Objective To evaluate the efficacy and safety of fosfomycin-trometamol (FMT)in the treatment of acute uncomplicated lower urinary tract infection (LUTI). Methods The medical records of acute uncomplicated LUTI patients,who had acute uncomplicated LUTI and received FMT or levofloxacin (LEV)in Qingdao Municipal Hospital from January 2015 to October 2017,were collected and analyzed retrospectively. Comparisons were made between the FMT group and the LEV group to investigate the patients＇clinical efficacy,bacteriological efficacy,bacteria isolated from urine cultures,the susceptibility of isolated strains to drugs and the occurrence of adverse reactions. Results Seventy patients entered the FMT group,including 31 males and 39 females,aged from 29 to 68 years with an average age of (51 ± 10) years.56 patients entered the LEV group,including 26 males and 30 females,aged from 31 to 66 years with an average age of (52 ± 10)years.The treatment periods of patients in the two groups were 3 to 7 days. Routine blood tests and liver and renal function tests were normal before the treatment. After the treatments, 59 patients were cured,5 patients improved,and the clinical efficacy was 91.4% (64/70)in the FMT group;while 28 patients were cured,4 patients improved,and the clinical efficacy was 57.1% (32/56)in the LEV group. And the difference was statistically significant (χ2＝20.16,P＜0.001). Positive bacteria were found in urine culture of 46 patients in the FMT group,including 35 strains of Escherichia coli[17 of which were extended-spectrum β-lactamases (ESBL)-producing Escherichia coli ],3 strains of Bacillus proteus [1 of which was ESBL-producing Bacillus proteus],3 strains of Enterococous faecalis,3 strains of Staphylococcus aureus,and 2 strains of Staphylococcus epidermidis. Positive bacteria were found in urine culture of 37 patients in the LEV group,including 29 strains of Escherichia coli (14 of which were ESBL-producing Escherichia coli),3 strains of Bacillus proteus (1 of which was ESBL-producing Bacillus proteus), 2 strains of Enterococous faecalis,1 strain of Staphylococcus aureus,and 2 strains of Staphylococcus epidermidis. Bacteriological efficacy were 91.3% and 56.8% ,for the FMT group and the LEV group, respectively and the difference was statistically significant (χ2＝13.38,P ＜0.001). Thirteen of the 17 ESBL-producing Escherichia coli strains isolated from patients in the FMT group were susceptible to FMT (susceptibility rate:76.5% ). Five of the 14 ESBL-producing Escherichia coli strains isolated from patients in the LEV group were susceptible to LEV (susceptibility rate:35.7% ). And the difference was statistically significant (P＝0.033). The difference of the incidence of adverse reactions was not statistically significant between the FMT group and the LEV group [11.4% (8/70)vs 16.1% (9/56),χ2＝0.575,P＝0.448]. Conclusion FMT was more effective and safer than LEV in the treatment of patients with acute uncomplicated LUTI.

Objective To evaluate the efficacy and safety of fosfomycin-trometamol (FMT)in the treatment of acute uncomplicated lower urinary tract infection (LUTI). Methods The medical records of acute uncomplicated LUTI patients,who had acute uncomplicated LUTI and received FMT or levofloxacin (LEV)in Qingdao Municipal Hospital from January 2015 to October 2017,were collected and analyzed retrospectively. Comparisons were made between the FMT group and the LEV group to investigate the patients＇clinical efficacy,bacteriological efficacy,bacteria isolated from urine cultures,the susceptibility of isolated strains to drugs and the occurrence of adverse reactions. Results Seventy patients entered the FMT group,including 31 males and 39 females,aged from 29 to 68 years with an average age of (51 ± 10) years.56 patients entered the LEV group,including 26 males and 30 females,aged from 31 to 66 years with an average age of (52 ± 10)years.The treatment periods of patients in the two groups were 3 to 7 days. Routine blood tests and liver and renal function tests were normal before the treatment. After the treatments, 59 patients were cured,5 patients improved,and the clinical efficacy was 91.4% (64/70)in the FMT group;while 28 patients were cured,4 patients improved,and the clinical efficacy was 57.1% (32/56)in the LEV group. And the difference was statistically significant (χ2＝20.16,P＜0.001). Positive bacteria were found in urine culture of 46 patients in the FMT group,including 35 strains of Escherichia coli[17 of which were extended-spectrum β-lactamases (ESBL)-producing Escherichia coli ],3 strains of Bacillus proteus [1 of which was ESBL-producing Bacillus proteus],3 strains of Enterococous faecalis,3 strains of Staphylococcus aureus,and 2 strains of Staphylococcus epidermidis. Positive bacteria were found in urine culture of 37 patients in the LEV group,including 29 strains of Escherichia coli (14 of which were ESBL-producing Escherichia coli),3 strains of Bacillus proteus (1 of which was ESBL-producing Bacillus proteus), 2 strains of Enterococous faecalis,1 strain of Staphylococcus aureus,and 2 strains of Staphylococcus epidermidis. Bacteriological efficacy were 91.3% and 56.8% ,for the FMT group and the LEV group, respectively and the difference was statistically significant (χ2＝13.38,P ＜0.001). Thirteen of the 17 ESBL-producing Escherichia coli strains isolated from patients in the FMT group were susceptible to FMT (susceptibility rate:76.5% ). Five of the 14 ESBL-producing Escherichia coli strains isolated from patients in the LEV group were susceptible to LEV (susceptibility rate:35.7% ). And the difference was statistically significant (P＝0.033). The difference of the incidence of adverse reactions was not statistically significant between the FMT group and the LEV group [11.4% (8/70)vs 16.1% (9/56),χ2＝0.575,P＝0.448]. Conclusion FMT was more effective and safer than LEV in the treatment of patients with acute uncomplicated LUTI.

Objective To explore the role of apelin in the pathogenesis of diabetic nephropathy.Methods A total of one hundred and fourteen patients with type 2 diabetes mellitus in Qingdao Municipal Hospital from July 2015 to June 2016 were divided into normal albuminuria group (56 cases in the NA group) and micro-albuminuria group (58 cases in the MA group),depending on whether the level of urinary micro-albumin in 24 h was higher than 30 mg,with 60 healthy subjects included as the controls group (NC group).Levels of serum apelin and other biochemical indexes were tested.Results (1) WC,BMI,TC,TG,LDL-C,FBG,FINS,HOMA-IR and apelin in the patients of the NA group and MA group were respectively (87.99±10.27) cm,(24.75±3.35) kg/m2,(5.27±1.28) mmol/L,(1.84±1.25) mmol/L,(3.36±0.91) mmol/L,(7.58±0.87) mmol/L,(13.29±3.57) U/L,4.50±1.41,(364.22±85.03) ng/L ,(90.10±8.97) cm,(25.47±2.82) kg/m2,(5.19±1.11) mmol/L,(2.23±1.43) mmol/L,(3.68±0.83) mmol/L,(7.89±1.11) mmol/L,(15.50±5.00) U/L,5.55±2.27,(397.42±91.29) ng/L,which were higher than those of the NC group ((83.20±5.36) cm,(22.59±2.67) kg/m2,(4.68±1.10) mmol/L,(1.37±0.58) mmol/L,(2.56±0.94) mmol/L,(5.11±0.82) mmol/L,(7.17±2.80) U/L,1.65±0.77,(309.34±68.28) ng/L,P<0.05).FINS,HOMA-IR and apelin in the MA group were significantly higher than those in the NA group (P<0.05).(2) After age,sex and BMI were taken into control,partial correlate analysis showed that serum apelin was positively correlated with LDL-C,FPG,FINS and HOMA-IR (r=0.183,0.314,0.374,0.378,P<0.05).(3) Multifactor regression analysis showed that HOMA-IR and BMI were independent related factors to serum apelin (r2=0.288,0.389,P<0.05).Conclusion Apelin levels in the MA group were significantly higher than those in the NA group,and the serum apelin was positively correlated with HOMA-IR.Thus,apelin may contribute to the pathogenesis and progress of diabetic nephropathy.

Objective To explore the association between inflammatory cytokines and islet β-cell function in chronic persistent asthma patients. Methods 112 adults with persistent asthma and 60 healthy volunteers were enrolled in this study. According to the severity of disease, all subjects were divided into persistent-mild group and persistent-moderate group. Plasma tumor necrosis factor-α(TNF-α), interleukin6(IL-6) and C-reactive protein (CRP) were determined. Oral glucose tolerance and insulin releasing test were performed. The ratio of the area under the curve of insulin to area under the curve of glucose ( AUC1/AUCG ), homeostasis model assessment for insulin resistance ( HOMA-IR), insulin sensitivity index( ISI),homeostasis model assessment for β-cell function (HBCI) and early insulin secretion index(△I30/△G30)were calculated. The values of forced expiratory volume in l second ( FEV1 ), forced vital capacity(FVC)and FEV1/FVC were recorded. Results In patient groups, the values for plasma TNF-α, IL-6, CRP,AUC1, AUC1/AUCG, HOMA-IR, HBCI significantly increased compared with those in control group, while ISI declined ( t =2. 02～13.62, P ＜0. 05). Multiple step regression analysis showed that HOMA-IR was positively correlated with CRP, LDL-C, BMI, AUC1, TNF-α( P ＜0. 01 orP ＜0. 05), but negatively correlated with FEV1 ( P ＜ 0. 05 ). Conclusion The results indicated that inflammatory cytokines ( TNF-α,IL-6,CRP) might result in insulin resistance in asthma patients who had hyperinsulinism at the same time.

Objective To investigate the state of oxidative stress in the subjects with different levels of serum uric acid and to explore the cause of endothelial dysfunction induced by hyperuricemia. Methods Male subjects with normal serum uric acid or hyperuricemia were enrolled in this study. According to the levels of serum uric acid,all the partieipante were divided into five groups. Every group consisted of about fifty subjects. Plasma malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase(GSH-Px) were determined. In the mean time plasma nitric oxide(NO) ,plasminogen activator inhihitor-1(PAI-1), endothelin-1 (ET-1) and other biochemical variables were also determined. Results When the serum uric acid level was more than 380 μmol/L, the levels of plasma MDA,SOD,GSH-Px, PAI-1 and ET-1 became higher, while the level NO became lower(P<0.05). However SOD and GSH-Px became much lower when the serum uric acid level was more than 420 μmol/L. Multivariate stepwise regressive analysis showed that PAI-1 was positively related to MDA,UA,HOMA-IR and TG, but negatively related to SOD and NO(t =-3.64 - 6. 08,P < 0.05). ET-1 was positively related to MDA, UA, HOMA-IR and negatively related to NO, GSH-Px and SOD (t = - 4.75 - 6.35,P < 0.05 ). Conclusions It is indicated that oxidative stress became much obvious when the serum uric acid level was more than 380 μmol/L . Oxidative stress,high serum uric acid level and insulin resistance may result in endothelial dysfunction.

Serum plasminogen activator inhibitor-1 (PAI-1) and endothelin (ET) levels were measured in patients with simple hyperuricemia or combined with hyperlipidaemia and hyperglycemia. The results showed that PAI-1 and ET levels in patients with hyperuricemia were notably higher than those in the control group( both P