OBJECTIVE To investigate the genetic markers of integron and transposon in multidrug-resistant strains of Escherichia coli.METHODS The genetic markers of integron(qacE△1-sul1) and transposons(merA,tnpA and tnpU) were detected by polymerase chain reaction(PCR).RESULTS In 20 strains,14 strains carried qacE△1-sul1,and 3 strains carried merA.CONCLUSIONS There are high percentages of the genetic markers of integron(qacE△1-sul1) and transposon(merA) in multidrug-resistant strains of E.coli.

Objective To investigate the distribution of aminoglycoside modifying enzyme genes (AMEs) and 16S rRNA methylase genes in drug-resistant strains of Pseudomonas aeruginosa. Methods Twenty strains of drug-resistant Pseudomonas aeruginosa were isolated from sputum and wound secretion samples collected from the First People's Hospital of Huai' an in Jiangsu province. Eight AMEs [aac(3)-Ⅰ , aac(3)-Ⅱ, aac(6')-Ⅰb,aac(6')-Ⅱ, ant{2)-Ⅰ ,ant(3)-Ⅰ , ant(4')-Ⅰ , aph(3')-Ⅱb] and 6 16S rRNA methylase genes (armA, rmtA, rmtB, rmtC, rmtD, npmA) were analyzed by PCR and verified by DNA sequencing. Results Out of 20 strains of Pseudomonas aeruginosa, aac(6')-Ⅱ was positive in 8 strains (40.0% ) , ant2- Ⅰ in 8 strains (40.0% ) , aac(3)-Ⅱ in 5 strains (25.0% ) , aac(6')- Ⅰ b in 2 strains (10.0% ) and rmtB in 1 strains (5.0% ) , respectively. The rest 9 genes were not detected. Among 2 strains harboring aac(6')- Ⅰ b, DNA sequencing confirmed that 1 was aac(6')- Ⅰ b (the clssical type) and another was aac(6')- Ⅰ b-cr. Conclusion Gene aac(6')- Ⅰ b-cr exists in drug-resistant Pseudomonas aeruginosa, and it has modifying effect on both aminoglycosides and quinolones.

Objective:To analyze routine blood test results of pregnant women at different periods of pregnancy and evaluate the health status of pregnant women.Methods:A total of 240 pregnant women with anemia who underwent antenatal care or delivery in Department of Obstetrics and Gynecology, The People's Hospital of Yuhuan from January 2018 to June 2019 were included in this study. They were divided into three groups according to different periods of pregnancy with 80 women in each group: first trimester, second trimester, and third trimester. Additional 80 non-pregnant women who concurrently received health examination were included as controls. Routine blood test results were compared among groups. The incidence of microcytic anemia and macrocytic anemia at different periods of pregnancy was determined.Results:The incidence of microcytic anemia in the third trimester group [3.75% (3/80)] was significantly lower than that in the first trimester group [26.25% (21/80)] and the second trimester group [25.00% (20/80), χ2 = 15.882, 14.675, both P < 0.05]. The incidence of macrocytic anemia in the third trimester group [22.50% (18/80)] was significantly higher than that in the first trimester group [1.25% (1/80)] and the second trimester group [3.75% (3/80), χ2 = 17.260, 12.333, both P < 0.05]. Red blood cell count and hemoglobin and hematocrit levels in the peripheral blood of pregnant women in the first, second and third trimester groups were significantly lower compared with the control group ( t = 8.579, 16.781, 13.964, 10.154, 15.891 and 15.512, all P < 0.05). Red blood cell count, hemoglobin and hematocrit levels in the second trimester group were significantly lower than those in the other three groups (all P < 0.05). In the first, second and third trimester groups, white blood cell count and percentage of neutrophils were increased, and platelet count was decreased ( t = 23.085, 24.187, 27.941, 15.722, 22.153, 13.277, 31.517, 32.901, 32.227, all P < 0.05) compared with the control group. The increases in white blood cell count and percentage of neutrophils in the second trimester group were significantly greater than those in the first and third trimester groups, and platelet count in the third trimester group was significantly lower than that in the first and second trimester groups (all P < 0.05). Conclusion:Monitoring routine blood indexes can help assess the health status of pregnant women. Adjusting nutrition program in time can decrease the incidence of adverse pregnancy outcomes.

Objective To execute quality control of OLYMPUS-PK7300 automated blood grouping analyzer to enhance the quality and efficiency in blood grouping.Methods Measures were proposed from the aspects of specimen quality,reagent quality,instrument maintenance,test parameters setup,internal quality control and external quality assessment,personnel and etc.Results Quality control was carried out at each link of the test by automated blood grouping analyzer to facilitate blood-related clinical operation.Conclusion Whole-course quality control of the analyzer has to be performed to improve blood grouping.

Objective To investigate the involvement of apoptosis in the lesions of patients with psoriasis. Methods The apoptosis was detected with terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL), and the expression of p53, PCNA and apoptosis suppressing protein bcl 2 was assessed with immunoperoxidase technique in psoriatic lesions and normal skin. Results A large number of keratinocytes showing biochemical and morphologic features of cells undergoing apoptosis were observed in all the suprabasal layers of the psoriatic epidermis. The plaques from all patients analysed showed marked increase in the number of PCNA positive cells in the middle and basal keratinocytes, and a dramatic reduction in the number of bcl 2 positive cells in the basal cell layer. Conclusion The increased apoptosis of keratinocytes in the lesions of psoriasis might be a homeostatic mechanism to the hyperplasia of cells.

OBJECTIVE To investigate the resistance gene spectrum and phylogenetic analysis in multidrug-resistant strains of Escherichia coli.METHODS The 34 kinds of resistant genes were detected by polymerase chain reaction and cluster analysis.RESULTS The positive rates of TEM,SHV,CTX-M-1 group,OXA-1 group,aac(3)-Ⅱ,aac(6′)-Ⅰb,ant(3″)-Ⅰ,rmtB,dfrA1,dfrA12,dfrA17,sul1,catB and cmlA were 95%,55%,40%,10%,75%,40%,15%,5%,10%,5%,75%,90%,15% and 35%,respectively.There was clone transmitted phenomenon.CONCLUSIONS There are very high positive percentages of TEM,SHV,CTX-M-1 group,aac(3)-Ⅱ,aac(6′)-Ⅰb,dfrA17,sul1 and cmlA genes in multidrug-resistant strains of E.coli.The multidrug-resistant strains of E.coli can induce clone transmitted hospital infection.

Objective To treat urinary calculi with pneumatic lithotripsy under non-endoscopy.Methodes We applied the pneumatic lithotripsy machine,which made in China,to treat huge or staghom nephrolith and calculi of anterior urethra under non-endoscopy,taken out stone fragmentations after lithotripsy.There was 1 case of huge nephrolith,7cases of staghom nephrolith,3 cases of anterior urethral calculi.Results Every case of nephrolith was successfully performed by using lithotrisy and extracted stones only one case.1 case in total nephrolith cases was found residual stones and sick-side renal functions were improved than before in all casws followed up for 3 moths to 2 years.the cases of anterior urethral calculi urinated fluently and had no urethral stenoses followed up 1～2 years.Conclusion This kind of operation used pneumatic lithotripsy to treat urinary calculi under non-endoscopy is safe,slight injury and curative effect is reliable.

BACKGROUND:The traditional treatment for thoracolumbar vertebral fractures is posterior short-segment pedicle screw fixation. This method uses vertebral soft tissue stretch through distraction reduction mechanism, makes shift bone reset, and restores shape and height of vertebral body. Long-term folow-up found that part of cases experience complications such as vertebral height loss, loss of spinal correction of Cobb angle, the pedicle screw breakage and loosening. OBJECTIVE:To explore clinical effects of pedicle screw fixation combined with the implantation of artificial bone composite for the treatment of thoracolumbar fractures, and to compare with conventional pedicle screw. METHODS: A total of 80 patients with thoracolumbar fractures, who were treated in the Yantaishan Hospital from March 2011 to May 2014, were randomly divided into two groups. In the experimental group, patients received pedicle screw fixation combined with the implantation of artificial bone composite. In the control group, patients received routine pedicle fixation. Pain visual analog scale score was evaluated before treatment and at 6 months after treatment in patients of both groups, and easement of pain was evaluated after treatment. Vertebral body height (normal anterior flange height and up and down the front cone height and the ratio of the average multiplied by 100%) and sagittal Cobb angle (sagittal measurements of X-ray film) were measured in patients of both groups before treatment and at 1 and 12 months after treatment. According to conventional hierarchical evaluation criteria used al over the world, prognosis was assessed at 6 months after treatment, including basic cure, powerfuly, effectively, and invalid. RESULTS AND CONCLUSION: At 6 months after treatment, significant differences in pain visual analog scale scores were detected in the experimental group (2.4 points) and control group (3.7 points) (P < 0.05). No significant difference in height of the injured vertebra and Cobb angle was detected between the two groups before treatment (P> 0.05). The height of the injured vertebra and Cobb angle were better in the experimental group compared with the control group at 1 and 12 months after treatment (P < 0.05). Significant differences in treatment efficiency were detectable between the experimental group (90%) and the control group (73%) at 6 months after treatment (P < 0.05). These data indicate that pedicle screw fixation combined with the implantation of artificial bone composite in the treatment of thoracolumbar fractures can be used to fix fracture reduction, effectively restore height of injured vertebral body, prevent postoperative Cobb angle loss, and improve the treatment efficiency.

OBJECTIVE:To investigate the effects of L-carnitine on inflammatory factor,oxidant stress index and cardiac func-tion in patients with maintenance hemodialysis. METHODS:One hundred and twenty maintenance hemodialysis patients selected from our hospital during Dec. 2014-Feb. 2016 were randomly divided into observation group and control group,with 60 cases in each group. Control group received maintenance hemodialysis for 1 month,and then was given rhEPO injection 3000 IU subcuta-neously,3 times a week. Observation group was additionally given Levocarnitine for injection 2 g,iv,qod,1 day after hemodialy-sis,on the basis of control group. Two groups were treated for consecutive 3 months. The levels of inflammatory factors (IL-6, TNF-α,CRP),oxidant stress indexes(MDA,GSH-Px,SOD)and cardiac function indexes(CO,LVEF,LVST)were observed in 2 groups before and after treatment;the occurrence of ADR was recorded. RESULTS:There was no statistical significance in in-flammatory factor,oxidant stress index and cardiac fuaction before treatment between 2 groups(P>0.05). After treatment,the lev-els of IL-6,TNF-α,CRP and MDA in observation group were decreased significantly,while the levels of GSH-Px,SOD,CO and LVEF were increased significantly,compared to before treatment;the improvement of above indexes in observation group were sig-nificantly better than control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treat-ment. CONCLUSIONS:L-carnitine can effectively alleviate the micro-inflammatory state in maintenance hemodialysis patients and protect myocardial function with good safety.

AIM: To study the pharmacokinetics of phenolic acids from Mailuoning injection in rats. METHODS: SD rats were given a single i.v. administration dose of Mailuoning injection 10 mL/kg, plasma and urine were collected before and after injection. Phenolic acid components in plasma and urine were measured by LC/MS. Pharmacokinetic parameters were determined from the plasma concentration-time data and urinary excretion-time data with the DAS software package. RESULTS: After i.v. of Mailuoning injection, chlorogenic acid (CGA), 1, 5-dicaffeylquinic acid (1,5-DCQA), 3, 4-dicaffeylquinic acid (3,4-DCQA), 3, 5-dicaffeylquinic acid (3,5-DCQA) and caffeic acid (CA) were quickly excrectioned. The t1/2 of CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA were 0.649, 0.334, 0.479, 0.486 and 0.330 h, respectively. AUC0-∞ were (22.522±2.716), (0.353±0.062), (3.620±1.246), (5.287±1.627) and (2.257±0.360) mg·L-1·h, respectively. After i.v. of Mailuoning injection, CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA can all be detected in the urine. The amounts of CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA excreted from urine during 0-24 h were (122.22±26.49)%, (3.30±1.26)%, (0.24±0.11)%, (1.93±0.77)% and (18.61±4.99)% of dose given in rats, respectively. CONCLUSION: After i.v. of Mailuoning injection, phenolic acids can be excreted quickly. Only a small quantity of 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA were excreted from urine. 3,4-DCQA and 3,5-DCQA may be metabolized into CGA in the rat plasma.