OBJECTIVE: Discuss the clinical features of primary ectopic thyroid carcinoma. METHOD: The clinical data of three cases diagnosed of primary ectopic thyroid carcinoma in our department since 1990 were analyzed ret respectively and related literature was reviewed. RESULT: All three patients were young females that had cervical lumps before surgery. The pathology results confirmed the diagnosis of ectopic thyroid papillary carcinoma. All cases had followed up till now and no relapse signs occurred. CONCLUSION Ectopic thyroid tissue is resulting from developmental defects at early stages of thyroid gland embryogenesis. They can cancerization, the treatment of ectopic thyroid carcinoma is also controversial. Here,we report 3 cases of primary ectopic thyroid papillary carcinoma, all of which were removed by surgery, take thyroxin orally after surgery and have a great prognosis.
Adult ; Carcinoma ; diagnosis ; therapy ; Carcinoma, Papillary ; Female ; Humans ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnosis ; therapy

Objective To investigate the distribution of virulence-related genes in multidrug resistant Escherichia coli.Methods Seven virulence genes papA,cnf1,cnf2,cfaB,ipaB,hofQ and ompT were detected by PCR in 20 strains of multidrug resistant Escherichia coli clinically isolated,and the positive genes were further searched in 31 strains of Escherichia coli in BioCyc database whose genomies had been fully sequenced.Results Virulence genes hofQ and ompT were detected in 20 strains of Escherichia coli with a positive rate of 95.0％ (19/20) and 55.0％ ( 11/20),respectively.Among 31 strains of Escherichia coli in BioCyc,21 (67.7％) were positive for hofQ gene and 15 (48.4％) were positive for ompT gene.Conclusion hofQ and ompT genes are prevalent in multidrug resistant Escherichia coli.

Objective:To investigate the recurrence of the neck and survival incidence of clinically possible pos-itive lateral cervical nodes in patients with well-differentiated papillary thyroid cancer and the essentiality of the performation of modified radical neck dissection. Method: Retrospective datum of 267 cases of papillary thyroid car-cinoma were collected and ananlyzed. They were divided into two groups with time; selective neck dissection with VI area was performed in 151 cases of group A and selective neck dissection was performed without VI area in 116 cased of group B. They were received the same treatment in the thyroid-total thyroidectomy on initial part and subtotal thyrodectomy on the other, and total thyroidectomy on both parts if both were invated. Incidence of posi-tive lateral cerivcal nodes of VI area in group A and the recurrence in the neck and survival incidence in groups B were analyzed. Result: Fiftynine patients in group A were treated with the modified radical neck dissection, and 22 patients of them were found metastasis in lateral cervical nodes with Ⅵ area. The other 92 patients were treated with neck dissection of Ⅱ,Ⅲ,Ⅳ,Ⅵ VI area, and 31 patients weren't metastasis, 33 patients were metastasis in both Ⅵ area and the others(35.8%), 17 patients were metastasis only in Ⅵ area(18.4%), 11 patients weren't metastasis only in Ⅵ area(11.9%). Thus, the incident of metastasis in Ⅵ area was 47.70% in group A(72/151). 47 patients in group B had metastasis in lateral cervical nodes though without performing VI area neck dissection (40.5%), and the survival rate of 5 years was 99.3%. The recurrence rate in the neck of group two was 6.0% (7/116). The metastasis rate of neck lymph node was higher in group A (54.9%) than group B(40.5%). Conclu-sion : Pretracheal and peripheral recurrent nerve lymph node are very susceptible to the metastasis of well-differenti-ated papillary thyroid cancer. The neck dissection of VI area could be performed as routine.

OBJECTIVE To study the existence status of class Ⅰ integron and transposable element of multi-resistant Acinetobactor baumannii isolated form ICU of Yinzhou People′s Hospital in Ningbo. METHODS The samples of 20 A.baumannii isolates were collected from Oct 2007 to Jul 2008.The susceptibility to 32 antibiotics of the isolates was measured.The genetic markers of integron qacE△1-sul1 and transposable element tnpU were analyzed by polymerase chain reaction(PCR).The PCR products of tnpU or qacE△1-sul1 were sequenced for determination. RESULTS In the 20 ABA isolates,the positive rate of class Ⅰ integron qacE△1-sull was 75%,and the positive rate of transposable element tnpU was 55.0%. CONCLUSIONS The positive rate of the integron qacE△1-sul1 and transposable element tnpU for multi-resistant A.baumannii is high in Yinzhou People′s Hospital in Ningbo.It should be reevaluated the preventative role of chlorhexidine for operation.

OBJECTIVE To investigate the antibiotic resistance of multi-resistant Acinetobacter baumannii(ABA) and distribution of aminoglycoside-modifying enzymes and 16S rRNA methylase genes in ICU in Yinzhou People′s Hospital in Ningbo. METHODS The samples of 20 ABA isolates were collected from Oct 2007 to Jul 2008 in ICU.K-B method was used to determine the sensitivity to 32 antibacterials and the aminoglycoside-modifying enzymes and 16S rRNA methylase genes were analyzed by polymerase chain reaction(PCR). RESULTS From 20 ABA isolates,8 strains carried aminoglycoside-modifying enzymes genes aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅰb,and ant(3″)-Ⅰ,their positive rate was 10%,15%,30% and 25%,respectively;no strain carried 16S rRNA methylase genes. CONCLUSIONS The antibiotics resistance of A.baumannii is very serious in Yinzhou People′s Hospital in Ningbo.Aminoglycoside-modifying enzymes genes aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅰb and ant(3″)-Ⅰ exist in multi-resistant A.baumannii widely.They would be the main causes of high drug-resistantce to aminoglycosides.

OBJECTIVE To investigate the antibiotics resistance of multi-resistant Acinetobactor baumannii(ABA) and genotypes of beta-lactamases in ICU.METHODS The samples of 20 A.baumannii isolates were collected from Oct 2007 to Jul 2008 from patients in ICU.To determine the sensitivity to the 32 kinds of antibacterials,K-B method was used and the detection of ESBLs and AmpC beta-lactamases was performed by three dimensional test and 21 types of beta-lactamases genes were analyzed by polymerase chain reaction(PCR).RESULTS Among the 20 ABA isolates,all carried TEM beta-lactamases gens(100%),10 carried OXA-23 beta-lactamases gens(50%) and 15 strains carried ADC beta-lactamases gene(75%),50% strains produced TEM,OXA-23 and ADC beta-lactamases simultaneously.Through determining sequence of one PCR product from TEM,OX23 and ADC respectively,we found TEM-116,OXA-73 and ADC-25 type beta-lactamases genes.CONCLUSIONS The antibiotics resistance of ABA is very serious.TEM,OXA-23 and ADC exist in multi-resistant A.baumannii widely.It should be the main causes as high rate of drug-resistantce to beta-lactamantibiotics.

OBJECTIVE To investigate the antibiotics resistance of Escherichia coli(ECO) and distrubtion of aminoglycoside-modifying enzymes and 16S RNA methylase genes in ICU.METHODS The samples of 20 ECO isolates were collected from Dec 2007 to Jun 2008 of patients in ICU.To determine the sensitivity to the 30 antibacterials K-B method was used and aminoglycoside-modifying enzymes and 16S RNA methylase genes were analyzed by polymerase chain reaction(PCR).RESULTS In among the 20 ECO isolates,8 strains carried aac(3)-Ⅱ(40%),3 carried aac(6′)-Ⅰb(15%) and ant(3″)-Ⅰ(15%),1 be found aph(3′)-Ⅰ(10%)and 13 be found aadA4/5 aminoglycoside-modifying enzymes genes,no strain carried 16S RNA methylase genes.CONCLUSIONS aac(3)-Ⅱ、aac(6′)-Ⅰb,ant(3″)-Ⅰ,aph(3′)-Ⅰ and aadA4/5 aminoglycoside-modifying enzymes genes exist in ECO widely,they should be the main cause inducing the high rate of drug-resistance to aminoglycosides.

OBJECTIVE To study the mechanisms of chromosome and plasmid-mediated quinolones resistance in Escherichia coli(ECO).METHODS Clinical isolates of ECO were collected from clinical specimens at ICU of Yinzhou People′s Hospital from Dec 2007 to Jun 2008.To detect the susceptibility to 30 types of antibiotics K-B disk diffusion method was used.The susceptibicity to ciprofloxacin and levofloxacin were detected by agar dilution testing.Then six type genes gyrA,qnrA,qnrB,qnrS,aac(6′)-Ⅰb-Cr,and qepA were investigated by PCR.In the meantime,the PCR products were sequenced.RESULTS The alterations in gyrA were found in all 20 tested strains.Two new subtypes were found in ECO 13 and ECO 15.Three strains were found acc(6′)-Ⅰb-Cr and ECO 2 was detected qurA gene.CONCLUSIONS The mutations in gyrA play a dominant role in the resistance to quinolones in ECO.Both aac(6′)-Ⅰb-Cr and qepA may responsible for quinolones resistance in ECO too.

OBJECTIVE To investigate mycoplasma infection in ICU patients.METHODS Sixty-five samples from blood,respiratory tract and genitourinary tract of patients were collected respectively from Oct 2007 to July 2008 in ICU.Mycoplasma pneumoniae(Mp),Urealasma urealytium(Uu) M.fermentans(Mf) and M.penetrans(Mpe) were cultivated by modified mycoplasma fluid and solid medium.Mf and Mpe positive isolates were verified by nested polymerase chain reaction(rPCR),Mp and Uu were confirmed by fluorescent quantitative PCR.RESULTS It was found that the positive detection rate for Mp was 12.3%(8/65)in blood and 35.4%(23/65) in respiratory tract excreta and for Mu 1.5%(1/65) and 26.2%(17/65) in blood or Genitourinary tract,respectively.Mpe and Mf did not detected.CONCLUSIONS The state of mycoplasma infection is very severe,and often accompanies bacterial infection.It is necessary to consider mycoplasma when chose antibiotics.

Objective To investigate the pathogen distribution and drug resistance of gram-negative bacteria causing lower respiratory tract infections in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) .Methods A total of 742 sputum samples were collected from AECOPD patients with lower respiratory tract infections in Taizhou Hospital of Zhejiang Province during January 2013 and December 2014.Vitek 2 Compact system combined with disk diffusion was used for strains identification and drug susceptibility test.Modified Hodge test and ethylenediamine tetraacetic acid (EDTA) synergic test were used to screen carbapenem-resistant strains.Statistical analysis was performed using WHONET 5.6 and SPSS 20.0 software.Results A total of 593 strains of gram-negative bacteria were isolated , in which 367 strains were nonfermentative bacteria (61.89%), 220 strains were enterobacteriaceae (37.10%), and the rest 6 strains ( 1.01%) were other gram-negative bacteria.Acinetobacter baumannii ( 186 strains ), Pseudomonas aeruginosa (99 strains), Stenotrophomonas maltophilia (33 strains) and Burkholderia cepacia (22 strains ) were top 4 nonfermentative bacteria , and they all showed high resistance to ampicillin , ampicillin/sulbactam, cefazolin, ceftriaxone, cefotetan and nitrofurantoin with resistant rates of 67.20%-100.00%. Drug resistance rates to other β-lactams, fluoroquinolones, aminoglycoside, compound sulfamethoxazole and minocycline were significantly higher in carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains than those in non-carbapenem-resistant strains , and the differences were statistically significant (P <0.05 or <0.01).Stenotrophomonas maltophilia and Burkholderia cepacia strains were only sensitive to levofloxacin , compound sulfamethoxazole and minocycline . Klebsiella pneumonia (89 strains), Escherichia coli (80 strains) and Enterobacter cloacae (25 strains) were top 3 enterobacteriaceae , which were almost completely resistant to ampicillin , but were sensitive to piperacillin/tazobactam , cefoperazone/sulbactam , amikacin and carbapenems ( with resistant rates <15%) .More than 50%strains of extended spectrum β-lactamases ( ESBLs )-producing Klebsiella pneumonia and Escherichia coli were moderately or highly resistant to ampicillin/sulbactam , most cephalosporins ( except cefotetan and cefoperazone/sulbactam ), gentamycin, tobramycin, fluoroquinolones, aztreonam, compound sulfamethoxazole and minocycline , and the resistant rates were higher than those in non-ESBLs-producing strains (P <0.05 or <0.01).Conclusions Nonfermentative bacteria and enterobacteriaceae are the most prevalent gram-negative bacterial pathogens in lower respiratory tract infections in patients with AECOPD . Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains, as well as ESBLs-producing Klebsiella pneumonia and Escherichia coli strains are highly resistant to most antibacterial agents .