Objective To investigate SCCmec genotypes and drug-resistance profiles of the methieillin-resistant Staphylococcus epidermidis (MRSE) strains isolated from the patients suffered from diabetic foot infections (DFI) in the Tianjin Metabohc Diseases Hospital. Methods After dabridement, specimens of 390 infectious diabetic foot ulcers in the hospital from Jan 2008 to Jun 2010 were collected from the wound basal parts by cotton swab for culture. The disk-diffusion method was performed to examine antimicrobial susceptibility. DNAs of the MRSE strains were extracted, and their SCCmec genotypes were identified by PCR. Results Twenty of the seventy(28.6% ,20/70)Staphylococcus epidermidis strains were mecA posifive. Among the MRSE isolates, 2 ( 10.0% )were SCCmec Ⅱ ,9 (45.0%)were SCCmecⅢ and 9 (45.0%)were SCCmec Ⅳ. None of the isolates were genotyped as SCCmec Ⅰ or Ⅴ. No mater which genotypes they were, all the MRSE isolates were multi-drug resistant. They were resistant not only to β-lactams (including penicillins, cefoxitin and cephems), but also to non-β-lactams (including macrolides, fiuoroquinolones and sulfonamides ) . Resistance to voncomycin and rifampicin were not found in these strains . Conclusion SCCmec Ⅲ and SCCmecⅣ are major genotypes of the MRSE isolates from the infectious diabetic foot ulcers.The SCCmec Ⅳ genotype strains with multi-drug resistant profiles are prevalent in the diabetic foot infections.

Objective To investigate clinical features and antibiotic resistance of pseudomonas aeruginosa (PA) strains isolated from patients with diabetic foot infections (DFI) in Tianjin Metabolic Diseases Hospital.Methods Eighty-five PA strains were isolated from 428 patients with diabetic foot in the hospital from Jan 2008 to Dec 2010.The clinical features of patients were summarized.Relationships between the isolates and depth of ulcer or severity of infection were analyzed.The disk-diffusion method was performed to examine antimicrobial susceptibility.Results Gram positive (G+) and Gram negative (Gˉ) isolates were 50.47％ and 41.12％,respectively.Multidrug-resistant PA composed 32.9％ of the total PA isolates.The size of ulcers with PA infections was bigger than those with non-PA bacterial infections (P＜0.05).Compared to G+ strains,patients with PA strains were older,had lower hemoglobin,but higher serum sensitive C-reactive protein; and more frequently,they had ischemic ulcer and osteomyelitis.Compared to G+ strains,the PA strains were more frequently isolated from deeper ulcers and with more serious infections(P＜0.05).The resistant rates of PA to cephalosporins,fluoroquinolones,and aminoglycosides were between 32.9％-61.2％,37.6％-42.4％,and 37.6％-62.4％,respectively.Only one out of 85 PA strains was imipenem-resistant.However,sensitiveness of all PA isolates to cefoperazone and sulbactam reached 100％.Conclusion PA strains are mainly found in patients with deeper ulcers and more serious infections.Multidrug-resistant PA is common in DFI.It is important to isolate pathogens and determine their antibiotic resistance correctly in diabetic foot patients in order to provide appropriate drug administration and to reduce the production and dissemination of drug resistant strains.

Objective To investigate the application of radiological diagnosis and treatment equipment and distribution of medical radiation levels in medical institutions at various levels in Shijiazhuang, China in 2019, and to lay a sound foundation for further radiation protection and management. Methods A universally designed questionnaire was used to investigate and compile data on the level of the sampled hospitals, the number of radiation workers, equipment information, the number of outpatients and emergency patients, the number of inpatients, and the frequency of radiological diagnosis and treatment; the application frequency of each radiological diagnosis and treatment item was calculated based on the demographic data of Shijiazhuang. Results In Shijiazhuang, there were 390 medical institutions (excluding dental clinics) certified for radiological diagnosis and treatment, with a total of 4262 radiation workers and 1215 radiological diagnosis and treatment devices; 1.11 radiological diagnosis and treatment devices were available per 10 000 people, and 3.89 radiation workers were available per 10 000 people. The number of annual outpatients and emergency patients was 30 208 471, the number of inpatients was 1 981 295, and the total number of people or times receiving radiological diagnosis and treatment was 5 987 230. The application frequency of medical radiation was 546.70 persons/times per 1000 people, with the highest frequency for X-ray diagnosis (534.63 persons/times per 1000 people), followed by diagnosis and treatment with nuclear medicine (6.16 persons/times per 1000 people), and the lowest frequency for radiotherapy (1.17 persons/times per 1000 people). In terms of regional distribution, the highest frequency of medical radiation fell in Yuhua District (1602.97 persons/times per 1000 people), and the lowest frequency fell in Shenze County (203.21 persons/times per 1000 people). Conclusion The development of medical radiation is imbalanced in Shijiazhuang, with high-quality medical resources concentrated mainly in the main urban area, thus resulting in long-term overworking of hospital staff and equipment in some areas. The government and health administration departments should strengthen macro-control and the rational allocation of medical resources; medical institutions at various levels should rationally use radiological diagnosis and treatment equipment, strengthen judgments on the justness of radiation, and strengthen the training of radiation workers on protection knowledge and radiation protection optimization.