Objective To investigate the drug resistance characteristics of Klebsiella pneumoniae lower respiratory tract infection in the patients with coexisting pulmonary tuberculosis (TB) and diabetes mellitus (DM ) to provide a basis for the prevention and treatment of Klebsiella pneumoniae infections .Methods The lower respiratory tract specimens were collected from the patients with coexisting pulmonary TB and DM in the Shenzhen Hospital of Peking University from January 2009 to May 2015 .The bacteri‐al species was identified by using the France Bio‐Merieux Vitek2‐Compact automatic microorganism identification instrument ,the drug susceptibility tests adopted the disk method (K‐B) ,and extended spectrum β lactamase (ESBLs) detection was conducted ,the drug susceptibility test results were judged according to the CLSI standards .The data were analyzed by the WHONET 5 .6 and SPSS18 .0 software .Results 139 strains of Klebsiella pneumoniae were isolated from the lower respiratory tract specimens in the patients with coexisting pulmonary TB and DM ,the ESBLs producing rate was up to 46 .0% .The drug susceptibility testing results showed that the resistance of non‐ESBLs producing and ESBLs producing Klebsiella pneumoniae to cefoperazone / sulbactam ,pip‐eracillin/tazobactam ,imipenem ,meropenem ,cefotetan and amikacin was lower and less than 15 .0% ,the resistance of ESBLs‐produ‐cing strains to most antibacterial drugs was significantly higher than that of non‐ESBLs producing strains (P< 0 .05) .Conclusion Klebsiella pneumoniae isolated from the patients with coexisting pulmonary TB and DM complicating lower respiratory tract infec ‐tion in this hospital has the high detection rate of ESBLs producing strains and strong drug resistance ,therefore clinic should strengthen the ESBLs detection and drug resistance monitoring for preventing the generation of multi‐drug resistance .In the treat‐ment of its infection ,the first choice is containing enzyme inhibitors and carbapenems antibacterial drugs .

Objective To analyze the relationship between baseline serum γ?glutamyltransferase (GGT) and risk of the metabolic syndrome (MS). Method A total of 4 935 adults from health checkup population in Shenzhen were enrolled into a 10?year follow?up study, of these adults 81.84%were male and 18.16% were female, the average age was 60.54 ± 10.38 years.The follow?up outcome measure was the occurrence of MS. The proportional hazards model was adopted to calculate the hazard ratios (HR) and 95%confidence intervals (95%CI) to analyze the association of GGT with the development of MS. Reslut The mean follow up period was 5.0 ± 2.9 years, and there were 24 713 person?years of follow?up, and 1 689 subjects developed MS. During the follow?up, the cumulative incidence and incidence density of MS were 34.22%and 68.34/1 000 person?years, respectively. For both genders, the association between GGT and MS presented dose?response relationship trend (male: M?C χ2=32.78, P<0.001; female: M?C χ2=18.80, P<0.001). After adjusting for age, gender, body mass index, systolic blood pressure, diastolic blood pressure, high?density lipoprotein cholesterol, low?density lipoprotein cholesterol, triglycerides, uric acid and fasting blood glucose in Cox regression model, the HR for MS in quartiles 3 and 4 level of GGT was 1.45 (95%CI:1.08-1.85) and 1.52 (95%CI:1.15-1.99), respectively. Conclusion The GGT level could be an important risk factor and predictor for the development of MS.

Objective To determine the effects of gender on distal femoral aspect ratio (DFAR),femoral component fit,and clinical outcomes at 2 years after total knee arthroplasty (TKA).Methods From December 2012 to December 2014,the clinical and radiographic characteristics of 107 consecutive patients (109 knees) were studied prospectively.All patients were divided into two groups according to gender:33 cases (33 knees) were male and 74 cases (76 knees) were female.These subjectives underwent unilateral primary TKAs for end-stage osteoarthritis by using Vanguard high-flex open-box posterior-stabilized fixed-bearing prosthesis.The anterior-posterior size increment of the Vanguard femoral components was 2 mm.The clinical outcomes (Knee Society Score,Western Ontario and McMasters University osteoarthritis index,time-up-to-go test,chair rise test,stair-climbing test,range of flexion,extensor lag,flexion contracture,anterior knee pain score and patient satisfaction) between two groups were compared at 2 years postoperatively.The femoral component fit and two kinds of DFARs were also compared intraoperatively.Results The total overhang value in zone 2 was-5.51±4.46 mm in male and-3.24±3.93 mm in female,respectively.That in zone 3 was-5.99±4.73 mm in male and-3.45±3.98 mm in female.The total underhang value in male was significantly higher than that in female (P＜0.05).The rate of significant underhang in zone 3 was significantly higher in male than that in female (60.6％,23.7％,P＜O.05).Two kinds of DFARs in male were significantly higher than those in female (1.56±0.12 vs.1.51±0.12,1.28±0.08 vs.1.24±0.11,P＜0.05).Compared with intra-operative range of flexion (ROF) in the condition of 90° hip flexion after prosthesis implantation,the loss of ROF against gravity and the loss of passive ROF at 2 years postoperatively were statistically significant higher than those in female (-8.73°±7.71° vs.-4.82°±6.67°,-11.45°±8.78° vs.-7.34°±8.71°,P＜0.05).In the male group,the natural ROF after capsule closed (132.85°±6.01°) was significantly larger than that of the female group (128.78°±6.34°),but there was no significant difference in passive flexion.The change of non-weight-bearing passive ROF (1.67°± 14.76°),the Knee Society stairclimbing score (45.15±7.12) and the proportion of being able to squat and rise (97.0％) in male group were greater than those in female group,postoperatively.Conclusion Although DFAR is different within gender;it has little effects on early outcomes after unisex posterior-stabilized TKA.The loss of ROF in male is more prominent than that in female.Increased size offerings of femoral components improve fit in female distal femur.However,distal femur of male still exist obvious underhang.