To help the clinical microbiology laboratories understanding the standards of antimicrobial susceptibility testing (AST) from Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) ; discuss when to perform AST,how to confirm unusual or inconsistent results and adopt the suitable AST method,how to interpret the information of continuous monitoring development of resistance and testing of repeat isolates,how the drug-resistance mechanism influence the report and treatment.This will provide accurate and timely AST results for clinicians.

Objective To summarize the clinical manifestations,diagnosis and treatment of the primary hyperparathyroidism (PHPT).Methods The clinical data of 89 patients with PHPT admitted during 1991 to 2013 were retrospectively analyzed.Results The mean age of the 89 patients was (44.7 ± 15.8) years (13-86 years),male to female ratio was 1 ∶ 2.1.79％ of the 89 patients were symptomatic.62％ of the 89 patients had been misdiagnosed.52％ had been misdiagnosed as kidney stones or bone diseases (fracture,tumor,and metabolic bone disease).The remaining subjects had been misdiagnosed as peptic ulcer,rheumatoid arthritis or pancreatitis.The median serum parathyroid hormone (PTH) level in 88 patients was 697.3 pg/ml (26.4-5 000.0 pg/ml,n =88),the mean serum calcium level was (3.03 ± 0.56) mmol/L (n =88).The 24 h urine calcium was (10.02 ± 4.73)mmol/24 h (n =36).The sensitivity of localization of the parathyroid lesions with technetium-99m methoxy-isobutylisonitrile (99mTc-MIBI) was 96％,being higher than ultrasound (71％),CT (71％),and MRI (72％) (P＜0.05,respectively).79 cases had been treated surgically.The median serum PTH level was 748.2 pg/ml (46.1-5 000.0 pg/ml) before surgery,79.9 pg/ml (11.35-838.0 pg/ml) 15 minutes after surgical removal of the lesions (P＜0.05 vs preoperative) and 22.9 pg/ml (2.3-1 203.0 pg/ml) on the first postoperative day (P＜0.05 vs preoperative).Serum calcium was (3.03 ± 0.56) mmol/L before surgery,(2.25 ± 0.37) mmol/L on the first postoperative day (P＜0.05 vs preoperative) and (2.08 ± 0.36) mmol/L on the second postoperative day (P＜ 0.05 vs preoperative).After the operation,42 cases(53％) had perioral and limb numbness,2 cases (3％) had hoarseness of voice and bucking while drinking,1 case(1％) had tetany.All these symptoms were improved after calcium supplementation.67 patients (85％) had been diagnosed as parathyroid adenoma pathologically,7 patients (9％) as hyperplasia,3 patients (4％)as cysts,and 2 patients (3％) as carcinoma.Among 67 cases of adenomas,62 cases had a single parathyroid adenoma,1 case with multiple parathyroid adenomas,and 4 cases with ectopic parathyroid adenomas.The ectopic lesions were located below the thyroid,in the rib cage,left mediastinum,and above the sternum.Conclusions The majority of domestic PHPT was symptomatic.Delayed diagnosis of PHPT is still very frequent.The clinical presentations of PHPT are variable,determination of serum calcium and PTH level simultaneously is the keypoint for early identification and diagnosis of PHPT.The clinician should be familiar with the various clinical manifestations of PHPT and thus enhance understanding of pathogenesis of the disease.99mTc-MIBI scintigraphy remained the first choice of preoperative imaging localization of the parathyroid lesions,followed by ultrasound,CT,and MRI.Surgical removal of the lesions is effective and safe.

In recent years, there is increasing evidence that the pathogenesis of Parkinson's disease (PD) may involve the more generation of reactive oxygen species, and investigations on patients have shown that PD is under a status of oxidative stress. The defense against the toxic effects of reactive oxygen species is an essential task within the brain. An important component of the cellular detoxification of reactive oxygen species is the antioxidant glutathione. Consequently, it seems reasonable to propose that increase of brain concentrations of glutathione including glutathione analogs or precursors could be very effective in diminishing the cumulative effects of oxidative damage, and have been investigated as potential therapeutic targets in the treatment and prevention of PD or other neurodegenerative disease.

Antioxidative effects of Suaeda heteoptera Kitag. extracts were measured using thiobarbituric acid method.The results showed that extracts obtained with water,methanol and hexane gave significant resistance to the lipid peroxidation of linolenic acid and hexane extract showed the highest antioxidative activities.Mechanism of this antioxidative effect was studied using chemiluminescence.The results showed that extracts can effectively scavenge O -? 2 but have no effects on OH ?.This illustrated that the antioxidative effects were achieved by scavenging O -? 2 radical.

The role of the microvascular disease in progressive renal disease is not well understood .This review presents evidence that progressive renal disease is characterized by a progressive lose of the microvasulature. And presents the factors that induce the lose of the microvasculature. Try to find out (agents) which may represent a novel therpeatic approach for slowing the renal disease.

Objective To investigate the effect of psychological intervention combined with parecoxib on cognitive function in patients after liver resection of hepatocellular carcinoma. Methods From March 2015 to March 2017 in the first people's hospital of Yongkang city for diagnosis and treatment of liver cancer were 40 cases according to different nursing, drug intervention were divided into control group and observation group, the control group were treated with basic nursing + saline intervention, observation group with psychological intervention + Tenai (parecoxib sodium) intervention. The changes of cognitive function (MMSE score), inflammatory factors (TNF-α, IL-6 and S100) levels were recorded before and after intervention in the two groups, and the data obtained were analyzed and summarized. Results The psychological intervention and intervention Tenai (observation group) resection for hepatocellular carcinoma is better than the basic nursing + saline patients (control group) intervention, patients with MMSE score and TNF- α, IL-6, beta S100 levels were better than the control group, the difference was statistically significant (P<0.05). Conclusion Resection for hepatocellular carcinoma patients psychological intervention + Tenai intervention effect, it can reduce the level of inflammatory factors in patients, and has a good effect on the recovery of cognitive function after surgery.

Objective To investigate the application effect of psychological intervention combined with parecoxib in rehabilitation of patients with bile duct carcinoma after the operation. Methods According to the different intervention models from January 2015 to March 2017 in the first people's hospital of Yongkang city surgical treatment of bile duct carcinoma,40 cases of patients groups: control group with routine nursing plus saline intervention, observation group with psychological nursing + Tenai (parecoxib sodium) mode of intervention; on the psychological state of the two groups before and after intervention to improve patients the cognitive function, to improve the situation, changes in pain scores were recorded, and the related data for comparative analysis. Results The psychological nursing + Tenai (parecoxib sodium) model (observation group) intervention in the treatment of patients with bile duct cancer surgery clinical effect is better than that of routine nursing mode + normal saline (control group) the clinical effect of intervention, the psychological state of patients to improve the situation, improve cognitive function, pain score changes were better than the control group, there was statistical significant differences (P<0.05). Conclusion The surgical treatment of patients with cholangiocarcinoma patients psychological nursing + Tenai (parecoxib sodium) intervention effect significantly, can effectively improve the patients psychological status, cognitive function, and can reduce postoperative pain fully, has an excellent role in promoting the rehabilitation of patients after surgery, worthy of clinical application.