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ObjectiveTo investigate correlation between drug-resistance related genes and mobile genetic elements of Klebsiella pneumoniae resistant to β-lactams. Methods Forty-seven strains of multidrug-resistant Klebsiella pneumoniae were collected from 6 hospitals in Hangzhou and Huzhou of Zhejiang province from August 2008 to May 2010.Modified Hodge test was performed to detect phenotypes of carbapenemases.Forty kinds of β-lactamases (class A-D),ompK35,ompK36,and 12 kinds of mobile genetic elements were detected by PCR,and the results were analyzed by index cluster.ResultsThirty-five strains were positive in modified Hodge test,and 5 kinds of β-lactamases gene ( including KPC-2-like,GenBank:HQ258934) and 9 kinds of mobile genetic elements were detected.Mutations were observed in ompK35 and ompK36 when compared with sensitive strains.Index cluster analysis showed that correlation existed between KPC-2,KPC-2-like and ISKpn6,between TEM-1 and ISEcpl,IS26,int Ⅰ 1,trbC,IS903,and between CMY-2,OXA-30,DHA-1 and tnpU,tnp513,trbC.ConclusionsFive kinds of β-1actamases genes,and mutations in ompK35 and ompK36 may be associated with the resistance to β-1actams in multidrug-resistant Klebsiella pneumoniae.
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Objective To investigate ehloramphenicol,tetracycline,rifampicin and trimethoprimsulfamethoxazole resistance and the related genes in multi-drug resistant Acinetobacter baumannii(MDR-ABA).Methods Sixty-two strains of MDR-ABA were isolated from clinical samples,and their susceptibilities to 22 antimicrobial agents were detected by Kirby-Bauer disk diffusion tests.Genes related to chloramphenicol(catB and cmlA),rifampicin(arr-2/3),tetracycline(tetA and tetB)and trimethoprimsulfamethoxazole(sull,dfrA1,dfrA5,dfrA7/17,dfrA12,dfr85)resistance and drug emux genes(tehA,emrB,emrD,emrE,smr-2,mdfA)were analyzed by PCR and verified by DNA sequencing.Results Resistant rates of these MDR-ABAs to chloramphenicol,rifampicin,tetracycline and trimethoprimsulfamethoxazole were 100.0%(62/62),100.0%(62/62),90.3%(56/62)and 82.3%(51/62)respectively,while62 strains(100.0%),46 strains(74.2%),36 strains(58.1%)and 8 strains (12.9%)were detected to carry mafA,tetB,sull and tehA genes,respectively.The lest 13 genes were all negative.tetB,sull,tehA and mafa genes(2 for each)chosen optionally from positive ones were verified by DNA sequencing and BLASTn.and all were identified as the same sequences in GenBank.Conclusions MDR-ABAs show hish resistance to chloramphenicol,tetracycline, rifampiein and trimethoprimsulfamethoxazole.Multi-drug resistant phenotypes of MDR-ABAs may be closely related to mdfA genes harboring in strains.
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[Objective]To investigate the possible etiological factors,pathogenesis,diagnostic criteria,clinic characteristics and the choice of treatment of the adolescent instability of lower cervical spine.[Method]The diagnosis,therapies and follow-up materials of the two typical cases were analyzed and researched with the available literatures.[Result]The two cases showed dissappearance of syndroms.The Roentgen film showed that the operative segments have gotten bone-fuse.Results were excellent according to Henderson-evaluation classification without any complications at 3 and 4 years follow-up.[Conclusion]The degeneration is probable one of the etiological factors causing adolescent instability of lower cervical spine.It is resemble on the pathogenesis,diagnostic criteria and the choice of treatment between the adolescent and the adult.But the each characteristic on the pathogenesis,pathologic process,clinical situation should be remarked.The growth potentiality and other correlated factors should be paid attention to for the choice of treatment.
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Objective To provide coronary sectional anatomical basis for imaging diagnosis of the injure and disease of the knees.Methods 5 right knees of male adults cadavers were used . After the MR imaging examination,all specimens were frozen and cut into 6 coronary sections . Results The morphological charactenstics relation and the law of variation of the articular facets,articular capsule,articular cavity,cruciate ligaments,menisci,synovial plicae and its surrounding structures on all coronary sections of knees were observed, and compared with the corresponding MR images .Conclusion The variation of morphology and structures of all coronary sectional specimens of knee joint provided foundation of dependable anatomy and clinical value for medical imaging diagnosis .
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Objective To provide transverse sectional anatomical basis for imaging diagnosis of the disease of thigh.Methods 10 right thigh of male adult cadavers (fresh 5,fixed by formalin 5) were used.After the CT and MR imaging examination,all specimens were frozen and cut into 3 transverse sections(upper 1/3,middle 1/3 and lower 1/3).Results The morphological characteristics and the law of variation of the structure,relation,blood vessels and nerves on all transverse sections of thigh were observed.The compact substance and medullary cavity in the middle 1/3 and lower 1/3 of the femurs were measured and compared with the corresponding CT and MR imaging.The significances of all anatomical structures in the imaging diagnostics and the interventional radiology were discussed as well.Conclusion The understanding of the detail sectional anatomy of thigh has an important significance for imaging diagnosis of the disease of thigh.
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The authors observed fifty petrosal veins in twenty five adult specimens with surgical microscope under ten times magnification.Special attentionwas paid to the microsurgical anatomical features of the petrosal vein andthe relations between these features and some aspects of the posterior rhi-zotomy of the trigeminal nerve. There is only one petrosal vein in each half of the specimen in themajority of the cases observed. All petrosal veins can be subdivided into three types: 1 ) single-trunk type; 2 ) two-trunk type; 3 ) three-trunktype. The micro-anatomical features of the vein are as follows: 1 ) in adeep position; 2 ) with a thinnest wall; 3 ) with a thicker and shortertrunk; 4 ) in a free and suspended manner during traversing the subarachnoidspace. During operation, the petrosal vein covered with a thin layer ofarachnoid can be seen. The method of how to sever the vein is different because the formationof it is different. Most of petrosal veins are located at a position superiorlateral to the teminal root, so they can be used as a guidance of looking for the nerve root.
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The vein s near the cardiac area of the stomach were studies in 60 cases of Chines cadavers (26 adults, 34 children). The main results are as follows: The coronary vein (lefe gastric) may be divided into 3 types. Type Ⅰ (2 branches) was found in 55 cases (91.66%.t In 33 cases (55.00%), the gastropancreatic fold was situated on the left side of the vertebral colum, and it ended in the splenic vein in 36 cases (60.00%). The average diameter at its terminal end was 3.81 (2.0-6.0) mm. The cardioesophageal branch may be classified into 2 types. Type Ⅰ (1 branch) was found most frequently in 55 cases (93.22%), and it ended in the arched portion of the coronary vein in 55 cases (87.30%). The right gastric vein (pylorus) opened into the portal vein in 49 cases (89.09%). The posterior gastric vein may be divided into 2 types. Type Ⅰ (1 branch) occurred in 45 cases (90.00%). The end of this vein was located in the mid-third of the splenic vein in 41 cases (74.55%). Short gastric veins two to six branches in number, among which three or four branches were most frequently observed.