HDL subfractions determined by microfluidic chip electrophoresis predict the vulnerability of intracranial plaque: A HRMRI study.

AIM: High-density lipoprotein (HDL) can be divided into several subfractions based on density, size and composition. Accumulative evidence strongly suggests that the subfractions of HDL have very different roles in the pathogenesis of atherosclerosis. The purpose of this study was to further delineate the relationship between HDL subfractions extracted by microfluidic chip electrophoresis and the vulnerability of plaques in patients with intracranial atherosclerosis with a high-resolution magnetic resonance imaging (HRMRI) study. METHODS: We prospectively enrolled patients with single atherosclerotic plaque in the middle cerebral artery (MCA) or basilar artery (BA) between July 2020 and Dec 2022 and performed 3-tesla HRMRI on the relevant artery. The HDL cholesterol concentration and HDL subfractions (HDL-2a, HDL-2b and HDL-3) percentage were analyzed in serum samples from the same patients by electrophoresis on a microfluidics system. RESULTS: A total of 81 MCA or BA plaques [38 (46.9%) symptomatic and 43 (53.1%) asymptomatic] in 81 patients were identified on HRMRI. Patients with symptomatic plaques had a significantly lower HDL-2b level than asymptomatic plaques [symptomatic vs. asymptomatic: 0.16 (0.10-0.18) vs. 0.27(0.21-0.34), p = 0.001]. After adjusting for demographics and vascular risk factors, logistic regression showed that HDL-2b was inversely associated with asymptomatic plaques (B = -0.04, P = 0.017). According to receiver operating characteristic (ROC) curve model analysis, the cutoff point of HDL-2b in predicting asymptomatic plaques was 0.21 mmol/L (Area under curve: 0.719, specificity: 73.7%, sensitivity: 72.1%). Furthermore, plaque enhancement on HRMRI (P < 0.001), positive remodeling (P < 0.001), plaque load (P < 0.001) and luminal stenosis (P < 0.001) were superior among patients with HDL-2b < 0.21 mmol/L. CONCLUSIONS: Our data showed that serum HDL-2b levels may serve as a biomarker for predicting vulnerability in intracranial atherosclerotic plaques.

Clinical Efficacy of Qingxin Zishen Decoction on Hot Flashes After Endocrine Therapy for Prostate Cancer and Its Preliminary Mechanism / 中国实验方剂学杂志

ObjectiveTo observe the clinical effect of Qingxin Zishen decoction on hot flashes after endocrine therapy for prostate cancer and explore its therapeutic mechanism. MethodA total of 60 patients who met the criteria and were admitted to Jiangsu Province Hospital of Chinese Medicine from December 2021 to December 2022 were collected and randomly divided into a treatment group and a control group， with 30 cases in each group. The treatment group was treated with Qingxin Zishen decoction， while the control group was only given routine nursing. The observation period of this study was eight weeks. The improvement of hot flash frequency， hot flash degree， hot flash score， ISS score， and TCM syndrome score were observed in the two groups before and after treatment. The changes of serum endothelin-1 （ET-1）， nitric oxide （NO）， calcitonin gene-related peptide （CGRP）， prostate specific antigen （PSA）， and testosterone were detected. ResultIn terms of efficacy， after treatment， the frequency， degree， and score of hot flashes， ISS score， and TCM syndrome score decreased in the treatment group （P<0.05）. Compared with the control group， all indicators were better in the treatment group （P<0.05）. In terms of laboratory indicators， after treatment， the serum NO level in the treatment group was increased. ET-1 level was decreased. The ratio of ET-1/NO was decreased， and the CGRP level was decreased （P<0.05）. However， testosterone and PSA levels were not significantly changed . Compared with the control group， after treatment， the serum NO level in the treatment group was higher， and the level of ET-1 was lower. The ratio of ET-1/NO and the CGRP level were lower （P<0.05）. There were no significant differences in testosterone and PSA levels between the two groups. ConclusionQingxin Zishen decoction can significantly improve hot flashes in patients with prostate cancer after endocrine therapy. The mechanism of Qingxin Zishen decoction may be to improve the vasomotor function by regulating the expression level of vasomotor factors， so as to treat hot flashes.

Effect of Tuina along "bladder meridian" alleviating intervertebral disc degeneration by regulating the transforming growth factor-ß1/Smad signaling pathway in a rabbit model.

OBJECTIVE: The aim of this study was to investigate the protective effects of Tuina (a traditional Chinese massage therapy) on intervertebral disc (IVD) degeneration and the regulatory mechanisms of the transforming growth factor-ß1 (TGF-ß1)/small mothers against decapentaplegic (Smad) signaling pathway. METHODS: Thirty New Zealand white rabbits were randomized into five groups: the control group, model group, model + Tuina group (Tuina group), model + TGF-ß1 group (TGF-ß1 group), and model + TGF-ß1 inhibitor SB431542 group (SB431542 group). The model was established by posterolateral annulus fibrosus puncturing (AFP). Recombinant TGF-ß1 and inhibitor SB431542 was injected into the TGF-ß1 group and SB431542 group with a microsyringe, respectively. The rabbits in the Tuina group received Tuina treatment along the bladder meridian for 4 weeks. Magnetic resonance imaging (MRI) was performed on rabbits before AFP and after 4 weeks of intervention. Lumbar IVDs (L2-L3 to L4-L5) were harvested after intervention. Histopathological changes in the IVDs were measured by hematoxylin and eosin (HE) staining. Type I collagen was analyzed by immunohistochemistry detection. The expression level of matrix metalloproteinase-3 (MMP3) was determined by enzyme-linked immunosorbent assay. Cell apoptosis was evaluated by terminal deoxynucleotidyl transferase-mediated nick end labeling and Western blotting. Real-time polymerase chain reaction and Western blotting were used to analyze the expression of TGF-ß1 and Smad2/3/4 and a disintegrin and metalloproteinase with thrombospondin motifs 5. RESULTS: Posterolateral AFP induced IVD degeneration in rabbits with histopathological damage and noticeable changes in MRI images. Tuina alleviated histo-pathological changes and reversed the expression of extracellular matrix degeneration-related molecules and apoptosis-related proteins. Furthermore, AFP induced the activation of TGF-ß1 and Smad2/3/4, whereas Tuina therapy markedly reduced the protein expression of Smad2/3 and the gene expression of TGF-ß1 and Smad2/3/4. Additionally, the TGF-ß1/Smad signaling pathway was activated in the TGF-ß1 group, while the TGF-ß1/Smad signaling pathway was inhibited in the SB431542 group. CONCLUSION: Posterolateral AFP induced disc degeneration as determined by MRI assessment and histological analysis. Tuina alleviated disc degeneration, possibly by inhibiting the fibrotic response mediated by the TGF-ß1/Smad pathway, thus alleviating extracellular matrix degeneration and reducing cell apoptosis.

Discussion on diagnosis and treatment of dizziness from cases / 临床耳鼻咽喉头颈外科杂志

Dizziness or vertigo is a common clinical symptom, and its underlying etiology is complex. Many clinicians are confused about its diagnosis and treatment. This article presents a case about chronic vestibular syndrome. And case appreciation and academic discussion are conducted by well-known domestic neurologists and otologists, so as to provide a good thinking model and basic ideas for the diagnosis and treatment of dizziness or vertigo, hoping to further improve the diagnosis and treatment level among clinicians.

Diversity analysis of leaf endophytic fungi and rhizosphere soil fungi of Korean Epimedium at different growth stages.

BACKGROUND: Rhizosphere fungi and endophytic fungi play key roles in plant growth and development; however, their role in the growth of Epimedium koreanum Nakai at different stages remains unclear. Here, we used the Illumina MiSeq system, a high-throughput sequencing technology, to study the endophytic fungi and rhizosphere microbiome of Korean Epimedium. RESULTS: Epimedium koreanum Nakai rhizosphere soil and leaves had highly diverse fungal communities during the growth process. The relative abundance of soil fungi in the rhizosphere stage was higher than that of leaf endophytic fungi in the early growth stage, but the overall abundance was basically equal. Sebacina is a significantly divergent fungal genera, and Sebacina sp. are present among leaf fungi species in the rhizosphere soil of Epimedium koreanum Nakai. Sebacina sp. can move to each other in rhizosphere soil fungi and leaf endophytes. VIF (variance inflation factor) analysis showed that soluble salt, whole nitrogen, alkaline lysis nitrogen, whole phosphorus, total potassium, and fast-acting potassium are useful environmental factors for rhizosphere soil and leaf endophytic fungi: potassium, total nitrogen, whole phosphorus, and three environmental factors were significantly and positively associated with the relative abundance of Sebacina sp. CONCLUSIONS: (1) This study is the first to clarify the species diversity of fungi in Epimedium koreanum Nakai leaf and rhizosphere soil. (2) Different fungal communities of rhizosphere soil fungi and leaf endophytic fungi at different growth stages of Epimedium koreanum Nakai were examined. (3) Sebacina sp. can move to each other between rhizosphere soil fungi and leaf endophytic fungi. (4) Nitrogen, phosphorus and potassium elements in the environment have a significant positive effect on the relative abundance of Sebacina sp.

Risk factors of bone cement leakage after percutaneous vertebroplasty for osteoporotic vertebral compression fracture / 中华创伤杂志

Objective:To investigate the risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF).Methods:A multi-center, large-sample, case-control study was carried out to analyze the clinical data of 2 273 OVCF patients (2 689 vertebrae) undergone PVP at four hospitals between May 2018 and October 2021, including 994 males and 1 279 females, with the age of 52-91 years [(69.1±3.1)years]. Of all, 581 patients (604 vertebrae) were allocated to leakage group and 1 692 patients (2 085 vertebrae) to no leakage group according to the occurrence of bone cement leakage. The gender, age, fracture sites, vertebral compression degree, endplate integrity of fractured vertebrae, surgical segments, surgical approaches and bone cement injection volume were recorded. Univariate analysis was used to investigate the correlation between those indicators with bone cement leakage. Multivariate Logistic regression analysis was used to identify the independent risk factors for bone cement leakage.Results:Univariate analysis showed that gender, age, fracture sites, vertebral compression degree, bone cement injection volume were related to bone cement leakage after PVP ( P<0.05 or 0.01), but no correlation was found in the endplate integrity of fractured vertebrae, surgical segments and surgical approaches (all P>0.05). Multivariate Logistic regression analysis showed that fracture sites ( OR=1.68, 95% CI 1.11-2.55, P<0.05), vertebral compression degree more than 40% ( OR=1.98, 95% CI 1.29-3.02, P<0.01), bone cement injection volume greater than or equal to 5.5 ml ( OR=1.55, 95% CI 1.07-2.26, P<0.05) were significantly associated with bone cement leakage after PVP. Conclusion:Thoracic vertebral fracture, vertebral compression degree more than 40% and bone cement injection volume greater than or equal to 5.5 ml are independent risk factors for bone cement leakage after PVP in OVCF.

Comparison of the curative effect of zero-profile bridge-shaped locking cage and anterior cage combined with titanium plate fixation in the treatment of cervical spondylotic myelopathy / 中华骨科杂志

Objective:To investigate the difference of curative effect between zero-profile bridge-shaped locking cage (ROI-C) and anterior cage combined with titanium plate fixation in the treatment of two-level and three-level cervical spondylotic myelopathy.Methods:A total of 85 patients (43 males and 42 females), aged 52.3±8.0 years (range from 28 to 66 years) with bi- and three-level cervical spondylotic myelopathy who received surgical treatment from June 2017 to October 2019 were retrospectively analyzed. There were 63 cases of two levels and 22 cases of three levels. 45 cases were treated with zero-profile bridge-shaped locking cage ROI-C (ROI-C group), and 40 cases with anterior cage combined with titanium plate fixation (titanium plate group). The main observation indicators include operation time, intraoperative blood loss, cervical Cobb angle, fusion segment Cobb angle, average intervertebral height, pain visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) Score and neck disability index (NDI).Results:All of 85 patients were followed up for 16.9±2.0 months (range 12 to 22 months). The operation time of two-level ROI-C group was 110.37±8.25 min, which was shorter than 139.5±10.54 min of titanium plate group; the intraoperative blood loss was 15.74±8.10 ml, which was less than 23.71±9.70 ml of titanium plate group; the operation time of three-level ROI-C group was 130.00±5.70 min, which was shorter than 162.83±5.59 min of titanium plate group, while the difference in the intraoperative blood loss between the two groups had no statistical significance. One year after operation, Cobb angle of cervical vertebra in double and three-level ROI-C groups were 15.31°±1.55° and 15.20°±0.42°, respectively, which were largerthan 11.23°±2.03° and 9.20°±1.14° before operation; in titanium plate group, they were 15.89°±1.13° and 16.08°±1.88°, which were higher than 11.25°±2.01° and 9.00°±1.60° before operation, and the differences had statistical significance. The differences between the two groups before operation and 1 year after operation had no statistical significance. One year after operation, the VAS scores of double and three-level ROI-C groups were 1.83±0.66 points and 2.60±0.52 points, respectively, which were less than the preoperative 7.49±0.51 points and 7.60±0.52 points; the titanium plate group was 1.79±0.50 points and 2.41±0.51 points, which were less than the preoperative 7.61±0.63 points and 7.42±0.52 points, and the differences had statistical significance. There was no significant difference between the two groups before operation and 1 year after operation. One year after operation, the JOA scores of double and three-level ROI-C groups were 15.00±0.84 points and 14.70±0.95 points, respectively, which were higher than the preoperative 7.20±0.87 points and 6.60±1.27 points; the scores of titanium plate group were 15.29±0.85 points and 14.83±0.58 points, which were higher than the preoperative 6.89±1.03 points and 6.92±0.67 points, and the differences had statistical significance. The differences between the two groups had no statistical significance. The postoperative JOA improvement rate was excellent. Postoperative dysphagia occurred in 1 case (2.22%, 1/45) in ROI-C group and 8 cases (20.00%, 8/40) in titanium plate group, and the difference in the incidence rate between two groups had statistical significance ( χ2=5.32, P=0.02). Conclusion:Both ROI-C and anterior cage combined with titanium plate fixation in the treatment of double and three-level cervical spondylotic myelopathy can achieve good short-term clinical efficacy, with shorter operation time and lower incidence rate of postoperative dysphagia using ROI-C.

Application of virtual experiment in clinical microbiology inspection technology / 中华医学教育探索杂志

Clinical microbiology examination technology experiment is an important part of clinical microbiology examination technology teaching. In the experimental teaching of clinical microbiology examination technology, the virtual simulation technology was combined with traditional teaching to give full play to the advantages of the virtual experimental platform. As to experimental projects that couldn't be carried out in traditional teaching and some important experimental projects, students could learn on the virtual experimental platform, and after learning, they would participate in the corresponding assessment. The perfect combination of the two can solve the problem of high experimental cost and limited experimental content in the current experimental class, make up for the shortcomings of traditional teaching, realize the sharing of teaching resources. Besides, it can strengthen the students' experimental operation skills and enhance the interest of learning for cultivation of application-oriented medical talents.

Safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions / 中华心血管病杂志

Objective@#To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions.@*Methods@#In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing. The definition of procedure success was defined as residual stenosis less than 20% after implantation of drug eluting stent and rotational atherectomy. After the procedure, the patients were followed up to observe major adverse cardiac and cerebral vascular events which including cardiogenic death, myocardial infarction, cerebrovascular accident, and target lesion revascularization.@*Results@#The 1.25 mm diameter burr was firstly selected in 80.6% (25/31) patients,and 96.8%(30/31) patients used only 1 burr to complete the rotational atherectomy procedure. The complication rate was 9.8% (3/31) including 1 patient with coronary dissection and 3 patients with slow flow or no flow. There was 1 patent with both coronary dissection and slow flow. The procedure success rate was 96.8%(30/31). Interventional treatment related myocardial infarction occurred in 3 patients during hospitalization.The 30 patients with procedure success were followed up 36(11, 96) months. The incidence rate of major adverse cardiac and cerebral vascular events was 13.3% (4/30), of which the cardiogenic death rate was 3.3% (1/30), the myocardial infarction rate was 6.7% (2/30), cerebrovascular accident rate was 3.3%(1/30),and the target lesion revascularization rate was 6.7% (2/30).@*Conclusion@#Rotational atherectomy is safe and effective in the interventional treatment of coronary CTO lesions.

Dendritic cells derived exosomes migration to spleen and induction of inflammation are regulated by CCR7.

Mature dendritic cells (DCs) home to secondary lymphoid organs through CC chemokine receptor 7 (CCR7). Exosomes derived from DCs (DC-exos) are reported to migrate to spleen and induce inflammation in vivo. In this study, we demonstrated that mature bone marrow DC-exos can activate immature DC and T cells in vitro. Then we intravenously injected DC-exos into C57BL/6 mice, observing that mature DC-exos accumulated more in spleen than immature DC-exos. These DC-exos in spleen could be uptaken by splenetic DCs and T cells and induce an inflammatory response. We further showed that the increased accumulation of mature DC-exos in spleen was regulated by CCR7, whose reduction led to a decrease of accumulation in spleen and attenuated inflammatory response in serum. These data provide us a new perspective to comprehensively understand exosomes, which might inherit some special functions from their parent cells and exert these functions in vivo.

Exploration and practice of scientific research ability training of students majoring in medical labo-ratory technology / 中华医学教育探索杂志

The new training standards of medical laboratory technology demand the graduates of medical laboratory technology should have the basic scientific research ability and quality. In order to com-plete the teaching work better and achieve the above training objectives, the members of the research group have made some attempts, adopting PBL, CBL and other teaching methods in theoretical teaching, develop-ing open experiments and comprehensive design experiments in experimental teaching, organizing students to study extracurricular undergraduate subject in spare time, in order to provide some basis for the training of students majoring in medical laboratory technology.

Effects of protein in wheat flour on retrogradation of wheat starch.

Albumins, globulins, gliadins, and glutenins were isolated from wheat flour and the effects of those proteins on retrogradation of wheat starch were investigated. The results showed that only glutenins retarded retrogradation of wheat starch and other 3 proteins promoted it. The results of IR spectra proved that no S-S linkage formed during retrogradation of wheat starch blended with wheat proteins. Combination of wheat starch and globulins or gliadins through glucosidic bonds hindered the hydrolysis of wheat starch by α-amylase. The melting peak temperatures of retrograded wheat starch attached to different proteins were 128.46, 126.14, 132.03, 121.65, and 134.84 °C for the control with no protein, albumins, glutenins, globulins, gliadins groups, respectively, and there was no second melting temperature for albumins group. Interaction of wheat proteins and starch in retrograded wheat starch greatly decreased the endothermic enthalpy (△H) of retrograded wheat starch. Retrograded wheat starch bound to gliadins might be a new kind of resistant starch based on glycosidic bond between starch and protein.

Therapeutic effect and safety of tirofiban combined large dose statin in patients with acute myocardial infarction / 心血管康复医学杂志

Objective:To observe and analyze the therapeutic effect and safety of tirofiban combined large dose statin in patients with acute myocardial infarction (AMI),and evaluate its influence on myocardial perfusion and cardiac function.Methods:A total of 97 consecutive AMI patients visited to our hospital from May 2011 to January 2013, who were beyond the emergency PCI time window (≥12h),their chest pain was remissive or not further aggravated were studied.All patients were pumped with tirofiban for 48h continuously;according to combined rosuvastatin dose,they were divided into large dose group (n = 52,20mg,once/d,until one month after infarction,then changed to routine dose of 10mg,once/d)and routine dose group (n=45,10mg,once/d).All patients received se-lective PCI after 7 ~ 10d conservative treatment.Myocardial perfusion level,left ventricular ejection fraction (LVEF)on one week after PCI and 30d after AMI,enzymology changes [creatine (CK),lactate dehydrogenase (LDH)]and major adverse cardiovascular events (MACE)during hospitalization were compared between two groups.Results:Compared with routine dose group,there were significant reductions in thrombus scores in infarct related artery (IRA)[(1.32±1.01)scores vs.(0.81±0.78)scores]and corrected TIMI frame [(32.4±4.73)vs. (26.8±2.34)]in large dose group (P =0.021,P 0.05).There was no MACE in both groups during hospitalization and 30d after PCI.Conclusion:Tirofiban combined large dose statin is safe and effective in patients with acute myocardial infarction,it can reduce intra-coronary thrombus burden,im-prove myocardial tissue perfusion and cardiac function without increasing MACE.

Study on Immunity Adjustment and Tumor-Inhibition of Bifidobacterium Cell Wall In Mice / 医学研究杂志

Objective To explore the Activation function of the bifidobacterium adolescence cell wall(BCW)on macrophage in abdominal cavity of mice and tumor-inhibition of BCW on human transitional cell carcinoma of bladder(BTCC)in vitro.Methods ①Twenty KM mice were randomly divided into two groups:control group(n=10)and BCW injection group(n=10).BCW was distilled by ultrasonic cell disintegrator.Then the BCW was injected into abdominal cavity of the BCW injection group mice,physiological saline was injected into the control group mice,then all the mice were killled,macrophage in abdominal cavity was collected under the condition of asepsis,the level of IL-2 and IFN-? which produced by macrophage was determined by ELISA reagent box;②The role of tumor-inhibition of BCW on human transitional cell carcinoma of bladder(BTCC,T24)in vitro was determined by MTT method:The cell of T24 in the stage of logarithmic growth was digested,inoculated in cell raise board,cultivated after 24 hours,different concentration of BCW were added into each hole,cultivated continually,replaced nutrient fluid on 1th day,3th day,5th day,MTT was added into each hole too,cultivated continually,DMSO was added into each hole,vibrated,shaked up,determined the A value at 490nm by ELIASA,calculated the tumor-inhibition rate;Observed the growth state under microscope:The cell of T24 in the stage of logarithmic growth was inoculated in cell raise board that comprise microscope slides,cultivated after 24 hours,BCW were added into each hole,cultivated continually,took out two slides after 24 hours,72 hours,120 hours,stained,observed the change of the shape of T24 under microscope,changed the culture liquid only on control group.each time.Results The level of IL-2 and IFN-? of BCW injection group was higher than of control group(P

Study on Immunomodulation and Tumor-inhibition of Bifidobacterium Cell Wall in Mice / 医学研究杂志

Objective To explore the immunologic regulation of the bifidobacterium adolescence cell wall(BCW) on function of macrophage in mice and tumor inhibition of BCW on human transitional cell carcinoma of bladder(BTCC) outside of body.Methods BCW wereinjected into abdomen of KM mice,the level of IL-1,IL12 and TNF-?which produced by macrophage was determined by ELISA reagent box.The role of tumor inhibition was determined by MTT method.Results The level of IL-1,IL12 and TNF-?of BCW injection group was higher than of control group(P

Clinical Study of Yifumin Capsule in Treating Type 2 Diabetic Insulin Resistance / 中国中医药信息杂志

Objective To study the clinical therapeutic effect of Yifumin Capsule in treating type 2 diabetic insulin resistance and its effect on relevance indexes.Methods Two hundred and forty cases of type 2 diabetic insulin resistance with deficiency of qi-yin and stagnation of phlegm and toxin were divided randomly into two groups,120 cases in each group.The treatment group was given orally Yifumin Capsule,and the control group was given orally pioglitazone.The treatment course of the two groups was 12 weeks.Clinical symptoms,blood glucose,blood lipid,CRP,ISI,FINS,HOMA-IR,liver and kidney function were detected respectively.Results Chinese medicine symptoms and signs were all improved.The total effective rate of clinical effect was 88.1% in treatment group and 52.9% in control group.The clinical therapeutic effect of the treatment group was obviously better than the control group.Both groups had a notable seducement in HOMA-IR,FINS,FPG,2 h PG,HbA1c,TG and LDL-C with an obviously improvement in ISI after the treatment.Compared with the control group,the treatment group had a significant decrease in TC and CRP with notable difference.Conclusion Yifumin Capsule can effectively improve the insulin resistance of type 2 diabetic patients.

Impact of Expression of DHA AmpC ?-Lactamases Mediated by Plasmid on Antibiotics Susceptibility of Clinical Isolates of Klebsiella pneumoniae / 中华医院感染学杂志

OBJECTIVE To investigate the prevalence of DHA AmpC ?-lactamases mediated by plasmid in Klebsiella pneumoniae in China.METHODS Antimicrobial susceptibility test was conducted by the methods of double agar dilution and ESBLs confirmatory in K-B method according to the criteria of guidelines of CLSI.AmpC ?-lactamases were detected on the basis that AmpC ?-lactamases could be inhibited by 3-aminophenylboronic acid(APB).Gene chip technology and PCR were used to detect ESBLs and AmpC gene.RESULTS Among total 34 isolates of K.pneumoniae 32(94.1%) produced AmpC ?-lactamases and ESBLs.The most common(38.3%) were types DHA and TEM and SHV.MIC50 and MIC90 of all strains to all tested antimicrobial agents were lower than 34 strains tested 0.25?g/ml and 0.5?g/ml.Fourteen strains AmpC and ESBLs were conjugated successfully.CONCLUSIONS DHA AmpC ?-lactamases mediated by plasmid are the most common in K.pneumoniae in General Hospital of PLA of China.The most common(38.3%) are types DHA and TEM and SHV.Fourteen(41.2%) strains can be spreaded by plasmid.