Objective To evaluate the clinical management and outcome in pregnancy complicated with preterm premature rupture of membranes (PPROM). Methods The clinical data of 98 patients with PPROM were retrospectively analyzed. 20 patients with PPROM at 28 ～ 33 +6 weeks were selected as the early group, while 78 patients with PPROM at 34 ～ 36 +6 weeks as the late group. Results The puerperal infection, postpartum hemorrhage and delivery methods had no statistical differences between early group and late group (all P＞0. 05). The neonatal Apgar Score in early group was less than that in late group ( all P ＜ 0. 05). The incidences of neonatal respiratory distress syndrome,infection and death in early group were higher than that in late group. There were significant differences between two groups (all P ＜ 0.05). Conclusion Pregnancy between 28 and 34 weeks gestation with PPROM should be managed expectantly to protect fetus to 34 weeks and over. Pregnancy should be terminated appropriately by use of suitable delivery method. The above methods could effectively decrease occurrence incidences of complications and mortality.

Objective To analyze the screening and confirmation test results of human immunodeficiency virus (HIV) antibody during 2009-2015 to provide the basis for the recruiting strategies in recruiting blood donors among the low risk population and blood donor′s returning to the team .Methods The blood samples of voluntary blood donors were detected the HIV antibody by the ELISA method ,with the reagents provided by 2 different manufacturers .The samples of HIV antibody positive or suspected sam‐ples were submitted to the Shenzhen Municipal Center for Disease Control and Prevention CDC for conducting the Western blot confirmation .The confirmation results of blood samples during 2009 -2015 were statistically analyzed .Results There were 197 766 blood samples from 2009 to 2015 .The overall infection rates of HIV were 1 .3 ,4 .7 ,5 .6 ,5 .4 ,5 .3 ,4 .6 ,7 .3/one hundred thousand respectively ,the average infection rate was 0 .004 9% (4 .9/one hundred thousand) ,the average confirmed positive rate was 22 .1% ,the false positive rate was 77 .9% .Among the blood donors of confirmed positive HIV antibody ,the donors aged 18-30 years old accounted for 67 .7% .Conclusion It is important for the recruitment work before the blood donation .Aiming at the blood donors of workers from outside and relative low cultural level ,especially the blood donors of high risk behavior ,the small card mode could be adopted to guide them to the disease control center to conduct the professional consultation and detection ,which can increase the blood transfusion safety coefficient and also prevents the spread of HIV/AIDS .Aiming at the false positive blood do‐nors ,the works of follow up ,tracking monitoring and return to the blood donation team should be done well for reducing the run a‐way of blood donors .Selecting more sensitive reagents and more sensitive method for the amplification of virus nucleic acid can shorten the infection risk of the window period as far as possible for ensuring the safety of blood transfusion .

The pre-examination process is the first key step in the total testing process of clinical laboratories.Specimen acceptability is an important indicator to measure the quality of pre-examination.In order to identify the risks and the root causes in the process , establishment and monitoring of quality indicators about specimen will effectively control the risks , enhance the acceptability of specimens , promote the improvement of pre-examination quality and finally get the aim of assuring patients′safety.

Objective To analyze serum calcium and phosphorus levels and its related factors of clinical type 2 diabetes mellitus (T2DM) with overt diabetic kidney disease (T2-dDKD).Methods Ninety cases of T2DM patients according to K/DOQI Recommendations in 2007 were selected as the study subjects.Based on the patients' 2 times mean urinary albumin/creatinine ratio (ACR),these people were divided into three groups,namely Normal albuminuria group (30 patients,ACR＜30 mg/gCr),Microalbuminuria group (30 patients,ACr =30-300 mg/gCr),Macroalbuminuria group (30 patients,ACR＞300 mg/gCr).Thirty cases of healthy at the same period were selected as the Control group.Serum calcium,phosphorus,hs-CRP,IL-6,HbA1c were detected.And glomerular filtration rate (eGFR) was calculated.Results The eGFR in Normal albuminuria group was more higher than other groups (P＜0.05),the eGFR of Microalbuminuria group was significantly lower than other groups (P＜0.05).Subgroups of T2DM with different albuminuria presence and severity,duration was also different between the groups,the more albumin in urine,the longer its duration.The contents of HbA1c in the groups of varying degrees of albuminuria increased as urinary albumin aggravation (HbA1c was (8.87±2.44) ％,(9.27±2.74)％,(11.04±2.86)％ respectively,P＜0.05),but there was not statistically significant between Microalbuminuria group ((9.27±2.74)％) and Normal albuminuria group ((8.87±2.44) ％).Compared with Control group,in subgroups of T2DM,serum calcium was decreased((2.22±0.19) mmol/L,(2.16±0.14) mmol/L,(2.13±0.18) mmol/L,and the Contorl group was (2.32±0.11)mmol/L,P＜0.05),and serum phosphorus ((1.16±0.31) mmol/L,(1.42±0.52) mmol/L,(1.98±0.58)mmol/L,and the Control group was (1.08±0.28) mmol/L),hs-CRP ((4.82±0.89) mmol/L,(8.46± 2.85)mmol/L,(13.09±3.49) mmol/L,and the Control group was (2.46±0.48) mmol/L),IL-6((10.32±4.19)pg/L,(14.78±4.34) pg/L,(16.67±6.62) pg/L,and the Control group was (7.03±2.15) pg/L) were increased(P＜0.05).In subgroups of T2DM,hs-CRP was significantly increased with the increase of the serum albumin((4.82±0.89) mmol/L,(8.46±2.85) mmol/L,(13.09±3.49) mmol/L,P＜0.05),there were no statistical significance about blood phosphorus among Macroalbuminuria group (1.98±0.58) mmol/L),control group((1.08±0.28) mmol/L),normal albuminuria group((1.16±0.31) mmol/L) and albumin urinary group (1.42±0.52) mmol/L).Serum phosphorus in Microalbuminuria group were positively correlated with hs-CRP,IL-6,HbA1c (r =0.431,0.384,0.517 respectively,P＜0.05).Serum phosphorus in Macroalbuminuria group were positively correlated with hs-CRP,IL-6,HbA1c (r=0.825,0.622,0.683 respectively,P＜0.01),but negatively with eGFR(r=0.600,P＜0.01).Conclusion Serum phosphorus metabolism is abnormal in patients with diabetic nephropathy,hs-CRP,IL-6,and HbA1c are the related factors influencing the progression of serum phosphorus in patients with diabetic nephropathy.

Currently, histological and molecular methods are considered for the treatment of advanced non-small cell lung cancer (NSCLC). Single-agent epidermal growth factor receptor tyrosine-kinase inhibitors (EGFR-TKIs) and anaplastic lymphoma kinase in-hibitors (ALK-TKIs) have been used as standard first-line therapies for patients with active EGFR mutation and ALK rearrangement, re-spectively. However, to date, the single-agent EGFR-TKIs as the first-line therapy for patients with known EGFR mutations has been demonstrated to provide a prolonged progression-free survival but does not affect overall survival (OS). Physicians these days focus on improving the OS of patients with advanced NSCLC. To patients with EGFR mutation, combining and maintaining EGFR-TKIs with chemotherapy could be a promising approach. In this article, various ways of combining EGFR-TKIs with chemotherapy were explored.

Objective To investigate the changes of drug resistance related genes and drug resistance of Acinetobacter Bau-mannii in hospital,and provide evidence for rational use of antibiotics in clinic.Methods A retrospective analysis of Shaanxi Corps Hospital of Chinese Peoples’s Armed Police Forces from 2011 to 2015 from clinical samples of 11 521 specimens were isolated and cultured 1 861 strains of Acinetobacter Baumannii,drug susceptibility test by K-B method.The antimicrobial minimum inhibitory concentration (MIC)according to the 2014 edition of the CLSI judgment criteria of judgment.Results 1 861 strains of Acinetobacter Baumannii were detected drug resistance genes gyrA,parC,OXA-51,OXA-23,int on the 1,I TEM,AAC (6’)-1,AAC (3’)-1,ant (3)-1,ant (2)-1 and Caro gene detection rates were 50.4%,72.1%,70.9%,55.7%, 56.2%,65.6%,12.9% and 89.9% respectively,and SHV,IMP and VIM genes were not detected.The sequencing results showed that gyrA and parC gene mutation was the main cause of quinolone resistance.The antibiotic resistance of Acineto-bacterBaumannii was an increasing trend year by year,and 1 861 strains has 1 419 strains showed multiple drug resistance, all strains were sensitive to polymyxin.In 2015,quinolones aminoglycosides resistance rate was more than 65%.To imipen-em,meropenem and Cefoperazone/sulbactam were 35.17%,36.01% and 42.40%.Conclusion The detection rate of Acine-tobacter Baumannii is increasing year by year,and the drug resistance and multi drug resistance is increasing year by year.It is necessary to strengthen the clinical rational drug use andcontrol the hospital infection.

Objective Investigate the relation between decrease of apoptosis caused by delayed preconditioning and expression of SMAC and XIAP.Methods Sprage-Dawleyt rats were divided into four groups: control,sham,I/R and IPC/SWOP.The rats in I/R group underwent ischemia for 1 hour by classic artery ligation and reperfusion for 1 hour.The rats in IPC/SWOP group underwent tree cycles of 5-minute ischemia and 5-minute reperfusion 24 hours prior to the index occlusion.Cell apoptosis was measured by flow cytometry,the activity of caspase-3 was also measured.The expression of SMAC and XIAP in cytosol of myocardial cell was measured by Western blot.Results Cell apoptosis rate,activity of caspase-3 and expression of SMAC significantly increased in I/R as compared with control(P

The pre-analytical process is the first key step in the total testing process of clinical laboratories,which will directly influence the accuracy and timeliness of testing results.Efficient preanalytical quality assurance system consists of scientific personnel structure,regular training and monitoring,bright and comfortable phlebotomy environment,advanced comprehensive phlebotomy facilities,strict biosafety practice in each procedure and harmonious relationship between clinicians/patients and laboratory.Besides,the application and monitoring of sound quality indicators in pre-analytical process will promote the improvement of quality and finally get the aim of assuring patients' safety.

Objective:To evaluate the changes of urinary and sexual function after pelvic autonomic nerve preservation with total mesorectal excision operation in patients of rectal cancer . Methods:Fifty-two patients of Dukes B stage received The PANP following TME with follow-up was complete in 38 cases while TME in 35 cases of Dukes B from January 2004 to August 2006. The urinary and sexual dysfunctions of patients in case and control group were analyzed retrospectively by case-control study. Urinary and sexual function were evaluated by means of questionnaires before and after operation.Results:The micturation dysfunction rate was 15.7%(6/38) and 40%(14/35) ,the sexual dysfunction rate was 18.4%(7/38) and 51.4%(18/35)in case and control group respectively,with the difference being significant(P=0.013,P=0.002).Conclusion:The PANP following TME for rectal cancer could reduce sexual and micturition disorder rate and improve the quality of life of the patients after operation.

Objective To study the clinical effect of compound Yisui Shengxue Keli(YSSXKL) on treating ?-thalassemia. Methods By using self-control study method,30 cases of major and intermediate ?-thalassemia had been first treated with placebo for three months,then were treated with YSSXKL in the followed three months in Guangxi province,the high incidence area of the disease. The clinical symptoms,traditional Chinese medicine symptoms and dynamic changes of the blood levels of Hb,RBC,Ret and HbF were observed before and after each treatment. The CRF tables were filled in according to the traditional Chinese medicine symptoms of the patients and the side effects recorded. Results During period of placebo treatment,the main curtive effective indexes Hb and RBC were not obviously raised,while the RBC levels were inversely degraded after the first month of taking placebo orally(P