Objective The aim of our study is to investigate the prevalence of Carbapenem-resistant Klebsiella pneumoniae (CRKP) and the genetic characteristics of the class 1 integron in CRKP on multi-drug resistance.Methods Clinical Klebsiella pneumoniae strains were collected from multiple departments of a hospital in central China. CRKP strains were identified among the isolates, and antibiotics susceptibility of CRKP strains was analyzed. The polymerase chain reaction (PCR) was adopted to amplify the class 1 integron variable area. The integron genetic structure was analyzed with enzyme digestion and DNA sequencing technology. The relation between class 1 integron and drug resistance was analyzed statistically.Results Totally 955 strains of Klebsiella pneumoniae were isolated from varied sites of the hospital, and 117(12.3%) of them were identified as CRKP, with a separation rate of 8.9% (26/292) in 2013, 11.3% (38/336) in 2014 and 16.2% (53/327) in 2015, which shows an increasing trend by year. 44.4% (52/117) of CRKP strains were separated from specimen of ICU, and 61.5% (72/117) were from sputum. Over 95% CRKP strains were resistant to ampicillin/sulbactam, aztreonam, imipenem, meropenem, ceftazidme, cefotaxime, cefepime,and piperacillin, while relatively low resistant rates were found in tigecycline (12.8%) and colistin (35.9%). The class 1 integron was detected in 77.8% (91/117) of CRKP strains. Class 1 integron of CRKP was significantly correlated with the antibiotic resistance to the tobramycin, gentamicin and amikacin (all P<0.01). The gene cassette analysis of variable area of class 1 integron showed that aadA2 accounts for 64.8% (59/91), aacA4-catB8-aadA1 23.1% (21/91), and aadA2-dfrA25 12.1% (11/91).Conclusions CRKP has an increasing trend in a clinical setting in China, and most of them were resistant to multiple antibiotics. Class 1 integron in CRKP has strong ability to capture the genes resistant to aminoglycosides antibiotics from environment, with the aadA2 gene as the most popular one.
Anti-Bacterial Agents ; pharmacology ; Carbapenems ; pharmacology ; Drug Resistance, Bacterial ; Integrons ; Klebsiella pneumoniae ; drug effects ; genetics ; isolation & purification

Objective The present study analyzed the performances of hearing impaired children and normal hearing children at age 3 on the open set monosyllables test to provide reference for rehabilitation .Methods 30 typi-cal children and hearing impaired children at age 3 were randomly selected and tested using the open -set monosylla-ble test in evaluation of auditory response to speech (EARS) .Results ① There were significantly differences be-tween different test items in both groups ,the decreasing order of the score was tone> vowel>consonant>word(P<0 .01) ,and the scores on vowels ,consonants and words of hearing -impaired children were respectively signifi-cantly lower than that in normal hearing children(P<0 .001) .②There were similarities and differences between the mistakes of typical children and hearing impaired children .Blade-palatals and laterals in both groups achieved the lowest accuracy .While the accuracies on bilabials ,labiodentals ,nasals and plosives were highest in typical children , the accuracy on velar was highest in hearing impaired children .And the accuracies of consonants and nasal vowels on each place and manner of articulation in hearing -impaired children were significantly lower .Conclusion The study showed that the performances on vowels ,consomants and words of hearing -impaired children aged 3 in the open set monosyllables test were poorer than that in normal hearing children .The main errors were between the same places or methods of articulation ,especially for Blade -palatals and laterals .It is possible related to the deficiency of lan-guage input with the hearing impairment and the age with HA/CI .

Objective To observe the therapeutic efficacy of acupuncture at the thirteen ghost points in treating postpartum depression and its effect on the quality of life. Methods Sixty patients with postpartum depression were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by acupuncture at the thirteen ghost points, while the control group was by oral administration of Fluoxetine. The Hamilton Rating Scale for Depression (HAMD) and the Short-Form (36) Health Survey (SF-36) were compared before and after intervention. Results The HMAD score was significantly changed in both groups after intervention (P＜0.05). There was a significant difference in comparing the HAMD score between the two groups after intervention (P＜0.05). There were significant differences in comparing the post-treatment bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), mental health (MH), and health transition (HT) between the two groups (P＜0.05). Conclusion Acupuncture at the thirteen ghost points can effectively improve the postpartum depression and the quality of life.

Objective To explore the establishment of peptide mapping database of Candida albicans ,laying the foundation for rapid diagnosis of Candida albicans infection .Methods 96 Candida albicans were collected clinically ,and its DNA was extracted . Polymerase chain reaction(PCR) was used to amplify the ITS1-5 .8S-ITS2 gene fragments and restriction endonucleases were a-dopted to identify them .Surface enhanced laser desorption ionization-time of flight-mass spectrometry(SELDI-TOF-MS) instrument was applied to detect the Candida albicans peptide mapping ,and Ciphergen ProteinChip software was used to collect data automati-cally .The established peptide mapping database was verified by confirmed Candida .Results According to restriction fragment length polymorphism analysis ,96 strains were confirmed as Candida albicans .15 peptide peaks were captured by SELDI-TOF-MS chips .Five peptide peaks of them with stable expression were screened out ,and the similarity analysis software was used to estab-lish peptide mapping database of Candida albicans .More than 95% of similarity was found between peptide mapping of Candida albicans and established database ,while less than 50% was found between peptide mapping of other Candida species and database . Conclusion The establishment of peptide mapping database of Candida albicans provides a theoretical basis for the rapid diagnosis of Candida albicans infection .

Objective To study the therapeutic value of endoscopy for secondary prophylaxis of esophagogastricvariceal bleeding(EGVB).Methods Records of 117 patients with EGVB who were treated with endoscopic ligation and/or histoacryl injection (n =55) and devascularization (n =62) from August 2006 to September 2014 were reviewed.Rebleeding rate,time of rebleeding,incidence of complication,cumulative survival rate,length of ward stay and mean total costs were compared between two groups.Indices were compared according to Child-Pugh.Results The rebleeding rate in the endoscopic group was higher than that in the surgical group[46.2％(24/52) VS 25.0％(15/60),P=0.019] during a mean follow-up of 32.5 months,especially in Child-Pugh B[60.0％(15/25) VS 22.2％(6/27),P=0.006].But the rebleeding time was similar between two groups(P＞0.05).The rate of complications in endoscopic group was lower than that in surgical group [20.0％ (11/55) VS 32.3％ (20/62),P =0.134].No significant difference in cumulative survival rate was observed between the groups (89.1％ VS 87.1％,P＞0.05).The length of ward stay[(14±9)d VS(23±8) d,P＜0.001] and mean total cost[(54 136.79± 44 836.32) yuan VS (73 601.86± 103 403.74)yuan,P＜0.05] in endoscopic group were significantly less than those in surgical group.Conclusion Therapeutic endoscopy is as effective as secondary prophylaxis of esophagogastric variceal bleeding.Endoscopic treatment leads to higher rebleeding rate,but is advantageous in similar rebleeding time,smaller injury,less complications,shorter length of ward stay and lower costs.

Objective To study the clinical characteristics and the influencing factors of hypertension in IgA nephropathy(IgAN)patients with normal renal function.Methods From 2002 to 2006,a total of 507 idiopathic IgAN patients with normal renal function(eGFR≥90 mL/min)confirmed by renal biopsy were treated in the First Affiliated Hospital of Sun Yat-sen University.The patients were divided into a hypertension group(n=93)and a normal group(n=414)according to the BP levels.Univariate and multivariate logistic regression analysis were used to analyze the relationship between the hypertension and the clinical characteristics.Results We found that 18.3%(93/507)of the IgAN patients had hypertension,with hypertension as the main symptom in some cases.Univariate analysis showed that male sex,older age,higher BMI,elevated level of triglyceride and cholesterol were the clinical risk factors for hypertension in IgAN patients(P

Objective To obtain the economic data in the aspects of cost-effectiveness and cost-utility of neonatal congenital hypothyroidism(CH) screening in Foshan City and to make assessment on the effect of screening works.Methods The economic related data were collected by the screening center,literatures,official resources and questionnaire investigation.The statistical tool and Tree Age Pro health decision analysis software were used to conduct the assessment on the cost-effectiveness and cost-utility of screening works.Results The screening program invested 17.95 million Yuan in total during 2000-2007,and the gain benefits was 117.69 million Yuan,net benefit was 9 975.52 ten thousand Yuan.The cost-benefit ratio was 1.00∶6.56.Each investing 3 216 Yuan could avoid a disability-adjusted life year.Conclusion The CH screening item has good economic applicability and is worth investing more funding for further promotion and popularization.

Objective To report a Chinese boy suffering from nephrotic syndrome associated with Schimke immuno-osseous dysplasia (SIOD). Methods The clnical data and pathological changes of renal biopsy were analyzed and associated literatures were reviewed. The clinicopathological features and diagnosis of SIOD were discussed. Results The first symptom of the patient was recurrent infections. Growth retardation, spondyloepiphyseal dysplasia accompanied by nephrotic syndrome and defective cellular immunity were seen as clinical features in this patient. Renal pathology showed focal segmental glomerulosclerosis. Conclusion Combining the clinical manifestation with renal pathology, the case is diagnosed as Schimke immuno-osseous dysplasia.

Objective To evaluate Mandarin disyllables recognition scores in noise for normal hearing people , and to establish a model for teaohing .The second goal is to get the spatial separated advantage while the noise chan‐ging its direction .Methods Percentage of correct word recognition was measured for each list by testing 50 Manda‐rin-speaking people aged from 18 to 30 with normal aural/oral communicational abilities And .6 of them joined the pilot study aimed to identify a presentation level that would be used in the formal test .The other 44 subjects partici‐pated in the formal speech test .Results When the noise was at 0 and 90 ,the speech recognition changed along with the change of signal-to-noise ratio levels .Despite of the speech recognition effect ,there was a strong relation be‐tween the signal-to-noise ratio of 0° and 90° .Conclusion The direction of speech and noise may strongly influence the speech recognition scores .When the noise and signal is separated ,the score will be better .

Objective To construct mutant strains of methicillin resistant Staphylococcus epidermi-dis (MRSE) with psm-mec gene deletion and to investigate the function of psm-mec gene.Methods The drug sensitivity test and DNA sequence analysis were performed to screen out the tetracycline and chloram -phenicol sensitive clinical strains of MRSE , whose upstream and downstream sequences of psm-mec gene were identical to those of the Staphylococcus epidermidis reference strain RP62A.The recombinant plasmid pBT2-Δpsm-mec was constructed by using the fusion PCR and a temperature sensitive shuttle plasmid .After being identified , the plasmid was transformed into the Staphylococcus aureus RN4220 strain by electropora-tion, and then transformed into the selected clinical isolates of MRSE .The mutant strains of MRSE with psm-mec deletion were screened out and identified after homologous recombination .The differences in biofilm formation between the mutant and wild-type strains were analyzed for further elucidation the relationships be-tween the psm-mec gene and biofilm formation in MRSE strains .Results Three clinical MRSE isolates for the construction of mutant strains with psm-mec gene deletion were screened out and identified by using drug sensitivity test and sequence alignment analysis .The mutants constructed via homogenous recombination were screened out and identified .Compared with the corresponding wild-type strains, the three mutants with psm-mec gene deletion showed significantly decreased ability of biofilm formation , demonstrating that the psm-mec genes strains induced the biofilm formation of MRSE .Conclusion The Δpsm-mec mutant strains were successfully constructed .The psm-mec gene played an important role in the biofilm formation of Staphy-lococcus epidermdis.