0.05). NDP had lower reaction rate, vomiting (15.62%) occurred in NDP group, compared to that which occurred in DDP group (46.88%), with a significant difference between the two groups (P

OBJECTIVE To investigate the prevalence of erythromycin resistance genes ermB and mefA and the relationship of drug resistance and genes in Streptococcus pneumoniae.METHODS Forty three strains of S. pneumoniae were collected from respiratory system infected children from Dec 2004 to Oct 2005 at Yuying Pediatric Hospital of Wenzhou Medical College.Erythromycin sensitivity test was done by using MIC method.The erythromycin resistance genes ermB and mefA were detected by PCR.RESULTS In all forty three strains,forty were erythromycin resistant(93%),three were erythromycin sensitive.The total detection rate of erythromycin resistance genes ermB and mefA was 76.7% and 23.3%,respectively.There were neither gene ermB nor gene mefA in 3 erythromycin-sensitive S.pneumoniae.In 40 strains the detection rate of gene ermB was 82.5% and that of gene mefA was 25%.The erythromycin resistance gene ermB or mefA were detected in 35 of the 43 strains.The total detection rate of erythromycin resistance gene was 81.4%.In the 35 erythromycin resistance strains there were 25 strains in which gene ermB existed lonely and 2 strains in which gene mefA existed lonely.There were both genes ermB and gene mefA in 8 of the 35 erythromycin resistance strains.CONCLUSIONS The erythromycin resistance of S.pneumoniae can be caused mainly by gene expression of ermB or mefA,but the gene mefA seems to be less important than gene ermB.Obviously the erythromycin isn′t useful in treating S.pneumoniae infection.

Objective In order to choose a suitable method in detecting MRS,the detection rate,sensitivity and specificity of Vitek-32 auto microbacteria indentity system,oxacillin agar dilution test,cefoxitin disk diffusion test and PCR for mecA gene are evaluated.Methods MRSA and MRCNS are detected by the four methods metioned above in 175 staphylococci,then comparing the postive detection rate by Chi-square test and calculating sensitivity and specificity of the other three methods based on PCR for meeA gene as a gold standard.Results The detection rate of four methods have no difference in detecting MRSA,but the detection rate of Vitek-32 auto microbacteria indentity system and oxacillin agar dilution test is better than that of PCR for mecA gene in detecting MRCNS.Sensitivity and specificity of Vitek-32 auto microbacteria indentity system,oxacillin agar dilution test and cefoxitin disk diffusion test in detecting MRSA are 100%、96.3%、96.3% and 88.2%、100%、100% respectively,the sensitivity of detecting MRCNS are all 100%,the specificity of detecting MRCNS are 50%、46.1% and 65.4% respectively.Conclusions Both mecA gene and the determination for MIC of Oxacillin should be considered in final decision for MRS,Furthermore.the MRS mediated by mecA gene and the MRS mediated by non-mecA gene should be treated differentially.

Objective To establish loop-mediated isothermal amplification(LAMP)method for detecting Streptococcus pneumoniae in clinical samples.Methods Four Streptococcus pneumoniae-specific LAMP primers were designed according to the published sequence of strain R6(GenBank accession number AE008540).Genomie DNA in positive blood cultures was extracted by nanidine hydrochloride and benzene-methanol.Then lytA was amplified by LAMP at 63℃ for 45 minutes.We observed the turbidity in thereaction tube.For further confirmation.The amplified products were also detected using electrophoresis in 2% agarose gels,followed by ethidium bromide staining.Resuits 16 strains of Streptococcus pneumoniae were detected in 196 positive blood cuhure bottles by LAMP.Compared with traditional method.It8 sensitivity and specificity were both 100%and the detection could be finished in an hour.The assay had a minimum detection limit of 102 CFU/m1.Conclusions This IJAMP-based assay is simple,rapid.Sensitive and specific.It can be used to detect trept OCOCCUS pneumoniae in clinical samples.

OBJECTIVE To establish a method of polymerase chain reaction(PCR) for detecting staphylococci in positive blood culture bottles.METHODS Genomic DNA in 493 positive blood culture bottles was extracted by guanidine hydrochloride and benzenemethanol,then genes 16S rRNA,ssa and mecA were amplified by PCR to identify staphylococci.Finally,the results of PCR were compared with that of traditional method.RESULTS To compare with traditional method,as the golden standard the sensitivity and specificity of PCR method were 98.6% and 100.0%,respectively,the detection could be finished in four hours.Method of PCR was better than traditional method in detecting meticillin-resistant staphylococci.CONCLUSIONS The PCR-based assay is simple,rapid,sensitive and specific,it can be used to detect staphylococci in positive blood culture bottles.

OBJECTIVE: To investigate the prospective efficacy of chronic sinusitis lost to short-term follow up after nasal endoscopic surgery and the influential factors. METHOD: Prospective efficacy of 153 chronic sinusitis (CRS) was evaluated . All cases were treated by nasal endoscopic surgery at least 1 year ago but lost to follow up within 3 months after surgery. The clinical data of 153 patients were analyzed, including gender, age, educational level, course of the disease, smoking and drinking history, early surgery history, allergic rhinitis (AR) history, nasal polyps, visual analogue scale (VAS) score, nasal endoscopy score, CT examination score, the endoscopic experience of surgeons, medication of intranasal glucocorticoid and nasal irrigation after surgery. Multifactor logistic regression analysis were used to analyze the data. RESULT: Among 153 patient, the symptoms of 32 cases (20.9%) were completely control, while those of 74 cases (48.4% ) were partially control, and the symptoms of 47 cases (30.7%) were not controlled. The curative effect were better for CRS without nasal polyps, AR or early surgery history, with CT examination score < or = 5, operated by surgeons with experience of endoscopy surgery for more than 5 years. and treated with intranasal glucocorticoid for more than -1 weeks after surgery. CONCLUSION Postsurgery follow-up should be paid more attention to in treatment of CRS. Plans of follow up should be adjusted to patients condition. Treatment of postoperative sinus cavity should be minimized when the lesion is slight and operated properly.
Adult ; Aged ; Chronic Disease ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Male ; Middle Aged ; Sinusitis ; surgery ; Treatment Outcome

Objective:To study the correlation between chronic urticaria and Helicobacter pylori infection,and to explore the significance of HP detection in the diagnosis and treatment of chronic urticaria. Methods: Totally 420 cases of chronic urticaria,who were treated in outpatient department from April 2014 to July 2015,and 450 cases of healthy physical people were selected randomly as healthy control group in the same period,then the serum HP unease antibody was detected by colloidal gold method,the positive rate of two groups patients with HP was analysed. Meanwhile 162 chronic urticaria patients with positive HP were divided into experimental group with 88 cases and control group with 74 cases. The patients in the control group were treated with conventional treatment,while the experimental group were treated with triple therapy based on the treatment of control group,and the clinical efficacy of different ther-apeutic methods was analysed in the chronic urticaria patients with positive HP. Results: The positive rate of HP in chronic urticaria group was 38. 6%, and the positive rate of HP in healthy control group was 14. 4%, the difference was statistically significant ( P<0. 05). The effective rate of clinical efficacy in the experimental group was significantly higher than the control group(P<0. 05). Con-clusion:There is close correlation between chronic urticaria and HP infection,HP detection has important clinical significance for the diagnosis and treatment of chronic urticaria.

Objective To investigate mutation and deletion of genes mecR1 and mecI in clinical methicillin-resistant staphylococci isolates and study the mutation and deletion have effect on gene mecA expression and drug resistance phenotype.Metheods PCR was used to detecte gene mecA and the regulatory genes mecR1 and mecI in staphylococci which were separated from clinical specimen in 2006,then the sequence of gene mecI was determined and compared with the sequence obtains from pre-MRSA strain N315(GI:BA000018).Results Gene mecA was detected in 60 strains of Staphylococcus aureus,58 strains of Staphylococcus epidermidis and 37 strains of Staphylococcus heamolyticus,but gene mecA in 6 strains of Staphylococcus epidermidis and 4 strains of Staphylococcus heamolyticus were only amplified by primer mecA2-F/R and not by primer mecA1-F/R.The percentage of gene mecR1 exist in Staphylococcus aureus was higher than Staphylococcus epidermidis and Staphylococcus heamolyticus,but the percentage of gene mecR1 exist in Staphylococcus epidermidis was not higher than Staphylococcus heamolyticus.The mutation and deletion of gene mecI were often seen,the wild type mecI was only detected in 14 strains,the point mutation of nucleotice 202 was detected in 36 strains.Conclusions Gene mecA expression in Staphylococcus aureus could be chiefly induced by mecR1,but which in coagulase-ngeative staphylococci could be other factors.The mutation and deletion of mecI were universal phenomenon in clinical strains,there could be a mechanism for overcoming the repressing of resistance caused by mecI in staphylococci.

Objective To explore the inflnence of autologous peripheral blood hematopoietic stem cell transplantation (auto-HSCT) for lymphoma process on the quality of patients blood coagulation.Methods Plasma samples were collected before the conditioning and on day 0,7,14,28,35 follow auto-HSCT from 20 patients.The following parameters were measured:prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB) and D-dimer(D-Di).Results Compared with the values before conditioning,a significant rise in the FIB values was detected on day 7 and day 14 after auto-HSCT,no essentially change in the FIB values was detected on day 21 and day 28 and day 35 after auto-HSCT.Other coagulation parameters investigated(PT.APTT.D-Di) remained essentially unchanged.All of the patients not concurrent thrombotic disease.Conclusion Lymphoma patients with autologous peripheral blood hematopoietic stem cell transplantation appear abnormality in coagulant function.Clinical doctors should concern.

Objective To investigate the influencing factors for post-discharge treatment compliance of patients with multidrug-resistant tuberculosis (MDR-TB).Methods MDR-TB patients who were hospitalized in a tubercu-losis hospital between November 2011 and January 2013 were chosen,post-discharge follow-up was conducted regu-larly through telephone call.Medicine-taking and re-examination of patients was inquired,factors influencing pa-tients’treatment compliance were analyzed.Results 299 patients were included in the study,the total treatment compliance rate was 81 .94% (n=245);249(83.28%)patients regularly took medicine,50(16.72%)didn’t regu-larly take medicine;254 (84.95%)were re-examined on time,45 (15.05%)were not re-examined on time;37 (12.37%)discontinued treatment,260 (86.96%)continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate,timely re-examination rate,interrupted treat-ment rate,and total compliance rate)was significantly different among MDR-TB patients of different ages,education levels,treatment time,and with or without adverse reactions(all P <0.05 ).Logistic regression analysis revealed that treatment compliance of MDR-TB patients was negatively correlated with treatment time(β=-1 .47,Wald χ2=24.28,P <0.05)and adverse reactions(β=-2.02,Waldχ2 =24.24,P <0.05 ),while positively correlated with education levels(β=0.79,Wald χ2 =6.50,p <0.05 ).Conclusion Prolonged treatment time and adverse reactions can reduce the treatment compliance of MDR-TB patients,the higher education levels of MDR-TB patients have, the better treatment compliance they implement.