Objective To study the genes of a carbapenem-resistant Klebsiella pneumoniae strain isolated from a patient. Methods The antibiotic sensitivity test of a multidrug-resistant Klebsiella pneumoniae strain was done according to K-B and MIC method. Metallo-β-lactamase was detected by Modified Hodge Test and EDTA-disk synergy test. Both nine genes encoding β-lactamases, including blaKPC, blaIMP , blaVIM , blaSME , blaCTX-M , blaSHV, blaDHA , blaACT, Class Ⅰ integrase and Class Ⅰ integron were detected by PCR. Positive products were sequenced. Results The Klebsiella pneumoniae was resistant to carbapenems, cephalosporins, cefoxitin, ampicillin and trimethoprim/sulfamethoxazole. Only susceptible to aztreonam, gentamicin, tobramycin, amikacin, ciprofloxacin and levofloxacin. The blaIMP-1 and Class Ⅰ integron were positive. The blaIMP gene was identified by PCR and DNA sequencing confirmed that the gene belong to IMP-1 type Metallo-β-lactamase gene. The strain also carried Class Ⅰ integron and IMP-1 was located in Class Ⅰ integron 5'. Conclusions It is the first detection of IMP-1 Metallo-β-lactamase in Klebsiella pneumoniae. The production of IMP-1 carbapenemase is the main mechanism of carbapenem-resistant in Klebsiella pneumoniae, and multidrug resistance is related to ClassⅠ integron.

Platelet activating factor(PAF), a potent phospholipid mediator of inflammation, has diverse physiological actions and participates in many diseases in vivo . In recent years, it has been revealed that PAF system involve in the expression of keratinocytes function and reaction of skin inflammation. Therefore, PAF system was found closely associated with inflammatory skin disease. Keratinocytes could express functional PAF receptors (PAF R) and involve in the action of epidermis cytokine system. The interaction between PAF system and other inflammatory mediators can lead to skin inflammatory cascade.

Objective To explore the MRI features of brain and spinal cord in patients with multiple sclerosis(MS).Methods The data of MRI of 110 patients with clinic definite MS were analyzed retrospectively.Results The lesions on brain MRI were usually seen in the white matter surround the ventricle(55.8%),deep frontal lobe white matter(54.7%),deep parietal lobe white matter(44.2%)and brainstem(25.6%).Basal ganglia(23.3%)and thalamus opticus(11.6%)were also affected.The size of the brain lesions was varied,the appearances were punctiform,mottling,patching,ellipse and so on.The lesions of the spinal cord were usually on the cervical cord(75.0%)and thoracic cord(68.8%).There were string lesions which parallel spinal cord long axial and mottled lesions.The spinal cord lesions existed in both white matter and gray matter.10.0% of the patients had spinal cord atrophy or spinal cord swelling.The signal intensity of lesions was equal T1,long T2 or long T1,long T2,which was related with the clinical course.Conclusion Different size and appearance lesions in the white matter of brain and spinal cord are the main MRI features of MS.

Adolescent ; Adult ; Female ; Hemorrhoids ; complications ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; physiopathology ; therapy ; Urinary Retention ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

This study was to investigate the role of urethral catheter balloon dilatation(F16)in the treatment of intrauterine adhesion after hysteroscopic surgery.A total of 523 patients with severe intrauterine adhesion(IUA)following hysteroscopic surgery underwent urethral catheter balloon dilatation during April 2000 and December 2005.During 3～15 months'follow-up,normal menses were seen in 340 patients (65.0％),nearly normal menses in 165 patients(31.5％),and menoschesis in 18 patients(3.4％).302 patients showed normal uterine cavity with no recurrent endometrial adhesion,203 patients(38.8％)were found slight IUA,and only 18 patients(3.4％)still presented with severe adhesion.No operative complication was reposed.and the pregnant rate was 47.6％.In summary.urethral catheter balloon dilatation.based therapeutic strategies is safe.effective and beneficial.

Objective To investigate the clinical diagnostic evidences of pleural tuberculosis (PT).Methods One hundred and eighty patients with pleural effussion, whom were admited into our hospital from December 2007 to December 2009 ,were enrolled into this study. The clinical data of patients confirmed with PT ( n = 90) or Non-PT ( n = 90) were analyzed retrospectively. The likelihood ratios( LR), sensitivity, specificity,positive predictive value,and nagative predictive value of six indices including pleural ADA, IFN-γ, sIL-2R ,TB-antibody in blood and pleural effusion, age and fever status were calculated. Results The variable with the hightest LR+ was ADA optimal threshold, followed by TB-antibody, IFN-γ, age, sIL-2R, fever status, If all six variables reached the optimal threshold,the probabilities of PT exceeded 99.9%. However,if all variables didn't reached the optimal threshold, the probabilities of PT were less than 1%. Among all the six variables, any four or over four variables reached the optimal threshold, the probabilities of PT exceeded 97%. Conclusion The combination use of these six variables can aid the clinical analysis, early detection, and therapy instruction,complication prevention of PT.

Objective To explore the impacts of 75％ low-protein diet intake during gestation on fetal growth restriction (FGR) rat model establishment.Methods Thirty-eight pregnant Sprague-Dawley rats were included into the study.At first,five pregnant rats were fed with sufficient normal diet with protein content of 22％.Their daily food consumption was recorded and taken as the basis to determine daily feed consumption of 75％ low-protein group (protein content 9.2％).In order to ensure that each group finally had at least ten pregnant rats to deliver,there were 11 rats assigned to the control group (pregnant rats fed with sufficient normal diet,protein content was 22％),13 to the low-protein group (pregnant rats fed with low protein diet,protein content was 9.2％,but the food consumption was the same as control group) and 14 to the 75％ lowprotein group (pregnant rats fed with low-protein diet,protein content was 9.2％,the food consumption was 75％ of the control group).All female rats were fed with sufficient normal diet after delivery.The body weight,overall weight gain during gestation,the mortality rate and the non-delivery rate of pregnant rats were compared.The third day's newborn weight after birth,FGR incidence and the mortality rate within three days after birth of newborns were also compared.One way analysis of variance,LSD-t test,independent sample t-test and Chisquare test were used as statistical methods.Results (1) The body weight of pregnant rats:There was no significant difference in body weight among the three groups at gestational day 0,3 and 6.On day 9,body weight of 75％ low-protein group [(271.9±8.4) g] and low-protein group [(274.1 ±7.8) g] were significantly lower than that of the control group [(287.2± 18.7) g] (t=2.514 and 2.170,both P＜0.05),but there was no significant difference between the former two groups.On Day 12,body weight of 75％ low-protein group [(275.7 ± 10.7) g] and low protein group [(285.1 ± 12.5) g] were significantly lower than that of the control group [(306.4±29.7) g] (t=3.262 and 2.218,both P＜0.05),and the difference between the former two groups was also statistically significant (t=2.098,P＜0.05).Before delivery,body weight of 75％ low-protein group,low protein group and control group were (300.4±14.1) g,(317.0±16.3) g and (372.9±19.1) g,respectively with statisticall significance (F=64.219,P＜0.05).The overall weight gain during pregnancy for 75％low-protein group,low-protein group and control group was (61.6± 19.8) g,(81.8±21.6) g and (139.3± 12.0) g,respectively.The difference among the three groups was statistically significant (F=55.863,P＜0.05).(2) The mortality rates of pregnant rats for 75％ low-protein group,low-protein group and control group were 3/14,2/13 and 1/11 respectively without significant difference (P＞0.05).Neither was the non-delivery rate within 30 days (embryonic resorption) for the three groups (1/14,1/13,0/11,P＞0.05).(3) The numbers of pups were 101 in 75％ low-protein group,104 in low-protein group and 107 in control group.The newborn mortality rate within three days after birth was 28.7％ (29/101) in 75％ tow-protein group and 23.0％ (24/104)in low-protein group,with were significantly higher than that of the control group (7.5％,8/107) (x2=16.022and 9.976,both P＜0.05),but there was no significant difference between groups.The third day's newborn weight after birth for 75％ low-protein group,low-protein group and control group were (6.3 ±0.8) g,(6.9±0.9) g and (8.1 ±0.9) g,the difference was statistically significant (F=90.602,P＜0.05).FGR incidence for 75％ low-protein group was 55.6％ (40/72),which was significantly higher than that of the low-protein group (28.8％,23/80) and the control group (5.0％,5/99) (x2=11.220,54.834 and 18.833 all P＜0.05).Conclusion 75％ low-protein diet feeding during pregnancy is an ideal method to induce FGR rat model with high FGR incidence,whereas and low mortality rates of pregnant rats,the fetuses and newborns.

Objective To investigate the clinical and skeletal muscular pathological features of chronic progressive external ophthalmoplegia(CPEO).Methods The clinical and skeletal muscular pathological data of 6 patients with CPEO were analyzed retrospectively.Results All of the 6 patients onset were 4 to 18 years old.The first symptom was blepharoptosis.The clinical mainly manifestations were limited activity of eyeball,accompanied with limbs muscle fatigue,weakness and level elevatation of serum creatine kinase(CK).5 cases had myogenic changes in electromyography(EMG).The skeletal muscular pathological examination showed that the ragged red fibers(RRF)were scattered among the muscle fibers,and the deficient or absent of COX activity in many fibers.A few degenerating and necrotic fibers were observed in 4 cases.Lipid-drops were increased by oil red "O" stain in 3 cases.Electromicroscope showed that abnormal mitochondria increased in number and aggregated under sarcolemma or in cytoplasm.Crystalloid inclusion body could be observed.Conclusions The clinical mainly features of CPEO are external ophthalmoplegia and accompanied with limbs weakness.RRF and COX activity deficiency or absence according to skeletal muscle pathology can be suggest and support the diagnosis of CPEO.Gene sequencing based on skeletal muscle biopsy is necessary to make the final diagnosis of CPEO.

Objective To evaluate the comparability of the detection results of different blood cells analysis systems in same hos-pital.Methods Referring to the Guideline for Comparability Verification of Quantitative Test Results in Medical Institutions,the comparability validation protocol was established.The EDTA-K2 anticoagulation fresh whole blood samples with proper concentra-tion were detected for 5 parameters of HGB,RBC,HCT,PLT and WBC by 4 systems (Sysmex XT-1800i,Sysmex XT-2000,Sys-mex XT-4000i and Mindray BC-5800).The range was calculated and the detection results consistency analysis was performed.Re-sults The acceptable standard of critical differentials was intended to be HGB3.5%,RBC3%,HCT3%,PLT12.5% and WBC 7.5%.The replication detection was at least 2 times and up to 5 times.The ranges of 3 concentrations after replication detection and sample comparison were 2.87%-6.29%,1.57%-2.99%,1.95%-4.77%,12.81%-25.74% and 6.72%-11.13% respective-ly.The ranges of RBC detection results in 4 systems were smaller than the critical differentials,the validation was passed.The ran-ges of HGB,HCT,PLT and WBC detection results in 4 systems all had the condition of more than the critical differentials,the vali-dation did not passed.After removing the test system with obvious bias,the validation of the detection results by other test systems was passed.Conclusion The RBC detection results by 4 systems have the comparability;the HGB,HCT and PLT detection results by Sysmex XT-1800i,Sysmex XT-2000i and Sysmex XT-4000i have the comparability;the WBC detection results by Sysmex XT-1800i,Sysmex XT-2000i and Mindray BC-5800 have the comparability.

Objective To investigate whether the protection of ischemic preconditioning (IPC) against myocardial ischemia/reperfusion (I/R) injury is mediated by toll-like receptor 4(TLR4)/NF-kB pathway,and whether these effects are related to the release of calcitonin gene-related peptide (CGRP).Methods Sprague-Dawley rats were subjected to 60 min of ligation of the left anterior descending coronary artery followed by 3 h of reperfusion to induce I/R injury.IPC was performed by 4 cycles of 3-min left coronary artery occlusion followed by 5-min reperfusion before the I/R.The expression of TLR4 mRNA was determined by RT-PCR.TLR4 and NF-kB protein expression were analyzed by immunohistochemistry.Myocardial infarct size,CGRP concentration in plasma and activity of creatine kinase in serum were also measured.Results IPC significantly reduced the infarct size and creatine kinase activity concomitantly with the increase in plasma CGRP concentration.The expressions of TLR4 protein and mRNA and NF-kB protein were increased by myocardial I/R injury,and dramatically inhibited by IPC.Conclusion IPC protects against myocardial I/R injury by inhibition of TLR4/NF-kB pathway.These effects are related to the increased the release of CGRP.