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Objective:To explore the teaching effect of case-based learning (CBL) teaching combined with high-fidelity simulation (HFS) system training mode in first aid skills training for postgraduates majoring in pediatrics.Methods:In this study, 200 pediatrics graduate students in emergency clinical rotation were randomly divided into 4 groups: control group, traditional lecture teaching combined with simple simulation training; CBL group, CBL case combined with simple model training; HFS group, traditional lecture teaching combined with high-fidelity simulation training; CBL+HFS group, CBL case combined with high-fidelity simulation training. All the data were statistically analyzed with STATA 14.0 software.Results:Recent assessment results showed that in cardiopulmonary resuscitation, electroshock therapy, tracheal intubation skills, the average score of the CBL group was higher than that of the control group, and the average score of the HFS group was higher than that of the control group, with statistically significant differences ( P<0.05). In terms of non-technical ability, the average score of CBL group was higher than that of control group, and that of HFS group was higher than that of control group, with statistically significant differences ( P<0.05). There was interaction and cooperation between CBL and HFS, and the analysis results of the long-term assessment results were the same as those of the short-term assessment results. Conclusion:CBL combined with HFS is helpful to improve the first aid technical ability and non-technical ability of postgraduates majoring in pediatrics, which is worth further popularizing.
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Objective:To predict the expression and molecular regulatory mechanisms of βⅢ-tubulin (TUBB3) in non-small cell lung cancer (NSCLC) using bioinformatics methods.Methods:The GEO profile, TransmiR, miRWalk and ConSite database were employed in the present study. The upstream transcription factor, co-expression gene and the interactive miRNA of TUBB3 were studied to determine the molecular regulatory mechanisms and possible role of TUBB3 in NSCLC.Results:The promoter region of TUBB3 could be recognized by transcription factors associated with NSCLC including Snail and n-MYC and so on. At the post-transcription level, the TUBB3 could be regulated by miRNAs including miR-200 family, miR-342-3p, miR-410 and so on. These miRNAs were associated with proliferation and invasion of NSCLC. TUBB3 was co-expressed with HDGF, GMPS, MRPL9, PMAIP1 and SLBP, and they were co-regulated by the transcription factor Snail. SLBP, PMAIP1 and transcription factor Snail were related to cell cycle and apoptosis.Conclusion:The expression of TUBB3 can be regulated at multiple levels in NSCLC. It may take part in cell cycle and apoptosis regulation in NSCLC, and further influence proliferation and invasion of cancer cells.
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Objective To study the neutrophil-lymphocyte ratio (NLR),CA19-9 and CEA in the diagnosis of pancreatic cancer (PC).Methods From January 2013 to June 2016,the data of 723 consecutive patients with pancreatic diseases were reviewed.Of these 723 patients,632 patients had PC (stage Ⅰ,Ⅱ 324 patients;stage Ⅲ,Ⅳ 289 patients),66 patients had pancreatic cystic tumors,and 26 patients had tumor-forming pancreatitis.The Receiver Operating Curve (ROC) and the logistic regression model were used to assess the blood biomarkers in predicting PC.Results Using the ROC,CA19-9 CEA,NLR,PLR,ALP,GGT,LDH,GLU and MONO# were useful in diagnosing malignant pancreatic diseases.Logistic regression analysis showed that CA19-9 (95% CI:12.928 ~ 103.330;P < 0.05),CEA (95% CI:1.041 ~3.472,P<0.05) and NLR (95% CI:1.020~ 3.525,P =0.043) were independent variables in predicting PC.The concentrations of CA19-9,CEA,and NLR had the highest values in predicting PC.When CA19-9 was <37 kU/L,the concentrations of NLR and CEA had a high sensitivity and specificity (AUC =0.746,95%CI:0.675~0.816,P<0.05) of 69.2% and 73.6%,respectively.Conclusions The concentrations of CA19-9,CEA,and NLR had the highest prediction value for PC.When the level of CA19-9 was <37 kU/L,the combined use of NLR and CEA significantly improved the diagnostic specificity.
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BACKGROUND@#Previous studies have found the lincRNAs play important roles in the occurrence and development of lung adenocarcinoma, but their regulated mechanims are still unclear. The aim of this study is to evaluate the relationship between DNA methylation and lincRNA expression, and the effect of prognosis in lung adenocarcinoma.@*METHODS@#The whole genome Illumina Methylation 450 DNA methylatiuon data and RNAseq for lung adenocarcinoma were download from TCGA. DNA methylation around lincRNA and their relationship to gene expression were analyzed. Their contribution to lung adenocarcinoma were further analyzed by comparing DNA methylation and lincRNA expression in tumor and adjacent tissues.@*RESULTS@#The methylation level in promoter region was lower than other positions in lincRNA, and was negatively correlated with gene expression. There were 427 lincRNA genes showed differential DNA methylation in their promoter regions in tumor and adjacent tissues. Among these, 15 lincRNA genes showed differential gene expression and negatively correlated with DNA methylation, including FENDRR (a tumor progression and metastasis gene) whose high methylation in its promoter showed poor survival in lung adenocarcinoma.@*CONCLUSIONS@#The expression of lincRNA can be regulated by DNA methylation in their promoter regions, and the level of DNA methylation is related to patient prognosis in lung adenocarcinoma.
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Adenocarcinoma , Diagnosis , Genetics , Adenocarcinoma of Lung , Computational Biology , DNA Methylation , Humans , Lung Neoplasms , Diagnosis , Genetics , Prognosis , Promoter Regions, Genetic , Genetics , RNA, Long Noncoding , Genetics , Survival AnalysisABSTRACT
Objective:To study the curative efficacy of transabdominal ultrasound-guided Lauromacrogol combined with radiofrequency ablation in the treatment of fibroid and its effects on the serum estradiol (E2),luteinizing hormone (LH),follicle stimulating hormone (FSH) levels.Methods:90 patients of fibroid who were treated from June 2014 to June 2015 in our hospital were selected as the research objects.According to random number table,those patients were divided into the observation group (n=45) and the control group (n=45).Both groups were routinely examined before operation,the control group was treated with transabdominal ultrasound radiofrequency ablation,while the observation group was treated with transabdominal ultrasound-guided percutaneous radiofrequency ablation combined with radiofrequency ablation,Then visual analogue scale (VAS),menstrual volume,uterine fibroid volume,uterine volume,E2,LH,FSH levels,myoma symptoms and quality of life score,curative effect were compared between two groups.Results:After treatment,the total effective rate of observation group was significantly higher than that of the control group [95.55%(43/45)vs75.55%(34/45)] (P<0.05);the VAS score,menstrual volume were significantly lower than those of the control group[(1.05± 0.23)score vs.(3.62± 0.50)score,(192.35± 22.10)mL 1 vs.(236.54± 24.57)mL](P<0.05);The myoma volume,uterine volume were significantly lower than those of the control group[(32.13± 13.20)cm3 vs(40.81± 14.11)cm3,(101.93± 9.89)cm3 vs(118.36±11.20)cm3](p<0.05);the serum E2,LH,FSH levels were significantly lower than those before treatment,but there was no difference between the two groups (P >0.05);the fibroid symptoms score was significantly lower than that of the control group [(4.50 ± 1.02)score vs.(10.34± 2.21)score] (P<0.05),the quality of life score was significantly higher than that of the control group [(95.36± 14.29)score vs.(80.84 ±14.06)score] (P < 0.05).Conclusion:Transabdominal ultrasound-guided lauromacrogol combined with radiofrequency ablation could enhance the efficacy of fibroid,which might be related to the decrease of serum levels of E2,LH,and FSH.
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Objective To explore the expression of CD44v8 protein in human bladder and urothelial carcinoma ,as well as the value in diagnosis of human bladder and urothelial carcinoma .Methods RT‐PCR was used to analysis the expression of CD44v8 protein in 75 patients with bladder and urothelial carcinoma in the pathological stage and clinical stage and 20 subjects of normal bladder mucosa were collected as control .Results CD44v8 protein was negative in all normal bladder and urothelial mucosa ,the copy number was less than 1 × 102 copy/mL ;26 cases of bladder and urothelial carcinoma was positive ,and the positive rate of CD44v8 was 34 .7% ,and Ct values were less than 35 and copy number was greater than 1 × 104 copy/mL .Positive rate was correla‐ted with high pathological grades and TNM stages ,but no significant difference was observed in recurrence of tumor .Conclusion CD44v8 could be useful indicator for the assessment of pathological grades and TNM stages of bladder and urothelial carcinoma .
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Objective To explore the surgical indication,diagnosis and treatment of suspected pancreatic cystic lesions.Methods To-tally 341 patients were admitted into our hospital because of pancreatic cystic lesions from October 2010 to October 2015.Except the 278 confirmed cases,the clinical data of the rest 63 patients with vague diagnosis were retrospectively analyzed.Results The surgical indication of pancreatic cystic lesions were:the lesion diameter was more than 4 cm;the imaging diagnosis was malignant;the lesion was combined with obvious clinical symptoms which can not explain with other diseases;there were asymptomatic pancreatic cystic lesion and main pancre-atic duct dilation without surgical risk factors;the follow-up showed that the desease is in development.Endoscopic ultrasonography guided fine needle aspiration is a useful supplement for more accurate diagnosis.However,it is an uncertain diagnostic value currently.Conclusion Diameter of lesion,uncertain imaging diagnosis,severe abdominal symptoms,obstructive jaundice and abnormal serum tumor markers are the surgical indication for patients.
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Objective To investigate the expression of CD44 varant 2(CD44v2) in bladder and urothelial carcinoma ,and to study its significance in the diagnosis of human bladder and urothelial carcinoma .Methods Real‐time fluorescent quantitative PCR was used to analyze the expression of CD44v2 protein in 70 bladder and urothelial carcinoma tissue samples from patients in different pathological and clinical stages .Meanwhile ,20 tissue samples of normal bladder mucosa were collected as controls .Results CD44v2 expression was negative in normal bladder and urothelial mucosa ,the gene copies were less than 1 × 102 copies/mL ,while the posi‐tive expression rate of CD44v2 was 42 .9% (30/70) ,and Ct values were less than 35 and copy number was greater than 1 × 104 cop‐ies/mL .Positive expression rate was correlated with high pathological grades and TNM stages .Conclusion CD44v2 could be an useful indicator for the early assessment of bladder and urothelial carcinoma .
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<p><b>OBJECTIVE</b>To systematically review whether statins can reduce the risk of infection and infection-related mortality.</p><p><b>METHODS</b>We searched the Cochrane Library, MEDLINE, EMBASE, PubMed, Elsevier and CBM databases for randomized placebo-controlled trials of statins published by September 2013, and each trial enrolled at least 100 participants with follow-up for at least 4 weeks. Two reviewers independently assessed the quality of the included studies and extracted the relevant data for analysis using Stata 12.0 software.</p><p><b>RESULTS</b>Sixteen trails involving a total of 48973 patients were included in our meta-analysis. The results showed that statins significantly reduced the risk of infection (OR=0.93, 95% CI 0.89 to 0.98, P=0.004) compared to placebo but did not significantly lower infection-related mortality (OR=0.96, 95% CI 0.82 to 1.12, P=0.592).</p><p><b>CONCLUSION</b>Statins can significantly reduce the risk of infection but does not lower infection-related mortality.</p>
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Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Therapeutic Uses , Infections , Epidemiology , Mortality , Randomized Controlled Trials as Topic , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To examine the correlation of the changes in the serum markers (C-reactive protein, endothelin-1, interleukin-6, and brain natriuretic peptide) with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension secondary to COPD.</p><p><b>METHODS</b>A total of 174 COPD patients with acute exacerbation, admitted between February 2011 and February, 2013, were enrolled in this study, with 43 volunteers with normal pulmonary functions as controls. Pulmonary arterial pressure was determined by Doppler echocardiograph, and the severities (mild, moderate and severe) of PH secondary to COPD was evaluated. The levels of serum markers were determined using ELISA kits.</p><p><b>RESULTS</b>The levels of serum markers in patients with COPD was significantly elevated compared with those of the control subjects (P<0.05), and further increased in patients with pulmonary hypertension secondary to COPD (P<0.05). A positive correlation was found between these serum markers and pulmonary artery pressure in COPD patients with mild and moderate pulmonary hypertension. In patients with severe pulmonary hypertension, only the serum level of brain natriuretic peptide continued to increase with pulmonary artery pressure (P<0.05), and the other markers did not further increase.</p><p><b>CONCLUSIONS</b>Early and combined examination of these serum markers in patients with COPD can help to identify pulmonary hypertension in early stage and estimate the severity of pulmonary hypertension. Hemodynamic monitoring of the changes of these serum markers can be of important clinical value in the treatment of pulmonary hypertension secondary to COPD and in evaluation of the prognosis of COPD.</p>
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Aged , Biomarkers , Blood , Blood Pressure , C-Reactive Protein , Metabolism , Endothelin-1 , Blood , Female , Humans , Hypertension, Pulmonary , Blood , Interleukin-6 , Blood , Male , Natriuretic Peptide, Brain , Blood , Pulmonary Disease, Chronic Obstructive , BloodABSTRACT
<p><b>OBJECTIVE</b>To examine whether calcineurin/NFAT signaling pathway mediates endothelin-1 (ET-1)-induced proliferation of pulmonary artery smooth muscle cells (PASMCs) by regulating phosphodiesterase-5 (PDE5) and the effect of the selective calcineurin inhibitor cyclosporine A and PDE5 inhibitor sildenafil on ET-1-induced PASMC proliferation.</p><p><b>METHODS</b>PASMCs were treated with ET-1 to stimulate their proliferation with or without prior treatment of the cells with CsA or sildenafil. Calcineurin activity in the cells was measured using a calcineurin activity assay kit, PDE5 expression examined using immunoblotting, and cGMP level detected using a cGMP direct immunoassay kit. PASMC proliferation following the treatments was determined using [(3)H]thymidine incorporation assay.</p><p><b>RESULTS</b>ET-1 caused a 2.05-fold increase in the cellular calcineurin activity, a 1.80-fold increase in PDE5 expression, and a 3.20-fold increase in the DNA synthesis rate, and reduced the cGMP level by 67%. Pretreatment of the cells with Cyclosporine blocked the effects of ET-1, and PDE5 inhibition by sildenafil pretreatment also abolished ET-1-induced reduction of cGMP level in the cells. Both Cyclosporine and sildenafil suppressed ET-1-stimulated PASMC proliferation.</p><p><b>CONCLUSION</b>Activation of calcineurin/NFAT signaling pathway mediates ET-1-induced PASMC proliferation by stimulating PDE5 expression, which further degrades cGMP. Both Cyclosporine and sildenafil can suppress ET-1-stimulated PASMC proliferation in vitro.</p>
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Animals , Calcineurin , Metabolism , Cell Proliferation , Cells, Cultured , Cyclic GMP , Metabolism , Cyclic Nucleotide Phosphodiesterases, Type 5 , Metabolism , Cyclosporine , DNA , Endothelin-1 , Pharmacology , Muscle, Smooth, Vascular , Cell Biology , Myocytes, Smooth Muscle , Cell Biology , NFATC Transcription Factors , Metabolism , Piperazines , Pulmonary Artery , Cell Biology , Purines , Rats , Rats, Sprague-Dawley , Signal Transduction , Sildenafil Citrate , SulfonesABSTRACT
Objective To evaluate the efficacy and safety of sublingual immunotherapy (SLIT) in patients with allergic asthma in order to provide reliable evidence for clinical application of SLIT.Methods To search published articles of randomized controlled trials (RCTs) in allergic asthma from CNKI,WANFANG,Pubmed and Medline databases.The methodological quality of trials was assessed by Jadadscale.The heterogeneity was examined by using Stata 11.0 software.Fixed effect model or random effect model was used to pool the data.The articles which could not be pooled were carried out by descriptive analysis.The Egger's and Begg's test were used to evaluate the publication bias.Results There were total 6 RCTs included in this text.Compared with control group,SLIT could significantly reduce asthma symptom scores (SMD =-0.89,95% CI-1.36--0.43,P =0.000) and asthma medication scores (SMD =-4.53,95%CI-6.97--2.08,P =0.000),but not forced expiratory volume (FEV1) of lung function (SMD =0.19,95% CI-0.02-0.41,P =0.078),neither serum sIgE levels (SMD =0.05,95% CI -0.58-0.69,P =0.870).There were no obvious adverse events reported after treatment of SLIT.No publication bias were indicated by Egger's and Begg's tests.Conclusion SLIT significantly reduces asthma symptom scores and medication scores,suggesting that SLIT is a safe and effective approach of immunotherapy.However,it still needs more highly qualified studies of RCTs to prove.
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Objective To explore the role of tumor inhibition of enhancer binding protein C/EBPα in the leukemic mice. Methods BALB/c nude mice were randomly divided into three groups. Three kinds of cells including pEGFP-C/EBPα-K562 cells, pEGFP-K562 cells and K562 cells as the control were injected into mice separately through the subcutaneous and tail vein, and subcutaneous tumors and leukemic models were formed. The changes of tumors were observed and the apoptosis of cells was detected by TUNEL; The capacity of proliferation of leukemia cells was observed in the bone marrow and the peripheral blood by Wright-Giemsa staining. The expression of genes of related to proliferation was detected by RT-PCR. Results The quality and the max diameter of tumors in the pEGFP-C/EBPα-K562 group were smaller than that of pEGFP-K562 group and K562 control group [(2.4±0.1) g vs (5.1±0.3) g and (5.7±0.4) g, both P <0.05; (11+2)mm vs (19+3) mm and (23+3) mm, both P <0.05]. More apoptosis cells were found in the pEGFP-C/EBPα-K562 group leukemic cells were found in the peripheral blood of leukemic models, and the proliferation of leukemic cells in the pEGFP-C/EBPo-K562 group were lower than that of other groups, accompany by the conspicuous cell differentiation. p53 was significantly elevated by RT-PCR, while down-regulated of c-myc.Conclusion Enhancer binding protein C/EBPα promote the apoptosis of cells and inhibit the proliferation of leukemia cells in leukemia mice, and further induce the cell differentiation. The inhibition of enhancer binding protein C/EBPα in the leukemia may have effect through the regulation of related genes.
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Objective To find out the relationship between fetal growth restriction (FGR) and transforming growth factor -β1 (TGF-β1). Methods The levels of TGF-β1 in maternal serum and placental tissue of FGR were detected with using ELISA and immunohistochemistry technique, and it was compared with those of normal term pregnancy. Results The levels of TGF-β1 in maternal serum of FGR group were significantly higher than those of normal term pregnancy (76. 5 ± 33. 4 VS 47.6 ± 24. 2, t' = 4. 65, P <0. 05). As for the intensity of the immunohistochemistry signal, TGF-β1 in syncytiotrophoblastic cells of FGR was markedly higher than that of control group (81.82% vs 5.83%, P <0. 01). Conclusions The levels of TGF-β1 are closely related with FGR.
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Objective To study the regulation of heparanase expression by hypoxia and its correlation to the invasiveness of tumor cells. Methods BxPC-3 cells were cultured in hypoxia in vitro and the heparanase mRNA and protein expression were detected by reverse transcriptional polymerase reaction chains (RT-PCR) and western blot respectively. Matrigel invasion assay was used to observe the invasive abilities of tumor cells in hypoxia and in the status of heparanase was inhibited by antisense oligodeoxynucleotide (AS-ODN) targeting to the heparanase gene promoter. Results In normoxia, there was a relatively low level of heparanase mRNA and protein expression in cultured BxPC-3 cells. In hypoxia, heparanase expression, mRNA and protein which expressed consistently, were inhibited slightly at 3h and upregulated significantly at 6h, 12h, 24h and 48h. When the heparanase expression was inhibited by AS-ODN, the heparanase mRNA and protein maintained low in hypoxia, however, the nonsense oligodeoxynucleotide (NS-ODN) did not block upregulation of heparanase expression. In matrigel assay, after 48h incubation, number of BxPC-3 cells that penetrated the Matrigel-coated filter of transwell chamber was increased 96.2% in hypoxia (P<0.01), the Hpa AS-ODN (400 nmol/L) inhibited the invasive cells by 37.2% (P<0.05). Conclusions BxPC-3 cells invasion ability is enhanced by hypoxia through upregulation of heparanase mRNA and protein expression in BxPC-3 pancreatic cancer cell lines.
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Non-invasive coronary artery angiography is one of the hotspots of imaging.This article reviewed the status and the relevant advancement of the cardiac EBCT, DSCT, MSCT and MR imaging.
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Objective To study the effects of ephedrine and phenylepbedrine for maintenance of arterial pressure during combined spinai/epidural anesthesia (CSEA) for caesarean section. Methods Forty patients, ASA grade Ⅰ - Ⅱ, who were scheduled for caesarean section by CSEA were randomly divided into two groups, when patients were hypotension, phenylephedrine 100 μg (group P, 20 cases ) or ephedrine 10 mg (group E, 20 cases). The variety of blood pressure (Bp), heart rate (HR) and oxyhemoglobin saturation (SpO2) were monitored; recorded before anesthesia (T0), at 15 min after anesthesia (T1), fetuses were taken out of uterus (T2) and at the end of operation (T3); umbilical arterial blood gas analysis was monitored; neonatal Apgar score was investigated. Results Umbilical arterial blood gas analysis of pH,PaO2, PaCO2, HCO3-, SaO2 were normal in two groups, there were no significant difference in PaO2, PaCO2 and SaO2 between two groups, but pH and HCO3- in group P were higher than those in group E [7.38±0.07 vs7.30±0.02 and (21.5±3.4) mmol/L vs (19.3±3.3) mmol/L] (P <0.05). There were no significant difference in Apgar score and Bp between two groups. Compared with group P, the HR in group E was increased obviously at T1 and T2 (P < 0.05). Conclusion Phenylephedrine is the vasopresser that most closely meets the criteria for the best vasopressor to use in obstetric patients.
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Objective To investigate the imaging characteristics and differentiating value of hepatic perfusion disorders(HPD)in small focal liver lesions(≤3 cm),the transient hepatic hyperechoic enhancement(THHE),with contrast-enhanced ultrasonography(CEUS)during arterial phase and explore the potential mechanism.Methods Two hundred and sixty-eight small foeal liver lesions found in 215 patients who had undergone CEUS were retrospectively evaluated in this study.Hepatic parenchymal THHEs around those lesions were diagnosed and the CEUS characteristics as well as the detecting rate related to different lesions were analyzed.Results Forty-five among 268 lesions(16.8%)showed surrounding THHEs during CEUS and they exhibited fast wash-in to form hyperechoic area of different shape and range and then those area became fast washout to be isoechoic in contrast with peripheral liver parenchyma.According to the imaging morphology,THHEs could be divided into four types:type Ⅰ,wedge-or fan-shaped(51.1%);type Ⅱ,encircling-shaped(20.0%);type Ⅲ,nodule-like-shaped(11.1%);type Ⅳ,irregular-shaped(17.8%).According to the pathology,the liver focal lesions could be divided into three groups:benign group,which consisted of 88 lesions and 8(9.1%)lesions showed surrounding THHEs of which 87.5% presented type Ⅲ and Ⅳ;malignant group,which consisted of 141 lesions and 31(22.0%)lesions showed surrounding THHEs of which 67.7% presented type Ⅰ;tumor-like lesions group,which consisted of 39 lesions and 6(15.4%)lesions showed surrounding THHEs of which 66.7% presented type Ⅱ.There was significant difference in the composition of THHEs type among three groups(P<0.001).The detecting rate of THHEs in benign group was lower than that in other groups(P<0.05).Conclusions THHEs showed with CEUS in small liver focal lesions are representation of HPD and have different detecting rate and imaging morphology type in different lesions.It is very important to recognize and distinguish THHEs surrounding focal lesions,which could help to make differential diagnosis,avoid incorrect diagnosis and judge the size of lesions correctly.
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0.05).Traction reactions,the use of sedative and centrally acting anesthesia drugs during the operation were significantly less in group AEA than those in group EA(P
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OBJECTIVE To investigate the antimicrobial susceptibility of Streptococcus pneumoniae isolated in Yantai and their mechanisms of resistance to macrolides.METHODS Antimicrobial susceptibility of S.pneumoniae was determined by agar dilution method.Phenotypes of macrolide-resistant S.pneumoniae were determined using double disk test with erythromycin and clindamycin disks.ermB And mefE genes were amplified by PCR.RESULTS Among 42 strains of S.pneumoniae,65.0% were intermediate to and no strain was resistant to penicillin.The resistance rates to erythromycin and clindamycin were 93.0%,respectively.Of 41 erythromycin resistantstrains,93.0% were constitutive resistant.ermB Was detected in 40 strains and mefE in 1 strain,both ermB and mefE genes were found in 9 strains.CONCLUSIONS The resistance rate of S.pneumoniae to penicillin is high in Yantai area,the resistance rates to erythromycin and clindamycin are very high.Target modification by ermB methylase is the predominant mechanism in macrolide-resistant S.pneumoniae in Yantai.