Objective: To analyze the correlation between serum HBV DNA level and HBsAg titer in hepatitis B e antigen positive pregnant women without antiviral therapy, and investigate the impact of genomic variability of preS/S regions on their correlations. Methods: Prenatal serum samples from 882 pregnant women with chronic HBV infection who were positive for HBsAg, HBeAg and HBV DNA and were not on antiviral therapy were included in the analysis. The Abbott i2000 and m2000 systems were used to qualitatively or quantitatively detect HBsAg, HBeAg and HBV DNA levels, respectively. HBV genotyping was performed using a type-specific primer nested polymerase chain reaction (nPCR). In addition, serum samples of pregnant women with HBV DNA levels correlated with HBsAg titer and HBV DNA levels higher than HBsAg titers were used to perform preS/S region amplification by nPCR method. PCR products were directly sequenced and mutation sites were analyzed by MEGA6.0 stasticial software. Mann-Whitney U test was used for the measurement data, and 2-test test for count data. Correlations between variables were analyzed using Spearman’s rank correlation. Results: Serum HBsAg titer of HBeAg-positive pregnant women was positively correlated with HBV DNA level (r = 0.754, P < 0.01). Compared with the control group, mutation sites A60V (100% vs. 15.38%, χ² = 7.61, P < 0.01), V90A (100% vs. 30.77%, χ² = 4.43, P < 0.05) and I161T of HBV preS/S region (80.00% vs. 0, χ² = 9.14, P < 0.01) showed a significant decrease in HBsAg titer. Conclusion Serum HBV DNA levels were positively correlated with HBsAg titer in HBeAg-positive pregnant women. Therefore, serum HBsAg titer may be used as a surrogate marker of serum HBV DNA. Single or multiple amino acid mutations sites A60V, V90A, and I161T in preS/S region may be one of the reasons that lead to a significant drop in HBsAg titer and affect its correlation with HBV DNA levels.

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.

Teaching purpose, teaching content, experiment and examination forms etc. were discussed, and how to practice the teaching of the public selective course Nutriology of Traditional Chinese Medicine was pointed out. All these are invaluable experience for the development and progress of this course.

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.