Autophagy in fate determination of mesenchymal stem cells and bone remodeling

Mesenchymal stem cells (MSCs) have been widely exploited as promising candidates in clinical settings for bone repair and regeneration in view of their self-renewal capacity and multipotentiality. However, little is known about the mechanisms underlying their fate determination, which would illustrate their effectiveness in regenerative medicine. Recent evidence has shed light on a fundamental biological role of autophagy in the maintenance of the regenerative capability of MSCs and bone homeostasis. Autophagy has been implicated in provoking an immediately available cytoprotective mechanism in MSCs against stress, while dysfunction of autophagy impairs the function of MSCs, leading to imbalances of bone remodeling and a wide range of aging and degenerative bone diseases. This review aims to summarize the up-to-date knowledge about the effects of autophagy on MSC fate determination and its role as a stress adaptation response. Meanwhile, we highlight autophagy as a dynamic process and a double-edged sword to account for some discrepancies in the current research. We also discuss the contribution of autophagy to the regulation of bone cells and bone remodeling and emphasize its potential involvement in bone disease.

Framework Phylogeny, Evolution and Complex Diversification of Chinese Oaks

Oaks (Quercus L.) are ideal models to assess patterns of plant diversity. We integrated the sequence data of five chloroplast and two nuclear loci from 50 Chinese oaks to explore the phylogenetic framework, evolution and diversification patterns of the Chinese oak's lineage. The framework phylogeny strongly supports two subgenera Quercus and Cerris comprising four infrageneric sections Quercus, Cerris, Ilex and Cyclobalanopsis for the Chinese oaks. An evolutionary analysis suggests that the two subgenera probably split during the mid-Eocene, followed by intergroup divergence within the subgenus Cerris around the late Eocene. The initial diversification of sections in the subgenus Cerris was dated between the mid-Oligocene and the Oligocene-Miocene boundary, while a rapid species radiation in section Quercus started in the late Miocene. Diversification simulations indicate a potential evolutionary shift on section Quercus, while several phenotypic shifts likely occur among all sections. We found significant negative correlations between rates of the lineage diversification and phenotypic turnover, suggesting a complex interaction between the species evolution and morphological divergence in Chinese oaks. Our infrageneric phylogeny of Chinese oaks accords with the recently proposed classification of the genus Quercus. The results point to tectonic activity and climatic change during the Tertiary as possible drivers of evolution and diversification in the Chinese oak's lineage.

Effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications in elderly patients with colorectal cancer: A prospective study

With the increasing number of elderly patients, the risk of diseases such as colorectal cancer (CRC) has increased. The objective of this prospective study was to explore the effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications among elderly patients who recently underwent colorectal surgery. Patients aged over 65 years who underwent surgery for CRC at the First Affiliated Hospital of Wenzhou Medical University were considered for this study. The demographical and clinical characteristics of these patients, as well as postoperative complications, were prospectively analyzed. The patients were divided into two groups depending on the diagnosis of sarcopenia, and the clinical variables corresponding to the two groups were compared. Further, the risk factors associated with postoperative complications were evaluated using univariate analysis and multivariate logistic regression analysis. A total of 360 patients fulfilled the inclusion criteria. Incidences of postoperative complications in the sarcopenia and non-sarcopenia groups were at 38.3% and 27.3%, respectively. In addition, sarcopenia (p=0.029) and hypoalbuminemia (p=0.010) were identified as independent risk factors, while laparoscopic surgery (p=0.023) was identified as a protective factor for postoperative complications. However, laparoscopic surgery was a protective factor for postoperative complications in the colon group only (p=0.001). Sarcopenia and hypoalbuminemia are independent risk factors that influence the probability of developing complications following CRC surgery. Laparoscopic surgery is a protective factor for postoperative complications of CRC patients, particularly colon cancer patients.

[Analysis of the occurrence of interstitial pregnancy during the re-pregnancy after modified tubal resection or ligation]

Objective: To investigate the effect of modified tubal resection or ligation on the incidence of interstitial pregnancy during the re-pregnancy. Methods: Patients who underwent tubal resection or ligation in our hospital from June 2017 to June 2019 were selected as research subjects and randomly divided into observation group and control group, with 43 cases in each group.The observation group received modified tubal resection or ligation, while the control group received traditional tubal resection or ligation, and the occurrence of re-gestation interstitial pregnancy was followed up. Results: A total of 86 subjects were included, with an average age of (32.3±2.6) years old, 2-5 pregnancies, and 2-4 births. There was no statistical difference in general data between the two groups.The success rate of operation in both groups was more than 95%, with 6.98% (3/43) patients in the observation group having temporary fever and other discomforts after operation, and 9.30%(4/43) patients in the control group having good outcomes.In the observation group and the control group, 36 and 34 patients underwent in vitro fertilization and embryo transfer three months after the operation, respectively, and 23 pregnancies were successful in each group. All pregnancies in the observation group were intrauterine, and no ipsilateral tubal interstitial pregnancy occurred; in the control group, 19 were intrauterine pregnancies, and 4 cases of ipsilateral tubal interstitial pregnancy occurred.Ipsilateral tubal interstitial pregnancy after modified tubal ligation was significantly lower than that after traditional tubal resection or ligation (χ(2)=4.195, P=0.041). Conclusion: Modified tubal ligation and resection can effectively reduce the occurrence of interstitial pregnancy during the re-pregnancy.

Evaluating Population Genetic Structure and Demographic History of Quercus spinosa (Fagaceae) Based on Specific Length Amplified Fragment Sequencing

Effectively identifying the genetic structure and related factors of a species can facilitate understanding the evolutionary history of the species. Phylogeographic patterns and genetic data are essential in investigating the species historical processes and diversification that response to environmental, climatic and geological influences. In this study, Specific Length Amplified Fragment Sequencing (SLAF-seq) data and ecological niche models (ENMs) are combined to identify the genetic structure and demographic modeling of Quercus spinosa, and evaluate the impacts of historical range shifts, climatic variation, and landscape factors on this species. The population topology and genetic divergence of the Cenozoic were inferred by a site frequency spectrum based composite-likelihood approach which is a novel strategy for maximizing the utility of linked SLAF markers. The overall genetic structure using model-based and model-free clustering methods was consistently identified as two geographically distinct genetic clusters. A deep divergence between two natural lineages (i.e., a western Himalaya-Hengduan Mountains lineage and an eastern Qin-ling Mountains lineage) was observed. The demographic modeling and Niche reconstruction indicated that the two groups were diverged in the late Miocene and then presented as two distinct genetic lineages. With the Quaternary glacial climate fluctuation, two groups had continuous asymmetrical secondary contact and gene exchange in the Sichuan Basin during the last glacial maximum. Besides, a significant relationship between genetic distance and geography in all individuals was identified by the Mantel test. Overall, this study 1) contributes to a better understanding of the role played by Quaternary climatic fluctuation in the present-day distributions of Q. spinosa; 2) provides a comprehensive view of the genome-wide variation of sclerophyllous forests in ecological adaptive evolution; 3) indicates that dispersal limitation and ecological divergence contribute to the genome-wide differentiation of Q. spinosa, which supports a hypothesis that complex geography and climatic changes strongly influence the evolutionary origin and history of the species.

[Analysis of clinical characteristics of 854 patients with thyroid cancer]

Objective:The aim of this study is to summarize and analyze the clinical features of thyroid cancer surgery patients, and provide information and guidance for clinical diagnosis and treatment. Method:The medical records of 854 patients with thyroid cancer who met the inclusion criteria from January 2013 to December 2018 were collected from the hospital's medical record system. Patients were grouped by age group and their stratified studies were performed on age, gender, pathological type, and cervical lymph node metastasis. Result:The total number of patients with thyroid cancer surgery in 2013-2018 showed an increasing trend. There was no significant difference in the age composition of thyroid cancer patients between different years （P>0.05）, but the age of 20-54 years old gradually increased with age, and reached a peak at 50-54 years old, then gradually decreased. There was no significant difference in gender composition between patients with thyroid cancer surgery in 2013-2018 （P>0.05）, but in 40-44 years old, the prevalence of women in the 50-54 age group was higher than that in men （P<0.05）, The prevalence of men in the 70-74 age group was higher than that in women （P<0.05）, and the peak period of both was 50-54 years old. Papillary carcinoma accounted for a high proportion （96.8%） in the pathological types of thyroid cancer surgery patients in 2013-2018, and the incidence of women in the 40-44 age group was higher than that in men（P<0.01）, in the 70-74 age range. The incidence was higher than that of women （P<0.01）. The incidence of follicular carcinoma （1%） was higher in men than in women （P<0.05）. The incidence of lymph node metastasis in women with thyroid cancer was lower than that in men （P<0.05）. Conclusion:The incidence of thyroid cancer in different age groups has its own characteristics, and prevention and control measures should be formulated according to age groups.

[Screening and antibiotic resistance analysis of nasal colonized bacteria in patients with chronic rhinosinusitis]

Objective:Since bacterial infection is one of the common pathogenic factors lead to chronic rhinosinusitis （CRS）, our study is designed to investigate the prevalence and antibiotic resistance of nasal colonized bacteria in patients with CRS, and to analyze the correlation between nasal colonized bacteria and pathogenesis of CRS. Method:Nasal vestibule samples collected from 200 patients with CRS were automatically inoculated on to various bacterial culture medium, cultured by WaspLab microbiology automated system, potential pathogenic bacterial colonies grew on agar plates were then examined, identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry, and analyzed their antibiotic-resistant phenotype by antibiotic susceptibility testing. Result:Two hundred and seventy-five bacterial strains of nasal colonization were isolated, including coagulase-negative Staphylococci, Staphylococcus aureus, Streptococcus pneumonia, Moraxella catarrhalis, Haemophilus influenza, Pseudomonas aeruginosa, and Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae. All strains displayed various degrees of antimicrobial resistance among children and adult patients, or among patients with and without endoscopic sinus surgery. Conclusion:The constitution of nasal colonized commensal bacteria in patients with CRS was partially similar to that of pathogenic bacteria causing CRS. They may form a reservoir of antimicrobial resistant pathogens, which would transform into pathogenic bacteria causing CRS under certain conditions. Screening of nasal colonized bacteria may represent an alternative approach for diagnosis and treatment of CRS.

[Clinical study of S-1 single agent adjuvant chemotherapy in the radical resection of extrahepatic biliary carcinoma]

Objective: To explore the clinical efficacy of S-1 single agent adjuvant chemotherapy for the patients undergoing radical resection of extrahepatic biliary carcinoma. Methods: The clinical data of 108 patients with extrahepatic biliary carcinoma receiving radical resection who were admitted from January 2014 to June 2017 were retrospectively analyzed. There were 62 males(57.4%)and 46 females(42.6%),with a median age of 59 years (range:26 to 79 years),10 cases(9.3%) in stage Ⅱ,85 cases(78.7%) in stage Ⅲ, and 13 cases (12.0%) in stage Ⅳ, 40 cases(37.0%) of hilar cholangiocarcinoma, 8 cases(7.4%) of middle cholangiocarcinoma, 25 cases (23.2%) of distal cholangiocarcinoma, 35 cases(32.4%) of gallbladder carcinoma.After radical resection of extrahepatic biliary carcinoma, 49 patients receiving S-1 single agent chemotherapy and 59 patients receiving non-special treatment were divided into the chemotherapy group and the operation group,respectively. All the dates of the patients were followed up and collected with the overall survival time,tumor-free survival time,1,2 and 3-year survival rate after operation,and the rate of major toxic reaction during chemotherapy of the chemotherapy group. Survival curve was drawn by the Kaplan-Meier method, and survival analysis was done using the Log-rank test. Results: There were no significant differences in the general date of two groups(sex, age, tumor size, tumor site, TNM stages, degree of differentiation). The median overall survival time and the median tumor-free survival time in the chemotherapy group were 27 months and 21 months,respectively,and in the operation group were 21 months and 17 months,respectively. There were differences between the two groups in the overall survival rates(χ(2)=3.967,P<0.05) and the 2 and 3-year survival rate(63.3%,36.6%;41.6%,20.4%;χ(2)=4.510,P<0.05;χ(2)=6.143,P<0.05),but the 1-year overall survival rate (83.4%,79.7%)was not statistically significant(χ(2)=0.286,P>0.05). There were no significant differences in the tumor-free survival time,1,2 and 3-year tumor-free survival rate(77.6%,41.4%,33.1%;62.7%,30.9%,21.2%)between the two groups(χ(2)=0.876,P>0.05;χ(2)=0.252,P>0.05;χ(2)=1.571,P>0.05;χ(2)=3.323,P>0.05,respectively). The main toxic reaction during chemotherapy were dyspepsia(28.6%, 14/49), anemia(26.5%, 13/49), and leukopenia(22.5%, 11/49), all of which were mild. Conclusion: S-1 single agent chemotherapy after radical reseetion of extrahepatic biliary carcinoma could effectly improve the survival of patients and all of the main toxic reaction during chemotherapy were mild.

[Effect of non-breathing-related sleep fragmentation on cognitive function in patients with cerebral small vessel disease]

Objective: To investigate the effect of non-breathing-related sleep fragmentation on cognitive function in patients with atherosclerotic cerebral small vessel disease(CSVD). Methods: Seventy-two patients with arteriosclerotic CSVD in the Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University were enrolled in this study from August 2017 to July 2018. The patients undertook MRA(Magnetic Resonance Angiography)+SWI(Susceptibility weighted imaging), polysomnography, Montreal Cognitive Inventory (MoCA) and Concise Mental State Examination (MMSE). The patients were divided into study group (≥19) and control group (<19) according to the median number of arousal events (median=19) at night. Results: The sleep efficiency, rapid eye movement (REM) sleep ratio and non-rapid eye movement-3 (NREM-3) sleep ratio of the study group were significantly lower than those of the control group (P<0.05), and the total MoCA score (18.2±4.3) , visual space score(1.9±1.4) and delayed recall score(1.4±0.9) of the study group were significantly lower than those of the control group (22.7±3.5, 2.9±1.2, 2.9±1.1, P<0.05). Conclusion: The incidence of non-breathing-related sleep fragmentation is high in CSVD patients and this kind of fragmentation is associated with cognitive impairment.

[Atypical epithelioid trophoblastic lesions after a cesarean section with cyst and fistula formation:a clinicopathological analysis of 4 cases]

Objective: To elucidate the clinicopathologic characteristics of atypical epithelioid trophoblastic lesions with cyst and fistula formation after cesarean section. Methods: The clinical and pathological data of 4 cases of post-cesarean atypical epithelioid trophoblastic lesions with cyst and fistula formation diagnosed at Women's Hospital, School of Medicine, Zhejiang University during April 2007 to June 2018 were evaluated by hematoxylin and eosin stain and EnVision two-step immunohistochemical staining technique. Results: The age of the 4 patients ranged from 32 to 41 years, with a mean age of 36.5 years. Three patients recieved cystectomy and one underwent subtotal hysterectomy. Histologically, the lesions were well circumscribed and consisted of uniform cells of medium size, irregularly enlarged with hyperchromatic nuclei and 1 to 2 inconspicuous nucleoli embedded in abundant hyalinized matrix with fibrinoid material in the center. The cells exhibited immunohistochemical feature of chorionic-type intermediate trophoblastic cells (CK18+, p63+ and CD146-). All patients were alive without recurrence during follow-up of 1 to 40 months (mean=22 months). Conclusion: Atypical epithelioid trophoblastic lesion with cyst and fistula formation after cesarean section has unique histological features, and its biological behavior and prognosis are still unclear, which need further exploration.

Low expression of PDK1 inhibits renal cell carcinoma cell proliferation, migration, invasion and epithelial mesenchymal transition through inhibition of the PI3K-PDK1-Akt pathway

As the most commonly occurring form of primary renal tumor, renal cell carcinoma (RCC) is a malignancy accompanied by a high mortality rate. 3-phosphoinositide-dependent protein kinase 1 (PDK1) has been established as a protein target and generated considerable interest in both the pharmaceutical and academia industry. The aim of the current study was to investigate the effect of si-PDK1 on the RCC cell apoptosis, proliferation, migration, invasion and epithelial mesenchymal transition (EMT) in connection with the PI3K-PDK1-Akt pathway. Microarray analysis from the GEO database was adopted to identify differentially expressed genes (DEGs) related to RCC, after which the positive expression of the PDK1 protein in tissue was determined accordingly. The optimal silencing si-RNA was subsequently selected and RCC cell lines 786-O and A498 were selected and transfected with either a si-PDK1 or activator of the PI3K-PDK1-Akt pathway for grouping purposes. The mRNA and protein expressions of PDK1, the PI3K-PDK1-Akt pathway-, EMT- and apoptosis-related genes were then evaluated. The effect of si-PDK1 on cell proliferation, apoptosis, invasion and migration was then analyzed. Through microarray analysis of GSE6344, GSE53757, GSE14762 and GSE781, PDK1 was examined. PDK1 was determined to be highly expressed in RCC tissues. Si-PDK1 exhibited marked reductions in relation to the mRNA and protein expression of PDK1, PI3K, AKT as well as Vimentin while elevated mRNA and protein expressions of E-cadherin were detected, which ultimately suggested that cell migration, proliferation and invasion had been inhibited coupled with enhanced levels of cell apoptosis. While a notable observation was made highlighting that the PI3K-PDK1-Akt pathway antagonized the effect of PDK1 silencing. Taken together, the key observations of this study provide evidence suggesting that high expressions of PDK1 are found in RCC, while highlighting that silencing PDK1 could inhibit RCC cell proliferation, migration, invasion and EMT by repressing the PI3K-PDK1-Akt pathway.

Genetic association between the NLRP3 gene and acne vulgaris in a Chinese population

BACKGROUND

Acne vulgaris is a common chronic skin disease. Inflammation is an important pathogenetic mechanism of acne, and NLRP3 polymorphisms have been reported to be involved in the mediation and occurrence of the inflammation. However, only a few studies on NLRP3 and acne have been reported, and the mechanism remains unclear.

AIM

To investigate two SNPs in the NLRP3 gene in patients with acne vulgaris (AV) and healthy controls (HCs) in a Chinese population.

METHODS

A case-control study was performed with 428 patients with AV and 384 (HCs). The SNPs rs10754558 and rs4612666 of the NLRP3 gene were genotyped using PCR with sequence-specific primers. A dual luciferase reporter assay was performed to determine whether the SNP rs10754558 might be responsible for the altered NLRP3 gene expression in AV by disrupting the interaction between micro-RNA (miR)-4273 and NLRP3 mRNA. Additionally, the mRNA level of NLRP3 was measured by PCR in the two groups.

RESULTS

The frequencies of the G allele of rs10754558 were 0.54 in patients and 0.49 in HCs (P < 0.05). No significant difference was observed for SNP rs4612666. Dual luciferase reporter assay revealed that luciferase activity was downregulated by about 40% when the G allele of rs10754558 coexisted with miRNA-4273, indicating that the G allele might interfere with miR-4273 function and alter NLRP3 expression. The level of NLRP3 mRNA in patients with AV was significantly higher than that in HCs.

CONCLUSIONS

Our study suggests that the NLRP3 SNP rs10754558 is associated with the incidence of AV. The G allele might be a genetic risk factor for AV in the Chinese population.

[Advances in the research of promotion effect of Aloe vera on wound healing and its clinical use]

Aloe vera has been widely investigated and used as folk medicine since ancient time. Biologically active substances in its gel include polysaccharides, glycoprotein, enzymes, anthraquinones or phenolic compounds, vitamins, minerals, and so on, which play important roles in anti-inflammatory response, antimicrobial, antiviral, antioxidant activity, immunoregulation effects, and especially in wound healing. In this paper, we review the advances in the mechanism and clinical application of Aloe vera and its extract on wound healing, so as to provide new ideas for the treatment of various kinds of wounds.

Disrupted Brain Network Hubs in Subtype-Specific Parkinson's Disease

BACKGROUND/AIMS

The topological organization of brain functional networks is impaired in Parkinson's disease (PD). However, the altered patterns of functional network hubs in different subtypes of PD are not completely understood.

METHODS

3T resting-state functional MRI and voxel-based graph-theory analysis were employed to systematically investigate the intrinsic functional connectivity patterns of whole-brain networks. We enrolled 31 patients with PD (12 tremor dominant [TD] and 19 with postural instability/gait difficulty [PIGD]) and 22 matched healthy controls. Whole-brain voxel-wise functional networks were constructed by measuring the temporal correlations of each pair of brain voxels. Functional connectivity strength was calculated to explore the brain network hubs.

RESULTS

We found that both the TD and PIGD subtypes had comprehensive disrupted regions. These mainly involved the basal ganglia, cerebellum, superior temporal gyrus, pre- and postcentral gyri, inferior frontal gyrus, middle temporal gyrus, lingual gyrus, insula, and parahippocampal gyrus. Furthermore, the PIGD subgroup had more disrupted hubs in the cerebellum than the TD subgroup. These disruptions of hub connectivity were not correlated with the HY stage or disease duration.

CONCLUSION

Our results emphasize the subtype-specific PD-related degeneration of brain hubs, providing novel insights into the pathophysiological mechanisms of connectivity dysfunction in different PD subgroups.

[Effect of ceramic thickness and resin cement shades on final color of heat-pressed ceramic veneers]

Objective: To analyze the effect of ceramic materials thickness and resin cement shades on the final color of ceramic veneers in the discolored teeth, and to investigate the color agreement of try-in pastes to the corresponding resin cements. Methods: Sixty artificial maxillary central incisor teeth (C2 shade) were used to simulate the natural discolored teeth and prepared according to veneer tooth preparation protocol. Veneers of different thickness in the body region (0.50 and 0.75 mm) were fabricated using ceramic materials (LT A2 shade, IPS e.max Press). The ceramic veneer specimens were bonded to the artificial teeth using the 6 shades of resin cements (Variolink Veneer: shades of LV-3, LV-2, HV+3; RelyX™ Veneer: shades of TR, A3, WO) (n=5). A clinical spectrophotometer was used to measure the color parameters of ceramic veneers at the cervical, body and incisal regions. Color changes of veneers before and after cementation were calculated and registered as ΔE1, and the changes between try-in paste and the corresponding resin cements were registered as ΔE2. Results: Three-way ANOVA indicated that ΔE1 and ΔE2 values were significantly affected by the ceramic thickness, resin cement shades and measuring regions (P<0.05). The ΔE1 values of six shades ranged from 0.59-8.27. The ΔE1 values were more than 2.72 when the ceramic veneers were cemented with resin cements in shades of HV+3 and WO. The ΔE2 values of six shades ranged from 0.60-2.56. The shades of HV+3, WO and A3 resin cements were more than 1.60. Conclusions: Different thickness of ceramic materials, resin cement shades and measuring regions could affect the final color of ceramic veneers. The color differences of some resin cements and corresponding try-in pastes might be observed in clinical practice.

[Analysis of distribution and drug resistance of pathogens isolated from 541 hospitalized children with burn infection]

Objective: To investigate the distribution and drug resistance of pathogens isolated from hospitalized children with burn infection. Methods: Totally 541 patients were hospitalized in Fujian Medical University Union Hospital, the 180th Hospital of Chinese People's Liberation Army(PLA), the 92th Hospital of PLA, and Longyan First Hospital from January 2013 to December 2015. Totally 848 clinical specimens (blood, catheter tip attachments, wound exudate, etc.) were collected for pathogen detection. After being identified by an automatic microbiological identification system, drug resistance of pathogens to 41 commonly-used antibiotics in clinic including gentamicin, aztreonam, erythromycin, clindamycin, etc. was tested by K-B paper disk diffusion method or minimal inhibitory concentration detection method. The SPSS 20.0 statistical software was used to analyze the following subjects: the detection rates of pathogens in different years, from different hospitals, and with different sources, the distribution of gram-negative bacteria, gram-positive bacteria, and fungi, the distribution of major pathogens, the detection rate of methicillin-resistant Staphylococcus, the resistant rates of common gram-positive bacteria and gram-negative bacteria to antibiotics. Results: The total detection rate of pathogens was 35.14% (298/848). The detection rates of pathogens were 52.29% (114/218), 33.20% (83/250), and 26.58% (101/380) in 2013, 2014, and 2015 respectively, 38.45% (198/515), 51.43% (18/35), 71.70% (38/53), and 17.96% (44/245) from Fujian Medical University Union Hospital, the 180th Hospital of PLA, the 92th Hospital of PLA, and Longyan First Hospital respectively, and 136/261, 8/137, 3/4, and 7/48 from wound exudate, blood, drainage fluid or tissue fluid, and the other specimens (including catheter tip attachments, sputum, feces) respectively. Among the 298 pathogens, 159 (53.36%) strains were gram-positive bacteria, 129 (43.29%) strains were gram-negative bacteria, and 10 (3.36%) strains were fungi. The detection rate of Staphylococcus aureus was the highest, totally 68 strains, accounting for 22.82%, followed by Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus epidermidis, with 37, 31, and 22 strains, accounting for 12.42%, 10.40%, and 7.38% respectively. Among Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA) accounted for 70.59% (48/68). Among Staphylococcus epidermidis, methicillin-resistant Staphylococcus epidermidis (MRSE) accounted for 68.18% (15/22). The resistant rates of MRSA and MRSE to penicillin and ampicillin were all 100.0%, and the resistant rates of MRSA to erythromycin, tetracycline, clindamycin and those of MRSE to erythromycin, cotrimoxazole were high. The high resistant rate of Pseudomonas aeruginosa towards antibiotics was detected with cotrimoxazole (83.3%) only. The resistant rates of Acinetobacter baumannii towards piperacillin, ceftazidime, and cotrimoxazole were high (from 58.8% to 71.4%). Conclusions: During the three years, there is large difference in the detection rate of pathogens from these four hospitals in Fujian province. The majority of pathogens were Gram-positive bacteria. The four dominant pathogens were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus epidermidis. Most of the pathogens were resistant to antibiotics commonly used in clinic in different degree, especially MRSA, MRSE and Acinetobacter baumannii, which showed high resistance towards antibiotics.