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Objective@#To investigate the distribution and expression of T3SS virulence genes in clinically isolated Pseudomonas aeruginosa (P. aeruginosa) strains and its correlation with drug resistance. @*Methods@#A total of 68 P. aeruginosa isolates were collected from the First Affiliated Hospital of Wenzhou Medical University in 2015. The antimicrobial susceptibility was detected by the agar dilution method. The distribution of virulence genes such as exoU, exoS, exoT and exoY from different isolates was detected by PCR. The expression levels of transcriptional regulator genes (ptrA and exsA) and effector-related genes (exoT and exoS) in some isolates were determined by real-time fluorescence quantitative PCR, and the Pearson correlation analysis was used to analyze the results. @*Results@#The detection rates of exoT and exoY in 68 P. aeruginosa isolates were higher, accounting for 79.4% and 75.0%, respectively. The detection rate of exoT in wound-sourced isolates was significantly higher than that in sputum (97.0% vs 61.8%, P＜0.01). In addition, the genotype of exoU - /exoS + was the most common, accounting for 51.5% (35/68). The resistance rates of sputum-sourced isolates to imipenem and meropenem were significantly higher than that of wound-sourced isolates (47.1% vs 8.8%, 47.1% vs 14.7%, P＜0.01). The resistance rates of isolates carrying exoU gene to carbapenems, aminoglycosides and fluoroquinolones were higher than those of isolates carrying exoS, exoT or exoY genes. Pearson correlation analysis showed that the expression level of ptrA gene was negatively correlated with those of exoT, exoS and exsA genes (P＜0.05). @*Conclusion@#The P. aeruginosa isolates from our hospital carrying T3SS virulence genes exoT and exoY are common, and the virulence genes are related to the drug resistance of P. aeruginosa. In addition, ptrA may be a potential negative regulatory gene for the expression of T3SS virulence genes.
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Objective To assess the outcome of renal artery stenosis approached by percutaneous transluminal renal angioplasty (PTRA) and stents.Methods Seventy-two patients (50 males and 22 female) were diagnosed as renal stenosis by renal angiography.Of them,68 cases were with atherosclerosis.The PTRA was done via femoral access site.Changes in blood vessel diameter and blood flow nd complications were recorded.Renal angiograph was performed to check the restenosis.Patient’s blood pressure and serum creatine level before and after the were observed.Results Angiograph showed unilateral artery lesion in 60 cases and bilateral stenosis in 12 cases.The ostium was involved in 72 sites and mid-part in 8.The lumen diameter of stenosis was 60%-95%.The stents were successfully implanted in 68 cases with 78 stents and 4 cases only by balloon.The lumen diameter of lesion increased from 2.0mm (0.8-2.6mm) to 6.5mm (4.0-8.0mm).TIMI flow decreased in 3 cases and renal function was impaired in 4 cases,but not severe.Blood pressure in 42 cases with hypertension decreased significantly.One case was complicated with perirenal hematoma.and there was no perioperative death.Conclusion PTRA and stenting treatment for renal artery disease are feasible and safe.
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Objective To assess the short-term outcome of percutaneous transluminal renal angioplasty (PTRA) and stents for renal artery stenosis. Methods Twenty-six patients (17 males and 9 females) were diagnosed as renal stenosis by renal angiography and underwent simultaneous or selective PTRA and/or renal stenting. Changes in vessel diameter and perioperative complications were recorded. The blood pressure level, prescription of pressure-lowering drugs and the serum creatine level before and after the operation were analyzed. Results Unilateral artery stenosis was found in all 26 cases. Ostial stenosis were found in 18 cases (69%) and non-ostial stenosis in 8 cases (31%). The degree of stenosis was 70%-99%. All the 26 cases received renal stenting and 11 of them also received PTRA. The mean lumen diameter increased from 2.0 mm to 6.0 mm. The renal function was improved in 2 cases with impaired renal function before operation. The blood pressure leveal decreased or returned to normal level after stenting in 20 cases (76.9%) out of all the 26 hypertension patients. The were no perioperative complications recorded. Conclusion PTRA and/or renal stenting are effective and safe in treating renal artery stenosis.