Objective:To analyze molecular epidemiological characteristics of drug resistance genes and carbapenem resistance of Pseudomonas aeruginosa (PA) in rural well water. Methods:According to Citation of Natural Mineral Water Inspection (GB 8538-2016), a total of 112 well water samples were tested in Juye county of Shandong province, and PFGE and drug susceptibility test were conducted for the identified PA strains. After PCR identification of carbapenem resistance genes, S1-PFGE and Southern blotting were used to determine the location of drug resistance genes, and combined experiments were used to determine gene transferability. Results:The detection rate of PA in rural well water samples in Juye county of Shandong province was 54.46% (61/112). The 61 strains could be divided into 56 PFGE types. There were 2 strains with 100.00% consistent band types, and there was no obvious predominant band type. The results of drug susceptibility experiments showed that 93.44% (57/61) were multi-drug resistant strains, and there were 2 strains carrying blaVIM-2, both of which were located on the plasmid, and both of them were transferred horizontally with the plasmid. Conclusion:PA carrying carbapenem resistance genes was detected in well water of rural communities in Juye country, and there is the possibility of horizontal transmission of such resistance genes.

Objective: To analyze the antimicrobial resistance and multilocus sequence typing (MLST) results of extended-spectrum β-lactamase (ESBLs)-producing Escherichia coli in rural residents in villages with pig breeding farms in a county of Shandong province. Methods: Antimicrobial susceptibility testing was performed with agar dilution method by using 360 ESBLs-producing E. coli strains from fresh stool samples of rural residents in villages with pig breeding farms in a county of Shandong. PCR was conducted to amplify the CTX-M, TEM, SHV genes and capillary electrophoresis was used to screen positive strains in July, 2016. MLST was performed for molecular typing analysis, and eBURST v3.0 software was used for cluster analysis. Results: Among 360 strains of ESBLs-producing E. coli, the resistance rates to cefotaxime, tetracycline, trimethoprim-sulfamethoxazole and florfenicol were 100.0% (360/360), 82.2% (296/360), 81.1% (292/360) and 80.3% (289/360), respectively. The positive rate of CTX-M gene was 99.2% (357/360), in which the positive rate of CTX-M-9 was 35.6% (128/360) and the positive rate of CTX-M-1 was 24.4% (88/360). The positive rate of TEM gene was 26.9% (97/360). A total of 132 STs were identified through MLST. The predominant ST was ST10, accounting for 12.5% (45/360). Cluster analysis showed that CC10 was the most important clone group, including 39 ST clones, involving 148 strains (41.1%). Conclusions The drug resistances of ESBLs-producing E. coli to cefotaxime, tetracycline, trimethoprim-sulfamethoxazole and flurfenicol are serious in this rural area. There is a small-scale clustering of CC10 and transmission mode from animals to humans might exist.

Objective: To better understand the evolution and epidemiology of human adenovirus-55 (HAdV-55) and provide a scientific basis for the prevention and control of the epidemic of HAdV-55 in China. Methods: HAdV-55 isolates from 5 provinces in China included Beijing, Hebei, Shandong, Hunan and Yunnan were collected during 2011-2014. The hexon, fiber and penton base gene were sequenced, and compared with other strains of HAdV-55 sequences downloaded from GenBank for homology and evolution analysis. Results: During the past decade, HAdV-55 was found in 15 provinces throughout China. Genetic and phylogenetic analysis showed that the HAdV-55 virus is highly conservative in evolution due to aggregation in a branch in the evolutionary tree. However, bayesian phylogenetic tree shows a certain time evolution trend. The evolution rate of hexon and fiber gene of HAdV-55 are 5.228×10^-5 and 1.238×10^-4 substitutions/site/year respectively, and the latest coevolutionary ancestor tMRCA of hexon gene can be traced back to 1963. Conclusions HAdV-55 has been widely spread and continued circulating in China. Establishing effective monitoring system and conducting vaccine related research is very important for its control and prevention.

Objective: To determine the serotypes and drug resistance profiles of Shiga toxin-producing Escherichia coli (STEC) in animal stools from the Weishan area in Shandong Province, China. To provide the basis for further study. Methods: Five hundred animal stool samples (from pigs, cattle, sheep, dogs and birds) were collected from the Weishan area and STEC strains were isolated from these samples. Strains were serotyped by a serum agglutination test, and their drug resistance profiles were determined through antimicrobial sensitivity experiments. In this study, PCR was used to detect tetracycline resistance genes (tetA, tetB, tetC, tetD) and beta-lactam resistance genes (blaSHV-1, blaCTX-M, blaTEM). Results: Sixteen strains of STEC were isolated from animal stool samples. Thirteen strains were isolated from pig stool samples, two from bovine stool samples and one from a sheep stool sample. Two of the strains were identified as E. coli O157:H7, and other 14 strains were non-O157 STEC of different serotypes. Antimicrobial sensitivity experiments showed that 15 of the strains were multidrug resistant. The rates of resistance were as follows: nalidixic acid (12/16 strains), sulfisoxazole (11/16), trimethoprim and sulphame-thoxazole (11/16), doxycycline (9/16), azithromycin (9/16), tetracycline (9/16), chloramphenicol (8/16) and streptomycin (8/16). Therefore, nalidixic acid showed the highest rate of resistance among the strains, followed by trimethoprim and sulphame-thoxazole, and sulfisoxazole. Resistance to cefepime or imipenem was not detected. In total, three types of drug resistance genes (tetA, tetB and tetC) were detected among the 16 strains. Conclusion The results showed that STEC strains isolated from animals in the Weishan area were of a range of serotypes. The 16 strains of STEC isolated from animal stools in this area were resistant to a number of antibiotics, with many strains displaying multidrug resistance.

Objective To explore the effect of quality control circle (QCC) in reducing the radiation dose during chest CT scan. Methods QCC was founded, activity themes were selected, activity schedule was planned, the reasons of high radiation dose was analyzed, countermeasures were planned and implemented jointly by circle members, and then per capita radiation dose and image quality before and after improving was compared to confirm the effect of QCC activities. The subjects of chest CT scan before and after improvement in our center were selected, included totally 218 cases, their average age was (47.05 ± 8.58) years, 162 were male, 56 were female, 44 cases had CT scan before improvement, 174 cases after improvement, and the data were analyzed by T-test and Chi-square test. Results The radiation dose per capita has declined from 13.75 mGy to 3.45 mGy, The rate of standard was 102.08%, progress rate was 74.91%. The rate of high-quality image was 92.52%. Compared with per capita radiation dose before and after the activities, the differences were statistically significant(P<0.001). The rate of high-quality image was 93.18% before activities, the percentage remained steady at 92.52% after the activities, there was no statistically significant differences in image quality(P>0.05). Conclusions Application of QCC not only reduced the radiation dose of the client without image quality changes, but also improved thinking and learning capacity, cooperative consciousness of the circle members.

Objective To study the molecular-biologic characteristics and epidemiological status of iatrogenic related Community-acquired methicillin-resistant Staphylococcus (S.) aureus (CA-MRSA) in China through Meta-analysis.Methods Data through systematic searching for peer-reviewed articles published before December 3rd,2015 from 4 main electronic databases including China National Knowledge Infrastructure (CNKI),Wanfang Data,PubMed and Web of Science Core Collection was collected,for this Meta-analysis.PRISMA guidelines were followed and the proportion of MRSA,CA-MRSA,hospital-acquired MRSA (HA-MRSA) and panton-valentine leucocidin (PVL) gene in certain populations were quantitatively analyzed by Stata 13.0 software.Results Average proportion of CA-MRSA from S.aureus was 12％ (95％CI:8％-16％).CA-MRSA in MRSA was 18％ (95％CI:12％-24％).42.1％ (95％CI:20.4％-63.7％) of the CA-MRSA carried a PVL gene,and the number was higher than general MRSA (t =-2.99,P=0.011).Conclusion CA-MRSA was in lower proportion than HA-MRSA,both seen in general MRSA and in S.aureu.s,but under higher proportion of carrying the PVL gene.Transmission of CA-MRSA could be prevented within the general population through conducting effective surveillances and preventive programs.

Objective To assess the relationship between type 2 diabetes and the risk of kidney cancer. Methods PubMed, Medline, CNKI and VIP were used to identify studies which regarded the relationship between type 2 diabetes and risk of kidney cancer up to July 2014. The relative risks (RRs) and the corresponding 95% confidence interals (CIs) were used to estimate the association between type 2 diabetes and the risk of kidney cancer through software STATA. Results 8 studies were included in this analysis. Compared to the popula-tion without type 2 diabetes, there was an increased risk of kidney cancer in the type 2 diabetes patients, the pooled RR (95%CI) was 1. 55 (1. 24,1. 92),P<0. 05. Conclusion Our meta-analysis suggestes that type 2 diabetes can increase the risk of kidney cancer.

To establish a new kind of minimally invasive surgical model of transurethral prostate enucleation operation and method that makes the operation easier and reduces the surgeon learning curve.According to the order and the path of surgical operation,prostate enucleation operation is split into 4 different modules named as A,B,C,D,and it is called modular transurethral enucleation of the prostate.The operation mode optimizes the process of operation design, modularizes the contents of surgical procedures,processes,and reduces the difficulty of the operation,and simplifies the surgical procedure,which can effectively shorten the operation time and make it easy for beginners to carry out and control the procedure.It has a great popularization value.

Virtual reality simulators and surgical demonstration were used in laparoscopic teaching combining teacher' guiding with students' practice to improve the teaching effectiveness hecause of the limitations of the traditional apprenticeship teaching methods.The new method was applied for 2 cycles and for 6 weeks.The results showed that the teaching methods of virtual reality simulators combined with surgical demonstration can significantly improve the effectiveness of laparoscopic teaching and shorten the initial learning curve,therefore it is worth promoting in laparoscopic operation training and teaching.

Objective To explore the value of diagnostic ultrasound mediated microbubble destruction in improving the myocardial perfusion and left ventricular systolic function when cooperated with the mecsenchymal stem cells(MSCs) transplantation in rabbit myocardial ischemia. Methods One week after myocardial ischemia (MI) modeling,36 rabbits were divided into 3 groups,the control group(group Ⅰ) ,intravenous injection of MSCs group(group Ⅱ) and ultrasound + microbubble + MSCs group (group Ⅲ). Myocardial contrast enhancement (MCE) was performed and quantification analysis of anterior wall was assessed with Photoshop. Left ventrieular systolic function was assessed with M-mode echocardiography and bi-plane Simpson's method. CD34 expression in heart was detected with immunohistochemisty(IHC). Western blotting was applied to detect the level of VEGF in three groups. Results The differences of gray scale analyzed with histogram of Photoshop in anterior wall of ischemia myocardium between the group Ⅰ and group Ⅱ or group Ⅲ were significant,and P value was 0. 032 and 0. 000 , respectively. There were significant differences of FS between group Ⅲ (30. 43±4.09)% and group Ⅱ (26.29±2.93)%, P<0.01, and similar to group Ⅰ (19.28 ± 2.84)%. The difference of EF(%) between group Ⅲ and group Ⅱ was significant [(61.5±5.8 vs 53.6±4. 71), P<0. 05] ,or markedly significant between group Ⅲ and group Ⅰ [(61.5±5.8 vs 42.6± 5.0), P <0.01]. EF(%) assessed with bi-plane Simpson's method was significantly increased from (34.64 ± 4.59) in group Ⅰ to (41.78 ± 4.21) in group Ⅱ and (48.6±3.96) in group Ⅲ. The expression of CD34 assessed with immunohistochemistry was the highest in group Ⅲ. The level of VEGF with western blotting in group Ⅲ was significantly higher than other two groups. Conclusions It is an efficacious transplantation means of MSCs infusion under the ultrasound mediated microbubles destruction in improving the myocardial perfusion and cardiac systolic function.