Objective To investigate serum leptin and adiponectin levels and their relationship in elderly coronary artery disease (CAD).Methods A total of 88 subjects aged 55 yeas or older were enrolled in which coronary angiograms were performed.The subjects were divided into CAD group (52 patients) and control group (36 patients) by angiography.Serum concentrations of leptin and adiponectin were evaluated by ELISA system.Results Serum concentrations of leptin were significantly increased in CAD group compared with that in control group [(9.38 ±3.51) μg/L vs.(7.27 ±3.25) μg/L,P ＜0.05].On the contrary,serum concentrations of adiponectin were significantly decreased in CAD group compared with that in control group [(11.08 ±3.87) mg/L vs.(13.34 ±4.94) mg/L,P＜0.05].Logistic regression analysis revealed that only serum leptin was the independent risk factor for CAD.Serum adiponectin concentrations had a negative relationship with leptin concentrations (r =-0.320,P =0.002).Conclusion Lower serum adiponectin levels are related to higher serum leptin concentrations.Elevated serum leptin but not decreased serum adiponectin is the independent risk factor for CAD.

Objective To investigate the distribution and antibiotic susceptibilities of quantitatively cultivated bacteria from bronchoalveolar lavage fluid (BALF) samples. Methods Totally 312 BALF samples were streak inoculated to chocolate,blood and MAC plates with 10 μL annulus,and the bacterial colony ＞ 104 CFU/mL was considered pathogenic bacteria. The identification of pathogenic bacteria was carried out with Vitek 2-Compact,and Kirby-Bauer disc agar diffusion method,Etest and dilution method were used for antibiotics sensitivity test.Results Totally 216 (69.2％) strains of pathogenic bacteria were isolated.The major gram-negative strains were Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumoniae and Escherichia coli, and the major gram-positive strains were Staphylococcus aureus,Streptococcus pneumoniae and Staphylococcus epidermidis.The resistance rate of Pseudomonas aeruginosa to aztreonam was high,but lower than 30％ to piperacillin/tazobactam,imipenem,cefepime,ofloxacin,ceftazidime and amikacin.Staphylococcus aureus was highly resistant to erythromycin,benzylpenicillin and clindamycin,but it was sensitive to furadantin,vancomycin,quinupristin/dalfoprisdn,tigecycline and linezolid.Conclusion The positive rate of BALF cultivation is high,and the main pathogenic bacteria Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli are resistant to several commonly used antibiotics.

Objective patients with pSS and 30 cases of healthv contrels.The streptavidin immunohistochemical staining was performed to detect the expression and distribution of MMP-9 and CD147 in labial salivary glands.Quantitative analysis was performed by image analysis software-image plus 5.0 at the site of positive expression of MMP-9 and CD147.The correlation between their expression and the infiltrating lymphocyte foci per 4 mm2 of labial gland was analyzed by SPSS software as well as the correlation between the expression of MMP-9 and CD 147 in the salivary glands of patients with pSS.Results MMP-9 was hiKhly expressed in labial salivary glands from 52 patients with pSS and 30 healthy controls,but the expression of MMP-9 in pSS was stronger compared with that of healthy controls(P<0.01).There was a significant positive correlation between lymphocyte foci score and up-regulated expression of MMP-9 in labial salivary glands from 52 patients with pSS(P<0.01).CD147 was highly expressed in labial salivary glands from 52 patients with pSS and 23 healthy controls，but over-expression of CD147 in PSS was more Drominent compared with that of controls(P<0.01).There was a significant positive correlation between lymphocyte foci score and up-regulated expression of CD147 in labial salivary glands from 52 patients with pSS(P<0.01).The expression of MMP-9 and CDl47 was detected in ductal and acinar epithelial cells,lymphocyte foci in pSS.There was linear correlation between the expression of MMP-9 and CDl47 in the salivary glands of patients with pSS(P<0.01).Conclusion The results of this study suggest that the abnormal expression of MMP-9 and CD 147 is involved in the pathogenesis of pSS and play a crucial role.The interaction of MMP-9 and CD147 may be one of theimportant mechanisms leading to labial salivary glands destruction found in pSS.

Objective To analyze the antibiotic resistance of Branhemella catarrhalis strains isolated from sputum specimens of patients with lower respiratory tract infections from Linyi, Shandong Province, and to explore the relationship between bro genotypes of the strains and their resistance to antibiotic agents.Methods Sputum specimens were colleted from the patients with lower respiratory tract infections in Linyi People ’ s Hospital from the January 2010 to December 2014.The specimens were inoculated into 4 different disks for bacterial isolation and cultivation.β-lactamase detection and drug sensitivity tests were performed, and PCR coupled with restriction endonuclease analysis was employed for bro genotyping.χ2 test was used to compare drug resistance of strains with different bro genotypes.Results A total of 497 Branhemella catarrhalis strains were isolated in five years, among which 221 strains were isolated in winter.All strains were sensitive to ertapenem and chloramphenicol, and the resistance rates to amoxicillin/clavulanate and cefaclor were low (≤2.8%).The strains were highly resistant to compound sulfamethoxazole, erythromycin and ampicillin (47.6%-89.8%), and there was a trend of increasing resistance rates with the year, but no statistically significant difference was observed ( P >0.05 ) .β-lactamases was positive in 412 strains (82.9%), and all of these strains were positive for bro gene, and the resistances to erythromycin, compound sulfamethoxazole, levofloxacin and ampicillin were higher in bro positive strains than those in bro negative strains (χ2 =12.16, 16.18, 8.41 and 200.00,P<0.05).Among bro positive strains, 391 (94.9%) were of genotype bro-1, 21 (5.1%) were of genotype bro-2, and their resistance to antibiotic agents was not of statistical difference ( P >0.05 ).Conclusions Most of Branhemella catarrhalis clinical isolates are β-lactamase producing strains, and bro-1 is the most common genotype.Strains are highly sensitive to carbapenems, cephalosporins andβ-Lactamaseinhibitors, which can be recommended for the treatment of Branhemella catarrhalis-related respiratory tract infections.

Objective To compare the drug resistance of mucoid Pseudomonas aeFagillosa with that of non-mucoid.Methods All specimens isolated and cultured from patients were identified and the antibiotic sensitivity was tested by automatic microorganism analyzer VITEK-32,GNI+,GNS-448,E-teat and K-B.Results Drug resistant rates of mucoid Pseudomonas aeruginosa to imipenem.levofloxacin.meropenem,cefepime,cefoperazone/sulbactam,amikacin,gentamicin,piperacillin.tazobactam,ceftazidime and cefotaxime were 5.3%, 16.1%, 5.6%, 20.6%, 1.1%, 10.5%,26.9%,5.3%.31.5% and 60.2%,respectively.The drug resistant rates of mucoid Pseudomonas aeruginosa were lower than those of non-mucoid except to ceftazidime.Conclusion Compared with non-mucoid Pseudomonas aeruginosa,antibiotic resistance of mucoid Pseudomonas aeruginosa is weaker in vitro.

Objective To investigate the drug sensitivity of mucoid Pseudomonas aeruginosa to common antibiotics and the expression of β-lactamase-resistant phenotype.Methods The specimens were inoculated onto different disks to isolate and cultivate bacteria.The antibiotic susceptibility of mucoid Pseudomonas aeruginosa isolates was detected and judged by CLSI 2013.The detection of drug resistance was done by Kirby-Bauer (K-B) method and β lactamase-resistant phenotype was detected by E-test.SPSS19.0 was used to statistic data and x2 test was used to compare the antibiotic susceptibility between different groups.For all statistical test,a P values less than 0.05 was defined as statistically significant.Results The susceptibilities of mucoid Pseudomonas aeruginosa to the regular antibiotics were above 70％,of which the sensitivities to amikacin,to bramycin,gentamicin,imipenem and meropenem were higher than 90％.The positive rate of ampler class C β-lactamase (AmpC) was 28.3％ (56/198).The drug sensitivity of positive strains was lower than that of the negative strains,and the differentiation was significant to piperacillin-tazobactam,amikacin,ceftazidime,levofloxacin,ciprofloxacin and aztreonam (x2 =3.89-14.45,all P ＜0.05).The positive rate of extended spectrum β-lactamase(ESBLs) was 10.6％ (21/198).The drug sensitivity to ceftazidime and aztreonam of positive strains[42.9％ (9/21) and 57.1％ (12/21),respectively].It was lower than that of the negative strains [73.5％ (130/177) and 72.3％ (128/177)],x2 =5.06 and 19.24,both P ＜ 0.05.The difference of the other antibiotics was not significant(x2 =0.01-3.47,all P ＞0.05).The positive rate of metallo-β-lactamase (MBL) was 19.7％ (39/198),and the drug susceptibility of positive strains was lower than that of negative strains except gentamicin and aztreonam(x2 =4.07-15.99,all P ＜ 0.05).All the detected strains were Klebsiella pneumonia carbapenemase (KPC) negative.Conclusions The antibiotic susceptible rate of mucoid Pseudomonas aeruginosa was high,but some enzyme-produced strains were lower.The clinician should adjust medicine program by the results of laboratory.

Objective To analyze the clinical features,diagnosis and treatment of fibromyalgiav syndrome (FMS).Methods Retrospectively analyzed 52 cases of FMS treated in our hospital between July,2008 to July,2011,and its clinical features,laboratory examination results,treatment and prognosis were analyzed.Results The ratio of female and male patients was 9∶1 in 52 FMS patients.The diagnosis was delayed for four years in average.Pain of FMS was diffuse and tenderness was symmetrical.Fatigue and sleepdisorder were the most common symptoms.There were no specific laboratory tests for this condition.Symptoms of 21 patients (57％) were alleviated among 37 patients who received drug treatment only,and comparatively,the symptoms of 12 patents (80％) were alleviated among 15 patients who received combined drugs and non-drug treatment.Conclusion The incidence of FMS is high and its clinical features vary.Clinician should pay much attention to the disease.Because the study sample size is small,so further study is needed to demonstrate the superiority of the combined therapy.

Objective To discuss the distributional characteristics and drug-resistance of Enterococcus species isolated from urine specimens.Methods 3096 middle-segment urine specimens were collected since January to December in 2011 for culture.The identification of pathogenic bacteria and antibiotics sensitivity tests were carried out with VITEK2-compact combined with GN,AST-GN13,GP,AST-GP67,and antibiotics sensitivity tested performed by K-B and E-test at the same time.The results were determined by CLSI 2011.Results 1248 of 3096 pathogenic bacteria were isolated (40.31％).549 strains of Escherichia coli were detected (43.99％) which was the most common and 159 strains of Enterococcus were detected (12.74％) which was the second most common.The Enterococcus detection rate in woman (15.02％)was higher than that in man (10.35％),in out-patients (15.54％) than the that in hospitalized patients (12.49％),and in the patients of non-surgical departments (13.65％) than those of surgical departments (11.38％).The Enterococcus was absolutely sensitive to tigecycline,and the sensitive rate to vancomycin and linezolid were over 90％.The antibiotics sensitivity was higher for Enterococcus faecalis than that for Enterococcus faecium,and in surgical departments than non-surgical departments.Conclusions The detection rate of Enterococcus in urinary tract infection patients is quite high and varied between sexes and departments.The difference of drug resistance between species is obvious,and the bacteria species should be identified in order to use the antibiotics reasonably to postpone the development of drug resistant strains.

Objective To investigate the correlation between serum osteocalcin and type 2 diabetes mellitus (T2DM) in elderly patients.Methods A total of 55 T2DM patients (diabetic group) and 50 non-diabetic subjects (control group) aged ≥60 years were enrolled in this study.The levels of fasting blood glucose (FBG),glycated hemoglobin (HbAlc),insulin resistance index (HOMA IR),osteocalcin (OC),body mass index (BMI) and bone mineral density (BMD) in groups were compared.The correlations between serum osteocalcin and the above indicators were analyzed.Results The levels of OC and BMD were higher in control group than in diabetic group [(11.2±3.2)μg/Lvs.(4.1±3.0)μg/L,(-1.3±0.3) vs.(-2.6±0.5),respectively,both P＜0.05].The levels of FBG,HbAlc,FINS,HOMA-IR were lower in control group than in diabetic group [(4.7±2.0) mmol/L vs.(9.4±2.1) mmol/L],[(4.8±1.5) ％ vs.(7.6±1.6)％,(7.4±3.2) U/L vs.(23.7±3.0) U/L,(1.5±0.7) vs.(9.9±1.2),respectively,all P＜0.05].Serum osteocalcin concentration was negatively correlated with the levels of FBG,HbAlc,FINS and HOMA-IR in elderly patients with T2DM (r=-0.739,-0.713,-0.613,-0.092,all P＜0.01).Conclusions Serum osteocalcin concentration is correlated with the levels of blood sugar and insulin resistance index in elderly patients with T2DM.A further study on the correlation between osteocalcin and T2DM may provide a new target for the treatment of type 2 diabetes mellitus.

Therapeutic hypothermia has been shown to improve neurological outcomes after global ischaemia/hypoxia in patients who have had cardiac arrest. Therapeutic hypothermia is one of the most extensively studied and influential therapeutic strategies of acute ischemic stroke. Previous studies of therapeutic hypothermia mainly focused on whole-body cooling. However, delayed induction and systemic complications have limited the clinical application of whole-body cooling. As a selective cerebral hypothermia, the selective intra-arterial brain hypothermia treatment has the characteristics of rapid and even induction of hypothermia, and less affecting the core body temperature. Therefore, it has become a promising treatment modality. This article reviews the application of selective intra-arterial brain hypothermia in acute ischemic stroke and its advantages and limitations in order to provide reference for further experimental studies and future clinical trials.