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 efficiency of interventional treatment and intramuscular injection of methotrexate for the treatment uterine scar pregnancy.Methods 22 patients with uterine scar pregnancy were divided into two groups,group A (n =12),transvaginal color Doppler ultrasound to guide percutaneous interventional treatment;group B( n =10) intramuscular injection of methotrexate treatment.Mass size and β-HCG preoperation and 4 days,7 days,1 month postoperation were evalutaed respectively.Results The cure rate of interventional treatment and intramuscular injection of methotrexate for the treatment uterine scar pregnancy were 83.3％ and 40.0％ respectively.And the difference was statistically significant ( P ＜ 0.05 ).Conclusion Compared with intramuscular methotrexate treatment of uterine scar pregnancy,guided by vaginal ultrasonography involved the injection of methotrexate is more effective and have important clinical significance.

Esophageal squamous cell carcinoma(ESCC) is a common malignancy in china,and TNM staging is the standard staging system for ESCC.However,in clinical practice,patients' prognosis is not always consistent with the staging.This phenomenon may be attributed from the fact that the current limitation and imperfect of the TNM staging system,and besides,another possible reason might be that some prognostic factors for ESCC other than TNM descriptors may exist.Among all the prognostic factors for ESCC,molecular biomarkers received widely concern.We searched the literatures and identified 12 molecular biomarkers that received the most concern and validated them in our single surgeon team.The results showed that only P21,COX-2 and E-cadherin were significant prognostic factors for ESCC in this series.Therefore,in the current study,we reviewed the literature regarding the prognostic significance of the above mentioned three biomarkers for clinical reference.

Objective To investigate the incidence and the drug-sensitivity results of mycoplasma infection in genital tract from the gynecological outpatients,in order to provide a laboratory evidence for clinical rational use of drug.Methods The drug sensitiv-ity kit was used for isolation and culture of mycoplasma,reproductive tract secretions samples of 1 067 cases of gynecological pa-tients were collected to do mycoplasma identification and drug sensitivity test.Results In 1 067 samples,the positive rate of myco-plasma were 659 samples,including ureaplasma urealyticum(Uu)positive rate was 72.99%(481/659),mycoplasma hominis (Mh) positive rate was 3.79%(25/659),Uu and Mh positive rate accounted for 23.22%(1 53/659).The drug sensitivity results of 12 kinds of antimicrobial agents showed that single infection Uu was more sensitive to josamycin,doxycycline,minocycline,tetracy-cline,clarithromycin,azithromycin and roxithromycin.Single infection Mh was more sensitive to doxycycline,josamycin,minocycline and tetracycline.Mixed infection of Uu and Mh was more sensitive to josamycin,minocycline and doxycycline.Conclusion The main pathogen isolated from patients infected with plasma in our hospital is Uu,whether single Uu or Uu,Mh mixed infection,there are differences in the sensitivity of antimicrobial,clinicians should use drug rationally according to the conditions of patients and drug sensitivity results to reduce drug resistance rate.

Objective To investigate the effects of cinobufacini on TGF-β1-induced epithelial-to-mesenchymal transition of human colorectal carcinoma cells in vitro.Methods The cultured colorectal carcinoma cell line(SW480) was divided into the control group,TGF-β1 (10 ng/mL) individual treatment group and co-treatment groups with TGF-β1 (10 ng/mL) + cinobufacini (2.5,5,10,20,40,80 mg/mL),which were cultured in vitro for 48 h.The proliferation of the cells were measured by CCK8 assay.The morphological changes were observed by inverted phase contrast microscope.The ability of cell invasion and migration was detected by Transwell assay.The mRNA and protein expressions of E-cadherin and Vimentin were detected with QRT-PCR and Western Blot.Results (1)Compared with the TGF-β1 (10 ng/mL) individual treatment group,TGF-β1 (10 ng/mL) + cinobufacini (10,20,40,80 mg/mL) co-treatment groups significantly had significantly proliferation inhibitory effect on SW480 (P＜0.05).(2) Compared with the normal control group,TGF-β1 individual treatment group and TGF-β1 (10 ng/mL) + cinobufacini(2.5 mg/mL) group exhibited classical mesenchymal phenotype,while the TGF-β1 (10 ng/mL) + cinobufacini (5 mg/mL) co-treatment group showed classical epithelial phenotype.(3) The ability of invasion and migration in the TGF-β1(10 ng/mL)+ cinobufacini(2.5,5 mg/mL) co-treatment group were significantly weakened compared with the TGF-β1 individual treatment group (P＜0.01).(4) QRT-PCR and Western Blot results indicated that compared with the normal control group,the Vimentin expression in the in the TGF-β1 individual treatment group was significantly increased and the E-cadherin expression was significantly decreased.Furthermore,compared with the TGF-β1 individual treatment group and control group,the Vimentin expression level in the TGF-β1 (10 ng/mL) + cinobufacini (2.5,5 mg/mL) groups was significantly decreased and E-cadherin expression was significantly increased.Conclusion Cinobufacini can inhibit TGF-β1-induced cell proliferation in human colorectal carcinoma SW480 cells,and its mechanism may be related with promoting E-cadherin expression increase,meanwhile decreasing the vimentin expression,thus inhibiting the EMT process induced by TGF-β1.

Objective To study the potential of bFGF to promote human bone marrow derived MSCs to differentiate into cardiomyogenic cells, and its effect on proliferation of MSCs. Methods MSCs isolated from adult human bone marrow were cultured in four different systems. Group A: medium with 5-aza. Group B: medium with bFGF. Group C: medium with 5-aza+bFGF. Control group: medium alone. The morphological changes of MSCs were observed. Then immunocytochemistry staining against ?-actin,cTnT,and Connixin43 was performed. The expression of Nkx2.5, GATA-4 and cTnT was detected by semi-quantitative RT-PCR. The proliferation of MSCs in different groups was measured by MTT. Results The MSCs in both group A and C partially differentiated into myogenic cells and expressed proteins of ?-actin,cTnT,and connixin43. In group A and group C, the mRNA level of Nkx2.5,GATA-4 and cTnT was higher than that of control group. In group B, mRNA level of Nkx2.5 and GATA-4 was higher than that of control group. As compared with the control group, cell proliferation was faster in group B than in group A and C. And the proliferation was faster in group C than in group A. Conclusion bFGF can promote the proliferation of MSCs significantly. When combining with 5-aza, bFGF can promote MSCs to differentiate into cardiomyogenic cells more effectively.

Missing data plagues almost all surveys and researches. The occurrence of missing data will cause losses of original sample information and undermine the validity of the research results to some extents, so researchers should attach great importance to this problem. In this article, we introduced 3 kinds of missingness mechanism, namely missing completely at random, missing at random, and not missing at random. We summarized some common approaches to deal with missing data, including deletion, weighting approach, imputation and parameter likelihood method. Since these methods had its pros and cons , we should carefully select the proper way to handle missing data according to the missingness mechanism.

Based on binocular disparity, three-dimensional (3D) display technology makes the right and left eyes see different images in a certain way, which generates a stereo image after the processing of the brain's visual cortex.Due to its high-definition stereoscopic surgical field of vision and accurate spatial positioning ability, 3D display technology has been widely used in surgery.Ophthalmic microsurgery is performed with the help of microscope because of the complex intraocular operation and small operating space, especially minimally invasive vitreoretinal surgery, which is the most difficult surgery with the longest learning curve in ophthalmology.The 3D display viewing system can improve surgical accuracy, reduce retinal phototoxicity, relieve the pressure on the neck and back of the surgeon as well as promote communication and cooperation between medical staff and so on.At present, the major 3D display systems applied in ophthalmology include the NGENUITY 3D Visualization System and TrueVision 3D Visualization System, both of which require wearing 3D glasses.The naked eye 3D display system is the main direction of future development.The combination of 3D display system and ophthalmic surgical robot system provides a new idea for the development of remote ophthalmic surgery.At the same time, broader application of 3D display system requires continuous improvement.In this article, the research and application of 3D display system in anterior segment surgery and vitreoretinal surgery were reviewed.

Objective To compare the antalgic effects of ropivacaine in various doses on brachial plexus nerves. Methods 87 patients undergoing upper arm surgery were enrolled in this study. The patients were unpremed-itated. The patients were randomized to receive ropivacaine of 0.30,0.25 or 0.20% (group Ⅰ,Ⅱ and Ⅲ) with mor-phine of 0.1mg/ml and Lidocaine of 10mg/ml. In order to analygesia of brachial plexus nerves,the rejecting of load dose is firstly 10ml,the total dose is 10ml/24h interval every time,the antalgic time is about 50 hours. To compare the antalgic effects of ropivacaine in various doses based on standard of VAS. Based on standard of Bromage to assess the situation of motor neuron blocking. Results According to standard of VAS in 6,12,24 and 48 hours after underwent surgery, the group Ⅲ is more effective than group Ⅰ and group Ⅱ ; according to standard of Bromage, the group Ⅰ is more effective than group Ⅱ and group Ⅲ. it has no adverse reactions to patients. Condusion 0. 25% of ropiva-eaine with morphine of 0.1mg/ml and lidocaine of 10mg/ml have obtained good antalgic effects for patients after un-dergoing upper arm surgery,it is fit for applying in clinic.

Objective To search for a procedure for correction of square face. Methods 68 patients with square face (aged from 21～40 years, with 65 females and 3 males) underwent osteetomy combined mandibular angle triangle resection with lateral cortex around the mandibular angle-splitting by intraoral approach. The mandible outer cortex was splited with bone chisel and mandible angle was resected by the high-speed pneumatic drill. The bulky masseter muscle and the enbonpoint buecal fat-pad were scissored. Results The application of high-speed pneumatic drill and bone chisel facilitated resection of the mandibular angle with lateral cortex splitting osteetomy. The operative effects were satisfactory in 56 patients during 3-24 months of follow-up. The bigonial distance was effectively re-duced, and facial shape became ellipse. The gross asymmetry and mandibular fracture were not conse-quences. The lateral contour of the mandibular angle was natural. Conclusion Ostectomy of mandible angle and lateral cortex of the mandible allows the reduction of the mandibular contour of the frontal view and the lateral contour of mandibular angle becomes soft, giving a more natural appearance. This new method is worthy to be applied widely because of the good result with effective reduction of the mandibular width.