Objective To investigate ?-Lactamase coding genes and OprD2 gene in multidrug-resistant Pseudomonas aeruginosa isolated from Xiangfan region in Hubei province.Method Polymerase chain reaction(PCR) was used to detect various ?-Lactamase coding genes including TEM、SHV、OXA、PER、GES、IMP、VIM、plasmid type AmpC ?-Lactamase DHA 、MIR and OprD2 in 35 strains of Pseudomonas aeruginosa.Results The detection rate of ?-Lactamase coding genes TEM、OXA、plasmid type AmpC ?-Lactamase DHA were 51.4%、17.1% and 2.9% respectively, all of the tested strains of Pseudomonas aeruginosa lossed OprD2 gene,but SHV、PER、GES、IMP、VIM、MIR genes were negative.Conclusion The study indicated that these Pseudomonas aeruginosa carried genes of TEM、OXA、plasmid type AmpC ?-Lactamase DHA and lossed OprD2 gene, which was the essential resistance mechanism of Pseudomonas aeruginosa to Beta-lactam antibiotics in local aera.

OBJECTIVE To study the mechanisms of imipenem resistance in Pseudomonas aeruginosa.METHODS PCR method was used to detect and analyze P.aeruginosa imipenem-resistance associated IMP gene and VIM gene of metallo-?-lactamases and outer membrane protein D2(OprD_2) gene.RESULTS All 35(imipenem)-resistant P.aeruginosa strains were negative for IMP gene and VIM gene of metallo-?-lactamases;and for OprD_2 gene;but 23S rRNA gene of all 35 P.aeruginosa strains was positive.CONCLUSIONS The study suggested that in(Xiangfan) area,Hubei Province P.aeruginosa doesn′t produce metallo-?-(lactamases),but in genetics it is(identified) that the loss of outermembrane protein D2(OprD_2) gene is the(essential) mechanisms of imipenem(resistance) in P.aeruginosa in Xiangfan area,Hubei Province.

OBJECTIVE To investigate nosocomial infection and drug-resistance of Pseudomonas aeruginosa(PAE) in our hospital to provide the evidence for clinical monitoring and control of nosocomial infection.METHODS The microbiological system MicroScan WalkAway-40 was used to identify PAE and the drug-resistance in vitro was determined by K-B methods.RESULTS Among 325 strains of PAE in two years,imipenem-resistant P.aeruginosa(IRPA) accounted for 14.8%.The highest isolating rates occurred in the intensive care unit(ICU),accounted for 20.9%.The following was senile disease department,accounted for 19.4%.The respiratory department rated the third,accounted for 16.9%.The resistance of IRPA to 11 kinds of common antibiotics was significantly higher than imipenem-sensitive P.aeruginosa(ISPA).Except the drug-resistance of IRPA to ceftazidime,cefepime and aztreonam was below 50.0%,that to the other eight antibiotics was all over 50.0%.CONCLUSIONS The drug-resistance of PAE is very serious in our hosptial.We should perform rigorous monitoring and prevent the outbreak of nosocomial infection with PAE.

Objective To study the change of Yes-associated protein (YAP) expression in rectal cancer and to explore the significance of YAP in rectal cancer.Methods Reverse transcriptase polymerase chain reaction(PT-PCR) and Western bloting technology were used to detect mRNA and protein expression of YAP in 30 patients with rectal cancer and 10 cases of normal rectal mucosa tissue.Results The expressions of mRNA and protein of YAP in rectal cancer were significantly higher than those in normal rectal mucosa tissue (73.2 ± 1 1.1 vs.10.4 ± 4.1,65.7 ± 9.5 vs.9.2 ± 4.3,P ＜ 0.05).Conclusion YAP high expression is related to the occurrence of rectal cancer.

Objective To identify an suspected Vibrio cholerae isolated from Xiangyang Central Hospital and characterize the strain in terms of antibiotic resistance and relevant virulence genes.Methods Pathogen identification and susceptibility testing were completed with MicroScan WalkAway 40 Automated Microbiology System.Slide agglutination was used for serotyping. PCR and sequencing technology were employed for 16s RNA gene analysis.PCR technique was used to detect six major viru-lence genes.Results This suspectedVibrio cholerae isolate was confirmed as non-O1 and non-O139 Vibrio cholerae .Suscep-tibility testing results indicated that the strain was sensitive to ampicillin,chloramphenicol,trimethoprim-sulfamethoxazole, and tetracycline.16s RNA gene sequence analysis showed 100% homologous with the registered sequence in National Center for Biotechnology Information database.Virulence genes rtxC and toxR were identified.The other virulence genes such as tcpAET,ctxA,hlyA,and tcpACL were negative.Conclusions This suspected Vibrio cholerae isolate is confirmed as non-O1 and non-O139 Vibrio cholerae .The pathogenic factors may be related to the virulence genes rtxC and toxR.

Objective:To study the effectiveness of inferior pole fracture of patella treating by the new tension band.Methods:From Dec.2011 to Dec.2013, 21 patients with inferior pole fracture of patella were treated with the new tension band which consisted of cannulated screw, titanium cable and shims. There were 21 patients[10 males, 11 females, the average age was 54 years(21 to 79)],of whom,all were“fell on knees”.Results:The average operation time was 89 min (57-197 min),the follow-up visits were done from 7-31 months ( average 18 months) , the bone healing time was from 8-12 weeks (average 10.5 weeks).The post operation assessment was done by Bostman score, from 20 -30 (average 27),10 excellent,and 11 good.No complication occurred.Conclusion:The new tension band is the effective treatment for inferior pole fracture of patella.The internal fixation is reliable, it is simple to operate, and patients can take exercises as early as possible.Therefore, the new tension band has a bet-ter clinical value.

Objective To evaluate the correlation between 3 different instruments,SF-36 Health Survey,Hospital for Special Surgery (HSS) knee score and Rasmussen Score,for measurement of surgical outcomes of tibial plateau fractures,and their clinical significances as well.Methods Included in this study were 94 patients with tibial plateau fracture who had been consecutively treated and followed up from January 2009 through February 2015 at our department.Their surgical outcomes were measured by SF-36 Health Survey,HSS-knee score and Rasmussen Score respectively for health-related quality of life (HRQL),knee function,and reduction of fracture.Pearson correlation test was used to determine the correlation between the 3 measurement instruments.Results 94 cases eventually finished their following-ups.The mean follow-up was 41.2 months (range,from 12 to 75 months).The Rasmussen scores for their first postoperative X-ray films averaged 14.7 ± 2.1 points,their HSS-knee scores at the final follow-up averaged 81.0 ± 13.7 points,and their SF-36 scores at the final follow-up averaged 85.5 ± 10.0 points.Statistical analysis showed that the HSS-knee score was positively related to the SF-36 score and Rasmussen score (P ＜ 0.05) but not to the Rasmussen score (P ＞ 0.05).Conclusions Fine reduction may be the basis for good functional recovery of the knee and good functional recovery may benefit the HRQL of the patients,but merely good fracture reduction does not promise a high HRQL for patients with tibial plateau fracture.In the treatment of tibial plateau fractures,it is not enough to take care of fracture reduction and functional recovery,and the HRQL of patients should be taken into consideration.More attention should be paid to other important factors influencing the HRQL of patients.

In this study Na2HPO4-Ca(NO3)2 system was used to synthesize hydroxyapatite (HA). Its synthetical method was simple and low in cost. With the physical-chemical characteristic observation and the animal experimentit was proved that HA was pure, with pores ranging from 20 to 200 ?m in diameter.The chemical structure of HA was similar to that of inorganic part of bones.An investigation of the histological changes and osteogenetic effectiveness of HA implanted was conducted and the mechanism of HA osteogenetic effectiveness is discussed. The study will provide scientific basis for the clinical use of HA as bone graft substitute.

Objective To discuss the role of non-fusion without decompression in surgical treatment of unstable AO type A thoracolumbar fractures. Methods A retrospective study was performed on 42 patients with AO type A thoracolumbar fractures (T11-L2) treated with short segment pedicle screw fixation from February 2004 to February 2008. Patients were divided into two groups, ie, Croup A (treated with short segmental pedicle screw fixation without decompression or fusion) and Group B (treated with short segmental pedicle screw fixation without decompression but with fusion). The pre-operative, postoperative and follow-up local kyphotic angle, vertebrae compression rate were compared between two groups. Results In Croup A, average local kyphotic angle and average vertebrae compression rate were 19.1° (15. 4°-29. 8°) and 46% (30%-63%) respectively before operation, but 5. 0° (0. 3°-10.3°) and 10% (0-28%) respectively after operation. Twenty-one patients were followed up for average 21.2 months (12-46 months), which showed average local kyphotic angle of 7° (1.8°-10.7°) and average vertebrae compression rate of 10% (2% -22%) at final follow-up. In Croup B, average local kyphotic angle and average vertebrae compression rate were 25.8° (15.9°-34.5°) and 55% (30%-76%) respectively before operation, but 7.1° (1.5°-19. 1°) and 15% (0-28%) respectively after operation. Fifteen patients were followed up for mean 17.9 months (12-31 months) , which showed mean local kyphotic angle of 8.3° (0.7°-19.2°) and average vertebrae compression rate of 15% (l%-26%) at final follow-up. There was no pseudarthrosis, implant breakage, pedicle screw pull-out or severe back pain. There was statistical difference in local kyphotic angle and vertebrae compression rate between two groups.Conclusion Unstable AO type A thoracolumbar fractures with minor neurological deficit can be treated with pedicle screw fixation only without decompression or fusion.

Objective To detect the possibility of posterior laminar fenestration combined with screw instrumentation for treatment of thoracolumbar burst fracture with canal encroachment.Methods Between January 2005 and December 2008,52 patients with AO-A3 thoracolumbar fracture underwent laminar fenestration to achieve canal decompression and pedicle screw instrumentation without interbody fusion.Canal encroachment,loss of anterior vertebral height,Cobb' s angle,and neurologic outcome were measured before and after operation.Results All patients were followed up for 24 months.Canal encroachment improved from preoperative (68.3 ± 15.1)％ to postoperative (11.5-3.9)％ (P ＜ 0.05).Cobb' s angle reduced from preoperative (32.5 ± 3.2) ° to postoperative (4.9-± 0.6) ° (P ＜ 0.05).Loss of anterior vertebral height restored from preoperative (50.1 ± 5.6) ％ to postoperative (85.5 ± 5.1) ％ (P ＜ 0.05).At the final follow-up,neurological recovery and fracture healing with no apparent vertebral height loss were noted for all patients.Conclusion Flaminar fenestration combined with pedicle screw stabilization attains good radiographic and clinical results in treating patients with AO-A3 thoracolumbar burst fracture.