The purpose of setting project of surveillance of antimicrobial resistance is:(1)To better understand development of resistance in local hospital,or country,and to compare with data from other countries;(2)To cooperate with clinic for controlling outbreak caused by clone strain-resistance;(3)To help doctors for management of treatment;and(4)To mining the mechanisms of resistance.In this text the history of surveillance of antimicrobial resistance in Peking Union Medical College Hospital starting in 1983 to present and the achievement were ihtroduced.But the fight against resistance between human being and microorganism is eternal and difficult.The main target pathogens and antimicrobial resistance at 21 st sentry were also introduced.The paper emphasized necessity and possibility of distinguishing CA-MRSA and HA-MRSA,VRSA,VISA and hVISA,ESBLs,AmpC and carbapenemases.To pay more attention to the relationship between resistance and serotypes in Streptococcus pneumoniae,it is important to survey the emerging resistance of the new antibiotics in China,such as linezolid,tigecycline,daptomycin,ceftobiprole and new fluoroquinolones and others.It is needed to develop pharmacokinetic/pharmacodynamic(PK/PD)- breakpoints as a substitute for old breakpoints,and to introduce emerging technologies,such as data mining artificially intelligent system,geographic information system,multiplex real time PCR with advanced reading techniques and other molecular methods for routine work in Clinical microbiology,SO that we can wisely fight against microbial resistance effectively.

The aim of this paper is to try to decrease the rate of bacterial resistance to ?-lactams, to recover partially its activity, then strengthen clinical efficiency of those antibiotics. Firstly we introduced surveillance results of SEANIR Program in China in which 15 hospitals from 14 cities of 13 provinces participated. There was big difference in rate of resistance of clinic strains to antibiotics between 15 hospitals. Three main reasons for the difference were analyzed. Secondly the great success in study on relationship between consumption of antibiotics and resistance rate of special organisms in Europe was introduced. AND We strongly recommend that similar study should be started in China for educating clinic personnel and helping administration officer to make guideline of hospital infection control.Lastly, we introduced the mathematical models of epidemiology and population genetic of antibiotics treatment.We also conclude that resistance in communities and in hospital can be controllde by reducing the rate of consumption of antibiotics, by reducing the by overall rate of transmission of resistance-strains, by correctly using antibiotics, by increasing the rate at which patients leave the hospital and by preventing entering patient with resistance-pathogens from mixing with other patients before those bacteria cleared.

The diagnosis with unknown pathogens is an important cause of inappropriate use of antimicrobial agents. The microbiology laboratory should intensively cooperate with the clinicians to evaluate the quality of respiratory tract samples. The technicians of microbiology should strengthen the training for basic skills, such as direct smear and a variety of staining. Meanwhile, the laboratory should perform the rapid detection techniques to improve the diagnostic level of pulmonary infections.

Antimicrobials resistance can be detected by conventional susceptibility testing and genetic method. Most genetic methods are based on PCR, and can be used directly in clinical specimens to guide therapy early and rapidly.Great achievement has made in basic study of antimicrobial resistance genes in China.Applied studies in genetic method of resistance genes are needed.

Objective To investigate resistance mechanism against erythromycin in Streptococcus pneumoniae from Beijing region. Methods 116 strains of erythromycin resistant Streptococcus pneumoniae were collected from 1998 to 1999 at Peking Union Medical College Hospital Serotyping was done with "capsular swelling" technique erm/mef genes were detected with PCR, pulsed field gel electrophoresis (PFGE) and penicillin binding protein (PBP) fingerprinting technique were used to detect the DNA of resistant strains Results The prevalent serotypes in the 116 erythromycin resistant strains were 23F(30 0%),6A(19 0%),19F(13 8%),15(7 8%),23A(5 2%) 95 7% of penicillin resistant strains were also macrolide resistant, most (85%) expressing the MLS phenotype with co resistance to clindamycin The macrolide resistance determinant in 86 4% of erythromycin resistant strains was the erm gene, both the erm and mef genes were found in 6%, mef alone in 1 7% and no mechanism in 4 2% PFGE identified two clones: one a serotype 23F clone resistant to penicillin; and the other a penicillin susceptible and macrolide resistant serotype 6A clone Conclusions Ribosomal modification (erm gene coded) was the main resistance mechanism against erythromycin in Streptococcus pneumoniae in Beijing region Two resistance clones bear concern

Recent major changes and updates of Clinical and Laboratory Standards Institute(CLSI) document M100 for performance standards for antimicrobial susceptibility testing were introduced in the article,which include changes of interpretive criteria and comments,antimicrobial susceptibility testing of infrequently isolated or fastidious bacteria,changes of appendixes and others,Brief comments were made for these changes.

[Aim]To create CPI mode of teaching Chinese as a foreign language in a TCM university. [Method]Based on conventional teaching, language partner and interculture communication class(mixing Chinese and international students) were introduced in CPI mode. The effect of this mode was ana-lyzed. [Result] By effectively promoting the cooperative learning between Chinese and international students, CPI mode could not only improve Chinese teaching effect, but also improve international students’ability on intercultural communication.[Conclusion] Based on its practice, CPI mode is believed as an effective way to improve teaching and study.

Objective: In the paper, the principle of determining similarity of chromatographic fingerprints of TCM has been introduced. Methods: In the chromatographic fingerprint analysis of TCM, the whole fluctuation of the chemical composition of TCM products could be estimated by the comparison between their chromatographic fingerprints. Two methods, which determine the similarity between chromatographic fingerprints using peaks area or data points of chromatogram, have been investigated by the simulation and experiments. Results: The results both suggest that compared with the method for determining similarity using data points, the method using peaks area is more robust and its calculating results is more reliable. Conclusion: Peaks area method is more suitable for chromatographic fingerprint of TCM.

AIM: To optimize the extraction of the anthraquinone aglycnes from Rhubarb using supercritical fluid extraction(SFE). METHODS: Orthogonal design and variance analysis were used to optimize five operational variables of SFE. RESULTS: The optimized operational variables of SFE were obtained as following: the temperature was 70 ?C , the pressure was 35 MPa, the static extraction time was 8 min, the dynamic extraction volume 5 mL and methanol were used as modifier. CONCLUSION: SFE is rapid, convenient and accurate, and can be used to extract athraquinone aglycones from Rhubarb.

In this article standard antibiotic susceptibility test methods and key terms in reporting results recommended by the Clinical and Laboratory Standards Institute (CLSI) were introduced into nine parts: (1) Key points in routine antibiotic susceptibility test. (2) Staphylococcus spp. (3) Enterococcus spp. (4) Streptococcus pneumoniae. (5) Streptococcus spp. other than Streptococcus pneumoniae. (6) Infrequently isolated strains or fastidious bacteria. (7) Enterobacteriaceae. (8) Pseudomonas aeruginosa and other non-Enterobacteriaceae. (9)Haemophilus influenzae and H. parainfluenzae. The author also introduced part of updated contents from CLSI M100-S19,2009.