Objective To understand the clinical characteristics of systemic lupus erythematosus with Antiphospholipid syndrome (SLE-APS).Methods The clinical data of 39 cases of SLE-APS were collected and analyzed retrospectively. Results Thirty-one patients had 48 thrombosis episodes in total, among which the most common presenting manifestations were deep venous thrombosis and stroke. 12 of 26 married women had fetal morbidity. The prevalence of anticardio lipin antibody (aCL) and lupus anticoagulant ( LA) was 72% and 41% , respectively. 24 patients had SLE at first,on an average of 9. 5 years later they had the characteristics of APS, 12 patients had thrombosis episodes or fetal morbidities ,4. 8 years later they developed into SLE,and 3 patients had the characteristics of SLE and APS from the onset The SLEDAI was less than 5 in five cases when they had thrombosis episodes or fetal morbidities.Conclusions The incidence of thrombosis episodes or fetal morbidities increased in SLE-APS patients. APS occurred before, after or at the same time with SLE. SLE patients might have the clinical features of APS during the steady stage. It's very important to ask the medical history in detail and measure aCL in lupus patients to find the risk factor of APS and prevent the APS' occurrence.

Objective To study the isolation and antimicrobial resistance of pathogens isolated from patients with brain damage in hyperbaric oxygenation department,so as to provide reference for clinical anti-infective treatment.Methods Bacterial culture and antimicrobial susceptibility testing results of pathogens isolated from blood,sputum,and urine specimens of 975 patients with brain damage in the hyperbaric oxygenation department of a hospital between January 2013 and December 2014 were analyzed retrospectively.Results A total of 1 328 strains of pathogens were detected,877(66.04%)of which were gram-negative bacteria,213(16.04%)were gram-positive bacteria,and 238(17.92%)were fungi.The top five isolated pathogens were Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,and Candida albicans.Specimens mainly isolated from sputum and urine,accounting for 58.59%and 35.24%respectively,resistance rates of Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,and Escherichia coli to imipenem were 16.67%,81.82%,82.44%,and 4.65%respectively.Vancomycin-resistant strains was not found among gram-positive bacteria,resistance rates of Enterococcus faecalis to most antimicrobial agents were lower than those of Enterococcus faecium.Conclusion Respiratory and urinary tract infection account for most of the infection in patients with brain damage in hyperbaric oxygenation department,gram-negative bacteria are the predominant pathogens causing infection.

Objective To type Acinetobacter baumannii using infrequent restriction site PCR (IRS PCR). Methods Strain specific electrophoretic patterns from PCR products by amplifying DNA sequences flanking infrequent restriction sites of 15 strains of Acinetobacter baumannii were compared with the results of biotyping and antimicrobial susceptibility. Results The 15 bacteria were divided into 5 gene types with IRS PCR, but 3 with biotyping, and 4 with antimicrobial susceptibility. Conclusion IRS PCR method for typing Acinetobacter baumannii is of strong sensitivity, high recognition, good repeatability, convenient operation, and wide range of application.

By analyzing and summarizing the previous research results regarding acupuncture for insomnia, factors influencing the efficacy of acupuncture on insomnia were discussed, and a summary was made from aspects of age, gender, duration of insomnia, use of medication, types of syndrome differentiation, acupoint selection, acupoint combination, acupuncture timing, etc. With respect to the influencing factors, precautions during the clinical syndrome differentiation were briefly reviewed, and the treatment plan of acupuncture for insomnia was optimized, which could provide new methods and thoughts for clinical and scientific research regarding acupuncture for insomnia.
Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Male ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy

Objective To investigate the infection situation of L-form bacteria in urinary calculi from the patients with urolithia-sis in a hospital to provide a scientific basis for postoperative anti-infection and prevention of urinary stone recurrence.Methods The calculi samples in 265 cases of urinary calculi from October to December 2015 were collected and performed the culture of com-mon bacteria and L-form bacteria respectively.Culture of common bacteria and bacterial L-forms.Results Among 265 cases of uri-nary calculi ,8 cases(3% ,8/265) were L-form Bacterial combined with common bacterial infection ,only 7 cases(2.6% ,7/265) were L-form bacterial infection ,80 cases (30.0% ,80/265) were common bacterial infection.15 strains of L-form bacteria were detected and 96 strains of common bacteria were detected.The drug resistance of L-form bacteria was significantly increased compared with common bacteria.Conclusion The positive rate of L-form bacteria culture of urinary calculi is lower than other domestic reports. Adding hypertonic medium for conducting L-form bacterial isolation and culture in the patients with urinary tract infection can re-duce the false negative.

Objective: To optimize the ultrahigh pressure extraction ( UPE) process for forsythoside from Forsythia suspensa by Box-Behnken experimental design. Methods:On the basis of single factor screening, a three-factor and three-level Box-Behnken ex-perimental design was employed with liquid/material ratio( X1 ) , extraction pressure ( X2 ) and extraction time ( X3 ) as the independent variables. The response variable was the extraction yield of forsythoside. Results:The optimal UPE conditions for forsythoside were as follows:the ratio of solvent to material (ml·g-1) was 70, the extraction pressure was 151 MPa, and the extraction time was 114 s. With the optimal extraction process, the extraction yield of forsythoside was 13. 15 mg·g-1 . Conclusion:As a novel extraction tech-nology for Chinese herbal medicines, UPE procedure has higher extraction yield, lower extraction temperature, shorter extraction time and less power consumption, which provides a brand-new method for the extraction of forsythoside from Forsythia suspensa.

OBJECTIVE To investigate the clinical distribution and resistance of Acinetobacter baumannii in our hospital in order to provide evidence to proper use of antibiotic drugs in clinics. METHODS A. baumannii isolates were collected in our hospital from Jan 2004 to Dec 2006. Antimicrobial susceptibility testing was performed by disk-diffusion method,according to the standards of CLSI/NCCLS, the data were analyzed by WHONET5.4 software. RESULTS The isolating rate of A. baumannii from 2004 to 2006 was 2.5%,3.8%, and 10.9%, respectively.It was distributed mainly from ICU (29.2%), respiratory ward (19.3%) and emergency ward (10.9%). The highest appearing rate was the sputum, up to 78.0%. More than 60% of isolates were resistant to antimicrobial agents tested such as PIP, CTX, CRO and ATM. A. baumannii showed the highest susceptibility to carbopenems with about 80%. CONCLUSIONS The infection of A. baumannii is one of the most complex problems. Therefore, monitoring A. baumannii constantly and regularly, finding out resistant strains timely, and adjusting the treatment regimen are very important to the prevention of nosocomial infection. The disinfection should be strengthened for hospital environment and medical staff in order to control existence and spread of A. baumannii.

OBJECTIVE To investigate the drug susceptibility of clinical isolates in local region for using antibiotic reasonably. METHODS Totally 3 170 strains of clinical isolates were identified by API and Microscan and tested for drug resistance against antimicrobial agents by K-B method. WHONET5.4 was applied for analysis. RESULTS The commonly encountered bacteria were Pseudomonas aeruginosa (24.3%), Acinetobacter baumannii (10.9%), Klebsiella pneumoniae (10.4%), Escherichia coli (8.9%), and Staphylococcus aureus (SA,8.0%). In Gram-negative isolates, the resistance rate to meropenem was 19.7%, and to piperacillin-tazobactam was 26.5%. The incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamases (ESBLs) were 49.1% and 33.5%, respectively. In Gram-positive isolates, the susceptibility rate to vancomycin and teicoplanin both was 100.0%. The oxacillin resistant rates of SA and coagulase negative Staphylococcus (CNS) were 54.2.0% and 82.3%. CONCLUSIONS The production ratio of ESBLs and oxacillin resistance of bacteria in local region are high. It is important to promote the rational use of antimicrobial agents and take effective contaminant methods to reduce resistant rates of bacteria and dissemination of multi-resistant bacteria.

Objective:To investigate the supply status of dementia care services in pension agency in Guang zhou,thus to put forward suggestions for improving the service quality of the long-term care for dementia.Methods:Using questionnaire research and individual interview,an interview survey was conducted among managers,dementia and nursing assistant in ten pension agencies in Guangzhou.The data was analyzed by SPSS16.0 statistical method.Results:The dementia had been increasingly paid attention by the pension agencies,but there were still considerable defects in the aspect of the zone set up and service supply;the professional quality of nursing personnel in pension agencies had steadily increased,but shorthanded situation was more obvious.Conclusions:It suggests that we should provide specialized nursing level and the classification standard of care requirements for dementia elders;strengthen the training of mental health worker to enhance the level of medical care and supply ability of nursing assistant;allocate the mental health resources rationally;explore the “combination of medical treatment and endowment” service model which meets the need of dementia elders.

Thiopurine S-methyltransferase (TPMT) is an important and key cytoplasmic enzyme in the metabolism of thiopurine drugs,whose activity can directly determine the amount of thiopurine drugs metabolized to cytotoxic 6-thioguanine nucleotides and consequently influence clinical efficacy and adverse drug reactions of thiopurine drugs.In order to deepen knowledge and role of genetic polymorphism of tpmt in the individualized thiopurine drug treatment,this present review mainly covered the following three frequently concerned aspects,including i) whether or not to determine the activity of TPMT priot to treatment of thiopurine drugs;ii) to genotype or to phenotype;iii) how to choose genotype methods.