OBJECTIVE To investigate the genetic polymorphism of imipenem-resistant Pseudomonas aeruginosa by randomly amplified polymorphic DNA(RAPD). METHODS The genes of imipenem-resistant P.aeruginosa were amplified by RAPD assay in 8 clinical isolates and PCR products were analyzed by agarose gel electrophoresis and cluster analysis. RESULTS The phenotypes of drug resistance were the same,but most of the genotypes were different,even though some of them could be equal. CONCLUSIONS RAPD assay reveals the special genotypes of imipenem-resistant P.aeruginosa and makes the relation between the phenotype of drug resistance with genotype of drug resistance definite,which provides molecular epidemiological evidence for strategies to control resistant imipenem P.aeruginosa infections.

OBJECTIVE To investigate the plasmid AmpC genes,?-lactamases genes and intⅠgenes in Escherichia coli.METHODS M-H test was performed to detect the antimicrobial susceptibility of 40 strains of E.coli isolated from the clinic.?-Lactamases genes,plasmid AmpC genes and intⅠgenes were detected by PCR methods.RESULTS Forty strains of E.coli were multiple-drug-resistant.The positive rate of genes of TEM,SHV,LEN,CTX-M-1,CTX-M-9,VEB,GES and PER was 55.0%,7.5%,55.0%,12.5%,45.0%,5.0%,45.0% and 35.0%,respectively.The positive rate of plasmid AmpC genes of ACT-1 and DHA was 57.5% and 40.0%,respectively.The positive rate of intⅠgenes was 47.5%.CONCLUSIONS E.coli isolated from the clinic is multiple-drug-resistant and wityh high positive rate of the plasmid AmpC genes,?-lactamases genes and int Ⅰ genes.

OBJECTIVE To investigate the drug-resistance and the existence of genes in 16S rRNA methylases and aminoglycoside modifying enzymes in strains continuously isolated from Pseudomonas aeruginosa(PAE) in two hospitals of Jiangsu and Zhejiang Provinces.METHODS The drug-resistance of the strains continuously isolated from PAE was detected with K-B test,five kinds of genes in 16S rRNA methylases(rmtA,rmtB,rmtC,rmtD and armA) and six kinds of aminoglycoside modifying enzymes [aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅰb,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ] were detected by PCR.RESULTS The strains were just sensitive to cefoperazone/sulbactam,imipenem,meropenem and amikacin(hospital A:74.2%,80.0%,82.9% and 68.5%;hospital B:90.0%,50.0%,50.0% and 95.0%,respectively).There was a high rate in the drug-resistance to ?-lactamase medicines,ciprofloxacin and sulfamethoxazole co.Genes in 16S rRNA methylases were not detected from PAE strains in the two hospitals.CONCLUSIONS The rates of genes in aminoglycoside modifying enzymes detected from strains in continuously isolated from PAE are different in different hospitals.

OBJECTIVE To investigate the antibiotic resistance and the genetical marks in Pseudomonas aeruginosa(PAE) strains in two hospitals of Jiangsu and Zhejiang.METHODS The drug-resistance in PAE strains was detected with K-B test,four kinds of genetical marks of integron and transposon(qacE△1-sul1,mer,tnpA and tnpU) were detected by PCR.RESULTS The strains were only sensitive to cefoperazone/sulbactam,imipenem,meropenem and amikacin.There was a high resistance rate to ?-lactamases,ciprofloxacin,and sulfamethoxazole.Genes of qacE△1-sul1(48.6%,45.0%) and merA(11.4%,5.0%) were detected from PAE strains in the two hospitals.There were no tnpA and tnpU too.CONCLUSIONS Multiple-drug-resistance in Pseudomonas aeruginosa(PAE) strains is caused mainly by qacE△1-sul1 and merA.

OBJECTIVE To detect the disinfectants-resistant gene of qacE-sul1 in nosocomial infected patients.METHODS The disinfectants-resistant gene of qacE-sul1 was detected by polymerase chain reaction(PCR).RESULTS The positive rate of gene of qacE-sul1 in 222 strains was 54.5%.The positive rate of gene qacE-sul1 in Klebsiella pneumoniae,Escherichia coli,Staphylococcus aureus,Proteus,Pseudomonas aeruginosa,Enterococcus,and Acinetobacter baumannii were 47.6%,58.3%,57.6%,54.2%,53.6%,53.3%,and 55.0%,respectively.CONCLUSIONS There are higher positive percentages of gene qacE-sul1 in nosocomial infected patients which possibly causes nosocomial infection and should be attention to.

OBJECTIVE To investigate the ?lactamase genes in Escherichia coli and their resistance.METHODS Twenty strains of E.coli producing extended spectrum ?-lactamases(ESBLs) were isolated from hospitalized patients.?-Lactamase drug-resistant genes were detected by PCR.RESULTS There were higher positive rates of ?-lactamase genes of TEM,SHV,LEN,CTX-M-1,CTX-M-9,VEB,GES,PER(75.0%,20.0%,95.0%,15.0%,70.0%,5.0%,85.0% and 70.0%,respectively). This study showed that there were high positive rate of drug resistance.CONCLUSIONS There are very high positive percentages of TEM,LEN,CTX-M-9,GES,and PER genes in ESBLs producing E.coli isolated clinically,and showing highly drug-resistant E.coli of producing ESBLs can be transmitted in hospital and induce fulminant prevalence.

Objective To evaluate the auxiliary diagnostic ability and applicability of ~(18)F-FDG PET/CT and the LungCare soft-ware of dual source CT in solitary pulmonary nodule(SPN). Methods 28 patients with SPN proved by pathologically were examined by ~(18)F-FDG PET/CT and LungCare software of dual source CT. ~(18)F-FDG PET/CT and LungCare software of dual source CT data were analysed comparatively in terms of the diagnostic accuracy in distinguishing malignant and benign. All data were analyzed for significance by using the χ~2-test,the value of P<0.05 was accepted as significance. Results There were 15 malignant and 9 benign nodules. In evaluating SPN,the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 80.0% ,88.8% ,83.3%,92.3% and 72.7% with ~(18)F-FDG PET/aT respectively,and 93.3% ,77.7% ,87.5%,87.5% and 87.5% with LungCare software, respectively. To evaluate SPN,LungCare software and ~(18)F-FDO PET/CT was not significant difference in accuracy(P>0.05) ,while there were significant differences in sensitivity , specificity , positive and negative predictive value (P< 0.05). The sensitivity and negative predictive values with~(18)F-FDG PET/aT were much better than that with LungCare software, but the specificity and positive predictive values were less than that with LungCare software. Conclusion ~(18)F-FDG PET/CT has certain auxiliary function in distinguishing benign SPN from malignant SPN,it combining with LungCare software , the accuracy of diagnosis can be improved.

Objective To evaluate the auxiliary diagnostic ability and applicability of the Lung Care software of dualsource CT in the study of solitary pulmonary nodule(SPN). Methods 40 cases with SPN proved by pathologically were examined by dual-source CT. R-MPR and VOI of Lung Care software three-dimension rebuilding image were obtained to analyze imaging features of SPN and compared with routine chest CT. 20 cases had regular visits during 12 months which were divided into three stages to measure the growing speed or doubling time. Results There were 28 cases of malignant nodules and 12 cases of benign nodules in 40 cases of SPN. The accuracy for malignancy of routine chest CT and LungCare software three-dimension rebuilding are 53.57% ,82.14% respectively. The accuracy for benign nodules is 41.67%,83.33% respectively. Both are significant difference (P

Objective To investigate the clinical efficacy and value of percutaneous transluminal angioplasty (PTA) in treating arteriosclerosis obliterans (ASO) of lower extremity that shows no visualization of its vascular outflow tract. Methods A total of 19 patients with ASO of lower extremities showing no outflow tract visualization were included in this study. The patients included 11 males and 8 females with a median age of 66 years (48-79 years. The main clinical symptom was rest pain of the leg in all patients; 10 cases had different degrees of foot ulcer and gangrene. Preoperative multi-slice CT angiography and DSA examination were performed in all patents. After PTA, the patients were followed up for 12 months, the changes of the clinical symptoms and signs were recorded. The claudication distance, toe skin temperature, ankle-brachial index (ABI), toe-brachial index (TBI), and CT angiography or color Doppler examination were separately performed before and one, 3, 6 and 12 months after PTA. Results In the 19 patients (38 diseased limbs in total), ASO with no visualization of vascular outflow tract was detected in 54 arteries, 3%), posterior tibial artery (n=18, 33.3%), peroneal artery (n=9, 16.7%) and popliteal artery (n=2, 3.7%). The technical success rate of limb PTA was 89.5%, while the technical success rate of single artery PTA was 85.2%. After PTA, the skin temperature of all the diseased limbs that had been successfully treated was obviously improved, the pain was significantly relieved or disappeared. One, 3, 6 and 12 months after PTA, the claudication distance, toe skin temperature, ABI and TBI were strikingly improved when compared with those determined before PTA (P<0.05). Twelve months after PTA the vascular restenosis rate was 39.5% (15/38), the limb vascular patency rate was 55.3% (21/38), and the limb salvage rate was 81.6%(31/38). Conclusion For the treatment of lower extremities arterial obliterans with obstructed outflow tract, PTA is safe and effective in short-term period. Although its long-term restenosis rate is higher, this technique can effectively control the progress of the disease, relieve the clinical symptoms, and help improve the limb salvage rate of ischemic limbs.

Objective To explore the association between genetic polymorphisms and haplotypes of tumor necrosis factor-related apoptosis inducing ligand (Trail) and ulcerative colitis (UC).Methods A total of 331 patients with UC and 832 age and sex-matched healthy controls were collected.After Trail gene was amplified by PCR,the genetic polymorphisms of three single nucleotides (G1525A/G1588A/C1595T) in 3' non coding regions of Trail gene were examined by direct sequencing.The relation between Trail haplotype and UC was analyzed.Results Compared with control group,the frequencies of variant allele A and genotype GA+ AA in Trail G1525A were significantly lower in UC group (both P＜0.01).The frequencies of variant allele A and T in Trail G1588A and C1595T were also significantly lower in UC group than that of control group,and the difference was statistically significant (both P ＜ 0.01 ).In mild and moderate UC patients,the frequencies of variant allele T and CT+TT in Trail C1595T were 49.15％ and 64.51％,in severe UC patients were 72.37％ and 84.21％,and the differences were significant between the two groups (OR=2.710 and 2.935,95％CI:1.598～4.596 and 1.188～7.249,all P ＜0.05).In severe UC patients,the frequency of variant allele A in Trail G1525A was 48.69％,which was higher than that of mild and moderate patients (35.16％,OR=1.750,95％CI:1.082～2.830,P=0.021).In UC group,the frequency of AAT haplotype was significantly lower than that of controls (43.09％ vs 58.41％,P＜0.01).The frequency of GAT haplotype was significantly higher in UC group (10.15％vs 0.18％,95％ CI:0.005 ～ 0.051,P＜ 0.01).Conclusion The genetic polymorphisms and haplotypes of Trail (G1525A/G1588A/C1595T) gene may be closely correlated with the susceptibility to UC.