1.Mechanisms of restenosis after vascular reconstruction
Jiehua QIU ; Ying HUANG ; Mier JIANG
International Journal of Surgery 2008;35(12):838-840
Restenosis is the major causee which leads to arterial occlusion and graft failure after vascular reconstruction.Thus to clarif the mechanism of restenosis is of great importance to prevent and treat postprocedural restenosis and improve long-term graft patency.Current studies on restenosis focus on elastic recoil,thrombosis,inflammatory reaction,neointimal hyperplasia and vascular remodeling,herein,we reviewed literatures.
2.Study on the genotypes of TEM-like and SHV-like extended-spectrum beta-lactamases in clinical isolates of Gram-negative bacilli in Guangzhou
Qingzhong XIAO ; Danhong SU ; Jiehua JIANG ; Nanshan ZHONG
Chinese Journal of Laboratory Medicine 2003;0(10):-
Objective To investigate the main genotypes and the epidemic characteristics of TEM-type and SHV-type extended-spectrum beta-lactamases (ESBLs) of the gram-negative bacilli in Guangzhou.Methods The phenotype of ESBLs from 3 500 clinical isolates were primary screened and confirmed by the NCCLS confirmatory test according to guidelines of NCCLS(2001). PCR were performed on 3 500 clinical isolates using primers specific for blaTEM and blaSHV, respectively, the PCR product were purified and sequenced by ABI prism 377 DNA sequencer.Results Total of 3 500 un-replicated and consecutive Gram-negative bacilli were isolated from 13 hospitals in Guangzhou in the past two years, and the prevalence of ESBLs-producing clinical Gram-negative isolates was 31.0%(1 084/3 500). The positive rates of PCR results for blaTEM, blaSHV, and both of them in all the clinical Gram-negative isolates were 24.0%(840/3 500),10.8%(378/3 500),and 3.7%(128/3 500), respectively. All PCR products for blaTEM were further identified as TEM-1-type non-ESBLs gene, including TEM-1,TEM-1B,TEM-1D,and TEM-1F,by DNA sequencing analyses. However, almost all of the blaSHV gene were further identified as SHV-type ESBLs gene(the prevalence of SHV-1 is 7.2% only).The prevalence of SHV-12/5a accounted for highest(50.0%,152/304) in Guangzhou. Our test also showed that 53%(340/641) of blaTEM-producers [JP2] were Escherichia coli, and 57.9%(176/304) of blaSHV-producers were Klebsiella pneumoniae.Conclusions [JP]We could conclude from above results that SHV-type ESBLs, especial SHV-12/5a, was the prevalent genotype of ESBLs of clinical gram-negative bacilli in Guangzhou. TEM-type ESBLs did not exist in our city. In addition, SHV-12/5a-producing strains probably were main epidemic strains in Guangzhou. As for detection of ESBLs with regular phenotype methods, there was possibility of false negative and false positive.
3.The appearance of a novel CMY type class C cephalosporinase (AmpC) in southern China
Weijiao LIAO ; Jiehua JIANG ; Jianyun YI ; Yunjian XU ; Sizeng PAN
Journal of Chinese Physician 2001;0(05):-
Objective To investigate the antibiotic resistance and molecular epidemiology character of ?-lactamase producers among clinical isolates of Citrobacter freundii.Methods Four strains of Citrobacter freundii were detected by K-B susceptibility method and three-dimensional test.The ?-lactamase gene was identified by polymerase chain reaction(PCR) and sequencing.Results The No.29 strain of Citrobacter friundii was multiple-drug-resistant and proved to produce CMY,DHA type AmpC,TEM and SHV type of extended-spectrum ?-lactamases(ESBLs).The sequencing of corresponding DNA revealed 97% identities of the CMY-2 amino acid sequence.It was a new type of cephalosporinase.Conclusion A novel strain of Citrobacter friundii with CMY type AmpC,DHA type AmpC,TEM and SHV type ESBLs has been found in southern China and it is multiple-drug-resistant.
4.Screening of ?-Lactamase in Multi-resistant Gram-negative Bacilli and Analysis of Characteristics of Susceptibility of Phenotype and Genotype
Jiehua JIANG ; Weijiao LIAO ; Jun XU ; Jianyun YI ; Yunjian XU
Chinese Journal of Nosocomiology 2006;0(05):-
OBJECTIVE To investigate the phenotypical and genotypical characteristics of the ?-lactamase in the 302 strains of Gram-negative bacilli,and assess the characteristics of the drug resistance.METHODS The phenotypes of ?-lactamase were detected in the Gram-negative bacilli by disc diffusion screen test,which were further ascertained by disc diffusion confirmatory test,a cefoxitin three dimensional test,and metallo ?-lactamases double-disc synergy test.The ?-lactamases were detected by multiple PCR amplification,then DNA product was sequenced.Antibiotics susceptibility was detected by K-B method.RESULTS Among the clinical Gram-negative isolates,a total of 26.49%(80/302)strains′ ?-lactamases phenotypes were positive,ESBLs,ESBLs combined with AmpC enzyme,ESBLs combined with AmpC enzyme and MBL,and AmpC enzyme producing strains were found in 16.56%,6.62%,1.66% and 0.66%,respectively.A total of 24.83% strains′?-lactamases phenotypes were positive,strains produced ESBLs,ESBLs combined with AmpC enzyme,ESBLs combined with AmpC enzyme and MBL,and AmpC enzyme producing strains were found in 17.55%,6.95%,0.33%,and 0.33%,respectively.Drug-sensitivity test showed multi-resistant Gram-negative isolates were more sensitive to amikacin(18.75%),and heavier resistant to ampicillin(97.50%).CONCLUSIONS ?-Lactamase producing Gram-negative bacilli are resistant to multi-antibiotics.
5.Study on the molecular mechanism of the dissemination of a novel CTX-M-like extended spectrum beta-lactamase-producing Escherichia coil
Jiehua JIANG ; Weijiao LIAO ; Jianyun YI ; Tao CHEN ; Xiuxin SUN ; Yunjian XU ; Yiquan LI
Journal of Chinese Physician 2008;10(7):882-885
Objective To investigate the distribution of the CTX-M- extended spectrum beta-lactamase (ESBLs) producing Esche- richia coli(ECO) and the molecular mechanism of dissemination. Methods To analyze the drug resistance of the 43 isolates, Kirby-Bauer susceptibility method was used. Multiple polymeraso chain reaction (PCR) was used to amplify the gene of ESBLs, AmpC, full length of blaCTX-M-like gene, insertion sequence (IS) ISEcp1B, IS903 , IS26 and integron I. NEST-PCR was used to detect if the beta-lactamase gene lo- cated in the integron I. The product of full length of bla-CTX-M like gone amplified by PCR was sequenced. Results Susceptibility test showed the resistance from high to low in turn was Ampicillin (97.68%), Coftriaxone (67.44 % ), piperacillin(65.12 % ), Cefotaxime (62.79 % ) ,Coftasidime(58.14% ), Cofasolin(55.81% ), Cofepime (53.49%), Cefexitin(51.16%), ciprofloxacin (44. 19% ), Aztreo- nam(41.86% ), Cefoperasone/Sulbactam ( 20.93% ), Amikacin (0% ), Imipenem (0% ), respectively. ECO was susceptive to Imipenem. CTX-M-G1 was found in 25 strains of ECO , TEM, SHV, CTX-M-G1, ISEcp1B, and integron I were found in the nine isolates. IS903 were found in ECO 3 and 5, and IS26 was found in ECO 3. In ECO 3 and 5, blaCTX-M-like was flanked upstream by ISEcp1B element that provided -35 and -10 promoter sequences and a right inverted repeat (IRR) recognized by transposase, downstream by IS903 provided an inverted re- peat, ISEcp1 B and IS903 composed the complex transpeson. Conclusion ISEcplB may drive the expression and dissemination of blaCTX-M-like gene at a high level.
6.Value of diffusion weighted imaging signal intensity in evaluating histopathological differentiation of hepatocellular carcinoma
Ting JIANG ; Jiehua XU ; Jin WANG ; Kangshun ZHU ; Zhuang KANG ; Hong SHAN
Chinese Journal of Hepatobiliary Surgery 2015;21(2):76-80
Objective To determine the relationship between visual signal intensity and quantitative signal intensity of HCC assessed with DWI and histopathological differentiation of HCC.Methods The MR examinations including MRI plain scan,LAVA dynamic enhanced scan and DWI (1.5T,b value:0 and 600 s/mm2) of 224 patients who had surgically resected HCCs were retrospectively reviewed.Histopathological examinations revealed that there were 31 well-,169 moderately-,and 24 poorly-differentiated HCCs.The incidence of each visually evaluated signal intensity and quantitative signal intensity of HCC assessed with DWI signal intensity and the relationship between signal intensity and histopathological differentiation were assessed for each sequence.Results (1) On DWI,56.7% of HCCs appeared as obviously hyperintense,24.1% tumors appeared as moderate hyperintense,and 19.2% tumors appeared as isotense or slight hyperintense to the surrounding hepatic parenchyma.There was a significant difference between isotense/slight hyperintense and obvious hyperintense and histopathological differentiation (P < 0.05).There was no significant difference between isotense/slight hyperintense and moderate hyperintense and histopathological differentiation (P < 0.05).There was no significant difference between moderate hyperintense and obvious hyperintense and histopathological differentiation (P > 0.05).Visually evaluated signal Intensity of HCC showed an inverse correlation with histopathological differentiation (r =-0.324,P < 0.05).On DWI,the tumors tended to show a brighter signal with decreasing histopathological differentiation.(2) There was a significant difference in DWI signal intensity value among the well,moderately and poorly differentiated HCCs (P < 0.05).The SI value of well differentiated HCCs was lower than that of moderately differentiated HCCs and poorly differentiated HCCs (P < 0.05).The SI value of moderately differentiated HCCs was lower than that of poorly differentiated HCCs.However,there was no significant difference between the SI value of the moderately and poorly differentiated HCCs (P > 0.05).ROC analysis showed that the optimal cutoff point of SI value in diagnosing well differentiated HCCs was 66.5.A cutoff SI value equal to or less than 66.5 was used to differentiate well-differentiated HCC from moderately-and poorly-differentiated HCC with a sensitivity of 90.1% and a specificity of 71.9%.Conclusions On DWI,the tumors tended to show a brighter,visually evaluated signal intensity and higher quantitative signal intensity with decreasing histopathological differentiation (P < 0.05).The quantitative signal intensity of HCC assessed with DWI signal intensity could only predict well differentiated HCC.It was limited in predicting histopathological differentiation of HCC using evaluating signal intensity and quantitative signal intensity of HCC assessed with DWI.
7.The distribution of high pathogenicity island in multiple-drug-resiatance gram-negative bacilli and analyzation of DNA sequence
Jiehua JIANG ; Huo TAN ; Jun XU ; Weijiao LIAO ; Jianyun YI ; Huanzhu ZHANG ; Yiquan LI ; Guixing ZHENG ; Zhicheng XU ; Boping ZHU
Journal of Chinese Physician 2009;11(1):37-41
Objective To investigate the distribution of high pathogenicity island(HPI)in multiple-drug-resistance gram-negative bacilli and analyze the protein sequence.Methods To amplify thefyuA-irp2 gene cluster of the 84 isolates by multiple polymerase chain reaction(PCR),the product was subsequently sequenced.Results The positive rate ofirpl,irp2,irp3,irp4 and fyuA was 40.48%,41,67%,5.95%,O%and 16.67%,respectively.Theamino sequence offyuA comefromEC06748,Kp7151 and PAE7 was usedto compare with AL590842,there are 100%identities.Amino sequence ofirp2 come from Kp49 and Kp51 have 99%identities with AAA27636.1,but amino sequence of irp2 come from EC04 and EC07 only have 90%identities with 1176840.The GenBank accession number is FJ211852 and FJ211851.Amino sequence ofirpl come fromKp 10,Kp49 and Kp51 have 99%identities with AL590842。and amino sequence ofirp3 come from EC03,Kp51,Kp10 and Kp49 have 97%identities with CAA73128.There are the same mutation among the same species,and different mutation among different species.Conclusion There was different extant mutant lost in thefy~t-i,v2 gene cluster in multiple-drug-resistanee gram-negative bacilli.
8. Quantitative three-dimensional methodology based on intraoral scan to assess the soft tissue contour alterations following single immediate implant and immediate provisionalization in maxillary central incisor: a 1-year prospective study
Donghao WEI ; Yijiao ZHAO ; Ping DI ; Jiehua TIAN ; Xi JIANG ; Ye LIN
Chinese Journal of Stomatology 2019;54(1):3-9
Objective:
To establish a quantitative three-dimensional method based on intraoral scan and apply it to evaluation of the facial soft tissue contour alterations following single immediate implant and immediate provisionalization (IIPP) in central incisor via intraoral scanning.
Methods:
This study was a prospective clinical study. The trial was conducted at Department of Implantology, Peking University School and Hospital of Stomatology, from January 2016 to September 2017. Twenty-nine eligible consecutive patients (15 women, 14 men) with a mean age of (34.3±12.0) were included and received immediate replacement of the failure maxillary single central incisor. A screw-retained immediate restoration was delivered for each patient. At 6-month follow-up, impression was taken and a screw-retained permanent restoration was performed for each patient. The anterior maxillary region was scanned by an intraoral scanning system at pre-surgery and 1-year follow-up. The Standard Tessellation Language (STL) files were output to a dedicated software and superimposed. Mid-facial recession and gingival zenith symmetry at 1-year follow-up were measured in the digital models. Three-dimensional configurations of the contour change volume were calculated and reconstructed for visual analysis. Furthermore, the following parameters were used to analyze the reconstructed volume: mean contour change in thickness (△d), mesio-distal width (DW), coronal-apical height (DH), contour change at 0, 1, 2, 3, 4, 5 mm apical to the free gingival margin on the implant site.
Results:
Twenty-seven out of twenty-nine enrolled patients were finally available for analysis. At 1-year follow-up, the mid-facial mucosa level at implant site was (0.23±0.39) mm apical to the gingival zenith of the contralateral tooth. In general, a contour collapse was found in every patient. △d, DW and DH of the collapsed volume were (0.62±0.22), (11.03±1.74) and (6.82±1.52) mm, respectively. Contour change at 0, 1, 2, 3, 4, 5 mm apical to the free gingival margin on the implant site were (0.54±0.48), (0.87±0.62), (1.03±0.46), (0.96±0.52), (0.90±0.52), (0.89±0.57) mm.
Conclusions
The described quantitative measurement based on intraoral scan can be an effective method for assessment of soft tissue contour changes. At 1 year following single IIPP treatment in maxillary incisor, free gingival margin is stable, with only mild recession. The mean level of the facial soft tissue contour collapse is 0.62 mm.