Objective To investigate the spreading characteristics of plasmid-mediated resistance and the clones dissemination in multidrug resistant Klebsiella pneumoniae.Methods A total of 53 strains of multidrug resistant Klebsiella pneumoniae were successively collected from the First Affiliated Hospital,Zhejiang University School of Medicine during December 2009 and February 2012.Antimicrobial agents susceptibility was determined by Kirby-Bauer (K-B) method,and pulsed field gel electrophoresis (PFGE) was used to investigate the clonality of clinical isolates.Filter mating method was used for plasmid conjugation,and the relative molecular mass of the plasmid was determined using S1-PFGE assay.PCR amplification and sequencing were used to screen common antimicrobial resistance genes.Results Fiftythree clinical isolated Klebsiella pneumoniae strains were all resistant to penicillins,and their sensitive rates to piperacillin/tazobactam,cefoperazone/sulbactam were below 15％.More than 86％ strains were resistant to cephalosporins,and 60％-70％ strains were resistant to quinolones,sulfonamides and tetracyclines.About 50％ strains were resistant or intermediate sensitive to carbapenems.PFGE results did not support the evidence of clone dissemination.Resistant isolates harbored conjugant plasmid with 34 000-355 000 bp size,which encoded penicillins,cephalosporins,carbapenems or aminoglycoside resistant determinants,including CTX-M,TEM,KPC type β-1actamase genes and plasmid-mediated quinolone resistance gene qnr.Conclusions Multidrug resistance is prevalent in clinical Klebsiella pneumoniae isolates.Rapid prevalence of resistance is mainly determined by conjugant plasmid horizontal transfer rather than simple clone dissemination.

[Objective] To study the influence on humoral immunity and ectopic endometrium by infusion of Bushen Tiaojing Decoction (BTD) with the Huoxue Sanjie Suppository (HSS) in anus. [Methods] One hundred and thirty SD rats were allocated to ten groups: normal control (A), model (B), normal dose of HSS (C), normal dose of BTD with HSS (D), 3 doses of BTD (E), 3 doses of BTD with HSS (F), 5 doses of BTD (G), 5 doses of HSS (H), 5 doses of BTD with HSS (I), and Danazol (J) groups. The endometriosis (EM) rats were modeled by endometrium implantation in all groups except those in Group A. Four weeks after the treatment, the contents of immunoglobulin (IgG、IgM、IgA), C_3, C_4 and ALT were tested, and histomorphomological analysis of the thymus, ovary, uterus, EM implants, liver and kidney were performed. [Results] Four weeks after EM implantation, the ectopic endometria were growing well, IgG and C_3 increased, but IgM decreased, and the uterus and ovary significantly enlarged. With the treatment of BTD and HSS or Danazol, the ectopic endometria were atrophied. In Groups F and G, IgG decreased; in Groups H and I, C_3 decreased, and uterus and ovary shrunk in Group I. Danazol can help to prolong the sexual cycle, while BTD and HSS can not. In all the medication groups, no obvious difference was found in ALT of the rats. [Conclusion] Oral administration of BTD with HSS can cause endometrial atrophy and improve humoral immunity in model rats.