Objective To analyze risk factors of nosocomial pneumonias due to ESBL-producing Klebsiella pneumoniae.Methods From July 2001 to December 2004,38 patients with ESBL-producing K. pneumoniae and 63 patients with non-ESBL-producing K. pneumoniae were enrolled. ESBL-producing strains were detected by confirmed test.Results Hospital duration,ICU stay,tracheal intubation or tracheotomy,indwelling catheters,mechanical ventilation and use of cefotaxime were found to be risk factors in the acquisition of K. pneumoniae with ESBLs by univariate analysis. Cefotaxime use remained as risk factors by multivariate analysis with logistic regression. Conclusion The reasonable use of cefotaxime is an important measure to control the prevalence of ESBLs-producing strains of Klebsiella pneumoniae.

Objective To compare three methods for detecting extend-spectrum ?-latamases (ESBL s) and investigate current resistance of ESBL s.Methods 538 isolates of Enterobacter were detected by VITEK-AMS, compound piece type confirm test, and double-disk synergy test.Results 20.1% (108/538) was found to be ESBL s positive by VITCK-AMS. The positive rate of ceftaxime/clavulanic acid and ceftaxime compound pieces test was 19.5% (105/538). The positive rate of double-disk synergy test was 13.0%. The resistant rate of 12 antibiotics to ESBL s positive strains was significantly higher than ESBL s negative strains.Conclusions It is important to select the proper and rapid method to detect ESBL s in time.

Objective To investigate the relationship between chronic prostatitis and the coagulase-negative staphylococci (CNS),and to study the diagnostic value and clinical significance of CNS in expressed prostatic secretion (EPS). Methods Overall,428 patients with chronic prostatitis were included in this study.Their mean age was 31 years (range,18 to 46 years).The mean cause was 6 months (range,3 to 32 months).The mean NIH-CPSI score was 23.2.Bacterial culture and antimicrobial agent sensitivity test were applied to samples from the 428 patients.The samples were taken with 4 tubes from the lower urinary tract segmented by Meares-Stamey method. Results Bacteria were found in 248 patients (57.94%) out of 428 ones.Gram-positive bacteria were found in 195 cases(78.63%).In the 195 cases,staphylococci were found in 160 cases(64.25%,160/248).CNS were found in 89 cases(35.89%,89/248),most of which were epidermidis staphylococci 81 cases(32.66%).The next were saprophytic staphylococci 3 cases and hemolytic staphylococci 2 cases.There was no correlation between NIH-CPSI score and bacterial culture results.The sensitivity test results showed the rate of drug resistance of CNS from EPS was high for ?-lactamases,quinolones and aminoglycosides(51.9% to 100%). Conclusions The results suggest that CNS is a main kind of pathogen of chronic prostatitis,so considerable attention should be paid to it.In addition,it is of significant importance to apply bacterial culture and sensitivity test in EPS to the diagnosis and treatment of chronic prostatitis.

Objective To explore distribution and genetypes of plasmid-mediated quionlone resistance genes qnrA.qnrB and qnrS in Enterobacteriaceae isolates iu Renmin Hospital of Wuhan University.Methods The qnrA,qnrB and qnrS genes in Enterobaeteriaceae isolates including nonrepetitive 129 isolates of E.coli.13 isolates of E.cloacae and 37 isolates of k pneunoniae were detected by PCR.Antibiotic suseeptibility testing for 15 antibiotics were also performed by K.B in virto.MICs of ciprofloxacin were determined by agar dilution methed.Plasmid conjugatable test wag applied to examine whether qnrA,qnrB and qnrS genes were located in conjugatable plasmid.For qnr-positive strains,integrase I and SHV-1,TEM-1,CTX-M,OXA-I,OXA-Ⅱ,OXA-Ⅲ,DHA and EBC β-lactamases genes were examined.Results 25 qnr-positive isolates were detected among 179 Enterobaeteriaceae isolates,including 6 qnrA-positive isolates,9 qnrB-positive isolates and 10 qnrS-positive isolates,which were presented in 3.35%.5.02%,and 5.59%respectively.All positive isolates were susceptible to imipenem but resistance to some other drugs.2 qnrA-positive isolates and 4 qnrB-positive isolates of them were susceptible to Quinolones.The plasmid wag eonjugatable in 2 qnrA-positive isolates and 4 isolates carrrying qnrB and qnrS.23 qnrA-positive isolates harbored type 1 Integrase,but one isolate with both qnrB and qnrS did not carry Type 1 Integrage.14 isolates of them were TEM-1 producing strains.6 isolates were OXA-Ⅲ-producing strains.and 7 isolates of them were EBC-producing strains.Conciusions In HuBei province,a low prevalence of qnrA,qnrB and qnrS wag determined in Enterebacteriaceae isolates.Muhidrng-resistance was found in qnr-pesitive isolates and qnr genes were detected in quinolone susceptible strains.Extendedspectrum β-lactamages could be presented in qnr-positive isolates too.

Objective To investigate the distribution of CYP2C19 metabolism phenotype in patients with clopidogrel treatment in Huangshi.Methods The peripheral blood samples were obtained from 76 patients with clopidogrel treatment in Cardiovascular Department.CYP2C19 genotypes were determined by the gene chip,CYP2C19 metabolism phenotype were investigated and com-pared with the data of healthy Han Chinese from the published papers.Results There were three kinds of metabolizers about the metabolism phenotypes of CYP2C19,which were extensive metabolizers,intermediate metabolizers and poor metabolizers.In the 76 patients,the ratios of these metabolism phenotypes were 39.47%,44.74% and 15.79%,respectively.The result coincided with the healthy Han Chinese.Conclusion The clinical individualized medication of healthy Han Chinese could be refered to the clinical indi-vidualized medication of patients with clopidogrel treatment in Huangshi.

Objective To study the effect of UHRF1 expression inhibition by RNA interference on the radiosensitivity of esophageal cancer cell line TE-1 and its mechanism.Methods Short hairpin RNA (shRNA) targeting UHRF1 gene was introduced into TE-1 cells by lentivector-mediated transfer.The cells were divided into three groups:non-transfected group,negative control (NC)-shRNA-transfected group,and UHRF1-shRNA-transfected group.The mRNA and protein expression levels of UHRF1 in TE-1 cells were measured by RT-PCR and Western blot before and after transfection.After transfection and X-ray radiation,the radiosensitivity of TE-1 cells was evaluated by colony formation assay; the cell cycle and cell apoptosis were determined by flow cytometry; the γ-H2AX (as a marker of DNA damage) level was measured by Western blot.Results After transfection with UHRF1-shRNA,the mRNA and protein expression levels of UHRF1 were significantly decreased in TE-1 cells,as compared with those in the NC-shRNA-transfected group and non-transfected group (0.11 vs 0.96 and 0.98,F =124.21,P =0.000;0.10 vs 0.89 and 0.94,F =125.25,P =0.000).The UHRF1-shRNA-transfected group had sensitization enhancement ratios of 1.53 (D0 ratio) and 1.95 (Dq ratio).X-ray radiation could cause G2/M arrest and increase apoptotic rate and γ-H2AX expression in TE-1 cells.Compared with the two control groups,the UHRF1-shRNA-transfected group showed significantly less G2/M arrest (F =500.15,P =0.000),a significantly higher apoptotic rate (F =100.10,P =0.000),and significantly higher residual γ-H2AX expression (F =61.00,P =0.000) at 24 hours after X-ray radiation.Conclusions RNA interference can effectively inhibit the UHRF1 expression and enhance the radiosensitivity of TE-1 cells.The mechanism may be related to cell cycle regulation,cell apoptosis,and DNA damage repair.

Objective To explore antibiotics resistance profiles and DNA fingerprints of Pseudomonas aeruginosa isolates resistant to imipenem (IRPA). Methods DNA fingerprints of 56 strains isolated from ICU (intensive care unit) were constructed by ERIC-PCR (enterobacter repetitive intergenic consensus-PCR). MICs (minimal inhibitory concentrations) were determined by agar dilution method.Results 33 genotypes were got from 56 strains by ERIC-PCR. Of 8 frequently used antibiotics, 5 of them showed resistance rate higher than 50%. Conclusion It is high time to pay attention to multi-drug resistance of IRPA. The exist of prevalence of IRPA clone in ICU advise us to control of IRPA in hospital effectively.

Objective To study the infection condition of AmpC ? lactamases producing strains for reasonable use of antibiotics in clinic. Methods Adopting modified three dimensional extract test was adopted to detect enterobacteriaceae strains, and 12 antibiotics were determined by the antimicrobial disk diffusion susceptibility tests in specimen collected from 233 senile infectious patients. Results The total isolating rate of AmpC ? lactamases producing enterobacteriaceae strains in senile patients was 8 6%. The incidence of AmpC ? lactamases producing strains was found most often in E.cloacae. The AmpC ? lactamases producing strains were susceptive to imipenem and there the resistance rates to imipenem were 100 0%. The resistance rates to cefepime were 85%～100% to the third generation cephalosporins and aztreonam Conclusions The drug resistance of AmpC ? lactamases producing enterobacteriaceae is very serious. It is important to surveillance and control drug resistance of AmpC producing strains.

Objective:To detect the clinical features of vulvar and vaginal intraepithelial neoplasias(VIN and VAIN,respectively).Methods:Total 148 women were performed vulvar or vaginal coloposcopy-directed biopsy pathology tests,from Sep.2004 to Dec.2007.Results:Among 148 women,vulvar or vaginal histologic results were vulvar cancer for 1,VIN or VAIN 2,3 for 23,VIN or VAIN for 16,condyloma for 61,vulvitis and vaginitis for 47.Eighty-five percent(33/39) women with VIN or VAIN 2,3 were more than 30 years old.Compared to women with cervical intraepithelial neoplasia(CIN),women with VIN or VAIN were older.The rate of high-risk HPV DNA in women with vulvar or vaginal lesions was 84%(84/100).VAIN occurred mainly in the upper vagina(90%,69/75).VIN or VAIN often accompanied or followed CIN or cervical cancer(79%,31/39),and VIN or VAIN 2,3 often accompanied or followed CIN 2,3 or cervical cancer(70%,16/23).Conclusion:Our data suggest that women with high-risk HPV infection are at risk of developing VIN or VAIN 2,3.The vulva and vagina should be carefully inspected by colposcopic examination at the time of colposcopy for any abnormal findings.