Objective To monitor the resistance of Streptococcus pneumoniae following the 2004 in Qingdao area, and to provide a reasonable basis for clinical application of antimicrobial agents. Methods Collecting respiratory tract, blood, cerebrospinal fluid and other specimens from out-patient and in-patients of some hospital in Qingdao from January 2005 to December 2008. According to the recommendation of NCCLS, antibiotic resistance analysis of 11 kinds of antibiotic to the isolated 231 Streptococcus pneumoniae by micro-agar dilution method, and analysis resistance trends and age differences. Results The results showed that the rate of Streptococcus pneumoniae not sensitive to penicillin is 23. 38% (PRSP: 9.52% , PISP: 13. 85% ) , resistant to cefotaxime is 9. 96% (23/231), resistant to amoxicillin is 12. 55% , resistant to erythromycin is 90. 48% (209/231). PRSP rate of patients younger than 14 years of age 27. 91% (12/43), significantly higher than that of the PRSP rate of adults 5. 38% (10/186). Conclusion The rate of resistant to penicillin Streptococcus pneumoniae increased significantly from 2004, and an increasing trend year by year, the resistance of Streptococcus pneumoniae is also a rising trend year by year. For patients infected low penicillin-resistant Streptococcus pneumoniae in this region, cefotaxime, amoxicillin are preferred drugs.

OBJECTIVE:To promote the clinical application and improve the curative effect of serum concentration.METHODS:In a retrospective review,the serum drug concentrations of 487 outpatients and inpatients of our hospital treated with 3 kinds of anti-epileptics included valproic acid,phenytoin and carbamazepine were analyzed.RESULTS:Among 487 samples,there were 248 cases(50.92%) whose serum concentration were in normal range,177 cases (36.34%) in low range and 51 cases(10.47%) in high range.Also,there were 11 cases(2.26%) whose serum concentration could not be monitored.The percentage of patients treated with valproic acid,carbamazepine and phenytoin whose serum concentrations in normal range were 48.18%,74.29% and 10.87%.CONCLUSION:The serum concentration monitoring of Anti-epileptic is the important measure which provide the basis for adopting individualized administration and ensures the clinical effect and safety in the medical care.

In 2010,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Chinese Center for Disease Control and Prevention conducted collaboratively a 2010 China Noncommunicable Disease Surveillance,and reported the results of diabetes prevalence and control in Chinese adults,which was published in the Journal of American Medical Association (JAMA) in 2013.This article is the interpretation of that report by original authors.

Objective To study wether dezocine (DZ) can attenuate neuropathic pain in rats and to investigate its mechanism.Methods Neuropathic pain was induced by tight ligation of the left L5 spinal nerve of the male SD rats. 24 Spinal nerve ligation (SNL) model rats were randomly divided into three groups:the first group (saline group, n=8), rats were given intraperitoneal injection of 1ml of saline 14 days after SNL surgery; the second group (dezocine group, n=8), rats were given intraperitoneal injection of 5mg/kg of dezocine in 1ml saline 14 days after SNL surgery;the third group (morphine group,n=8),rats were given intraperitoneal injection of 5 mg/kg of morphine 14 days after SNL surgery. Results Intraperitoneal injection dezocine and morphine had significant analgesic effect in neuropathic pain rats. This analgesic effect lasted for 4-6 hours.Continuous injection of morphine for 3 days produced significant tolerance, while continuous injection of dezocine for 7 days still had significant analgesic effect on neuropathic pain. Conclusion Intraperitoneal injection of dezocine and morphine can attenuate SNL neuropathic pain, continuous injection of morphine for 3 days can produce significant tolerance, while continuous injection of dezocine for 7 days still has significant analgesic effect on neuropathic pain.

Objective:To evaluate the effect of remote lifestyle intervention on the management of weight and related indicators in the overweight and obese population.Methods:A total of 400 individuals with overweight or obesity who participated in remote lifestyle intervention in the Health Management Department of Shenzhen People′s Hospital from May 2015 to December 2018 were included as the remote intervention group, and 400 individuals with overweight and obesity who matched their age and gender were selected as the control group. Dietician established individual WeChat groups with the remote intervention group, and the WeChat platform was used to conduct remote lifestyle intervention for them, including setting weight control goals, giving timely feedback to the food log based on photos, providing exercise guidance and psychological support. The control group received personalized diet and exercise prescriptions, but did not receive remote intervention. After adjusting the data by propensity score matching method, univariate and multivariate logistic regression models were used to analyze the management effect of weight and related indicators in the two groups after one year.Results:After one year of intervention, effective data were obtained from a total of 755 cases (371 cases in the remote intervention group and 384 cases in the control group), and effective data were retained from 446 cases (223 cases in the remote intervention group and 223 cases in the control group) after bias matching. The body mass index (BMI), systolic blood pressure, fasting blood glucose, triglyceride, total cholesterol, low-density lipoprotein, and serum uric acid of the remote intervention group [(24.85±2.52) kg/m 2, (110.21±10.53) mmHg, (4.96±0.65) mmol/L, (1.25±0.82) mmol/L, (4.87±1.11) mmol/L, (2.88±0.74) mmol/L, and (306.01±95.66) mmol/L respectively] were significantly lower than that of the control group [(27.76±2.28) kg/m 2, (121.14±14.07) mmHg, (5.10±0.87) mmol/L, (1.54±0.83) mmol/L, (5.28±0.96) mmol/L, (3.13±0.80) mmol/L, (355.16±92.68) mmol/L respectively] (all P<0.05). After intervention, intervention was consistently being influencing factors when BMI was reduced by 4%―12%, ( P<0.05). The probability of a 12% reduction in BMI in the remote intervention group was 112.486 times higher than that in the control group (95% CI: 16.852-890.266). At the same time, the initial BMI was an influential factor for the restoration of normal BMI. For every 1 kg/m 2 decrease in the initial BMI, the probability of restoration of normal BMI was 4.76 times higher than that before the decrease (95% CI: 3.222-5.057). Conclusions:Remote lifestyle intervention has a certain effect on the management of weight and related indicators in the overweight and obese populations. It has significant effect on weight loss of overweight and mildly obese people, but has limited effect on moderate and severe obese people.

Objective To investigate the expression of Vacuolar-H +-ATPase (V-ATPase) and P-glyeoprotein (P-gp) protein in colon carcinoma tissues,the correlation between the expression of V-ATPase and P-gp and their clinicopathological significance.Methods In samples from 80 cases of colon cancer,20 cases of colon adenoma and 10 cases of normal colonic mucosa tissues,the expression of V-ATPase and P-gp protein were detected by immunohistochemical method,their relationship was analyzed,the clinicopathological features and prognosis were evaluated.Results In colon cancer,V-ATPase and P-gp protein expression was 72％ and 80％,higher than that in colon adenomas (40％,35％),and in normal colon mucosa (20％,20％),the difference was statistically significant (P ＜ 0.05).There was a positive correlation between the expression of V-ATPase and that of P-gp (r =0.567,P ＜0.01).V-ATPase and P-gp protein expression in colon cancer was associated with TNM stage,lymph node metastasis and tumor differentiation (P ＜ 0.05).Patients with high V-ATPase expression had lower 5-year survival rate than those with low V-ATPase expression (P =0.023),and 5-year recurrence rate was higher than those with low expression (P =0.024).Conclusions The expression of V-ATPase is up-regulated in colon cancer,there is a positive correlation with colon cancer progress and metastasis,and high V-ATPase protein expression predicts poor prognosis.

Objective To investigate diagnostic value of GP73 in alcoholic disease .Methods GP73 was measured by ELISA in 44 alcoholic fatty liver ,43 alcoholic hepatitis ,32 alcoholic cirrhosis ,67 non‐alcoholic fatty liver patients and 120 healthy control per‐sons .Meanwhile ALT ,AST ,ALP ,GGT ,Alb ,TBil ,AFP were measured .Results GP73 of alcoholic fatty liver ,alcoholic hepatitis , alcoholic cirrhosis ,non‐alcoholic fatty liver patients and healthy control group were (84 .22 ± 26 .22) ,(157 .98 ± 39 .71) ,(201 .23 ± 61 .14) ,(62 ± 14 .02) ,(47 .08 ± 22 .75)ng/mL respectively .The GP73 differences between patients and healthy control group had statistical significance(P<0 .05) .Before and after therapy of alcoholic hepatitis and alcoholic cirrhosis patients had statistical signif‐icance(P<0 .05) .Sensitivity of diagnostic value of GP73 in ALD was 71 .4% and specification was 95 .2% .Conclusion Serum GP73 elevates in types of alcoholic liver disease and show significant diagnostic value .Decrease of GP73 could be applied to assess treatment of alcoholic hepatitis and alcoholic cirrhosis .

Objective To explore the diagnostic value of video bronchoscope-guide transbronchial needle aspiration(TBNA) combined with transbronchial lung biopsy(TBLB) on pulmonary sarcoidosis.Methods Twenty-two patients,definitely diagnosed as stage Ⅰ pulmonary sarcoidosis,were enrolled into the study and accepted TBNA and TBLB.Results The positive diagnostic rates of TBNA and TBLB were 63.6%(14/22) and 40.9%(9/22),but the rate increased to 90.9%(20/22) when the two methods were used together,which showed significant differences(x2=12.24,4.66,P＜0.01 or ＜0.05).Conclusion TBNA combined TBLB test is a safety method with high diagnostic accuracy for pulmonary sarcoidosis.

BACKGROUND: Whether ceramic alloy can be reused after casting depends on its chemical composition, microstructure, castability, as well as mechanical property. However, the effects of recasting on the composition and microstructure of Ni-Cr ceramic alloys are poorly understood. OBJECTIVE: To investigate the effects of recasting on the composition and microstructure of Ni-Cr ceramic alloys. DESIGN, TIME AND SETTING: In vitro materials observation. The experiment was performed at the Department of Prosthodontics, Affiliated Stomatological Hospital, Fujian Medical University, Instrumentation Analysis and Measurement Center, Fuzhou University, from June to August 2007. MATERIALS: The Ni-Cr ceramic alloys were recast 6 times in argon protection to obtain testing sample with diameter of 30.0 mm, thickness of 1.0 mm and side length of 10.0 mm, thickness of 1.0 mm, namely generation I VI. Simultaneously, the sample produced by initial alloy was called generation 0. METHODS: The original alloy and each generation square plates were analyzed by X-ray fluorescence spectrometry (XRF) for qualitative and semi-quantitative analysis. The microstructure and the phase structure of original alloy and each generation castings which had been polished by buffing machine were observed and analyzed by metallographic microscope and X-ray diffractometer (XRD). MAIN OUTCOME MEASURES: Contents of chemical composition, shrinkage cavity, porosity and inclusion, and distribution of XRD patterns. RESULTS: The results of XRF indicated that there were no significant difference on the main composition (Ni, Cr, Mo, Al, Be) among the Ni-Cr ceramic alloys multiple recast 0-6 times in argon protection and accorded with the demands. The metallographic structure of Ni-Cr ceramic alloys were dendritic eutectic structure, but the size of dendritic crystal grain in the casting coarsening, shrinkage cavity, porosity and inclusion gradually increased, with the increase of multiple recast times. The phase structure of Ni-Cr ceramic alloys were Ni-base solid solution (face-centered cubic lattice structure) and the chromium was widely distributed in the nickel base. There were neither significant difference of phase structure nor the new phase structure appeared among the Ni-Cr ceramic alloys multiple recast 0-6 times. CONCLUSION: There is no significant difference of main composition and phase structure between original alloy and each generation castings in argon protection. With the increase of recast times, the size of dendritic crystal coarsening, shrinkage cavity, porosity and inclusion gradually increased.

Objective To evaluate the diagnostic significance of blood cells and electrolyte in preoperative diagnosis and surgical treatment of Cushing's disease (CD).Methods 116 csses of CD and 21 cases of adrenocortical adenoma (ACA) patients pathologically proven adrenocorticotropic hormone (ACTH) adenoma from Jan.2003 to Dec.2010 were enrolled into the study.They were given transsphenoidal surgery (TSS) and laparoscopic resection of adrenal adenoma (LRAA).Patients were divided into remission group ( group A),non-remission group (group B) and ACA group (group C) according to the remission criteria of CD.The preoperative and postoperative level of blood cells and electrolyte were determined.Results TSS treatment improved the abnormal level of blood cells and electrolyte in patients with CD.Group A had significant change in preoperative and postoperative level of blood cells and electrolyte,while group B and group C didn't.Conclusions Compared with the endocrine examination items which need huge expense and harsh conditions,the change of blood cells and electrolyte level is more superior in assessing diagnostic and cruative effects on CD patients.