OBJECTIVE To apply D-test for detection of inducible resistance of erythromycin to clindamycin in staphylococci and investigate their resistant rate to erythromycin and clindamycin. METHODS According to the standards of NCCLS to detect inducible resistance of erythromycin to clindamycin in staphylococci . RESULTS Co-resistance to erythromycin and clindamycin accounted for 50% and 22.8% in 77 strains of staphylococci (20 of S.aureus and 57 of coagulase-negative staphylococci). The rate of erythromycin resistance and clindamycin sensitivity accounted for 20% and 59.6%. D-test positive rate was 50% and 61.8% of which were erythromycin resistant and clindamycin sensitive respectively. CONCLUSIONS D-test for detection of inducible resistance of erythromycin to clindamycin in staphylococci should be checked in clinical microbiology laboratory in order to help physicians to select MLSb antimicrobial agents correctly.

Objective To compare two methods of patient controlled epidural analgesia (PCEA) with 0 2% ropivacaine plus fentanyl 2?g?ml -1 with or without background infusion for labor Methods Ninety ASA Ⅰ Ⅱ full term primigravidae in active labor who had a single fetus with vertex presentation and were expected to have vaginal delivery were randomly divided into three groups of 30 each: group A received PCEA without background infusion; group B received PCEA with background infusion and group C received no analgesia of any kind and served as control PCEA included a bolus of 4 ml with a 15 minute lock out When the primigravida was in first stage of labor, an intravenous line was established and 5% glucose normal saline 500 1000 ml was being infused When the external cervical os was dilated to 3 cm, epidural catheter was placed at L 2 3 and a test dose of 4 ml was given 5 min later when no signs of subarachnoid injection was evident, block height was tested by pinprick and another 6 ml was given 30 min later in group B background infusion of 0 2% ropivacaine + fentanyl 2?g?ml -1 was started at a rate of 4 ml?h -1 until the second stage of labor began Maternal vital signs (BP, ECG, SpO 2, P ET CO 2), VAS scores, degree of motor block, drug consumption, side effects of PCEA, gas analysis of umbilical venous blood, progress of labor, and Apgar scores were noted Venous blood samples were taken before PCEA and at the end of first stage of labor for determination of serum epinephrine and norepinephrine levels Results There were no significant differences in Apgar scores, blood gas of umbilical venous blood and the durations of first and second stage of labor among the three groups There were no differences in VAS scores, degree of sensory and motor block, serum concentrations of epinephrine and norepinephrine and percentage of cesarean section between group A and B The percentage of cesarean section was significantly higher in control group than that in group A and B Plasma NE and E concentrations at the end of the first stage of labor were significantly higher in control group than those in group A and B The ropivacaine and fentanyl consumption was less and the incidence of itching and percentage of instrumental delivery were lower in group A than those in group B Conclusions PCEA with 0 2% ropivacaine and fentanyl 2?g?ml -1 was safe and effective It reduces the percentage of cesarean section PCEA without background infusion provides the same level of analgesia as PCEA with background infusion with less drugs and side effects

Objective To understand the biological characteristicsand drug resistance of methicillin-resistant staphylococcus aureus (MRSA) isolated from neonatal clinic and the nose swabs of medical staff in the neonatal department.Methods Twenty-six strains of MRSA clinically isolated from the neonatal department and the nose swabs of medical staff in this department were collected and performed the multilocus sequence typing (MLST),spa typing, staphylococcus cassette chromosome mec (SCCmec) typing and pulsed-field gel electrophoresis (PFGE) typing.The Panton-Valentine leukocidin (PVL) gene was simultaneously detected.The antimicrobial susceptibility test of 14 antibacterial dugs was performed.Results Among 26 strains of MRSA,53.8% was isolated from sputum,2 strains were detected from the nase swab of medical staff.The MLST type had 5 types,ST59 accounted for 76.9%.The spa type had 8 types,t437 acoounted for 65.4%.the SCCmec type had only 2 types,20 strains were SCCmecⅣ(76.9%,20/26) and 4 strains(15.4%) were SCCmecV.In the PLV gene detection,the PVL positive rate was 15.4%.One strain of MRSA from the nose swabs of medical staff in the neonatal department was100% homologous with 1 strain from the patient by PFGE analysis.The drug susceptibility test results showed that all MRSA strains were 100% sensitive to antibacterial drugs of nitrofurantoin,quinupristin/dalfopristin,vancomycin and quinolone,while had higher resistance rates to tetracycline,erythromycin and clindamycin,which were above 50%.Conclusion In MRSA strains isolated from the neonatal department in this study,the most common clones were MRSA-ST59-SCCmecⅣ-t437.Erythromycin and clindamycin should not be preferred in the empiric treatment of newborn MRSA.

OBJECTIVE To investigate the disinfectant-sulfanilamide resistance gene(qacE△1-sul1)and integrase gene(IntⅠ1)of Acinetobacter baumannii(ABA)isolated in pediatric clinic and analyze the relationship between these genes and multidrug resistance.METHODS Twenty eight strains of A.baumannii were collected and isolated from the sputum culture in the deep trachea of children with pneumonia during 2006.Identification of bacteria and susceptibility test by VITEK-32 automicroscan using GNI and GNS cards,were undertaken,qacE△1-sul1 gene and IntⅠ1 gene were analyzed by polymerase chain reaction(PCR).RESULTS Three of 28 strains of A.baumannii showed multidrug resistance,the positive rate was 10.71%.A.baumannii 4 strains were resistant to sulfamethoxazole/trimethoprim(SXT)with the positive rate 14.29%.Eleven strains that carrying qacE△1-sul1 genes and 4 strains carrying IntⅠ1 genes were detected,the positive rate was 39.29% and 14.29%,and qacE△1-sul1 and IntⅠ1 genes positive strains of A.baumannii were resistant to SXT,the other 7 qacE△1-sul1 positive strains were sensitive to SXT.CONCLUSIONS The main drug resistance in ABA resistant to SXT is to obtain qacE△1-sul1 gene.It should be paid attention to qacE△1-suⅠ1 positive but sensitive to SXT strains.It indicates that the strain carrying integron Ⅰ may show multidrug resistance.

OBJECTIVE To evaluate application of cefoxitin disk diffusion method in detecting meticillin-resistant staphylococci(MRS)mediated by mecA gene.METHODS The cefoxitin disk diffusion method,oxacillin disk(diffusion) method,oxacillin agar dilution test,VITEK automicroscan as well as PCR amplification were performed and compared simultaneously for detection of MRS,and VITEK automicroscan was used in testing MIC.(RESULTS)(Among) 96 strains of Staphylococcus(16 S.aureus and 80 coagulase-negative staphylococci strains),54 strains of MRS(2 S.aureus and 52 coagulase-negative staphylococci strains) were identified by oxacillin disk(diffusion) method,oxacillin agar dilution test and VITEK automicroscan,48 mecA-genes were identified by PCR amplification(2 S.aureus and 46 coagulase-negative staphylococci strains) which was the same as by cefoxitin disk diffusion method.CONCLUSIONS The(cefoxitin) disk diffusion method is highly consistent with mecA gene method,and a reliable one of screening and(identifying) MRS mediated by mecA gene.

Objective To evaluate pathogens and antimicrobial resistance of pathogens causing refractory pneumonia in children.Methods Children with refractory pneumonia who admitted to a hospital between May 2008 and December 2014 were performed bronchoscopy,and bronchoalveolar lavage fluid (BALF)were performed bacterial culture and antimicrobial resistance testing.Results 1 693 patients were recruited in the study,273 bacterial isolates were isolated from BALF speci-mens of 226 children,gram-positive bacteria accounted for 38.10% (104/273 ),the main gram-positive bacteria were Streptococcus pneumoniae (n=71)and Staphylococcus aureus (n=23);gram-negative bacteria accounted for 58.24%(159/273),including 44 isolates of Haemophilus parainfluenzae ,28 Klebsiella pneumoniae ,19 Escherichia coli ,and 17 Pseud-omonas aeruginosa ;10 isolates of fungi were also detected,8 of which were Candida albicans .The sensitivity of Streptococ-cus pneumoniae to quinolones,ceftriaxone and cefotaxime were high.Methicillin-resistant Staphylococcus aureus (MRSA) positive rate was 26.32%.ESBLs-producing rate of Haemophilus parainfluenzae and Klebsiella pneumoniae was 32.72% and 62.96% respectively.Conclusion The major pathogens causing refractory pneumonia were Streptococcus pneumoniae and Haemophilus parainfluenzae ,empirical treatment should be conducted accordingly,antimicrobial resist-ance should be considered if therapeutic effect is poor,and targeted therapy should be performed according to cultured re-sults and antimicrobial susceptibility testing result.

Objective To investigate the effect of universal salt iodization (USI) on the profile of in-patient thyroid diseases. Methods Informations on thyroid diseases were collected by retrospective approach in hospitalized patients. Results With USI for 1-4 years, the incidence of thyroid diseases in the total in-patient cases increased from 7.6‰ to 11.0‰, the female/male ratio increased from 3.6 to 4.1, patients aged

Objective To test amyloid beta protein(Aβ)40 and Aβ42 levels in CSF and apolipoprotein E (ApoE) genotype in patients with Alzheimer's disease(AD) and study whether or not the Aβ is related to the severity of dementia and the genotypes of ApoE.Methods 48 AD patients including 27 cases of mild type and 21 cases of serious type and 35 normal controls were selected.Aβ40 and Aβ42 in CSF and ApoE genotype were analyzed.Results Aβ40 levels were ( 12.3 ±4.6) μg/L,( 11.7 ±4.1 ) μg/L,( 12.6 ±4.9) μg/L and ( 11.0 ±3.7) μg/L(t = 1.377,0.705 and 1.385 ,all the p values were greater than 0.05) and Aβ42 levels were ( 105.3 ±25.4) ng/L,(110.7 ±21.7) ng/L,(96.9 ±23.9) ng/L and (123.5 ±29.6) ng/L(t=3.006,2.832,and 3.488,all the p values less than 0.01 ),in AD group,mild AD group,moderate to serious AD group and normal controls,respectively.Aβ40 levels were (11.9 ± 5.2) μg/L vs.(10.5 ± 3.8) μg/L in AD and controls with ApoEε4(t=0.696,P＞0.05) and (12.6 ±4.5) μg/L vs.(11.4 ±3.4) μg/L without ApoEε4(t = 1.008,P＞0.05).Aβ42 levels were (99.7 ± 23.8) ng/L vs.( 129.6 ± 31.0) ng/L in AD and controls with ApoEε4( t =1.632,P ＞ 0.05 ) and ( 110.4 ± 28.4) ng/L vs.( 129.6 ± 31.0) ng/L in those without ApoEε4 ( t = 2.110,P ＜0.05 ).Conclusions The CSF level of Aβ is abnormal in AD,and it is related to the severity of the disease and the ApoE genotypes.

Objective To analyze the epidemiological characteristics of mycoplasma pneumoniae (MP) infection among the out-patients and inpatients children in Shenzhen area during 2010-2012 and to explore the significance of the results of the laboratory routine tests in the diagnosis of MP infection .Methods The children patients with respiratory tract infection from 2010 to 2012 were selected and the MP infection and the non-MP infection were screened out .The epidemiological characteristics of gender ,age , etc .,among the children patients with MP infection during these 3 years were analyzed .The differences in the laboratory routine tests and high sensitivity C reactive protein (hsCRP) were compared between the MP infection and the non-MP infection .Results The positive detection rate of MP-DNA in males was slightly higher than that in females ,the difference had no statistical signifi-cance (P>0 .05);MP infection occurred in different age groups ,the positive detection rate of MP-DNA was lowest in the children patients aged <1 year old and highest in the children patients aged 3 - < 6 years (P< 0 .05);the routine laboratory tests and hsCRP level had no specificity in the diagnosis of MP infection .Conclusion The MP molecular epidemiology in Shenzhen area shows that MP infection has the seasonality ,the laboratory routine tests and hsCRP level can not be used as the basis of the MP la-boratory diagnosis .

Objective To investigate the level of insulin and amyloid beta-protein (Aβ) in patients with Alzheimer disease(AD). Methods The levels of fasting plasma glucose, true insulin, C-peptide, Aβ40 and Aβ42 in 70 healthy age-matched adults and 55 patients with AD were measured and analyzed. Results No differences were observed for the levels of fasting plasma glucose between AD groups and normal group (P>0.05). The level of the true insulin and C-peptide of the moderate/severe AD group were significantly higher than that of the normal control group(P<0.05), as well aw that of the Aβ40 (P<0.05). The level of Aβ42 of the mild AD group waw significantly higher than that of the normal control group(P<0.01). Conclusion Plasma insulin and Aβ are abnormal in AD, and they are related to severity of dementia.