Objective To study the biologic characteristics of the new qnr gene subtype and multi-drug resistant mechanism in a clinical isolate of Klebsiella oxytoca.Methods We cloned and expressed the qnr gene,?-lactamase and integrase genes were detected by PCR.Results Susceptibility of transformant containing qnr gene against common fluoroquinolones was 3~25 times lower than recipient stain,but drug-resistance was 4~256 times lower than the clinical isolate.KLUC-1,TEM-1 and OXA-30 genes were also found in the isolate.Conclusions qnr gene can raise the drug-resistance to fluoroquinolones slightly. There are multiple drug-resistant genes in the strain containing the qnr gene.

Cardiovascular System ; Pharmacogenetics

BACKGROUND:Swel ing after knee arthroplasty can produce tension bul ae, worsen pain, and even block venous return. Thus, intraventricular pressure of osseous fascia increases, which can block arterial blood circulation, even induce osteofascial compartment syndrome.
OBJECTIVE:To evaluate efficacy of Cryf/cuff Systems and intermittent cold compress with hypertonic saline fol owing total knee arthroplasty.
METHODS:A total of 60 patients with unilateral total knee arthroplasty were randomly assigned into two groups. Persistent freezing group received treatment with Cryo/cuff Systems after arthroplasty, and intermittent cold group received intermittent cold compress with hypertonic saline after arthroplasty.
RESULTS AND CONCLUSION:Significant differences in circumference differences in superior patel ar pole, patel ar midpoint, and thickest point of gastrocnemius muscle were detected between persistent freezing group and intermittent cold group at 1 and 2 days after total knee arthroplasty (P<0.05), but no significant difference was detectable at day 3. Visual analogue scale scores at rest and during activity were significantly lower in the persistent freezing group than those in the intermittent cold group at 1 and 2 days after total knee arthroplasty (P<0.01), but no significant difference was visible at day 3. Range of motion was better in the persistent freezing group than that in the intermittent cold group at 1, 2 and 3 days (P<0.01), but no significant difference was observed at 1 and 2 weeks. Mean skin temperature was higher in the persistent freezing group than that in the intermittent cold group at 3 days (P<0.05). Results suggested that Cryf/cuff Systems could lessen tissue swel ing and pain, increased range of motion compared with intermittent cold compress with hypertonic saline at 1 and 2 days after total knee arthroplasty, but no significant difference was detected at day 3. That is, intermittent cold compress with hypertonic saline can reach the same effect as Cryf/cuff Systems at day 3.

Objective To explore the method of treatment of sunken cheek deformity.Methods The longitudinal platysma-faseial flap was overturned 180 degree upward,the flap's pedicle located in the margin of mandible,and then combined with abdominal dermis fat graft to form as a sandwich,which filled in the sunken area of face.Results Five patients were treated with this method from 2003 to 2007,and satisfactory results were gained but only mild absorption was found in the transplanted tissue area during followed up for 3 months to 3 years.Conclusion Platysma-fascial flaps survive easily with rich blood supply and strong anti-infection,and are also easy to incise and operate as well,which,together with free abdominal dermis fat flap,could increase the amount of the needed tissue.It is a better approach to repair the sunken cheek deformity and in particular suitable for the more serious deformity in patients with sunken cheek.

Objective:To explore the possibility of treatment of microencapsulated transgeneic cells on allotransplantation cells. Methods: The peritoned cavity of mice were injected with Alginate-chitosan microencapsules, which were prepared by drop generative technique and contained human fibroblastlike bone marrow stroma cells transgened by partial CEA gene. Results: The microencapsulated cells transplanted in mouse abdominal cavity could go on growing, proliferate and increase the immune reaction of T lymphocyte from mice spleen to ConA stimulation in 3 months. Conclusion :The study shows that Alginate-chitosan have good biocompatibility, strength and can be used as an immunoisola-tion tool in cell transplantation. The microencapsulated cell transplantation can help to broaden the cell source of allotransplantation and provide reliable proof for the study on treatment malignant tumor with microencapsulated transgeneic cell vaccine.

OBJECTIVE To investigate the genotypes of meticillin-resistant Staphylococcus aureus(MRSA)and its resistance.METHODS A total of 73 MRSA clinical isolates were collected in Anhui Province,MIC of sixteen different antibacterial agents against the isolates were determined by agar dilution method.PCR amplified the mec associated hypervariable region(HVR)of MRSA,and the genotypes were classified based on the fragments of amplified products.The correlation of genotypes and antimicrobial resistance was analyzed.RESULTS Seventy three strains of MRSA from Anhui Province were grouped into A,B and C genotypes based on HVR polymorphism,and respectively 17.8%,23.3%,and 58.8%.All strains were sensitive to vancomycin.CONCLUSIONS MRSA is multi-drug resistant and can be divided into 3 genotypes based on the HVR PCR amplified products.HVR PCR method is a rapid and convenient method for molecular epidemiology study of MRSA infections.

Objective To evaluate the application of modified Abbe flap in repairing moderate defects of the upper lip and time point to divide the pedicle.Methods Classic Abbe flap was modified in its design,pedicle cutting and dividing time,which was used to repair moderate defect of the upper lip in 12 cases.Surgery was divided into two phases:one with modified Abbe flap surgery was performed for the combined nasal deformity repair simultaneously,and then the pedicle was divided 9days after surgery.Results 12 patients underwent modified Abbe flap.No vascular complications were found in these flaps.Upper lip shape was well and satisfactory functional recovery,corresponding improvement in nasal appearance.Conclusions The surgery that the modified Abbe flap with the pedicle is divided 9 days after surgery is very simple.On one hand,it greatly improves the patient's appearance and function of the upper lip,improve the overall shape of midface,on the other hand,dividing pedicle time is significantly shorter than in the past,specially reducing the suffering of patients and duration.It is particularly suitable for unilateral and bilateral cleft lip of the upper lip on secondary moderate deformities and combined nasal deformities.

0.05). The CYFRA21-1 level measured at the fifth day after treatment in death group was higher than that in survival group (P

Objective To investigate the practical anatomy and clinical applications of the lateral sural nerve-lesser saphenous vein vascular plexus island flap with median sural nerve preserved.Methods Ten lower limbs injected with color red latex and 20 fresh limbs were observed.Based on anatomical studies,the island flap pedicled with the vascular axis of lateral sural nerve and lesser saphenous vein was designed for clinical application in 63 cases.In procedure,the median sural nerve were preserved in donor site and the distal end of the lesser saphenous vein were not ligated.Results The accompanying arteries formed a favourable vascular plexus around the nerve and the vein,lied along the lateral sural nerve and the lesser saphenous vein and nourished the skin through cutaneous branches.The distance of the lateral ankle to the confluent of lateral and median sural nerve was (8.5± 0.8) cm.63 patients with soft tissue defects in the distal leg and foot were repaired.Their appearance and function were satisfaction without feeling lose in the heel and lateral side of the foot.Conclusions The lateral sural nerve-lesser saphenous vein vascular island flap is a reliable source of soft tissue to cover defects in the lower leg and foot.This flap has sufficient blood supply and high survival rate without the sacrifice of the median sural nerve.

Objective:This study aims to analyze the occurrence rate, positive rate, and other related factors influencing interpec-toral lymph nodes (IPNs) in breast cancer patients. This work further aims to explore the significance and indications of the surgical dis-section of IPNs. Methods:Clinical and pathological data from 1673 breast cancer patients were retrospectively analyzed. All patients were subjected to modified radical mastectomy, and IPNs were pathologically examined. The occurrence rate and metastasis of IPNs were recorded, and the relationship between the IPN positive rate and tumor size, axillary nodes, clinical stages, neo-adjuvant chemo-therapy, hormone receptors, Her-2 expression, and molecular subtypes of breast carcinoma was determined. Results:The occurrence rate, overall metastasis rate, and the positive rate of IPNs in patients with axillary lymph node metastasis were 13.39%, 4.30%, and 10.01%, respectively. IPN metastasis was significantly correlated with axillary node metastasis and the tumor, node and metastasis (TNM) stage of tumors (P<0.05). However, IPN metastasis was not significantly related with hormone receptor and Her-2 expressions. IPN metastasis rate may be unaffected by neo-adjuvant chemotherapy. Patients with IPNs metastasis were characterized by larger tu-mors, more positive axillary lymph nodes, and later TNM stages. Conclusion:IPN metastasis usually occurs in patients with larger tu-mors, more positive axillary lymph nodes, later TNM stages, as well as those with locally advanced cancer that meet the standard of neo-adjuvant chemotherapy. These indications suggest that the surgical dissection and pathological examination of IPNs should be rou-tinely performed.