Objective To investigate the distribution and drug resistance of major pathogens for urinary tract infections in the First Affiliated Hospital of Nanjing Medical University.Methods Strains from midstream urine culture of patients with urinary tract infections were collected during January 1 and December 31,2011.All strains were identified by API system,and disk diffusion method was used for drug sensitivity test.Results Totally 1129 strains were isolated,in which 667 (59.1％ ) were Gram-negative strains,266 (23.5％) were Gram-positive strains,and 196 (17.4) were Candida.Among Gram-negative strains,Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were highly sensitive to carbapenem antibiotics; while Acinetobacter baumannii and Pseudomonas aeruginosa were highly resistant to most antibiotics including cephalosporins and penicillinase inhibitor,and the resistance rates were over 50％.Among Gram-positive strains,the major strains Enterococcus avium and Enterococcusfaecalis were completely sensitive to vancomycin and teicoplanin,and highly sensitive to linezolid (resistance rate below 10％ ).Candida albicans and Candida glabrata were highly resistant to voriconazole and fluconazole (with the resistance rates of 47.2％ - 60.0％ ), but were completely sensitive to amphotericin and nystatin.Conclusion Gram-negative strains account for most urinary tract infections in the First Affiliated Hospital of Nanjing Medical University with high drug resistance rates.

CYP2D6 is one of the cytochrome P450 isozymes which are involved in the metabolism of various drugs with wide use. Polymorphism at the CYP2D6 locus is one of the most widely known causes for pharmacogenetic variability in humans beings. This review focuses on the importance of CYP2D6 polymorphism in the metabolism of tamoxifen, relationships between the genetic polymorphism and prognosis of patients who have underwent endocrine therapy, and evidences indicating that CYP2D6 may be used as a predictive marker for choosing optimal endocrine therapy for patients with breast cancer.

Objective To observe the correlation between 1-hour postload plasma glucose and carotid intima-media thickness (IMT) in elderly male patients with hypertension.Methods One hundred and twenty six elderly male patients with hypertension were enrolled and divided into four groups: normal glucose tolerance with normal 1 h plasma glucose (1 hPG) group (low-NGT, n=42); normal glucose tolerance with high lh plasma glucose group (high-NGT, n=23);impaired glucose tolerance group (IGT, n=27) and diabetic group (n=84). The differences of blood pressure, blood glucose, blood lipid and intimia-media thickness among groups were analyzed.Results OGTT 1 hPG in high-NGT group was similar with IGT group[(12.0±1.1)mmol/L vs. (11.1±1.8)mrnol/L, P>0. 053 ,but significantly higher than that in Iow-NGT group ((12.0±1.1)mmol/L vs. (9. 1±1.4) mmol/L, P<0.01]. The value of IMT was gradually increased in four groups (P<0.05) and it was (1.02±0. 12) mm in high-NGT group. OGTT 1 hPG was the independent risk factor for IMT(P< 0.01).Conclusions OC-TT 1h plasma glucose is associated with atherosclerosis in elderly male hypertensive people.

n positive blood culture, and they are resistant to a variety of antimicrobial agents, which should be called attention.

Background and purpose:Positron emission tomography-computed tomography (PET/CT) is playing an increasingly important role in the diagnosis, therapy and follow-up of lymphoma patients. This study aimed to explore clinical and pathological features and bone marrow infiltration status in lymphoma patients with diffused high bone marrow glucose uptake on18F-FDG PET/CT.Methods:It was a retrospective study. Bone marrow infiltration status, pathological and clinical data from 62 cases of pathologically diagnosed lymphoma and diffused high bone marrow glucose uptake were analyzed.Results:Distribution of histopathological subtype in those cases was in accordance with that in previously reported Chinese lymphoma patients. Significant difference was demonstrated in standard uptake value (SUV) between pa-tients with aggressive and indolent histopathological subtypes (8.43vs 5.38,P=0.048), patients with and without B symp-toms (8.30vs 5.72,P=0.033), and patients with and without bone marrow infiltration (8.78vs 6.96,P=0.020). 32 patients were diagnosed as “bone marrow infiltration” by bone marrow biopsy. There was significant difference in histopathologi-cal subtype distribution between patients with and without bone marrow infiltration (P=0.001). In patients with bone marrow infiltration, there were higher proportions of mantle cell lymphoma, nodal marginal zone B cell lymphoma, Burkitt’s lym-phoma and anaplastic large cell lymphoma. In contrast, patients without bone marrow infiltration suffered more from diffuse large B-cell lymphoma, peripheral T cell lymphoma, enteropathic T cell lymphoma and extranodal NK/T-cell lymphoma (nasal type). False positive results in bone marrow glucose uptake may be caused by fever or anemia.Conclusion:Diffused high bone marrow glucose uptake on18F-FDG PET/CT should be evaluated in combination with the uptake values, clinical features and histological subtypes, to minimize the misdiagnosis and to better guide staging and therapy of lymphoma.

Objective To investigate the resistance status of different integrons of Shigella sonnei (S.sonnei) and to analyze the distribution of resistant genes in integrons in Jiangsu Province.Methods A total of 32 strains of S.sonnei isolated from six cities of Jiangsu Province in 2011 were collected.The antibiotic susceptibility was tested by disk diffusion method.The molecular homology was analyzed by pulsed field gel electrophoresis (PFGE).The detection and classification of integrons were achieved by analyzing the positive polymerase chain reaction (PCR) products using restriction fragment length polymorphism (RFLP).RFLP and DNA sequencing were used to analyze the resistance genes in integrons.Results Multi-drug resistance (MDR) was detected in 28 (87.5％) S.sonnei strains.The resistant rates to ampicillin,nalidixic acid and tetracycline were highest (87.5％,respectively).However,it was sensitive to norfloxacin.PFGE analysis showed that there were 3 kinds of homologous clones involving 31 strains of the 32 S.sonnei strains.Among them,2,5 and 24 strains had the same clones,respectively.Accordingly,they spread within one,two and five different cities.The detection rates of class 1,class 2 and the atypical class 1 integrons in S.sonnei were 62.5％ (20/32),81.3％ (26/32) and 21.9％ (7/32),respectively,and no class 3 integron was detected.Sequence analysis of class 1 integron variable area revealed that it contained multiple resistant genes (aacA4-cmlA1 and dfrA1-aadA 1) ; dfrA1-sat 1-aadA 1 from class 2 integron and blara-30-aadA 1 from atypical class 1 integron were also identified.Conclusions In 2011,homologous S.sonnei strains spread among different cities in Jiangsu Province.MDR strains are prevalent and integrons are widespread which mediated the emergence of MDR strains.

Objective:To study the signal enhancement of lung adenocarcinoma nude mice after injection of immunomagnetic bead solution (magnetic beads conjugated with monoclonal antibody NJ001) in micro-CT scan. Methods:The models of lung adenocarcino-ma nude mice were established by injecting SPC-A1-luc cells through the tail vein and were validated by bioluminescence imaging (BLI). The nude mice were divided into three groups: physiological saline group, bare magnetic bead group, and immunomagnetic bead group. Three groups of nude mice were injected with physiological saline, 750 nm bare magnetic bead solution, and immuno-magnetic bead solution via the tail vein every week, and micro-CT scan was taken before and 4 h after injection. Immunohistochemis-try (IHC) was used to detect the expression of antigen SP70 in tumor tissues. Results:The tumor was detected in the immunomagnetic bead group at the fourth week, whereas in the physiological saline and bare magnetic bead groups, the tumor was undetectable until the sixth week. The tumor intensities detected at the sixth week by micro-CT scan in the physiological saline, bare magnetic bead, and immunomagnetic bead groups were 59.05 ± 0.66, 60.69 ± 0.55, and 58.25 ± 0.32 before injection and 60.30 ± 1.83, 61.05 ± 0.68, and 67.41±3.82 after injection, respectively. Compared with the tumor intensities before injection, they significantly increased after injec-tion in the immunomagnetic bead group;the difference was statistically significant (P=0.0079). By contrast, no statistical significance was observed in the tumor intensities before and after injection in the physiological saline and bare magnetic bead groups (P=0.1867 and P=0.3839, respectively). Conclusion:The immunomagnetic beads had enhanced effect on micro-CT scan of lung adenocarcinoma nude mouse models.

Objectives To evaluate accurately hepatocyte injury degree of severe hepatitis patients by quantifying plasma DNA of severe hepatitis patients and study its clinical application in diagnosis of severe hepatitis comparing with ALT.Methods Six milliliters of peripheral blood samples were collected from 185 patients with hepatitis B which are divided into four groups, severe hepatitis with 30 cases, acute hepatitis with 20 cases, chronic B hepatitis with 90 cases, and liver cirrhosis with 45 cases. 100 healthy controls were enrolled. Circulating DNA was extracted from plasma by the BILATEST virus DNA/RNA extraction kit and quantified with a novel duplex real-time PCR assay, respectively.Results Plasma DNA levels of hepatitis B patients were significantly higher than those of healthy controls (104.2 ng/ml vs. 23.4 ng/ml (median),P=0.0000).A significant difference of plasma DNA concentration was found between severe hepatitis and acute hepatitis (P=0.0018), and chronic B hepatitis (P=0.0000), and liver cirrhosis (P=0.0000).The median value of serum ALT of hepatitis B patients was 107.5 U/L, much higher than that of the healthy controls (24.1 U/L,P=0.0000).The levels of serum ALT were significantly different between severe hepatitis and acute hepatitis (P=0.0024), while there was no remarkable difference between severe hepatitis and chronic B hepatitis (P=0.0600), liver cirrhosis (P=1.0000). Moreover, for distinguishing severe hepatitis from liver cirrhosis and chronic B hepatitis, the plasma DNA assay was notably superior to ALT by the analysis of receive operating characteristic (ROC) curves (AUC, 0.95 vs. 0.51,P=0.0000; 0.86 vs. 0.34,P=0.0000).Conclusion The results by measuring plasma DNA of hepatitis B patients with the novel duplex real-time quantitative PCR showed that plasma DNA may be considered as a robust predictive marker for accurately evaluating hepatocyte injury degree of severe hepatitis patients.

To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.
Biological Specimen Banks ; Database Management Systems ; Humans ; Medical Records Systems, Computerized ; Medical Records, Problem-Oriented

Objective: To investigate the pathogen spectrum distribution and drug resistance of febrile neutropenic patients with hematological diseases in Shanghai. Methods: A retrospective study was conducted on the clinical isolates from the febrile neutropenic patients hospitalized in the departments of hematology in 12 general hospitals in Shanghai from January 2012 to December 2014. The drug susceptibility test was carried out by Kirby-Bauer method. WHONET 5.6 software was used to analyze pathogenic bacteria and drug susceptibility data. Results: A total of 1 260 clinical isolates were collected from the febrile neutropenic patients. Gram-positive bacteria accounted for 33.3% and Gram-negative bacteria accounted for 66.7%. Klebsiella pneumoniae (12.5%) , Stenotrophomonas maltophilia (9.5%) , Escherichia coli (9.1%) , Pseudomonas aeruginosa (8.7%) , Acinetobacter baumannii (6.6%) , Staphylococcus aureus (5.6%) and Enterococcus faecium (5.0%) were ranked in the first 7 of all pathogens. In the respiratory tract secretions specimens, non-fermented strains accounted for 56.2%. Stenotrophomonas maltophilia accounted for 15.2%. Enterobacteriaceae and coagulase-negative Staphylococci accounted for 42.3% (104/246) and 32.6% (85/246) respectively in blood samples. Enterobacteriaceae and Enterococcus bacteria accounted for 39.4% (76/193) and 28.5% (55/193) respectively in pus specimens. The detection rates of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative Staphylococci (MRCNS) were 54.3% and 82.5%, respectively. Staphylococcus bacterial strain was not found to be resistant to linezolid, vancomycin and teicoplanin. The detection rate of Enterococcus vancomycin-resistant strains was 8.9%. Enterococcus was not detected resistance to oxazolidinone strains. Enterobacteriaceae bacteria were highly sensitive to carbapenems. The resistance rate of Pseudomonas aeruginosa to imipenem and meropenem was 34.1% and 15.8%, respectively. Stenotrophomonas maltophilia was more sensitive to minocycline hydrochloride, levofloxacin and sulfamethoxazole. The resistance rate of Acinetobacter baumannii only to cefoperazone-sulbactam was less than 10.0%. The antibiotic resistance rate of Klebsiella pneumoniae, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Acinetobacter baumanii to most of common antibiotics was lower than that of the CHINET surveillance. Conclusions The pathogenic strain distribution in common infection sites of febrile neutropenic patients was characterized. Bacterial resistance surveillance was better than the CHINET nationwide large sample surveillance in China.