OBJECTIVE To study the drug resistance and ?-lactamases produced by Acinetobacter baumannii isolated from lower respiratory tract.METHODS The drug sensitivity was detected with K-B test,and the ESBLs producing strains and ?-lactamases strains were screened by double disk test and confirmed by the NCCLS confirmation test.RESULTS Patients mostly were old from RICU,and broad-spectrum antibiotic therapy was applied,with history of re-oxygenating,sputa extraction and invasive operation.Fifteen received mechanical ventilation.Results of drug sensitivity showed almost all were resistant to FOX and CFZ,more than 70 percent resistant to CXM and MEZ,IPM and SCF,less than 10 percent resistant to AMX/CLAV,CAZ and OXL.There were no strains showing drug resistance to IPM,CAZ/CA and SCF.Test showed 5 strains(16%)produced AmpC enzyme and 9 strains(29%)produced ESBLs enzyme.CONCLUSIONS Rate of drug resistance is high,so drug susceptibility test should be enforced to guide reasonably clinical applying antibiotics in order to prevent outbreaks.

OBJECTIVE To investigate the incidence of extended-spectrum ?-lactamases(ESBLs) of Escherichia coli and Klebsiella pneumoniae and to observe their relationship with antibiotic resistance patterns during the last one and a half years in our hospital.METHODS The API half-automicroscan system was used to identify the pathogenic bacteria and conduct drug resistance test.RESULTS The incidence of ESBLs was 22.2% in E.coli and 21.8% in K.pneumoniae.ESBLs producing strains were more resistant to penicillins and cephalosporins,but few of which were resistant to imipenem and meropenem.The resistance rate of ESBLs producing strains to antibacterial agents was higher than of non-ESBLs producing strains.CONCLUSIONS Extended-spectrum ?-lactamases play a most important role in bacterial resistance to penicillins and cephalosporins.Detecting ESBLs strains producing rate and their susceptibility to antibiotics is very important in guiding the clinical administration of drugs.

OBJECTIVE:How to explain and predict individual difference of artificial cochlea so as to evaluate rehabilitative effect of implant has been paid much attention by audiological scholars,clinical physicians,patients,and their relatives. This study was designed to analyze and evaluate rehabilitative status of patients accepting artificial cochlea implantation to investigate the relative influential factors of auditory rehabilitation. METHODS:A total of 28 patients were selected from Department of Otolaryngology Head and Neck,Affiliated Hospital of Qingdao Medical College from June 2002 to April 2008. They were accessed by age,time of rehabilitation training,usage of hearing aids,audiology and aural image before surgery,and NRT monitoring in cochlear implantation so as to observe auditory improvement. The clinical results were analyzed to detect the effect of various factors on auditory rehabilitation. RESULTS:Age,preoperative preparations and good audiology and aural image are important premises for a successful rehabilitation. Longer the time of using hearing aids and language rehabilitation are,and better results will get. NRT response during operation is also an important factor for good auditory rehabilitation. CONCLUSION:The influential factors of auditory rehabilitation after cochlear implant included the age,audition remains,usage of hearing aids,NRT response during operation,and the time after the cochlear implant operation.

OBJECTIVE To develop the strong and the specific multi-epitope antigen for the exploiting diagnosis of Treponema pallidum.METHODS The immuno-dominant epitopes of Tp0453 and Tp17 were amplified by PCR respectively,and subcloned into the expression vector pQE32 to generate multi-epitopes recombinant plasmid pQE32/Tp0453-17.The recombinant protein was expressed in Escherichia coli M15.The immunoresponse of recombinant fusion protein was analyzed by Western blot.RESULTS The multi-epitopes recombinant plasmid was successfully constructed,enzyme digestion analysis and sequencing showed that the inserted target genes were Tp0453 and Tp17 gene,compared with the gene reported by GenBank,it had 100% similarity;SDS-PAGE analysis showed the recombinant plasmid could be expressed in M15,its relatively molecular mass(Mr) of expressed product was about 52.0?103.The Western blot result showed the recombinant protein could be recognized by anti-T.pallidum positive serum.CONCLUSIONS The expressed multi-epitopes recombinant antigen showed excellent immunoresponse.The results lay the foundation for research on development of quick diagnostic kit applying to detection of T.pallidum infection.

OBJECTIVE To investigate the bacterial distribution and antibiotic resistance of main pathogens from urinary tract infection (UTI) in our hospital for the guidance of rational use of antibiotics. METHODS The antibiotic resistance of clinical pathogen isolates from urinary tract infection by routine bacterium culture from Jan 2006 to Dec 2007 were studied retrospectively. The extended spectrum ?-lactamases (ESBLs) were detected out to the Gram-negative bacilli. RESULTS There were 722 strains of pathogens in the whole 2773 urinary samples with the isolating rate 26.0%. Most of the Urinary tract infections of patients were caused by Gram-negative bacilli (69.4%),then by Gram-positive cocci (16.3%) and fungi (14.3%). The most common pathogens in urinary tract infection were Escherichia coli (47.9%),Enterococcus faecais (7.9%),E. faecium (4.0%),Proteus mirabilis (3.9%),and Pseudomonas aeruginosa (3.5%). The Gram-negative bacilli were found to be sensitive to imipenem and meropenem,but highly resistant to the most other antibiotics,while P. mirabilis was susceptive to amikacin and cephalosporins. The Gram-positive cocci were more sensitive to nitrofuvantoin and vancomycin,but highly resistant to penicillin,oxacillin and SMT. CONCLUSIONS E. coli is still the primary urinary pathogen among patients,and highly resistant to a lot of antibiotics,We should carry out cultivation,isolation,and antimicrobial susceptibility testing as soon as possible to guide reasonable clinical drug therapy.

Serum adipocyte fatty acid-binding protein (A-FABP) was raised in metabolic syndrome (MS)patients (n= 121) as compared with age-matched healthy subjects [n = 120, (14.7±4.8 vs 6.8 ±3. 0) μg/L,P<0.001]. It reached higher level in MS subjects with visceral obesity [(15.7±4.2 vs 12.6±5.1) μg/L, P<0.001]. Serum A-FABP concentration was positively correlated with body mass index, waist circumference, waist-tohip ratio, fasting insulin, homeostasis assessment for insulin resistance (HOMA-IR), fasting glucose, triglycerides,total cholesterol,and mean arterial blood pressure, whereas negatively correlated with HDL-C (r =-0. 448, P< 0.001).

Objective To evaluate the patient's health care demands in communication,diagnosis,treatment and medical counseling of geriatric BPH outpatients in China.Methods A survey study was carried out in 33 medical centers from 11 different cities in China (North:Lanzhou,Beijing,Shenyang; South:Chengdu,Changsha,Wuhan,Jinan,Nanjing,Hangzhou,Shanghai,Guangzhou).2027 BPH outpatients aged (60 years participated in the survey to measure their health care demands using a questionnaire.Results There were 955 cases (47.1％) thinking communication is necessary before inspection items by a doctor,807 (39.8 ％)thinking communication is necessary before determining the treatment program,389 cases(19.2％) thinking respection items by a doctor is necessary,730 cases(36.0％)the treatment program by a doctor is necessary,849 cases (41.9 ％)thinking health guidance on BPH dignosis is necessary,934 cases (46.1 ％)thinking health guidance on BPH treatment is necessary,The multilevel model showed the demands scores data is similarity among the north and the south.And the patients with more severe lower urinary tract symptoms have more demands on communication and medical counseling.Conclusions It is to get better therapy,considering the patient's health care demands.

A total of 121 patients with metabolic syndrome (MS) and 120 normal subjects were recruited for exploring the association of serum adipokines with MS. The levels of resistin and adipocyte fatty acid-binding protein (A-FABP) increased, while adiponectin decreased gradually ( all P<0.05 ) in normal control group, MS without abdominal obesity group, and MS with abdominal obesity group. In MS group, resistin was positively correlated with body mass index ( BMI), waist circumference, systolic blood pressure, fasting plasma glucose, and A-FABP ( P<0.05 or P<0.01 ). Adiponectin was positively correlated with high-density lipoprotein-cholesterol and negatively correlated with BMI, waist circumference, fasting insulin, triglyceride, and homeostasis assessment of insulin resistant index.

OBJECTIVE To evaluate the spectrum of imipenem-resistant Pseudomnas aeruginosa and the production of metallo-?-lactamase.METHODS The clinical strains of P.aeruginosa were collected from Jan to Dec 2007.The results of antimicrobial susceptibility tests and detection of metallo-?-lactamase were analyzed.Antimicrobial susceptibility tests were performed by K-B methods;the production of metallo-?-lactamase was tested by CAZ-EDTA synergy method.RESULTS Sixty strains were isolated,imipenem-sensitive and resistant strains were 40(66.7%) and 20(33.3%),respectively,and 7 strains with metallo-?-lactamase were detected.Among imipenem-resistant strains,at least 90.0% strains were resistant to meropenem,gentamicin,tobramycin,ciprofloxacin and SMZ-TMP;at least 80.0% strains were resistant to piperacillin and piperacillin/tazobactam;50.0% strains were resistant to ceftazidime and cefepime;polymyxin E was less resistant than others.Twenty strains were resistant to at least 3 antimicrobial agents,which was obviously higher than 27.5% of imipenem-resistant strains.CONCLUSIONS The resistance rate of imipenem-resistant P.aeruginosa is higher than imipenem-sensitive ones.The production of metallo-?-lactamase is one of the mechanisms of P.aeruginosa resistance to imipenem and shou1d be detected carefully,which could help us medicate reasonably in clinic and avoid using medicine which could induce and strengthen the resistance.

Objective To evaluate the value of a Treponema pallidum (TP) recombinant protein TP0993 in the serodiagnosis of syphilis.Methods A bioinformatics method was used to obtain the sequence of TP0993 gene.The open reading frame (ORF) without upstream non-coding region of TP0993 gene was ligated into the expression vector PET-28a (+),which was then transformed into Escherichia coli Rosetta.Isopropyl-β-d-thiogalactoside (IPTG) was used to induce the expression of TP0993 protein.The expressed protein was purified with nickel-nitrilotriacetic acid (Ni-NTA) affinity chromatography.Western blot was performed to evaluate the immunoantigenicity of the protein.New Zealand rabbits were immunized with the recombinant protein for immunogenicity evaluation.Indirect enzyme linked immunosorbent assay (ELISA) was developed by using the purified recombinant protein to coat microwell plates.Anti-TP antibodies were detected by the established ELISA and TP particle agglutination assay (TPPA) in 480 clinical serum samples.Results The prokaryotic expression vector PET-28a (+)-0993 was successfully built,and a fusion protein with a relative molecular weight of about 34 000 Da was attained after IPTG-induced expression and purification.Western blot proved that the recombinant protein could specifically react with clinical sera positive for anti-TP IgG antibodies.Specific humoral response was elicited in New Zealand rabbits by the recombinant protein.Compared with TPPA,the established indirect ELISA showed a sensitivity of 88.3％ and a specificity of 85.8％.There was a consistency of 86.5％ between the indirect ELISA and TPPA.Conclusion The expressed recombinant protein showed favorable immunocompetence,and may serve as a candidate antigen for serodiagnosis of syphilis.