene oprD2 are high in these 32 multi-drug resistant P.aeruginosa clinical strains.

OBJECTIVE To investigate genes associated with aminoglycosides modification enzymes(AMEs)in Pseudomonas aeruginosa(PAE)isolated from NICU patients.METHODS Drug-resistant genes encoding AMEs such as aac(3)-Ⅰ,aac(3)-Ⅱ,aac(3)-Ⅲ、aac(3)-Ⅳ,aac(6')-Ⅰ,aac(6')-Ⅱ,aph(3')-Ⅵ,ant(3″)-Ⅰand ant(2″)-Ⅰwere detected bypoly merase chain reaction(PCR)amplification in 36 PAE isolates.The bacteria were identified by ATB.RESULTS The positive rates of aac(6')-Ⅱ,aac(3)-Ⅱ,aac(6')-Ⅰ and aph(3')-Ⅵ genes were 52.8%,47.2%,11.1% and 2.8% of 36 isolates,respectively.Drug-resistant genes encoding AMEs were detected positively in 77.8% of 36 isolates.CONCLUSIONS AMEs genes are present in high percentage of PAE isolated from NICU patients.