MELAS syndrome(mitochondrial myopathy encephalophathy with lactic acidosis and stroke-like episodes),as one of the most common diseases in mitochondrial encephalomyopathies,is characterized by highly variable manifestations.So,more and more people come to realize the importance of molecular basis of MELAS.This review took the commonest mtDNA point mutation(A3243G) for example to overview its molecular biological mechanism,test strategy and recent progress of study on MELAS syndrome.

Objective To investigate the effect of pregnancy management of gestational diabetes mellitus (GDM) on pregnancy outcome.Methods One hundred and two patients of GDM was as our case group and 100 patients with non-diabetic and no medical complications in pregnant women in the same period were as control group who all hospitalized from January 2008 to December 2011.The information of maternal and prenatal complications were collected.Results Pregnancy women were underwent the pregnancy management.No significant difference was seen in terms of the incidences of pregnancy induced hypertension polyhydramnios,preterm delivery,premature rupture of membranes and postpartum hemorrhage between case group and control group(x2 =1.33,0.80,0.68,0.35,0.20,respectively,P ＞ 0.05),so were other indices including of the incidences of fetal macrosomia,fetal distress,neonatal asphyxia,hyperbilirubinemia and neonatal hypoglycemia between the two groups(x2 =0.09,0.23,0.15,0.15,0.49,respectively,P ＞0.05).Conclusion Enhancing the management and standardized treatment of GDM can control the level of serum glucose and decrease the maternal and prenatal complications.

Objective To investigate the effect of comprehensive rehabilitation on the stroke.Methods 120 cases of stroke divided into rehabilitation group(60 cases)and control group(60 cases).They were assessed with Fugl-Meyer Assessment(FMA),Modified Barthel Index(MBI),and Satisfaction with Life Scale(SWLS)before and 1 month,3 months and 6 months after treatment respectively.Results The scores of FMA,MBI and SWLS were improved significantly in rehabilitation group,especially in the 1st month,while that of control group presented the tendency of decline.Conclusion Comprehensive rehabilitation is effective on motion function,activity of daily living and quality of life of stroke patients.

Objective To investigate the status quo of nutrition knowledge,attitude and practice(KAP) among elite female small ball athletes of Guangdong province and its influencing factors.Their serum ferritin was also observed to explore its correlation with their KAP,so as to provide evidences for formulating and implementing scientific and reasonable nutrition education schemes.Methods Fifty-four female small ball athletes,including 20 handball,20 hockey and 14 softball players,were selected to complete a self-designed diet questionnaire based on KAP education mode and their serum ferritin indicators were analyzed at the same time.Results (1)The average scores(all out of 100)of nutrition knowledge (K),attitude (A) and practice (P) were 43.64 ± 11.66 (with a failure rate of 90.7％),78.37 ± 10.21 (with the rate of excellence of 59.3％)and 63.10 ± 10.17(with a passing rate of 37.0％),and the average KAP score was 185.10 ± 23.01,with a passing rate of 44.4％.(2)The one-way ANOVA found that there were significant differences in the average A score and the total KAP score (P＜0.05) among the athletes of different small ball teams.The correlation analysis results showed that the average A score was of significant positive correlation to the average P score.Moreover,the average KAP total score was of significant correlation with sports events (P＜0.05) and the education level (P＜0.05),but not with the age,training period and exercise level(P＞0.05).The multiple stepwise regression analysis results showed that training period(P＜0.05) and sports events(P＜0.05) was the influencing factor of nutrition knowledge and attitude respectively,and that education level (P＜0.01) was the influencing factor of both nutrition practice and KAP.(3)Significant differences were found in the serum ferritin among athletes of different sports events(P＜0.05)the serum ferritin was of significant positive correlation with the nutrition knowledge(P＜0.05).Conclusion (1)The lack of sports nutrition knowledge and the unbalance of nutrition behavior are common in elite female small ball athletes,but they had a positive attitude.It is necessary to carry out a series of effective nutrition education programs to improve their sports nutrition knowledge,cultivate their good nutrition attitudes and finally formulate rational and effective nutritional intervention measures to promote the formation of healthy nutrition behavior of athletes.(2) The sport event is the key influencing factor of the nutrition attitude and dietary behaviors,which suggests that more more attention should be paid to athletes' dietary management and focus should be put on their diary behavior on no-training days and on their energy ratios control of each meal,especially breakfast and extra meals,and rational intake of snacks.(3)The incidence of iron deficiency is consistent with KAP questionnaire survey results,which indicates that it may be an effective measure to prevent iron deficiency anemia through strengthening athletes' dietary nutrition education.

Objective To compare the advantages and disadvantages of three methods of yeast-like fungi identification of vulvovaginal candidiasis (VVC).Methods The pathogenic candida strains were identified by CHROM agar chromogeinc culture medium,the chromogenic medium of Autobio and VITEK 2 system,and the result of VITEK 2 system was the gold standard.Results All candida strains were appraised.By VITEK2 system,217 candida isolates were identified as candida albicans,and 26 were detected as non-candida albicans.214 isolates were identified as candida albicans and 13 isolates were identified as non-candida albicans by Autobio.214 isolates were appraised as candida albicans,16 isolates were identified as non-candida albicans.The coincidence rate of identification of CHROMagar and the chromogenic medium of Autobio were 94.7％ and 95.06％.Compared with VITEK 2 system,there was no significant difference between these two chromogeinc culture medium identifying candida albicans and non-candida albicans.Conclusion The chromogenic medium of Autobio has higher cost-effectiveness,higher color discrimination and simpler technical operation,and is worthy of promotion in identifying candida species in clinic.

Objective To investigate the value of X-ray Knife in the stereotaxis radiotherapy of lung cancer.Methods 52 cases with pulmonary carcinoma were treated with X-ray knife,before and after that,general radiotherapy was applied.After whole radiotherapy,2 or 3 months later,all patients were followed by CT scan.The changes of tumor and clinical appearances were compared before and after therapy.The curative effect was estimated according to clinical appearances and CT findings.Results 6 patients were complete response(11.5%) ,29 patients were partial response(55.8%) and 13 patients were no changes or reduced less than 50%.The total responsive rate was 92.3%.Conclusion The treatment of lung cancer with X-ray Knife can give tumor accuracy high dosage irradiation.The short term therapeutic effectiveness is significant and safe on clinical.

Objective To investigate the resistance of clinical isolated gram negative bacilli to tigecycline.Methods One hun-dred and fifteen Escherichia coli isolates,110 Klebsiella pneumoniae isolates and 99 Acinetobacter calcoaceticus-Acinetobact-er baumannii complex isolates were collected from Affiliated Second Hospital of Zhejiang University College of Medicine from the year 2012.The other 393 A.calcoaceticus-A .baumannii complex isolates were collected from 15 hospitals of nine cities in Zhejiang province during September to October 2012.Species identification and susceptibility test were confirmed by VITEK-2 compact system,while the 393 A.calcoaceticus-A .baumannii complex strains isolated from Zhejiang province were identified by MALDI-TOF MS.Moreover,159 A.baumannii isolates with tigecycline MIC value ≥8 μg/ml or 4 μg/ml and part of the MIC value ≤0.5 μg/ml,1 μg/ml and 2 μg/ml which were firstly determined by VITEK 2 GN AST-16 Suscepti-bility card were then determined by Etest.Results The 393 A.calcoaceticus-A .baumannii complex strains were identified as 317 of A.baumannii,32 of A.pittii and 44 of A.nosocomialis.When using the FDA breakpoints,the resistance rate of tige-cycline against 115 E.coli isolates,110 K.pneumoniae isolates and 99 A.calcoaceticus-A .baumannii complex isolates were 0.0%,7.3% and 6.1%,respectively.Interestingly,85.7% of the tigecycline-resistant gram negative bacilli were resistant to carbapenems.However,only 10.0% of the carbapenem-resistant gram negative bacilli were resistant to tigecycline.Conclu-sion Tigecycline had a good activity against clinical isolated multi-drug resistant or even pan-drug resistant gram negative bacilli.No matter which criteria for tigecycline was referred to,the resistance rate oftigecycline was slightly lower by Etest than by GN AST-16 Susceptibility card.

Objective To observe the clinical effects of phosphocreatine treatment on left ventricular function and on amino-terminal pro-brain natriuretic peptide (NT-proBNP) level in elderly patients with chronic heart failure. Methods In our department, the 172 elderly patients with chronic heart failure were randomly divided into treatment group and control group (n= 86, each).The control group received routine anti-heart failure treatment. The treatment group received conventional therapy plus creatine phosphate sodium for 4 weeks. The cardiac function was evaluated and the NT-proBNP level was measured in all subjects. Results Four weeks after treatment, the improvements of left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic dimension (LVEDD) were better in treatment group than in control group (all P＜0.05). The plasma NT-proBNP level decreased significantly in treatment group as compared with control group [before treatment: (956.4 ± 644.2) pmol/L and (973.6 ±639.8) pmol/L; after treatment: (414. 5 ± 163.8 ) pmol/L and ( 719.3 ± 477. 5 ) pmol/L, all P＜0. 05]. Conclusions Phosphocreatine could improve left ventricular function and decrease plasma NT-proBNP level in elderly patients with chronic heart failure.

Stroke patients usually are complicated with degeneration of body function as well as emotional and cognitive problems; consequently it will affect capacities of daily lives and recreation in most cases. Recreational therapy (RT) being favorable as far as stroke rehabilitation is concerned. The authors reviewed current developments of applications of RT to carry on a brief talk about present and future utilization of RT in stroke rehabilitation and it holds the point that when practicing RT we should introduce relevant evaluation Methods and techniques adopted in physical therapy (PT) and occupational therapy (OT) area into comprehensive rehabilitation program for some better Results . Evidence based principal should also play a positive role to make a systematic and specific intervention plan in further procedure of RT treating stroke patients.

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.