Objective To investigate the mechanism of fluoroquinolone resistance in clinical isolates of Enterococcus faecium. Methods The MICs of six fluoroquinolones(norfloxacin,ciprofloxacin,ofloxacin,levofloxacin,gatifloxacin and moxifloxacin) against 35 clinical isolates of E.faecium from eight hospitals in Tianjin were determined by agar dilution method in the absence or presence of multidrug resistance efflux pump inhibitor reserpine.The quinolone-resistance determining region(QRDR)of parC and gyrA were amplified and sequenced.Results No less than twofold decrease in MIC values of the six fluoroquinolones in the presence of reserpine was observed in 35,29,1,0,6 and 2 of the 35 strains of E.faecium respectively.One fluoro- quinolone-susceptible isolate and five fluoroquinolone-resistant isolates were selected randomly to analyze the QRDR of parC and gyrA.All five fluoroquinolone-resistant isolates had single amino acid alteration in both GyrA and ParC.Ser-80 in ParC was substituted by lie(4 isolates)or Arg(1 isolates).Glu-87 in GyrA was replaced by Lys(2 isolates)or Gly(2 isolates). The other one had an Ser-83-to-Ile substitution.The one fluoroquinolone-suseeptible isolate had no alteration in the QRDR of either ParC or GyrA.Conclusions Both target alteration and active efflux are responsible for the resistance to fluoroquinolone in clinical isolates of E.faecium.

OBJECTIVETo explore the clinical techniques and effects of repairing skin defects of the forefoot by free perforating flap nourished by peroneal artery.

METHODSFrom June 2007 to June 2011, 11 patients with skin and soft tissue defects of the forefoot were repaired by free peroneal artery perforating flap in emergent or subemergent. There were 10 males and 1 female with an average age of 28.6 years old ranging from 23 to 46 years old. Among them, 4 cases injured for traffic accidents, 3 for crush and 4 for machine strangulation. In all cases, the defect area of forefoot tissue varied from 2.0 cm x 4.0 cm to 4.0 cm x 8.5 cm,and the adopted area varied from 2.5 cm x 4.5 cm to 4.0 cm x 9.0 cm. The operation time was from 6 to 96 h (averaged 31.8 h). The blood vessels were anastomosed end-to-end.

RESULTSAll of the transferred free flaps survived uneventfully. Nine of them were successfully followed up from 6 to 24 months. The appearance, elasticity and functions of flaps were satisfied accompanied with slight damage of donor site although seemed bloated. The smaller donor site could be intimately seamed if necessary.

CONCLUSIONThe vessels anatomy of knee with antegrade extended peroneal artery was relative constant with a moderate thickness and simple operation, is useful to repair small or middle areas of skin defects in forefoot.

Adult ; Female ; Foot Injuries ; surgery ; Forefoot, Human ; surgery ; Free Tissue Flaps ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Young Adult

Objective:To explore the clinical techniques and effects of repairing skin defects of the forefoot by free perfo-rating flap nourished by peroneal artery. Methods:From June 2007 to June 2011,11 patients with skin and soft tissue defects of the forefoot were repaired by free peroneal artery perforating flap in emergent or subemergent. There were 10 males and 1 fe-male with an average age of 28.6 years old ranging from 23 to 46 years old. Among them,4 cases injured for traffic accidents,3 for crush and 4 for machine strangulation. In all cases ,the defect area of forefoot tissue varied from 2.0 cm × 4.0 cm to 4.0 cm × 8.5 cm,and the adopted area varied from 2.5 cm×4.5 cm to 4.0 cm×9.0 cm. The operation time was from 6 to 96 h (averaged 31.8 h). The blood vessels were anastomosed end to end. Results:All of the transferred free flaps survived uneventfully. Nine of them were successfully followed up from 6 to 24 months. The appearance ,elasticity and functions of flaps were satisfied ac-companied with slight damage of donor site although seemed bloated. The smaller donor site could be intimately seamed if nec-essary. Conclusion:The vessels anatomy of knee with antegrade extended peroneal artery was relative constant with a moderate thickness and simple operation,is useful to repair small or middle areas of skin defects in forefoot.

Adult ; Aged ; Alanine Transaminase ; blood ; Blood Platelets ; chemistry ; Cholesterol ; blood ; Dietary Fats ; metabolism ; Fatty Acids ; blood ; Fatty Liver ; blood ; etiology ; metabolism ; pathology ; Female ; Humans ; Liver ; metabolism ; pathology ; Male ; Middle Aged ; Phospholipids ; blood ; Risk Factors ; Triglycerides ; blood

Objective To establish UV spectrophotometry and HPLC methods for content determinations of total flavonoids and puerarin from Puerariae Lobatae Radix and Puerariae Thomsonii Radix; To compare the ultrasonic method at room temperature, conventional refluxing method and ultrasonic method at heating conditions at the aspect of content determinations. Methods The content determinations of total flavonoids was determined by UV spectrophotometry at 250 nm; the content of puerarin was determined by HPLC with octadecylsilane-bonded silica gel as the stationary phase, a mixture of methanol and water (25:75) as the mobile phase, 256 nm as the detection wavelength, 1.0 mL/min as the flow rate. Results Contents of total flavonoids in Puerariae Lobatae Radix by ultrasonic method at room temperature, conventional refluxing method and ultrasonic method were15.09%, 14.48%, and 12.71% (n=3), respectively. The contents of puerarin were 4.37%, 4.09%, and 3.80% (n=3), respectively. Contents of total flavonoids in Puerariae Thomsonii Radix were 2.09%, 2.23%, and 2.17% (n=3), respectively. The contents of puerarin were 0.50%, 0.53%, and 0.52% (n=3), respectively. Conclusion Ultrasonic method at room temperature can replace conventional refluxing method for content determinations of total flavonoids and puerarin from Puerariae Lobatae Radix, and ultrasonic method at heating conditions also can replace conventional refluxing method for content determinations of total flavonoids puerarin from Puerariae Thomsonii Radix. Puerarin contents from Puerariae Lobatae Radix and Puerariae Thomsonii Radix in South Anhui Province are all in line with the Pharmacopoeia standards.

Objective According to results from the two-month consecutive surveillance program in Maanshan,six suspected cases of non-O1 non-O139 Vibrio (V.) cholerae infection,were found that called for identification of pathogens as well as molecular-epidemiological analysis to determine the aggregation of the epidemic situation.Methods Biochemical and serotype identification,hemolysis test,and drug sensitive test were used to detect the drug resistance spectrum.Real-time PCR and conventional PCR were used to detect the presence of V.cholerae specific genes,virulent genes and its related genes,including ompW,ctx,tcpA,toxR,hlyA,zot,ace,rstR and g ⅢCTX.Pulsed-field gel electrophoresis (PFGE) was used to analyze the molecular type of strains.Results All the six isolates of non-O 1 non-O 139 V.cholerae were identified by biochemical and serologic tests,and appeared to be β hemolytic.Twelve out of the 14 kinds of drugs showed 100％ sensitive.All isolates were positive of ompW gene by real-time PCR,but negative for ctx,tcpA,zot,ace,rstR and gⅢ CTK.Five of the six isolates were positive for toxR and hlyA,except for strain 1001434446.All strains had different PFGE types,but two strains had similar types.All strains had a low similarity compared to the toxigenic V.cholerae.Conclusion Six cases ofnon-O1 and non-O139 nontoxigenic V.cholerae infection appeared in the same period.Along with epide(m)iological information,we noticed that these cases had a sporadic nature,but frequently appeared in the same area.We got the impression that public health measurements should be strengthened,with special attention paid to those diarrhea outbreaks caused by non-O 1 /non-O 139 strains since V.cholerae had appeared in low incidence.