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.

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.

Objective To investigate the features of kidney transplantation in patients over 60 years old.Methods From May 1998 to Oct. 2001,the clinical data of 81 cases over 60 post kidney transplantation were retrospectively analysed and compared with those of 432 patients below 60 age. Results The dialysis time of senile group was longer and the hypoproteinemia was sever than that of control group (P 0.05). The postoperative incidence of pulmonary infection was higher(P

Objective To summarize the experiences of kidney retransplantation from 1978 to Dec. 2002.Methods The clinical data of 86 cases subject to first renal transplantation and 86 cases to second renal transplantation were retrospectively analyzed. The main causes of failure of the first renal transplantation were CAN, while those of the second renal transplantation were HAR, and other complications such as AR, graft rupture and serious graft T.B. PRA or CDC in 31 cases was positive before retransplantation. The clinical data such as antibody-inducing therapy, the protocols of immunosuppression and the survival rates of patients and grafts in these patients were analyzed.Results Survival rates at 1, 3, 5 year of the patient/graft of retransplantation group were 84.8 %/61.6 %, 79.1 %/45.3 % and 58.1 %/41.9 % respectively, while those at 1, 3, 5 years of the patient/graft with the first renal transplantation were 89.5 %/79.1 %, 81.4 %/74.4 % and 67.4 %/58.1 % respectively. No significant difference in the patient survival rates and graft survival rates was observed (P

Objective To investigate the technical features, postoperative complication and therapeutic regimen of immunosuppressant in pediatric and adolescent renal transplantation. Methods From February 1998 to December 2004, clinical data of 46 pediatric and adolescent patients who underwent renal transplantation were retrospectively analyzed to observe the patient and graft survival rate, growth and development of recipients and postoperative complication. Results Ten episodes of acute rejection (AR) were diagnosed in 46 cases. Four cases suffered delayed graft function (DGF), one urinary leakage and 8 drug-induced hepatic injury occurred. Eight cases suffered pulmonary infection, 3 cases suffered bone marrow depression and 2 granulocytopenia. One allograft artery stenosis and one ureteral necrosis occurred. Renal functions were returned to normal in all recipients 4 weeks after operation. The 1-year patient and graft survival rates were all 100 %, and the 3-year patient and graft survival rates were 100 % and 97.4 % respectively. Conclusions Renal transplantation is an effective treatment for pediatric and adolescent patients with end-stage renal disease. In addition to its higher AR incidence than adult, pediatric renal transplantation has especial treatment in the operation process and therapeutic regimen of immunosuppressant.

Objective To evaluate the effects of fructose-1,6-diphosphate (FDP) on the preservation and high-energy phosphate metabolism of hypothermic SD rat hearts. Methods Sixteen SD rats were randomly divided into 2 groups. Their hearts were harvested and preserved in UW solution at 4℃ for 12 hours. In the study group (n=8), FDP (5mmol/L) was added to the UW solution, whereas in the control group, FDP was not added. Langendorff perfusion was established with the isolated hearts, and cardiac functions were examined, as well as the activities of lactate dehydrogenase (LDH) and creatine kinase (CK) in the perfusion fluid collected from coronary. Then the high-energy phosphate concentration, ATP, ADP, and AMP contents in the myocardium were determined with HPLC. Results The high-energy phosphate concentration was remarkably higher in the study group than that in the control group (P

0.05).The acute rejection rates in non-dialysis group was significantly lower than that of dialysis group(19.53% vs 34.27%,P0.05).The 1 year survival rates of patient/graft were 98.44% in non-dialysis and(97.72%/)95.96% in dialysis group(no significance);the 3 year survival rates of patient/graft were 96.23% in nondialysis and(94.4%/88%) in dialysis group(no significance).Conclusion:Renal transplantation without dialysis can avoid the dialysis complications and transfusion-induced sensitization,and reduce the risk of hepatitis infection as well as the acute rejection rate;while its patient/graft survival rate is similar to that of dialysis renal transplantation,making it feasible for clinical application.

ObjectiveTo observe the relativity between cerebral infarction and dyslipidemia in patients with diabetes mellitus (DM).MethodsThe blood glucose and lipid of 66 DM cases and 30 normal healthy persons (as control group) were tested.ResultsIn the blood lipids of the diabetes group without vascular disease, only densities of triglyceride (TG), apolipoprotein A-Ⅰ (apoA-Ⅰ), apolipoprotein B (apoB), apoA-Ⅰ/apoB changed significantly compared with the control group (P<0.05), others without significant change. But blood lipids level of cerebral infarction group was significantly higher than that of the control group (P<0.01). In DM group, the patients with cerebral infarction had higher fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), TG, low density lipoprotein cholesterol (LDL-ch), apoB, α-lipoprotein (LPα), but lower apolipoprotein A1 (apoA1) and apoA-Ⅰ/apoB than those of the without vascular disease group (P<0.05 or P<0.01).ConclusionDyslipidemia has some relativity with the cerebral infarction of DM.

Objective To discuss the treatment efficacy of the femoral-head osteonecrosis by umbrella strut bone grafting and bone marrow mesenchymal stem cells. Methods The femoral-head osteonecrosis models on one side were established in forty-two goats using liquid nitrogen, which were randomly classified into three groups after 8 weeks. Group A were conducted umbrella strut bone grafting and bone marrow mesenchymal stem cells transplantation, group B were conducted simple unit side muscle bone flap grafting, and group C were conducted umbrella strut bone grafting and Cancellous bone grafting transplantation. The health side of three groups was treated as self-control. The radiological and histology examination were made at 3,6treated lateral femoral-head shape restored,cystic cnlow-density area disappeared, the original collapse had repaired, and no further collapse of the femoral-head shaped for both group A and B. Bone fusion was good and bone column shadow had been vague for group A, while the bone fusion healed somewhat less and bone column shadow still clear for group B. Group C had irregular contour of femoral head, flat collapse, uneven density, and fracture cracks could be seen at weight-bearing area of femoral head, obviously was the poorest bone had different states: mature and arranged ruled for group A, childish and irregular arrangement for group B, thinning, sparse and fracture for group C. The percentage of empty lacunae counts decreased, while the percentage of trabecular bone area fraction increased for group A. In contrast with group B, and C, the difference was statistically significant (P ＜ 0.05), but the difference was no longer statistically significant when contrast with healthy sides (P ＞ 0.05). 6 months later, the radiological and histology examination showed that:group A and group B had been no significant difference comparing to normal femoral heads, while the femoral head of group C collapsed and disappeared completely. Group A and group B were no difference comparing the healthy side (P ＞ 0.05)in the area fraction of trabecualr bone and percentage of empty lacunae counts, neither it was between group A and group B(P ＞ 0. 05). Conclusion The treatment efficacy of the femoral-head osteonecrosis by umbrella strut bone grafting and bone marrow mesenchymal stem cells was good and was better than cancellous bone grafting transplantation and simple unit side muscle bone flap grafting.

Objective To find out the risk factors of early pulmonary infections after renal transplantatioa Methods The data were collected from 96 patients receiving renal transplantation between Oct. 2006 and Oct 2010, including 48 cases of early lung infection after renal transplantation as infection group, and 48 patients receiving immunosuppressive regimen at the same period as-control group. Taking the factors of lung infecition as variables, t test or chi-square test was used in univariate analyses whereas logistic regression was used in multivariate analyses. Results Single factor analysis showed that induction therapy, albumin levels, dose of steroid in 1 month after operation,family income and prophylactic SMZ treatment were related to lung infectioa Analysis of multiple variables logistic regression revealed that induction therapy, albumin levels, dose of steroid in 1 month after operation and prophylactic SMZ treatment were related to lung infection. Conclusion The correlation analysis indicated that induction therapy and dose of steroid in 1 month after operation have positive correlations with pulmonary infection, while albumin levels and prophylactic SMZ treatment have negative correlations with pulmonary infection.