Objective To study antimicrobial resistance of clinically isolated Escherichia coli (E.coli),the preva-lence of integrons in E.coli,and relation of integron with antimicrobial resistance of E.coli.Methods E.coli isola-ted from three hospitals of Guangdong Province from 2010 to 2012 were collected,and antimicrobial susceptibility testing was performed by Kirby-Bauer method;integrons were detected by polymerase chain reaction (PCR),and gene cassette was analyzed by sequencing.Results A total of 156 E.coli isolates were collected,antimicrobial sus-ceptibility testing showed that resistance rate of E.coli to most penicillins,cephalosporins,fluoroquinolones,amin-oglycosides and sulfonamides were over 50%;the resistance rate to antimicrobials < 10% included cefoperazone/sulbactam(0),imipenem(3.85%),cefotetan(4.35%),ertapenem(7.69%)and piperacillin /tazobactam (8.97%);The positive rate of class I integron was 57.69%(90/156);the positive rate of class I integron in multidrug-resist-ant and non-multidrug-resistant E.coli was 66.00% (66/100)and 64.71 % (22/34)respectively,the difference was not statistically different (P >0.05),but compared with sensitive E.coli (9.09%,2/22),the difference was statisti-cally different (P<0.01 ).There were nine types of integron-drug resistant gene cassettes in the variable regions, most of which contained aadA and dfrA.Conclusion Antimicrobial resistance of E.coli is serious;high incidence of class I integrons are widely found in E.coli,and is closely related with drug resistance of E.coli,class I integrons mainly mediated aminoglycosides,sulfonamides and beta-lactams resistance.

Objective:To study the correlation between smoking and clinicopathology in patients with upper tract urothelial carcinoma(UTUC), and to evaluate the effect of smoking on the prognosis of patients with UTUC treated with adjuvant chemotherapy for Gemcitabine plus Cisplatin (GC).Methods:A retrospective cohort study was used to select 91 patients who underwent resection of the kidney and ureter, and sleeve cystectomy in Beijing Friendship Hospital, Capital Medical University from January 2013 to December 2021, all patient received GC adjuvant chemotherapy after surgery. Patients were divided into smoking group ( n=33) and non-smoking group ( n=58) according to their smoking history. The median follow-up time was 38 months (3-83 months). The age, gender, presence or absence of hydronephrosis, tumor stage, multifocality, lymphatic vascular invasion, lymphatic metastasis, tumor grade, overall survival (OS) and cancer-specific survival (CSS) were statistically analyzed. The measurement data were expressed as mean ± standard deviation ( ± s), and the t-test was used for comparison between groups; the count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Kaplan-Meier curve was used for survival analysis and comparison, and Long-rank test was used for comparison between groups. Cox proportional risk regression model was introduced to explore the independent influencing factors of OS and CSS by univariate and multivariate Cox regression analysis. Results:Among 91 patients, 41 were males and 50 were females, with a median age of 65 years, and 19 patients (20.9%) died, of which 17 patients (18.7%) died of UTUC. The comparison of clinical indicators between the two groups showed that smoking was associated with male, tumor stage, multifocality, lymphatic vascular invasion, lymphaitc metastasis, and tumor grade and hydronephrosis ( P<0.05). Multivariate Cox regression analysis showed that smoking, male, higher tumor stage, and lymphatic vascular invasion were independent risk factors for OS and CSS. For the subgroup of patients who smoked, smoking duration significantly affected CSS, with each additional year of smoking duration increasing the risk of death by 0.065. Conclusion:Smoking is associated with adverse pathology in patients with UTUC, and smoking is an independent factor affecting the prognosis of postoperative adjuvant chemotherapy with GC in UTUC.