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.

Nowadays partial splenic embolization (PSE) is an important therapeutic means to treat secondary hypersplenism caused by portal hypertension. By reducing the splenic blood flow and increasing hepatic blood supply, the peripheral blood picture and the liver function indexes as well as the portal hypertension can be effectively improved. This article aims mainly to make a comprehensive review on the therapeutic effect and mechanism of PSE, its clinical efficacy, as well as the factors affecting the clinical results, and to discuss the postoperative complications, the advantages and disadvantages of different embolic materials.

Objective To investigate the clinical effect of interventional embolization in the treatment of intractable hematuria after percutaneous nephrolithotripsy. Methods A retrospective analysis of the First Affili?ated Hospital of Kunming Medical University from February 2014 to March 2016 after percutaneous nephrolithot?omy appears intractable hematuria patients in 36 cases was conducted. All patients were treated with conservative treatment but invalid,then lesion was confirmed by renal artery angiography,after that,line embosphere micro?spheres or polyvinyl alcohol particles combined with spring ring interventional the treatment was conduc?ted. Postoperative urine color changes, postoperative complications and follow?up were observed whether have bleeding again. Results ( 1) The success rate:36 cases patients all with successful embolization,the symptoms of hematuria in 1?3 days gradually disappeared,and the effective rate was 100%. ( 2) Complications:the compli?cations after operation in 10 patients appeared different degree of embolism syndrome,given analgesic and antie?metic,the symptoms gradually ease after treatment. One case patient with a transient increase of creatinine after operation,renal function returned to normal 7 days after the treatment. ( 3) Follow up:there was no recurrence of hemorrhage after 3?6 months of follow?up. Conclusion Transcatheter embolization in the treatment of intracta?ble hematuria has definite curative effect,less trauma,high safety,less complications and faster postoperative re?covery.

Objectives To investigate the distribution of uridine diphosphate-glucuronosyltransferase 1A1 (UGT1A1) gene promoter polymorphism and its relation to the toxicities caused by irinotecan in Chinese patients with cervical cancer and ovarian cancer.Methods Sixty-four blood samples were taken from the patients with ovarian cancer and cervical cancer.The DNA was extracted and amplified with PCR.Then,the sequences of UGT1A1 gene promoter were detected by capillary electrophoresis allele fragment analysis (size-based analysis) methods.The relationship between UGT1A1 gene promoter polymorphism and the toxicity caused by irinotecan was analyzed.Results In all the patients,TA 6/6 was the most common genotype of UGT1A1 gene promoter (44 cases),accounting for 69％ (44/64),followed by genotype of TA 6/7 ( 17 cases,27％,17/64),while genotype TA 7/7 was rare (3 cases,5％,3/64).The genotypes of UGT1A1 gene promoter was an independent factor for the occurrence of delayed diarrhea (P =0.040,OR =4.228,95％ CI:1.065 - 16.785 ) but not for neutropenia ( P =0.068,OR =3.659,95％ CI:0.911 - 14.700).The patients with both genotype TA 6/7 and TA 7/7 presented much higher risk of delayed diarrhea and neutropenia than those with TA 6/6 ( all P =0.001 ).Conclusions UGT1 A1 gene promoter polymorphism may be a significant influencing factor for delayed diarrhea.The patients with both genotype TA 6/7 and TA 7/7 could present much higher risk for delayed diarrhea than those with TA 6/6,while genotype TA 6/6 may be the most common UGT1A1 promoter type in Chinese patients with cervical or ovarian cancer.

0.05).[Conclusion]The osteochondral scaffold of the collagenⅠ-sodium hyaluronate-fbrin glue tri-copolymer scaffold bonding with antigen-extracted bovine cancellous bone has an appropriate structure and a good biocompatibility,which makes it a useful scaffold in the osteochondral tissue engineering.

Objective To verify the reliability of home blood pressure measurement in clinic and research works by comparison three methods[home(H),office(O) and ambulatory(A)]of blood pressure(BP) measurements. Methods The"study-effects of salt substitution on blood pressure among the hypertensive patients and their families"was a randomized,double blinded control trial.In this study,BP was measured in 220 hypertensive patients using office,home and ambulatory BP measurements concurrently at the baseline and the end of the intervention. Two hundred seventeen patients had baseline eligible data,while at the end of the intervention,only 189 patients had eligible data.Bland-Altman method and Person's correlation analysis were used to compare the agreement of BP levels by 3 methods,and McNemar chi-square test compared rates of the agreement,assuming the ambulatory as the reference.Results The mean BP levels using office,ambulatory and home BP measurements were 149.5?16.4/87.2?9.5 mm Hg,137.8?17.1/83.2?10.3 mm Hg,and 138.0?14.2/82.4?9.3 mm Hg,respectively. H BP was more strongly related with ambulatory BP(SBP/DBP)(H:r=0.55/0.62 vs O:r= 0.36/0.46).The difference of BP between H and A was smaller[H:A—0.2 mm Hg/—0.7 mm Hg vs O:A(ll.7 mm Hg/4.0 mm Hg)].Intra-individual agreement between H and A SBP was significantly higher than that between O and A(28.3%vs 16.5%for≤|5| mm Hg and 49.7%vs 33.5%for≤|10| mm Hg,all P0.05).Conclusion Home and ambulatory BP was more strongly related and better agreement than office-ambulatory BP measurement.

Objective To explore the dynamic changes of neuron-specific enolase (NSE) and myelin basic protein (MBP) in serum of rats with temporal epilepsy (EP) induced by kainic acid (KA) and to judge the degree of injury of brain neuron and nerve myelin after seizure.Methods KA was injected into rat's hippocampus by stereotactic operation to establish an animal model of temporal EP.The levels of NSE and MBP in serum of rats with temporal EP were measured at the time 3 h,6 h,12 h,24 h,48 h and 72 h after seizure.Results The level of NSE in serum increased gradually and reached its peak at 24 h after seizure, as well as MBP at 72 h.Conclusions There are the nerve cell damage and necrosis after seizure in rats with temporal EP, then brain white matter nerve myelin appear to damage.

Objective To analyze the detection rates,species distribution and drug-resistance of urinary fungal infection in elderly patients at Beijing Hospital from 2011 to 2013,in order to provide the basis for the reasonable clinical use of anti-epiphyte medicines.Methods Totally 263 patients with an average of 79.6 years old were collected from Beijing Hospital.The urine from freshly voided midstream or bladder puncture was collected under aseptic condition for fungal culture,then the strains of epiphytes were identified by using API 20C AUX.The drug sensitivity was tested with ATB fungus3.Results 263 strains of epiphytes were isolated from the 2 983 urine samples,of which 92 were C.tropicalis,85 were C.glabrata,77 were Candida albican,and 9 were other fungus candida.The rates of drug resistance to fluconazole were 14.1 ％ (13 strains),37.6 ％ (32 strains) and 15.6％ (12 strains),and to itraconazole were 16.3％(15 strains),35.3％(30 strains) and 9.1％(7 strains),respectively.All of the 263 strains were not found to have drug resistance to amphotericin.Conclusions The isolation rate of urinary fungal infections is 8.8％ in Beijing Hospital.The majority of the tested fungal are C.glabrata,C.tropicalis and Candida albican,the former has higher resistance rate to azoles,and the two latter have better sensitivity to azole,and all of them have the sensitivity to amphotericin.

Objective To investigate the effect of breviscapine on neuroplasticity in intracerebral hemorrhage in rats.Methods A total of 108 Sprague-Dawley rats were randomly divided into a sham operation,a model and a breviscapine group.Intracerebral hemorrhage was induced by collagenase injections.Neurological scores were performed for each group.Immunohistochemical staining was used to detect the expression levels of nestin and Shankl in the perihematomal tissue.A transmission electron microscope was used to observe the synaptic ultrastructural changes.Results The synaptic ultrastructures were basically normal in the sham operation group.The synapses and organelles were dissolved and destroyed in the model group.The synapse ultrastructures tended to be normal in the breviscapine group.Compared with the model group,the number of synapses,interfacial curvature,and postsynaptic dense zone were increased significantly (allP ＜0.01),the synapse gaps were narrowed significantly (P ＜0.01),and the expression levels of Shankl and nestin increased significantly (P ＜ 0.01).The neurological function was normal in the sham operation group.After modeling,the neurological scores increased in the model and breviscapine groups,and the neurological function was improved rapidly in the breviscapine group.There were significant differences in the neurological scores at day 3,7,and 14 in the breviscapine group compared with the model group (all P ＜0.01).Conclusions Breviscapine may promote the neural repair and the neurological function recovery in intracerebral hemorrhage in rats.Enhancing the plasticity of brain tissue may be one of the possible mechanisms.

Objective To observe destruction of tibias created in ablating of the swine limbs in vivo with radiofrequency,the influence on the surrounding organization structure,and the repair process of lesions for treating bony tumor.Methods There were eight pigs included in the first part of the experiment.RFA was performed under DSA guidance at the same position of the diaphysis and the upper end of their right tibias in hind leg during anesthesia,then X-ray and CT examinations were performed at different time points after RFA,and subsequently the pigs were executed by depth anesthesia.Control specimens,specimens of the immediate time,the third day,the tenth day,the twenty-fourth day,the fifth week,the eighth week,the twelfth week after RFA were obtained at the diaphysis and the upper end of their tibias.X-ray and CT examinations of these specimens were performed.These specimens were observed both by naked eye and under microscope.The observation included the general state of the laboratory animals after RFA,the configuration of RFA lesions in the gross specimen and the corresponding histologic changes,the boundary of necrosis in RFA lesions and the corresponding boundary of the gross specimen.There were sixteen pigs in the second part of the experiment.RFA was performed at the same position of the diaphysis and the upper end of their right and left tibias in hind leg during anesthesia,and the pigs were immediately executed by depth anesthesia after RFA to get thirty-two capitulum specimens and thirty-two diaphysis specimens.The scope of necrotic tissue in RFA lesions was observed and measured.The border and scope of necrotic tissue in RFA lesions were observed.Major axis,minor axis,and necrosis volume were measured.The independent sample t test was employed to compare the volume of necrotic tissues between capitulum and diaphysis.The one sample t test was employed to analyze volume of necrotic tissue among capitulum,diaphysis and the standard data.Results No accidental death of the animals occured in the first experimental.The loss of neurological function of the hind leg did not happen.Coagulation necrosis in cancellous bone of capitulum and marrow of diaphysis lesions created in ablating was observed.On 3th to 10th day after RFA,inflammatory cells infiltrated in hemorrhage tape and then granulation tissues formed.Granulation tissues replaced necrotic bone gradually from outside to inside.Low density band was showed on images of X-ray and CT examination in the specimen of 10th day,and it extended inward.The immature bone was observed in fibrous tissue sited at the edge of lesions,which appeared as sclerosis on X-ray and CT examination.The scope of necrotic tissue in RFA lesions included coagulation necrosis and hemorrhagic zone of its periphery.The dead bone and secondary pathological fracture appeared in two of eight pigs.RFA hardly damaged compact bone in the diaphysis,but the damage of soft tissue was observed outside the compact bone.In the second experiment,the shape of lesions in cancellous bone of capitulum was ellipsoid,with long axis of(2.59±0.21) cm,minor axis of(2.15±0.10) cm,and volume of(6.34±0.27) cm3.The shape of lesions in the diaphysis of tibias was ellipsoid,with long axis of(4.53±0.20) cm,minor axis of(1.71 ±0.22) cm,and volume of(7.14±0.36) cm3.There was significantly difference of necrosis volume between the capitulum and diaphysis lesions,(t=2.011,P＜0.05).The virtual necrosis volume of the capitulum and diaphysis lesions was significantly different from the presumed volume with RFA instrument(t=-613.371,-295.878,P＜0.01).Conclusion Cancellous bone of the capitulum can be damaged by RFA,but the compact bone of the diaphysis can hardly be damaged.The intact compact bone can be helpful to protect the surrounding soft tissues.X-ray and CT examination can be used in the evaluation of curative effect of RFA for treating bone tumors.Pathological fracture of the diaphysis may appear after RFA.