ored carefully.

Objective To research the distribution and the characteristics of the plasmid mediated quinolone resistant genes in Shewanella algae. Methods The qnr, qepA, aac(6')-Ib-cr genes were amplified by PCR, then the positive PCR products were sequenced to determine the gene type. The transferability of plasmid mediated quinolone resistance was ensured by conjugation experiment. MICs were measured by E-test. qnrA gene was mapped to plasmids to locate it. Results The qnrA gene were detected in the Shewanella algae, this is a newfound subgroup qnrA7, the GenBank accession no. was GQ463707, qnrB, qnrS,qnrC, qnrD, qepA and aac(6')-Ib-cr genes were not detected. qnrA7 reside in a plasmid about 33 kb, conjugation experiment was unsuccessful. The strain was susceptible to quinolones. Conclusion It deserves paying close attention to the report of an original qnrA subgroup in an isolate of water-borne species of Shewanella algae.

Objective To understand the status of type 2 diabetes mellitus (T2DM) patients′ trust in their family physicians, and to explore the role of the trust on patients′ medication adherence. Methods A total of 1078 patients with T2DM were recruited by cluster and systematic sampling method, from ten rural communities in Sanlong township in Yancheng city and five rural communities of Pingchao township in Nantong city, during February to April in 2018. The survey covered their trust behavior and attitude scale (PTBAS), and an 8-item Morisky medication adherence scale ( MMAS-8). Both measurement data and enumeration data were subject to descriptive analysis by mean ± SD and proportion respectively. Multiple linear regression was employed to explore the determinants of trust in physicians. Ordered logistic regression analysis was used to explore the relationship between patient-physician trust and medication adherence. Results The mean scoring of patients′ trust and medication adherence was 20. 16 ± 2. 13, 7. 07 ± 1. 54 respectively. 55. 40 percent of the patients had high medication compliance, 28. 53 percent of them had medium compliance and 16. 07 percent had poor compliance. Multiple linear regression analysis showed that the patient′s occupation, course of disease, self-reported health status and mental health status influenced their trust behavior (P < 0. 05). Ordered logistic regression analysis showed that each 1 point increase in patient′s trust in physicians, the medication compliance increased by 11. 0％ (OR = 1. 110, P < 0. 001). Medication adherence is also affected by age, employment status, course of illness, and mental health status. Conclusions Diabetes patients′ trust in their family physicians improves their medication adherence.

Objective To explore the prevalence and characteristics of occult hepatitis B virus infection （OBI） among blood donors in Huzhou region. Methods A total of 31 348 blood donors collected from October 2018 to February 2020 were selected for detecting HBV infection markers by serological and nucleic acid detection techniques. According to the detection results， 27 cases of HBsAg double negative （two kinds of reagent detection）， nucleic acid amplification technology （NAT） positive samples were identified as the occult HBV infection group （OBI group）； 25 cases of HBsAg double positive （two kinds of reagent detection）， NAT positive samples were identified as dominant HBV infection group， respectively. HBV nucleic acid quantitative detection， serum hepatitis B three line markers， liver function markers detection， and the results of the two groups were compared and analyzed. Results There were 31 034 HBsAg negative blood donors， 27 of whom were HBV-DNA positive， and the prevalence of OBI was 0.87 ‰. Six kinds of serology were found in 27 OBI patients， among which 25 cases （92.6%） were HBcAb， 17 cases （63.0%） were HBsAb， 17 cases （63.0%） were HBeAb， 15 cases （55.6%） were HBcAb and HBsAb， and 14 cases （51.9%） were HBcAb and HBeAb. There was no significant difference in gender， HBcAb positive rate， TBI， AST and ALT between the two groups （ P >0.05）. There were significant differences in age and HBsAb level （ χ ²=1.201， P <0.001； t =28.336， P <0.001）， and the average viral load was （25.86±19.68） IU/mL， which was significantly lower than the average viral load of the control group （3 254.65±535.98）IU/mL（ t =32.412， P <0.01）. Conclusion There is a certain prevalence of OBI in blood donors in Huzhou area. The main kinds of serology are HBcAb and HBsAb. Serological detection combined with nucleic acid detection can ensure the safety of blood transfusion and reduce the risk of blood borne diseases.

【Objective】 To analyze the characteristics of gene mutation in S region of blood donors with occult hepatitis B virus infection (OBI) in Huzhou area. 【Methods】 A total of 60 107 blood samples in Huzhou between October 2018 and June 2020 were collected by our blood station. Among them, 52 samples were NAT, yield and their epidemiological characteristics were analyzed. Twenty-seven OBI out of the 52 NAT yield samples were included in experimental group. Other eight HBV-infected individuals with positive HBsAg, core antibody (anti-HBc) and HBV-DNA were selected as positive control. Liver function and 5 serological markers of HBV were compared between the two groups, and HBV genotypes and amino acid mutation in S region in the two groups were analyzed. 【Results】 The number of NAT-yield samples were different by gender, age, and educational background (P<0.05). In 18~30 aged donor population, the number of NAT-yield samples were significantly more in males than in females (P<0.05). No significant differences in liver function indicators, e antigen (HBeAg), and anti-HBc were noticed between the two group (P>0.05). Surface antigen (HBsAg) in the experimental group was significantly lower than that in the control group, while surface antibody (anti-HBs) and e antibody (anti-HBe) were significantly higher than those in the control group (P<0.05). Twenty sequences in S region were obtained from the experimental group, including 4 in S region and 16 in preSS region; 16 cases with type C and 4 cases with type B. 【Conclusion】 The follow-up of NAT-yield blood donors in Huzhou area should be conducted. Compared with HBV infected individuals with positive HBsAg, anti-HBc and HBV-DNA, those with OBI have a higher gene mutation rate in S region.

【Objective】 To investigate the prevalence of occult hepatitis B virus infection (OBI) among blood donors in Huzhou, and to analyze the viral load and molecular characteristics of OBI. 【Methods】 45 368 blood samples were screened by enzyme linked immunosorbent assay (ELISA) and nucleic acid testing (NAT) for HBV infection from October 2018 to February 2020 in our center. HBsAg-/NAT+ blood donors were studied as experimental group, contemporary HBsAg+ /NAT+ donors as the control. The serum viral nucleic acids of the two groups were extracted, and HBV DNA copies were detected by real-time PCR, the differences between the two groups were compared. The S region gene of the virus was amplified and sequenced by Nested PCR, then compared with the reference sequence of HBV wild type, in order to confirm the genotyping and molecular mutation characteristics of S region. 【Results】 36 samples were confirmed as OBI (0.08%, 36 / 45 368). The HBV DNA load of 8 samples was lower than the detection limit, and the average HBV DNA load of other 28 samples was (42.3±1.24) IU / mL, which was significantly lower than that of the controls (3.32±1.94) ×10⁴ IU / mL(P<0.05). Among the 28 OBI samples, 20 were type B (71.43%), and 8 were type C (28.57%). The frequency of amino acid variation in HBsAg epitopes was significantly higher in OBI than in MHR(P<0.05). 【Conclusion】 The viral load of OBI blood donors in Huzhou, mainly genotype B, is low, and the variation sites were mainly focused in HBsAg epitope and amino acid region (124~147).