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ObjectiveTo study the correlation with Genes Coding forESBLs and ClassⅠIntegron in ESBLs-producing Escherichia coli from children.MethodsPCR was used for gene typing detection of 100 strains of ESBLs-producingEsche-richia colistrains. While detection of class I integrase gene in the 100 strains ESBLs-producingEscherichia coli and 100 strains of non-ESBLs producingEscherichia coli were separately performed by PCR. It provides the solid base not only to reveal the relationship between class I integron and drug resistance, but also the relationship between class I integron and ESBLs-producing. ResultsThe most frequently genotyping from ESBLs-producingEscherichia coli in children isCTX-M (84%), followed by TEM-1(63%). The predominant distribution of genotype in ESBL- producing strains isTEM-1 +CTX-M (45%), followed by CTX-M (34%). Class I integrase gene detected in ESBLs- producing and non- ESBLs producing strain were 100 cases (100%) and 25 cases (25%) separately, the difference was statistically signiifcant (P<0.05); drug resistance in class I integron positive strains were signiifcantly higher than in class I integron negative strains, especially in Ciprolfoxacin, Levolfoxacin, and Amino-glycoside (86.4%, 88%, and 80%).ConclusionsThe distribution of Class I integron in ESBLs-producingEscherichia coli is signiifcantly higher than that in non-ESBLs-producing strains, It is rational that Class I integron highly correlate with strong drug resistance in ESBLs-producing strains.
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Objective To determine the pathogenic bacteria distribution and drug resistance in children with sepsis. Methods From 2002 to 2011, a ten consecutive years of monitoring of pathogenic bacteria distribution, drug resistance in pediatric patients with sepsis were conducted. Results From 2002 to 2011, 2 493 strains of pathogenic bacteria were detected in 68 419 specimens of blood culture. The positive rate was 3.64%. Among them, 1 913 strains (76.73%) were the gram-positive bacteria (G+bacteria), 562 strains (22.54%) were gram-negative bacteria (G-bacteria) and 18 strains (0.72%) were fungi. From 2002 to 2006, 959 strains (4.73%) of pathogenic bacteria were detected in 20 287 specimens of blood culture. Among them, the G+bacteria was 731 strains (76.23%), G-bacteria was 228 strains (23.77%). From 2007 to 2011, 1 534 strains (4.73%) of pathogenic bacteria were detected in 48 132 specimens of blood culture, G+ bacteria was 1 182 strains (77.05%), G-bacteria was 334 strains (21.77%), fungi was 18 strains (1.17%). The positive rate of blood culture, the pathogenic bacteria distributions of G+, G-, and fungi were signiifcantly different between the ifrst and the second 5 years (P<0.01). The positive rate of G+bacteria tended to increase and the positive rate of G-bacteria tended to decrease. Com-paring between the ifrst and second 5 years, the positive rate of coagulase-negative staphylococci, Klebsiella, Alcaligenes, fungi tended to increas, and the positive rate of Staphylococcus aureus, Enterococcus, Pseudomonas, Salmonella tended to decrease. The distribution of pathogens in different age groups of children with sepsis also were signiifcantly difference (P<0.001). Over the 10 years, G+positive bacteria were highly resistant to penicillin and erythromycin, but not resistant to Vancomycin. ESBLs positive E. coli strains and Klebsiella Trevisan became highly resistant to antibiotics. Salmonella was sensitive to commonly used antibiotics. Conclusions Coagulase negative staphylococcus was the most common pathogenic bacteria in children with sepsis in the last 10 years, multiple pathogenic bacteria also show a growing trend in drug resis-tance.
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Objective A considerable percentage of gallbladder cancers are accompanied by su-perficial cancer spread adjacent to the main tumor. Therefore, cholecystectomy for early gallbladder cancer must be performed carefully to avoid leaving cancer cells at the surgical margins. Methods Thirty-six patients with gallbladder cancer invading no more than perimuscular connective tissue un-derwent surgical resection at our medical center. After operation, the resected specimens were investi-gated macroscopically and microscopically to clarify the clinicopathological features and the risk factors of superficial cancer spread. Results Seventy percent of all cases (25 cases) had superficial cancer spread. Comparison between the cases having superficial cancer spread and the cases without it re-vealed that the macroscopic morphology of the primary tumor and the depth of cancer invasion in the gallbladder wall were significantly different between the two groups. Furthermore, multivariate analy-sis indicated that 'superficial raised type' in macroscopic morphology was an independent predictive factor for having superficial cancer spread. Superficial cancer spread from the main tumor located in the neck of the gallbladder grew predominantly in the direction of the fundus. More advanced gallbladder cases were accompanied by more extensive superficial spread. Conclusion Superficial cancer spread is frequently observed adjacent to the gallbladder cancer, especially in the superficial raised type. A negative margin should be confirmed by intraoperative frozen section while performing cholecystectomy.
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Objective To evaluate the impact of laparoscopic cholecystectomy(LC) on the prognosis of unsuspectedgallbladder cancer(GC).Methods A retrospective clinicopathologic study was performed on 21 patients with unsuapective GC,but diagnosed gallbladder cancer postoperatively by pathology.Of which,11patients underwent LC and 10 patients underwent open cholecystectomy(OC),The correlation was evaluatedbetween cumulative survival rates and the following 5 prognostic factors:histopathological grade,pathologic stage,occurrence of bile spillage,type of cholecystectomy(LC or OC),and additional surgical treatments.Results Eight patients(73%) after LC and 7 patients(70%) after OC had cancer recurrence,and the difference was of no statistical significance(P=0.86).There were no recurrences of cancer in the abdominal wall after either LC or OC.Survival rate was statistically correlated to tumor stage(P=0.006),and to the occurrence of bile spillage(P=0.003).Survival rate did not differ according to whether the operation was carried out using LC or OC(P=0.74).Conclusions LC does not worsen the prognosis of unsuspected gallbladder cancer.
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Objective To evaluate the results of breast conservation surgery combined with radiotherapy for early stage breast cancer.Methods The cinical data of 76 breast cancer patients who underwent breast(conservation) operation plus radiotherapy at Changzheng Hospital in the recent 6 years were retrospectively(analyzed).Results The 3-,and 5-year survival rate was 96.05% and 94.8%,respectively,the 3-,and 5-year local recurrence rate was 5.3% and 6.6% respectively,and the 3-,and 5-year breast conservation rate was 96.05% and 93.3%,respectively.Only one case had chest wall recurrence and there was no mortality.The case with recurrence was a 25-year old unmarried woman,who had an intense desire for breast conservation.After tumor recurrence,mastectomy was performed again and chemotherapy was(administered).The patient is presently alive and in good health.Postoperative cosmetic physical results were(satisfactory) in 80.5% of cases.Conclusions Breast conservation surgery plus radiotherapy can get(satisfactory) results.The important aspects for success of breast conservation treatment are standardization of(resection) and postoperative radiotherapy and integrated systemic therapy.