Individualized therapy is dependent on rapid and accurate diagnosis of pathogens,and refined susceptibility reporting.The annually revised interpretive criteria of Clinical and Laboratory Standards Institute (CLSI) causes widespread concern of microbiologists.The major changes in CLSI M100-S24 are described in this article.The document mainly changed the Cefepime breakpoint for Enterobacteriaceae and introduced a new concept-- susceptible-dose dependent interpretive category.Optimizing the use of antimicrobial agents requires clinical microbiologists and clinicians to have a good knowledge of the new breakpoints.

Drug resistance is becoming a serious issue worldwide.Obtaining accurate antimicrobial susceptibility results requires refined standard operation procedures,thus achieving the goal of individual therapy.The interpretive criteria CLSI revised annually causes widespread concern of clinical microbiologists.The major changes in CLSI M100-S25 are described in this article,focusing on the introduction of Carba NP confirmatory test for suspected carbapenemase production and epidemiological cutoff values.

Antithrombotic therapy is essential to success of percutaneous cardiovascular intervention(PCI)and reduction of postprocedural thrombotic complications.Antiplatelet and anticoagulant therapies are central to current antithrombotic therapy.The mechanism of thrombogenesis,related factors,clinical guidelines and considerations associated with antithrombotic drugs are illustrated in this paper.

Objective:To develop the Abusive Behavior Scale for Superiors under the Chinese context (ABSSC) and test its validity and reliability.Methods:Based on literature analysis and the open questionnaire survey in 32 employees,this study defined the construct of ASBSS,and compiled the preliminary questionnaire.A sample of 200 employees coming from companies was selected for item analysis.A sample of 445 employees was investigated with this questionnaire,223 of them were assessed for exploratory factor analysis and 222 of them were assessed for confirmatory factor analysis and internal consistency test with 2 week interval.Results:The ABSSC consisted of 11 items in 3 factors,which were neglect and slander,obstructionism and hard on subordinates.The 3 factors explained 55.45％ of the total variance.Furthermore,the result of CFA indicated that the model fitted the data with well constmct validity (RMSEA =0.06,GFI =0.94,NFI =0.92,CFI =0.96,IFI =0.96).The Cronbach α coefficient of the whole scale and its three facts were 0.87,0.79,0.78,and 0.76,respectively.Conclusion:It suggests that the Abusive Behavior Scale for superiors under the Chinese context (ABSSC) is reliable and valid enough to be applicable to measure superiors' abusive behavior under the background of Chinese culture.

The topographical projection between the parabigeminal nucleus and the superiorcolliculus in the cat was investigated by retrograde and anterograde HRP tracingtechnique.Following HRP injection in the rostral superior colliculus,the labeledsomata were found predominantly in the rostral region of contralateral parabigeminalnucleus,but labeled terminals were heavily distributed in the ipsilateral parabigeminalnucleus,mainly in the caudal region.Following injection of HRP into caudal superiorcolliculus,the labeled somata and terminals were seen in ipsilateral parabigeminalnucleus,chiefly in caudal part,but their number was significantly decreased.It wasnoted that the labeled somata were sparse but labeled terminals were not found inthe parabigeminal nucleus,when the injection was restricted to superficial layers ofsuperior colliculus.After HRP injection into deeper layers of superior colliculus,there existed not only the labeled somata but also the labeled terminals in theparabigeminal nucleus,the former was distributed in bilateral parabigeminal nucleus,the latter in ipsilateral nucleus,chiefly in the caudal part.These results show thatthere are topographical connections between the parabigeminal nucleus and superiorcolliculus,and the parental somata contributing axons to the parabigeminal nucleusare located in deeper layers of the ipsilateral superior colliculus.

Purpose:To explore the regularity of lymph node metastasis in thoracic esophageal carcinoma.Methods:From March 2000 to June 2001,100 patients with thoracic esophageal carcinoma underwent radical esophagectomy with three field lymphadenectomy. Dissection was done through a right lateral thoracotomy followed by repositioning and simultaneous laparotomy and neck incision. Results:The hospital mortality rate was 0%.Nodal metastases occurred in 54% (54/100) of patients. The rate of metastasis to neck, mediastinum and abdomen were 31%, 34% and 26%. Cervical nodal metastasis was not correlated with the depth of tumor penetration. There was a higher frequency in nodal metastasis near the bilateral recurrent laryngeal nerves than that in the bilateral supraclavicular region. Conclusions:①Neck, mediastinum and abdomen nodal metastases occurred frequenthy in thoracic esophageal carcinoma. ②Cervical nodal metastasis could occur in early stage of tumor infiltration.③Cervical lymphadenectomy was a very important factor for accurate staging of thoracic esophageal cancer.

Objective This study analyzes the expression and clinical significance of Gli1 and Gli3 proteins in hepatocellular carcinoma.Methods 36 patients with hepatocellular carcinoma were studied.The expressions of Gli1 and Gli3 in the carcinoma and adjacent non-tumor tissues were detected with immunohistochemical assay,and their correlations with clinicopathological factors were statistically analyzed.Results Expression rates of Gli1 in hepatocellular carcinoma and adjacent nontumor tissues were 75 ％ and 36.1％,respectively.Expression rates of Gli3 in hepatocellular carcinoma and adjacent non-tumor tissues were 58.3％ and 30.6％,respectively.Expression rates of Gli1 and Gli3 in hepatocellular carcinoma were significantly higher than in adjacent non-tumor tissues (P＜0.05),and a positive correlation was found between the expression of Gli1 and Gli3 (r=0.423,P＜0.05).There was no association between the expression of Gli3 and clinicopathological factors such as age,tumor size,tumor differentiation and lymphatic metastasis.The expression of Gll1 was not related witha patient's age and tumor size,hut there were significant associations with tumor differentiation and lymphatic metastasis.Conclusions Therefore,the expression rate of Gli1 was positively correlated with tumor malignancy,which makes the detection of Gli1 and Gli3 valuable for the diagnosis and prognosis of hepatocellular carcinoma.

OBJECTIVE:To observe the clinical efficacy of qianliexin combined with tamsulosin hydrochloride and finasteride in the treatment of elderly benign prostatic hyperplasia.METHODS:Ninety-four patients diagnosed as benign prostatic hyperplasia in our hospital during May.2012-Oct.2014 were selected and divided into observation group (48 cases) and control group (46 cases) according to even and odd admission number.Both groups received Finasteride tablet 5 mg,po,qd.Basedon this,control group was additionally given Tamsulosin hydrochloride sustained-release capsules 0.2 mg,po,qd;observation group was additionally given Qianliexin capsules 2.5 g,po,tid,on the basis of control group.Clinical efficacies of 2 groups were observed as well as IPSS,BS,IIEF-5 score,ultrasonic measurement indexes and TCM syndrome score before and after treatment.RESULTS:Clinical total response rate of observation group was 93.75％,which was significantly higher than 76.09％ of control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in IPSS,BS,IIEF-5 score,ultrasonic measurement indexes and TCM syndrome score between 2 groups (P＞0.05).After treatment,IPSS and BS score,prostate volume (PV),residual urine(RU),each item score and total score of TCM syndrome were significantly decreased in 2 groups,while IIEF-5 score and Qmax were increased significantly;the observation group was significantly better than the control group,with statistical significance (P＜0.05).CONCLUSIONS:Qianliexin combined with tamsulosin hydrochloride and finasteride shows significant therapeutic effi cacy for elderly benign prostatic hyperplasia,and is helpful to improve prostate symptoms and TCM syndromes,reduce PV and RU,and improve sexual function.

Objective To investigate the impact of daily life ability, self-efficacy and social support on post-stroke depression. Methods This was a cross-sectional questionnaire survey. A convenience sample of stroke patients from neurology department was created. Data were collected from patients about their level of daily life ability, self-efficacy, social support and depression measured. Inferential statistics multiple regression analysis was used to estimate the relationships between the predictors and post-stroke depression. Results A total of 144 (96.00%) of 150 stroke patients completed the questionnaires. The level of depression was 14.19 ± 9.25 with 25.00% (36/144) of incidence of post-stroke depression. Self-efficacy scored 40.45 ± 11.41, social support scored 28.34 ± 8.02, which negatively predicted depression (r=-0.834 and-0.736, P<0.01 respectively). Self-efficacy had the most significant impact on depression (t=-6.433, P < 0.01), however, the impact from daily life ability scored 76.74 ± 22.12, which had not statistically significant impact on depression (t=-1.773, P=0.083). Conclusions During treatment and nursing management of post-stroke depression, attention should be paid to the psychiatric variable such as self-efficacy and social support.

Objectives To explore status of health prevention knowledge awareness and the formation of healthy behaviors of community residents in Guagzhou and provide evidence for health-management-related departments to put forward pertinent intervention strategies. Methods A questionnaire-based survey was conducted among 2 790 community residents in Guangzhou by multistage stratified random sampling. Results The awareness rate of residents′ basic health prevention knowledge was 78.14%, the awareness rate of key knowledge was 74.77%, the rate of health behavior formation was 48.14%. The rate of women′s behavior formation was higher than that of men′s. The awareness rate of basic knowledge among the residents aged over 50 years was lower than that that among those aged less than 50 years , but the awareness rate of key knowledge and behavior formation rate were higher. The level of knowledge awareness and the rate of behavior formation rate of urban residents were higher than those of rural residents and migrants. The knowledge awareness and behavior formationi were positively correlated with degree with statistically significant difference (P < 0.01). Conclusions The health belief and behavior of the community residents should be cultivated and strengthened , the basic prevention knowledge should be made universal for middle-aged and old people , the health education of key prevention knowledge should be strengthened for the middle-aged and young people , the public health services should be made more open and equal further promoted, and the community comprehensive intervention focusing on the health education should be strengthened.