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Objective To analyze the mechanism of imipenem resistance in Pseudomonas aeruginosa clinical isolates. Methods? Antibiotic?resistance?was?analyzed?using?VITEK32?system.?Metallo?β-lactamase?activity?was?determined?by?double-disc?synergy?test.?Amp?C?β-lactamase?activity?was?determined?by?Kirby-Bauer?disc?method.?OprD?protein?was?analyzed?by?sodium?dodecyl sulphate-polyacrylamide gel electrophoresis. PCR was performed to amplify gene oprD. The amplified products were subject?to?sequencing?analysis.?The?phylogenetic?relationship?was?determined?using?random?amplified?polymorphic?DNA?(RAPD)?method. Results Membrane protein OprD was analyzed in 7 clinical isolates of imipenem-intermediate P. aeruginosa. Two strains were devoid of OprD proteins and the corresponding oprD genes were found disrupted by the insertion element ISRP10 in the coding regions. Five strains had OprD proteins with different sizes. Sequence analysis showed that the peptides ranged from 427 to 443 amino acids. Multiple amino acid substitutions and / or deletions were found within the Loop 1 through Loop 8 of the OprD secondary structures. Conclusions ISRP10 inactivation and amino acid substitutions in oprD gene confer imipenem resistance in the clinical isolates of P. aeruginosa.
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Objective To investigate the protective effect of GSH on lung injury in rats with severe acute pancreatitis(SAP) and investigate the mechanism of severe acute pancreatitis associated lung injury. Methods Fifty-four Spragwe Dawley rats were randomly divided into three groups: control group, model(SAP)group and herbal group. Rats in model group and herbal group were induced pancreatitis by retrograde injection of 5% sodium taurocholate into the pancreatobiliary duct. Animals were killed at 3h, 6h, 12h after injection. The serum amylase was examined at 3h, 6h, 12h after injection. Pulmonary tissue fluid content was measured.The expression of pulmonary TNF-α mRNA and LIF mRNA was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Results The serum level of amylase was lowered significantly in herbal group in comparision with that in model group (P<0.05) and pulmonary tissue fluid content in herbal group was reduced compared with model group (P<0.05). Similarly, the level of pulmonary TNF-α mRNA and LIF mRNA expressions was both significantly reduced in herbal group compared with model group (P<0.05). LIF mRNA was not examined in normal control group. Conclusion Treatment with GSH can prevent lung injury of rats with SAP.
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Objective To investigate the diagnosis and treatment of bilateral thyroid carcinoma(BTC).Methods Clinical data of 68 cases with BTC from July 2001 to July 2008 were analyzed retrospectively.Results All patients underwent surgical treatment.22 cases received total thyroidectomy and bilateral functional neck dissection,30 cases received total thyroidectomy and unilateral functional neck dissection,14 cases received total thyroidectomy and lymph node dissection of Ⅵ area,2 cases received palliative resection.12 cases received proper radioactive 131I therapy after operation.Postoperative complications occured in 16 cases,including 5 cases with transient recurrent nerve paralysis,1 case with permanent injury of recurrent laryngeal nerves received trachea incision,1 case with tracheomalacia and asphyxia,6 cases with convulsion caused by hypocalcemia,1 case with permanent hypoparathyroidism,2 cases with chylous fistula(one was cured by saturing and ligaturing and the other by conservative treatment).Low echo solid or cystic solid nodules in thyroid were found by preoperative ultrasonic scan in all cases,in which 38(55.88%)cases were associated with gravel calcified lesion in thyroid nodules.The diagnosis was comfirmed by needle aspiration biopsy(NAB)in 42 cases preoperatively and 64 cases(94.12%)by frozen section intraoperatively.63(92.64%)cases were followed up postoperatively for a period from 6 months to 5 years,all 5 cases with recurrence and/or metastasis had tumor-free survival after reoperation except for 1 case with undifferentiated cancer died on the 6th month after operation.Conclusions Total thyroidectomy and lymph node dissection is essential to the treatment of BTC.Gravel calcified lesion revealed by preoperative high frequency ultrasonagraphy is an important characteristic for preoperative diagnosis of thyroid cancer.