OBJECTIVE To explore the drug-resistance,the existing forms,genotype,and transfer ways of extended spectrum ?-lactamases(ESBLs) and plasmid AmpC enzyme in Klebsiella pneumoniae.METHODS The drug sensitivity of K.pneumoniae to 17 antibiotics was done by slip-diffusion and microdilution methods.The genotype of two enzymes was assessed by PCR and sequencing.The transfer ways of K.pneumoniae drug-resistant gene were identified by transconjugants-test.RESULTS The ESBLs were mainly produced in 55 cefoxitin resistant K.pneumonia strains.The major genotypes of ESBLs and plasmid AmpC nzyme were CTX-M,MIR and DHA.These genes could be transferred from clinical isolates to recipient bacteria.CONCLUSIONS ESBLs as well as AmpC enzymes are the most important resistance mechanism in K.pneumoniae.The resistance could be transferred through the bacterial conjugation.

OBJECTIVE To study the drug resistance genes in imipenem-resistant Pseudomonas aeruginosa.METHODS Five main drug resistance genes:IMP,VIM,SPM and GIM which are pertinent with metal ?-lactamase and outer membrane protein oprD2 gene were analyzed using PCR method.RESULTS The oprD2 genes in 48 strains of imipenem-resistant P.aeruginosa were negative,and in 14 strains were positive from all 62 strains tested.There were 16 strains with positive IMP type and 5 strains with positive VIM type metal enzyme genes positive,7 metal enzymes producing strains were with negative oprD2 gene.The SPM and GIM metal enzyme genes detected were all negative.CONCLUSIONS The loss of outer membrane protein oprD2 gene is the main mechanism of imipenem resistance in P.aeruginosa in Tai′an area.

Objective:To study the efficacy of paroxetine and psychotherapy in patients with poststroke de- pression and anxiety.Methods:81 patients who met the CCMD-3 criteria of depression and anxiety after acute brain stroke were recruited and randomized into 3 groups.Group A was treated with routine antistroke medication and paroxetine;Group B was treated with routine antistroke medications,paroxetine plus psychotherapy;Group C(con- trol)was treated with routine antistroke medication.All patients were treated for 6 weeks and evaluated with SSS, HAMD,HAMA as measures of efficacy and side effects.Results:The comorbidity rate of poststroke depression and anxiety was 65.9%.According to the reduction of SSS,HAMD and HAMA scores,and increase of BI score,signifi- cant improvement has been showed in all patients.There was significant difference among group A,B and the control group(P