OBJECTIVE To get knowledge of the distribution and drug-resistance of Stenotrophomonas maltophilia in our hospital and improve the level of diagnosis and treatment.METHODS The automatic drug sensitive test and the paper spreads medicine sensitive test were carried on to 162 strains of S.(maltophilia) with the index of the VITEK system.RESULTS In all clinical samples,S. maltophilia isolated from phlegm was the most(90%),then was from secretion and swab.The majority of 162 strains were multidrug resistant.But to the(trimethoprim)-sulfamethoxazole and ciprofloxacin,the drug resistance was low((20.4%) and 22.2%,respectively).CONCLUSIONS S.maltophilia is the prevalent pathogen of nosocomial infection in ICU.And most of it are(isolated) from phlegm.So use antibiotics correctly,(reduce) invasive examinations or treatments and strengthen drug-resistant monitoring,are helpful to prevent and control S.maltophilia nosocomial infection.

OBJECTIVE To investigate the clinical practicability of inducible clindamycin resistance and to evaluate the clinical value of cefoxitin disk diffusion method in detecting the mecA gene of meticillin-resistant Staphylococcus(MRS). METHODS Resistant phenotypes were classified with erythromycin and clindamycin discs using the D test method and the cefoxitin disk diffusion method in detecting mecA gene of the staphylococcus. RESULTS Of all 390 Staphylococcus strains,218 strains(55.9 %) were resistant to erythromycin and clindamycin(cMLS).Seventy strains(17.9 %) which were resistant to erythromycin but susceptible to clindamycin showed the positive D test results(iMLS),79 strains(20.3 %) resistant to erythromycin but susceptible to clindamycin showed the negative D test results(MS).From 390 strains of clinical isolated staphylococcus,which using the cefoxitin disk diffusion method,272 strains were MRS. CONCLUSIONS Using the D test method to investigate the inducible resistance to erythromycin and clindamycin in the Staphylococcus strains,which could help the doctors choose correctly the antibiotics such as macrolides and clindamycin.At the same time,cefoxitin disk diffusion method can be used reliably by the clinical laboratory in detecting and conforming MRS.

Pseudomonas aeruginosa (PA) is a kind of opportunistic pathogen which can cause a wide range of serious infections clinically.These infections are often associated with the formation of biofilm, and are difficult to treat due to the complexity of mechanisms.Some studies have showed that genotype and phenotype of biofilm PA will change, and biofilm PA will aggregate together and secrete extracellular polymeric substance.Therefore, innate immune system could not recognize the camouflaged antigens.Besides, biofilm PA can secrete a variety of virulent factors to hamper the function of innate immune system.This article introduces the main chronic infection caused by PA biofilm and the relationship between biofilm PA and natural innate immune system.

Objective To explore the relationship between serum tumor markers and cervical cancer by using Logistic regression, and to further establish the diagnosis model of squamous cell carcinoma antigen (SCC) in cervical cancer by using chi-squared automatic interaction detector (CHAID) analysis of decision tree.Methods Total of 581 cases of cervical cancer,342 cases of cervical benign diseases and 341 cases of healthy controls who detected tumor markers in Taizhou Hospital of Zhejiang during 2010-2013, were retrospectively studied.The test results of carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), SCC, and alpha fetoprotein (AFP) were reviewed.The Logistic regression were firstly used in screening the related tumor markers of cervical cancer, and then the CHAID method of decision tree was used in determining the values of the related tumor markers on the diagnosis of cervical cancer.The SCC elevated cases of uterine disease from January 2014 to December 2014 were collected to verify the diagnostic value of SCC in cervical cancer patients.Results Logistic regression analysis showed that among the 5 tumor markers which might be associated with cervical cancer, SCC was the only one which had statistical significance between cervical cancer and cervical benign diseases (Wald x2 =22.120,P =0.000), the OR and its 95％ CI was 1.900 (1.454-2.483).With the SCC numerical increases, the proportion of patients with cervical cancer also gradually increased, when SCC ＞ 2.20 μg/L, the positive predictive value was 94.7％.In 284 cases of SCC higher than 2.20 μg/L who considered as uterus related diseases, there were 270 cases (95.1％) who were eventually confirmed as cervical cancer.Conclusion There was a good diagnostic value of SCC for cervical cancer patients.

Objective To investigate whether exogenic brain derived neurotrophic factor (BDNF) can permeate placental barrier into fetus and further through fetal blood brain barrier(BBB) after transient ischemia. Methods Seventeen day pregnant rats were selected. The uterine arteries of the rats were clamped for 30 minutes in experimental group. BDNF labeled with 125 I was injected into the rats through caudal veins. The radioactivity of BDNF in different fetal organs was measured at 24 h, 48 h and 72 h. Results 125 I BDNF was detected in amniotic fluid, placenta and fetal organs including brain, heart, lung, liver and kidney. This indicated that BDNF partly permeated placental barrier. The permeability of BDNF through placenta barrier and fetal BBB increased with the increased dose injected. BDNF reached the fetal brain through BBB under hypoxia eschemia condition. The rates of penetration of BDNF through placental barrier and BBB increased under the condition of fetal ischemia and hypoxia. Conclusions Exogenic BDNF may partly go through placental barrier and BBB into fetal brain, which makes it possible for BDNF to be a treatment for fetus suffered from ischemia and hypoxia.

OBJECTIVE To investigate the ESBLs ′ genotypes and the resistance of Escherichia coli and Klebsiella pneumoniae in Taizhou Hospital of Zhejiang Province.METHODS We collected 30 strains of E.coli and K.pneumoniae expressing ESBLs,then analyzed their encoding genotypes of TEM,SHV,PER,VEB and CTX genes by PCR and DNA sequencing technology separately.RESULTS There were 26 strains expressing blaCTS-M gene among 30 strains,in which 16 strains belonged to blaCTS-M-9 subgroup genotype,8 strains to blaCTX-M-1,7 strains to blaCTX-M-2,4 strains to blaCTX-M-1 as well as blaCTX-M-2,1 strain to blaCTX-M-2 as well as blaCTX-M-9 and 1 strain belonged to blaCTX-M-1 as well as blaCTX-M-9.CONCLUSIONS The prevalent clinical genotype of E.coli and K.pneumoniae is blaCTX-M-9.

Objective To investigate drug resistance and carbapenemase genotypes of carbapenemresistant Acinetobacter baumannii.Methods A total of 75 clinical isolated strains of carbapenem-resistant Acinetobacter baumannii were collected from Taizhou Hospital in Zhejiang province during January 2011 and June 2012.Vitek 2 Compact microbial identification system was used for bacterial identification and drug susceptibility test,and modified Hodge test was used to screen strains producing carbapenemases.Genotypes of carbapenamases were determined by polymerase chain reaction.Results All 75 carbapenem-resistant Acinetobacter baumannii strains were resistant to most antibacterial agents except amikacin.The resistant rate to amikacin was 13.3％ (10/75).OXA-23 gene was positive in 69 strains (92.0％),and OXA-51 gene was positive in 67 strains (89.3％).No IMP,VIM and SIM gene was observed.Conclusion OXA enzyme is the main cause of drug resistance in this group of carbapenem-resistant Acinetobacter baumannii,and OXA-23 and OXA-51 genes are the most popular carbapenemnases coding genes.

Objective To investigate the resistance mechanisms and epidemiology of Enterobacteriaceae isolated from clinical with reduced susceptibility to imipenem or meropenem.Methods 18 strains of Enterobacteriaceae with reduced carbapenem susceptibility were collected during January to August in 2010.The MICs of these strains were determined using automated microbial identification system.ESBLs,AmpC and KPC were tested using the agar dilution method.PCR amplification and DNA sequence were performed to analyze the KPC genes,PFGE was used to examine the molecular epidemiology.Results All 18 strains were detected ESBLs and AmpC,14 strains were detected KPC-2.3 strains with EDTA paper method positive may produce other metal carbapenem,in which 2 strains harbor KPC-2.PFGE types indicate that there were six genotypes among 15 strains of Klebsiella pneumoniae.Conclusion Plasmid-mediated KPC-2 was the main reason which makes Enterobacteriaceae reducing carbapenem susceptibility and causes short-term epidemic in hospital.Clinical strains harboring KPC-2 gene may carry multiple resistance genes meanwhile.

AIM: To investigate the immunologic mechanism of CXC chemokine ligand 10(CXCL10) and its receptor CXC chemokine receptor 3 (CXCR3 ) involved in the process of endometriosis (EM). METHODS: Serum samples were collected from 3 groups; EM patients without operation (n = 76) , EM patients with operation (n = 10) and the normal control persons (n =76). CXCL10 and CA12S concentrations were detected by means of ELISA and chemilumino-metry. Cell surface antigens on the activated PBMC - CD3 and CXCR3, as well as CXCR3 subgene - CXCR3A and CX-CR3B were tested by flow cytometry (FC) and RT - PCR when PBMC was separated from women with EM ( n = 10) and without EM (n = 10), and then activated. RESULTS: Serum CXCL10 concentrations between three groups were signifi-canly different (P < 0.05). Compared to normal control group, although the supernatant CXCL10 concentration and CD3~+ /CXCR3~+ PBMC number in EM group has no significant difference (P >0.05) , highly expressed CXCR3B in EM group rather than CXCR3A was observed. CONCLUSION: CXCL10 in women with EM is low, indicating that it plays a vital role in the process of EM and immune system of the women with EM is defected and impaired. The immunoreactivity of PBMC from both EM patients and normal person is same to activated signal, but the productions are different: PBMC in EM group mainly express CXCR3B but PBMC in normal person mainly express CXCR3A after activation, which may be one of the immune mechanisms that EM escapes from immunological lethal effect of the infected host.

s were 0.573±0.016, 0.707±0.008 and 0.711±0.013). Conclusions CXCL10 can express stablely in MCF-7 cell lines, which resulted in down-regulation of expression of VEGF and STAT3 gene. CXCL10 played an important role in anti-tumor effect.