OBJECTIVE To investigate whether efflux mechanism is involved in fluoroquinolone-resistant Klebsiella pneumoniae strains isolated in China. METHODS We compared the ciprofloxacin accumulation in clinically isolated K. pneumoniae with or without CCCP by fluorospectrophotometry. Use reverse transcriptase-polymerase chain reaction (RT-PCR) to measure the mRNA expression level of acrAB-tolC efflux gene. RESULTS The accumulation of ciprofloxacin in resistant strains was lower than that in susceptible ones, and it could increase to a high level nearly to the susceptible strains. The mRNA level of efflux gene acrA was higher in resistant strains than in susceptible ones. CONCLUSIONS Efflux mechanism is associated with the resistance to fluroquinolones in K. pneumoniae strains isolated in China and CCCP can inhibit its active efflux mechanism , which provides a sensitive method to detect the active efflux system of K. pneumoniae.

Objective To study the clinical characteristics of multi-drug resistance bacterias(MDROs) isolated from hospitalized patients in the Second People′s Hospital of Longgang District,to provide strategies for the prevention of MDROs infection.Methods The MDROs data of hospitalized patients from January 2015 to December 2016 were analyzed retrospectively.The multi-drug resistance incidence of each bacterias,each types of specimens and each clinical departments were analyzed and compared by SPSS16.0.Results A total of 104 strains of MDROs were isolated,and the top five bacteria were E.coli(32 strains,30.77%),coagulase negative staphylococcus(24 strains,23.08%),pseudomonas aeruginosa(16 strains,15.38%),staphylococcus aureus(10 strains,9.62%),kiebsiella pneumonia(10 strains,9.62%) respectively.There was significant difference in the multi-drug resistance incidence of each bacterias(χ2=20.62,P<0.05),the average incidence was 25.12%,and the top three incidence were E.coli(36.78%),pseudomonas aeruginosa(33.33%),coagulase negative staphylococcus(28.24%) respectively.There was significant difference in the multi-drug resistance positive rate of each types of specimens(χ2=43.68,P<0.05),the average positive rate was 5.84%,and the highest positive rate were wound secretion and pus(11.00%),followed by urine(8.25%).There was significant difference in the multi-drug resistance positive rate of each clinical departments(χ2=40.36,P<0.05),and the highest positive rate were in department of urinary surgery(12.63%),followed by department of gynaecology and obstetrics(11.16%).Conclusion E.coli coagulase negative staphylococcus and pseudomonas aeruginosa were mainly epidemic MDROs,and the MDROs are mainly distributed in urological surgery,obstetrics and gynecolog in this hospital.The occurrence of MDROs should be for the prevention and control strongly in the hospitalized patients with all kinds of trauma or diseases of urinary system and in the clinical department of urinary surgery,gynaecology and obstetrics.

Objective To compare the karyote counting and classification results of Sysmex XE-5000 automatic blood analyzer (XE-5000) and manual method in special body fluids .Methods 100 cases of special body fluid specimens (including cerebrospinal fluid and serous cavity effusion) were analyzed ,and the the karyote counting and classification were respectively detected by XE-5000 and the traditional manual method of microscope .Results When the karyote counts were 31-1 000/μL ,there was no signifi-cant difference between XE-5000 and manual method (P>0 .05) .And the karyote counting and classification results of XE-5000 correlated with those of manual method (r=0 .981 ,0 .991 ,P<0 .05) .Conclusion When the karyote counts are 31-1 000/μL ,XE-5000 has good accuracy and high precision in karyote detection in special body fluids .

Objective To investigate the relationship between Hepatitis B patients with different viral loads and immunoglob-ulin A,G,M and complement C3,C4.Methods Firstly,followed by real-time fluorescence quantitative PCR detection 210 cases of hepatitis B patients with HBV-DNA levels,according to 10n copies/ml different viral load detection results,it was divided into 102 ~108 copies/ml of the experimental groups.Then the experimental groups and control group were simulta-neously detected in immunoglobulin A,G,M and complement C3,C4.Analysed the correlation between HBV loads and im-munoglobulin A,G,M and complement C3,C4.Results When the viral loads of hepatitis B patients were 105 ~108 copies/ml,the testing results of IgA,IgG and IgM were both increasing (U =12.43,10.96,6.42,P <0.01),while C3 and C4 were both decreasing (U =8.37,6.0,P <0.01).When the viral loads of hepatitis B patients were 102 ~ 104 copies/ml,only IgA and IgM were increasing (U =2.36,2.04,P <0.05),the other testing results had no statistical significance.Between the test of 7 experimental groups compared with each other,only 104 group and 105 group had significantly changed (IgA and IgM were increasing,C4 was decreasing,U =2.39,2.46,2.09,P <0.05,IgG was increasing,U = 3.25,P <0.01),but between other low viral loads or high viral loads were not significantly differences.Conclusion The different viral loads of hepatitis B patients could cause the different changes of immunoglobulin A,G,M and complement C3,C4,especially in the 4 groups from 105 to 108 copies/ml.Followed by increasing in viral loads,there were immunoglobulin A,G,M increasing and comple-ment C3,C4 decreasing,and also serious impaction on the immune function of organism.There was a positive correlation be-tween viral loads in vivo and immune damages,correlation coefficient (γ =0.967,P <0.01).When the viral loads from 104 to 105 copies/ml,the testing results had changed significantly.It suggest that should control viral loads under 104 copies/ml in the hepatitis B antiviral treatment,so the effect of immune function damage will be the minimum.

Objective To investigate the application value of 16S rDNA-based detection technique in the rapid screening for and confirmation of gonococcemia. Methods A 41-year-old male patient was hospitalized for recurrent regular fever and chills for 1 month. Several days before the admission, he developed urgent micturition, frequent micturition and pain in urination, anemia with emaciation appearance, slightly pale-looking skin and mucous membranes. No petechia, skin eruption or superficial lymphadenectasis was observed, but routine blood test and urine test results were abnormal. No abnormality was found in stool test or hepatic and renal function. DNA was extracted from the blood of the patient and subjected to PCR for the amplification of 16S rDNA followed by sequence analysis and homology analysis. At the same time, bacterial culture of blood and drug sensitivity test for the bacterial isolate were performed. Results Homology analysis indicated that the amplicon sequence was consistent with the known sequence of 16S rDNA of Neisseria gonorrhoeae in GeneBank, which agreed well with the culture result of peripheral blood. Conclusion The detection of 16s rDNA with PCR from peripheral blood is highly efficient, specific, sensitive, rapid and accurate for the screening for and confirmation of gonococcemia.

Objective To investigate the relationship between serum visfatin level and coronary artery stenosis.Methods Based on coronary angiography,85 patients were diagnosed as coronary heart disease.According to oral glucose tolerance test,these patients were divided into 3 groups,34 patients with normal glucose tolerance(CHD group),25 with impaired glucose regulation(CIG group),and 26 with type 2 diabetes mellitus(CDM group).30 non-comary heart disease subjects with normal glucose tolerance were selected as the control group(CON group),and they underwent coronary CT angiography scan and were confirmed coronary disease-free.Blood pressure,body mass index(BMI),waist circumference(WC),waist hip ratio(WHR),fasting plasma glucose(FPG),blood lipid analysis,fasting insulin,and HbA1C were determined.Serum visfatin concentration was assayed and the status of coronary artery was assessed.Coronary artery stenosis was screened by coronary interventional angiography and assessed by Gemini scoring system in CHD,CIG,and CDM groups.Results Compared with control group,serum visfatin in CHD,CIG,and CDM groups were significantly higher(all P<0.05).Compared with CHD group,serum visfatin in CIG and CDM groups were significantly higher(all P<0.05).The correlation analysis showed that serum visfatin level was positively correlated with the involved branches of coronary arteries(r=0.807,P<0.01),serum visfatin level was positively related with Gensini coronary artery score(r=0.669,P<0.01).Visfatin was also positively correlated with WC,WHR,triglyceride(TG,r=0.200,P=0.032,r=0.185,P=0.047,r=0.321,P<0.01),while high density lipoprotein cholesterol(HDL-C)was negatively correlated with visfatin(r=-0.354,P<0.01).Multiple regression analysis showed that senlm hvel of TG and WC were the main influencing factors of visfatin.Conclusion (1)The level of serum visfatin may reflect the severity of coronary artery stenosis,detection of visfatin helps to make early diagnosis of CHD.(2)The raised serum level of visfatin in comary heart disease patients with imparied glucose tolerance is consistent with clinical evidence that diabetic patients have more severe coronary diseases.(3)WC and serum TG are main inilucencing factors,suggesting that visfatin is correlated with abdominal obesity.

Objective To assess the relationship between the serum IgG antibody titer of pregnant women and the hemolytic dis‐ease of newborn(HDN) .Methods Using microcolumn gel coombs card assay method to determine titer of 255 cases of couples an‐tenatal serum IgG antibody and ABO blood group .Results with 195 cases of ABO‐incompatible couples ,the positive rate of abnor‐mal serum IgG antibody(≥64)was 93 .8% .The titer of anti‐A/B IgG :in 12(6 .2% ) cases was <64;in 12(6 .2% )cases was 64;in 60(30 .8% )cases was 128 ;in 39(20% )cases was 256 ;in 45(23 .0% )cases was 512 ;in 27(13 .8% ) cases was 1 024 .There were no statistical differences between IgG anti‐A(B) titers distribution between A/O blood group matching and B/O blood group matching (χ2 =4 .361 ,P=0 .499) ,IgG anti‐A( B) titers was higher in AB/O blood group matching .Conclusion we can take early and effec‐tive prevention ,treatment ,reducing the incidence of HDN by the determination of prenatal serum IgG antibody titers in ABO‐in‐compatible couples ,which is important for the population of eugenics .

Objective To investigate the drug-resistance of Staphylococcus aureus induced by erythromycin in vitro and its changes in growth and susceptibility of antibiotics.Methods Erythromycin in vitro induction was conducted with the S.au-reus reference strain ATCC25923 on the serial of erythromycin agar plates.The growth of S.aureus,and the susceptibility a-gainst other antibiotics was compared after induced to the parent strain.Results Resistance to erythromycin was successful-ly,and themaximum MIC was over 256 mg/L.The Erythromycin-resistant S.aureus grew much slower than the susceptible parent,and the strains didn’t have cross-resistance to other antibiotics.Conclusion S.aureus could be induced resistance in vitro by erythromycin,and this resistance inherited stably.Some phenotype and biochemical characteristic features of the strain were changed after induced.

Objective To study the role of VEGF in the development of portal hypertensive gastropathy(PHG). Methods Forty-four portal hepertensive patients were investigated according to with or without PHG. The degree and the location of PHG were recorded. The specimens were obtained to perform RT-PCR to measure VEGF mRNA. Results VEGF mRNA in severe (3.48?1.02) or moderate PHG (2.28?0.33) with portal hypertension was higher than that in control (1.40?0.23) and those (1.51?0.32) with portal hypertension without PHG( P

OBJECTIVE: To compare endoscopic variceal ligation (EVL) with propranolol for prophylaxis of first variceal bleeding. METHODS: We chose 168 patients with cirrhosis and esophageal varices in our hospital and allocated them to EVL and propranolol groups. Treatment effectiveness and safety in the 2 groups were observed. RESULTS: he parameters of two groups were similar before therapy. Follow-up period was 8-36 months. Variceal bleeding occurred in 24 (28.6%) of the EVL group and in 20 (23.9%) of the propranolol group (P>0.05). Overall mortality and death related to bleeding were similar (21.4% vs 17.9%; 7.1% vs 6.0%, P>0.05). Adverse events related to EVL were 43 (3 of them life-threatening) compared to 16 in the propranolol group (51.19% vs 19.05%, P<0.05). CONCLUSION Propranolol may be the better choice in prophylaxis of variceal bleeding with similar effects and lower adverse events than with EVL.
Aged ; Endoscopy, Gastrointestinal ; methods ; Esophageal and Gastric Varices ; complications ; drug therapy ; surgery ; therapy ; Female ; Gastrointestinal Hemorrhage ; etiology ; prevention & control ; Humans ; Ligation ; methods ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Propranolol ; therapeutic use