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.

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.

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 study the molecular mechanism of IL-17A induced the secretion of CXCL 12 in non-small cell lung cancer cell line A549.Methods Cultured non-small cell lung cancer cell line A549 in vitro with recombination cytokine IL-17A or STAT3 signal path-way inhibitor pre-incubated for 1 hour, and then the level of CXCL12 were detected by enzyme-linked immunosorbent assay .And chemotaxis assay was used to analyze the chemotactic movement of neutrophil .Results After IL-17A stimulation,the secretion of CXCL12 by non-small cell lung cancer cell line A549 was significantly increased(P<0.01),which is in a dose and time dependent manner .However,IL-17A in-duced the secretion of CXCL12 by A549 was significantly decreased after pre-incubated by the STAT3 inhibitor(P<0.01).In addition,neu-trophil could have chemotaxis by cell suspension obtained from IL-17A stimulated A549 cell line,but such chemotaxis would be declined while CXCL12 was neutralized.Conclusion IL-17A could induce the secretion of CXCL12 in non-small cell lung cancer cell line A549 through STAT3 signal pathway , so as to promote the chemotaxis of neutrophil .

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 investigate the risk factors and the immune functions for noeocomial palmonary fungal infection (PFI) in COPD patients.Methods The data of 55 cases of nosocomial PFI were analyzed,and examined the level of T Lymphocyte Subsets (TLS) in peripheral blood from 67 cases COPD,then compared with 54 healthy donors.Results Nosocomial pulmonary fungal infection Candida Albicans was ranked the first pathogen.CD3 and CD4 of COPD with PFI were significantly ower than COPD and healthy donors(P＜0.05).Conclusions We should improve the immunity of patients in the process of therapy.We should reasonable use of bread spectrum antibiotics and corticosteroids in order to reduce incidence of pulmonary fungal infection.

0.05). However, the 5-year local control rate appeared significantly different in three groups (?~2=7.239, P0.05). The 1-,3-,and 5-year disease-free survival rate among three groups were significantly different in the three groups (79.1%, 41.9% and 35.6% for CFR group, 85.7%, 57.1% and 38.1% for FHR group, and 95.4%, 62.8% and 58.1% for LAHR group) (?~2=6.60,P0.05). The incidence of loss of hearing, the radiation-induced temporomandibular joint lesion, and the radiation-induced brain injury was 31.3%, 41.9% and 9.3% in CFR group, and 25.0%, 35.7% and 7.1% in FRH group, and 22.7%, 35.7% and 7.0% in LAHR group, respectively. Conclusion A better 5-year local control rate and disease-free survival rate were achieved in patients in LAHR and FHR groups than those in CFR group. There are no differences in the incidence of late complications and overall survival rate among three groups.

Objective To investigate the protective effect of extract of Picrhoriza scrophulariflora on renal ischemia/reperfusion injury(I/R). Methods Male SD rats were randomly divided into sham-operated group (n=5), I/R group(n=8), I/R+ extracts of Picrhoriza scrophulariflora groups (each group had 8 rats). Acute renal ischemia/reperfusion injury in rats was reproduced by removing the right kidney and clamping the left renal artery with a non-traumatic vascular clamp for 60min followed by reperfusion for 72h. Serum creatinine, urine creatinine and renal pathological changes, were compared between I/R and I/R+ extracts of Picrhoriza scrophulariflora groups, malondialdehyde (MDA) and glutathione peroxidase (GSHPx). Results CCr levels were significant decreased after renal I/R injury. Kidneys of animal with I/R injury displayed significant pathological changes. 72h after ischemia, Ccr and serum GSHPx of animals of the I/R+ extracts of Picrhoriza scrophulariflora group were significantly higher than those of I/R group(P