OBJECTIVE:To observe the effect of metformin on related indicators of obese patients with type 2 diabetes. METHODS:136 obese patients with type 2 diabetes were randomly divided into control group and observation group. All patients were given conventional examination,conventional education about diabetes,diet control and stressed physical exercise. Based on it,control group was given 80 mg Metformin tablet(Ⅱ),once a day,and monitored blood glucose levels,the dosage was adjusted based on fasting blood glucose levels to ensure blood glucose in 3.9-6.1 mmol/L;observation group was given 0.5 g Metformin en-teric-coated tablet,twice a day. The 2 groups were compared after 12 weeks treatment. The glycated hemoglobin (HbA1c),body mass index (BMI),resistin,insulin-like growth factor-1(IGF-1),inflammatory cytokines [interleukin-1β(IL-1β),interleukin-6 (IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)] levels in 2 groups before and after tveat-ment were observed,and the incidence of adverse reactions in 2 groups was recorded. RESULTS:After treatment,resistin,IGF-1, IL-6 and hs-CRP levels in 2 groups were significantly lower than before,and observation group was lower than control group;the differences were statistically significant(P<0.05);BMI,IL-1β and TNF-α levels in obser vation group were significantly higher than before and control group,the differences were statistically significant(P<0.05);HbA1c level in 2 groups was significiantly lower than before,the difference was statistically significant(P<0.05),but there was no significant difference between 2 groups(P>0.05);BMI level in observation group was lower than before and control group,and there was no significant difference in the inci-dence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Metformin can effectively improve insulin resistance in obese patients with type 2 diabetes and inhibit the inflammatory reaction.

Primary immunodeficiency diseases (PID)are a heterogeneous group of congenital and genetically determined conditions caused by one or more defects of innate and/or adaptive immunity,which are a common retarding factor of vaccines immunization.The infections,however,play a major role in the final prognosis of most PID.The immune response after the vaccine injection may be impaired in some PID cases,even no protection is evoked.Moreover,some disease caused by the live vaccine virus or bacteria strains could occur after immunization.The contents of this paper is to introduce the consensus of the vaccine immunization based on the category of PID,immunization of the contacts and other concerns.

Antimicrobial resistance has been identified as one of the world′s most pressing public health threats.The number of antibiotic -resistant bacteria and the diversity of molecular mechanisms of resistance have in-creased sharply in recent years.The presence of antimicrobial resistance in children complicates patient management and arouses widespread concern.The use of antimicrobial agents is the single most important factor leading to the deve-lopment of resistance.New effective antimicrobial agents has been needed but has not kept pace.Antimicrobial -resis-tant infection can be prevented by immunization as well.Appropriate and judicious use of antimicrobial agents is the most important factors contributing to control resistance.Clinicians should collaborate well with microbiologist and know well about resistant bacteria and its proper antimicrobial drugs.A good application of antibiotic formulary restriction has the potential to decrease antimicrobial resistance.An antimicrobial resistance surveillance between regions and countries is urgently needed.It can help us to understand and slow antimicrobial resistance in the long run.

BACKGROUND: Joint instability may be a key agent contributing to the progress of developmental dysplasia of the hip (DDH). Neurac technique is a new modality focused on activating neuromuscular function and improving joint stability. Neurac technique may be helpful for delayed diagnosed DDH.OBJECTIVE: To observe the therapeutic efficacy of Neurac training on DDH patients.METHODS: A female patient of 23 years old with delayed diagnosed DDH received Neurac training for 14 days was retrospective analyzed.RESULTS AND CONCLUSION: The pain was relieved at 14 day after treatment. The Harris scoring showed that the hip function was improved. At 6 months follow-up, the results indicated that the remission was kept fine. Patient with delayed diagnosed DDH may get fine remission of pain and function through Neurac treatments. The effectiveness can last for a long time.

[Objective]To evaluate the surgical results and value of posterior lumbar decompression and intervertebral bone fusion with pedicle screw interval fixation in degenerative sympotomatic lumbar scoliosis.[Method]From Jan.1999 to Apr.2006,37 cases with degenerative sympotomatic lumbar scoliosis underwent posterior lumbar decompression and intervertebral bone fusion with pedicle screw interval fixation,including 21 male and 16 female patients,aged 62.6 years old averagely.All the patients were assessed by routine X-ray and Bending X-ray.CT and MRI were performed necessarily.According to patients ' symptom,total or semi-laminectomy,intervertebral bone fusion with pedicle screw interval fixation were performed.[Result]The fellow-up period varied from 1 year to 6 years(averaged,2 years and 7 months),clinical symptoms were effectively relieved after operation in all cases.Neurological functions were evaluated using JOA system,the clinical success rate in all 37 patients was 91.9%.The corrective rate was 54.8%.The average solid arthrodsis time was 11.6 weeks.The height of intervertebral disc and corrective rate had no loss.All patients X-ray of the third month and the first year didn 't show the interplantation 's clinch and breakage.[Conclusion]In the treatment of the elderly patients with degenerative sympotomatic lumbar scoliosis,first of all,the particular principle of surgical operation should be applied,the old age and long course of disease are not absolute contraindication.In addition,The technique of posterior lumbar decompression and intervertebral bone fusion with pedicle screw interval fixation can be safely performed in the elderly patients with degenerative sympotomatic lumbar scoliosis.

Objective To study the relationship of social support and quality of life of liver transplantation patients, investigating the effective measures to improve their life quality. Methods Questionnaires were filled in by 90 liver transplantation patients and a descriptive study was used. Results Positive correlation was found between social support and life quality of liver transplantation patients. Conclusion Social support was related to the life quality of liver transplantation patients. Nurses should pay attention to the effect of social system to improve their life quality.

Objective To investigate the bacteriological features and the epidemiology of methicillin－ resistant Staphylococcus aureus (MRSA) in patients with impetigo, and provide evidence for selection of appropriate agents for treating impetigo and its complications. Methods Two hundred and forty－ six out- patients with impetigo were surveyed. Cultures were obtained from impetiginous lesions. Antibiotic susceptibility tests on 212 S.aureus isolates were performed by standard agar dilution testing (MIC). Results In a total of 246 isolates, 87.0％ yielded S.aureus alone, 2.0％ S.aureus and Group A beta－ hemolytic streptococcus (GABHS), 1.6％ GABHS alone, 4.1％ Staphylococcus epidermidis. Fifteen antimicrobial agents were used in the susceptibility tests. One hundred percent of S. aureus isolates were resistant to penicillin, 87.7％ were resistant to erythromycin, followed by clindamycin (75.5％ ), tetracycline (63.2％ ), chloramphenicol (54.2％ ), ampicillin－ sulbactam (44.8％ ), oxacillin (30.2％ ), ciprofloxacin (12.8％ ), cefotaxime (0.9％ ), fusidic acid (0.9％ ) and gentamicin (0.9％ ). None of the S.aureus isolates was resistant to vancomycin, cefazolin, cefuroxime and mupirocin. Sixty- four MRSA strains were isolated. No vancomycin resistant S.aureus strain was found. Conclusions Penicillin, erythromycin, clindamycin, tetracycline, chloramphenicol and ampicillin－ sulbactam prove to be no longer the appropriate therapeutic agents. Cephalosporin, mupirocin and fusidic acid might be the good choice for treatment of impetigo in our region.

Objective To obtain information on the distribution of serotypes and antimicrobial agents susceptibilities to group B streptococcus(GBS) strains. Methods Bacterial isolates of GBS were obtained from vaginal and cervical tract of pregnant and nonpregnant women in Beijing Tian Tan Hospital. A total of 76 GBS strains were identified finally by Coagglutination. Serotyping was determinted by Standard Lancefield method. Susceptibility to test agents was assessed by determining the mininum inhibitory concentrations (MICs) with agar dilution method that was established by the National Committee for Clinical Laboratory Standards (NCCLS). Results Seven serotypes were identified among 76 GBS strains isolates. Type II(33%), III(23%) and Ia(16%) were the predominantly serotypes in pregnant and nonpregnant women. MICs of penicillin G and anpicillin were≤0.06 ?g/ml; MICs of cephazolin,cefuroxime, cefoperozone were 0.006～0.03 ?g/ml; MICs of erythromycin was 0.003～0.03 ?g/ml;MICs of gentamycin was 1～32 ?g/ml,MICs of amikacin was 4～≥64 ?g/ml,nearly 12.8% and 40.4% the strains were resistant to gentamycin and amikacin,respectively. Conclusion Our study provide useful epidemiologic data for preparation of GBS type specific vaccines which can prevent GBS infections and antimicrobial agents susceptibility patterns in China. Routine reports on GBS susceptibolities by clinical laboratories and continuous surveillance for changes in the susceptibility is of considerable clinical importance.

Objective To explore the significance and practical value of videomorphometric analysis in differential diagnosis of the thyroid gland in benign and malignant follicular lesions. Methods A videomorphometric analysis of surgically resected thyroid follicular tumors and normal thyroid gland was respectively performed with CMM-3 image analysis system. 50-100 tumor cell nuclei each case were studied at random for their area, perimeter, average diameter, shape factor and atypical index.Results Hightly significant statistical difference was observed in every parameter between normal and malignant, benign and malignant cases.Conclusion It is suggested that videomorphometry is an useful tool for the differential diagnosis of benign from malignant tumors of thyroid gland.

Objective To explore the reason of low incidence of neonatal GBS infection in China. Methods The serum level of GBS type III specific antibody in 102 randomly selected prenatal mother and their neonatal cord blood were measured using ELISA method. Sixty-two neonates less than 7 days old and 32 children between 2 months and 13 years old served as control. Results The average level of GBS type III specific antibody in the mother was 21.59 mg/L, and that in the paired cord serum was 17.90 mg/L, which was correlate with their mother(r=0.83,P