Objective To determine the causative organisms and antimicrobial susceptibility of community- and hospital-acquired pneumonia (CAP and HAP) in type 2 diabetes in Fujian Provincial Hospital. Methods The data of becteria spectrum and their drug susceptibility in patients with type 2 diabetes complicated by pulmonary infection were retrospectively analyzed in January 1995 to October 2006. Results The isolated bacteria of sputum culture of 494 cases included 73 gram-positive cocci(16.7%),139 gram negative bacilli(31.9%)and 224 fungus(51.4%).G+ cocci mainly included staphylococci,G-bacilli mainly included Klebsiella pneumoniae,Bowman immovability bacillus and Pseudomonas aeruginosa.In both CAP and HAP,fungus and G- bacilli were the dominant pathogens.The pathogenic bacteria were resistant to multi-antibiotics,and the resistant rates from HAP patients was higher than those from CAP. Of the bacterial strains isolated from blood culture,G-bacilli constituted 87.5%. Conclusions Fungus and G-bacilli were the dominant pathogens.Phlegm culture and drug sensitive test are helpful for reasonable use of antibiotics for patients with type 2 diabetes complicated by pulmonary infection in clinical practice.

Objective To investigate the feasibility and value of combined administration of rapamycin and low dose of cyclosporin A in kidney transplantation recipients. Methods Twenty-five recipients who received their kidney transplantations for 2 months to 10 years were transferred to a new immunosuppression regimen of combined administration of rapamycin,low dose of cyclosporin A and prednisone. During the clinical observation,the average serum trough level of cyclosporin A was maintained between 0.042 and 0.083 μmol/L,and the average serum trough level of rapamycin was controled to 4～8 μg/L. Meanwhile, the dosage of immunosuppressive drugs was adjusted properly according to the white blood cells counting,liver function,blood lipid level and clinical settings.Twenty-five kidney transplant recipients with usual immunosuppression regimen of cyclosporin A in combination with MMF and prednisone served as controls. Results Druing a follow-up period of 2 to 8 months,no acute rejection events were found in this group. All the recipients survived well with functional renal grafts. Two patients in the experimental group quitted during the follow-up. One was incurred to serious pulmonary infection diagnosed as cytomegalovirus infection,and another was sufferred from persistent unknown fever. Other main adverse effects included leucopenia, hyperlipemia and dental ulcer,similarly as control group. No significant abnormal liver function event was found in this group. Conclusions This new immunosuppression regimen of combined administration of rapamycin,low dose cyclosporin A and prednisone in kidney transplantation recipients could avoid or diminish the adverse and toxic effects of calcineurin inhibitors,mainlain well-functional allografts and not increase the incidence of severe untoward reactions. Meanwhile,the costs for taking medicine were also significantly reduced with this regimen. Therefore,it would be an ideal and optimal immunosuppressive maintainence regimen.

[Summary] Kisspeptin is vital for the neuroendocrine regulation of GnRH secretion. Kisspeptin neurons are now recognized as a central pathway responsible for conveying key homeostatic information to GnRH neurons. A number of metabolic modulators have been proposed as regulators of kisspeptin including leptin, adiponectin, insulin, ghrelin, POMC, and neuropeptide Y. Recent data indicate that kisspeptin may have a direct role in regulating energy balance by its regulation of food intake and glucose homeostasis. Thus, kisspeptin may serve as a new connection between reproductive function and energy metabolism.

Objective:Evaluate the role of video-assisted thoracic surgery (VATS) in the treatment of bilateral synchronous multiple primary lung cancers.Methods and Results:Two paitents diagnosised as bilateral synchronous multiple primary lung cancers received one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery,performing open lobectomy to remove the larger tumor,performing wedge resection using thoracoscopy to excise the smaller one.The surgery time is short.Patients all recover smoothly without complications.To date,these two patients all alive without any sign of recurrence or metastasis of tumor,median follow-up time is 5 months (2 months+8 months).Conclusions:It is feasible to carry out one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery on patients with bilateral synchronous multiple prima-ry lung cancers,when one of the tumors of bilateral synchronous multiple primary lung cancers is classificated as T1N0M0.

Objective To investigate the relation between paraoxonase (PON) 1 Q191R gene polymorphism and type 2 diabetes mellitus complicated with hypertension. Methods Genomic DNA was extracted from peripheral blood leukocytes. The studied DNA was amplified by PCR, and then digested with the restriction endonuclease AlwⅠ and separated on 2% agarose gel electrophoresis. PON activity was estimated by spectrophotometer. Serum insulin and C-peptide were measured by radioimmunoassay. Results The frequencies of QQ genotype and Q allele in type 2 diabetes mellitus with hypertension group were significantly higher than those in type 2 diabetes mellitus group (P

Objective To investigate the relationship between the single nucleotide polymorphisms of exon 6 C161→T of peroxisome proliferators activated receptor γ(PPART)gene and osteoporosis in elderly male. Methods Polymerase chain reaction restriction-fragment length polymorphism(PCR-RFLP)was used to analyze the gene frequency distribution in the groups of nonosteoporosis and osteoporosis in elderly male.Bone mineral density of lumbar and hip(neck of femur,greater trochanter,Ward's triangle)were measured by dual energy X-ray absorptiometry.Serum osteocalcin level was measured by enzyme-labeled immunosorbent assay(ELISA). Results The exon 6 of PPARγ had 3 genotypes(CC,CT and TT).The frequency of T allele in osteoporosis was higher than that in non-osteoporosis.Compared with the control group,serum bone glaprotein level and bone mineral density was lower in osteoporosis group.The bone mineral density in the genotype of CT and TT groups were lower than that in the genotype of CC group. Conclusions The study shows that the single nucleotide polymorphisms of 6th exons of PPARγ may relate to osteoporosis in elderly male.T allele of PPARγ may be a predisposing factor of osteoporosis in elderly male.PPARγmay be a candidate gene of osteoporosis in elderly males.

Objective:To determine and evaluate the antimicrobial effectiveness of 10% chloral hydrate solution. Methods:The determination of antimicrobial effectiveness of 10% chloral hydrate solution from two different manufacturers was carried out according to Chinese Pharmacopoeia (2015 edition). Results:The antimicrobial effectiveness of 10% chloral hydrate solution met the require-ments of Chinese Pharmacopoeia (2015 edition). Conclusion:10% Chloral hydrate solution shows adequate antimicrobial effective-ness.

17α-hydroxylase/17,20-lyase deficiency (17OHD) is a rare cause of congenital adrenal hyperplasia.The patient predominantly presents with low-renin hypertension,hypokalemia,lack of secondary sexual development,and in women with primary amenorrhea,in male with pseudohermaphroditism.We herewith analyse the clinical features of a case of 17OHD diagnosed by gene sequencing.And the etiology,clinical manifestations,genetic features,diagnosis and treatment for 17OHD were reviewed.

Type B insulin resistance (TBIR) is a rare disease caused by the presence of insulin receptor autoantibodies (IRA).African middle-aged women are predisposed to it.Most patients have an underlying autoimmune disease,most commonly systemic lupus erythematosus (SLE).The patients predominantly present with abnormalities of glucose homeostasis ranging from extreme insulin resistance and symptomatic hyperglycemia to lifethreatening hypoglycemia,usually accompanied with manifestation of insulin resistance such as acanthosis nigricans,hyperandrogenism,and polycystic ovary.The diagnosis can be established by the elevation of IRA.We herewith report a ease of TBIR complicated with SLE,and the clinical features,diagnosis and treatment of TBIR are reviewed.

Objective To evaluate the clinical, endocrinologieal and pathological characteristics of adrenal incidentaloma. Methods Ninety-seven patients (53 males and 44 females) diagnosed with adrenal incidentaloma confirmed by pathology were retrospectively analyzed in this study. The mean patient age was 45 years old. Thirty-eight cases had left adrenal lesions, 52 cases had right adrenal le-sions and 7 cases had bilateral adrenal tumors. Of these patients, 74 cases had accepted full range en-docrinological investigations. The tumor size was measured by uhrasonography (US) in 8 cases, CT scanning in 54 cases and MRI in 35 cases, respectively. Results Of these 97 adrenal incidentalomas, 20 cases(20.6%) were malignant tumors (12 adrenoeortical carcinomas, 3 malignant pheochromocyto-mas, 2 metastatic cancers, 1 sarcoma, 1 neuroblastoma and 1 malignant sehwannoma), 21 cases (21.6%) were benign pheochromocytomas, 26 cases (26.8%7 were adrenal adenomas, 9 cases (9.3%) were myelolipomas,13 cases(13.4%) were adrenal cysts, 5 cases(5.2%) were ganglioneuro-ma and 3 cases(3.1%) were neurofibroma. Endoerinological study showed that 21 (28. 4%) of the in-cidentalomas were functional. Forty patients(41.2%) had hypertension. Tumor size less than 4 cm in diameter were found in 25.8%cases,tumor size ranged from 4 to 6 em were found in 34.0% cases and tumors larger than 6 em were found in 40.2% cases. The average diameter of malignant tumors was 9.9±4.6 cm which was significantly larger than the average diameter of benign tumors, 5.6±3.2 cm (P=0.01). Tumor size greater than 6 cm was more frequently found in patients with malignant tumor (75.0% vs 35.1%, P=0.001). Only 4% of the ineidentalomas less than 4 cm selected surgery were malignant tumors. Weight loss was more frequently found in patients with malignant tumor than that in benign tunor(25.0% vs 2.6%, P =0.004). Conclusions Adrenal adenomas, benign pheochro- mocytomas and malignant tumors are the main types of adrenal incidentaloma. The endocrinological evaluation should be performed in all adrenal incidentalomas. In patients with normal endoerinologieal study, tumor size less than 4 cm is an important eharaeteristie for benign tumors.