Objective To verify and confirm the optical performance of the Olympus AU5400 Automatic Analyzer is satisfied for the professional requirements.Methods According to the Medical Standard of the People's Republic of China:Automatic chemistry analyzer(YY/T 0654-2008),the Analyzer Modular Ⅰand Ⅱ optical performance were measured to verify the stray light,the ab-sorption accuracy,linear range,stability and repeatability.Results The stray light absorption of tow modular was 4.789 4-5.158 9;The absorption accuracy of potassium dichromate standard solution (1-1)was (-0.002 1--0.024 7),and solution (1-2)was (-0.008 6--0.067 7);The D-value of stability that the highest absorption of standard solution (1-1)minus the lowest was 0.000 5-0.001 5;The CV% of repeatability for standard solution (1-2)was 0.02%-0.04%;Therof absorption linear was 0.999 6-0.999 9. Conclusion The optical performance of Olympus AU5400 Analyzer conforms to the standard of YY/T 0654-2008.

Objective To evaluate the comparability of the detection results of different blood cells analysis systems in same hos-pital.Methods Referring to the Guideline for Comparability Verification of Quantitative Test Results in Medical Institutions,the comparability validation protocol was established.The EDTA-K2 anticoagulation fresh whole blood samples with proper concentra-tion were detected for 5 parameters of HGB,RBC,HCT,PLT and WBC by 4 systems (Sysmex XT-1800i,Sysmex XT-2000,Sys-mex XT-4000i and Mindray BC-5800).The range was calculated and the detection results consistency analysis was performed.Re-sults The acceptable standard of critical differentials was intended to be HGB3.5%,RBC3%,HCT3%,PLT12.5% and WBC 7.5%.The replication detection was at least 2 times and up to 5 times.The ranges of 3 concentrations after replication detection and sample comparison were 2.87%-6.29%,1.57%-2.99%,1.95%-4.77%,12.81%-25.74% and 6.72%-11.13% respective-ly.The ranges of RBC detection results in 4 systems were smaller than the critical differentials,the validation was passed.The ran-ges of HGB,HCT,PLT and WBC detection results in 4 systems all had the condition of more than the critical differentials,the vali-dation did not passed.After removing the test system with obvious bias,the validation of the detection results by other test systems was passed.Conclusion The RBC detection results by 4 systems have the comparability;the HGB,HCT and PLT detection results by Sysmex XT-1800i,Sysmex XT-2000i and Sysmex XT-4000i have the comparability;the WBC detection results by Sysmex XT-1800i,Sysmex XT-2000i and Mindray BC-5800 have the comparability.

Objective To analyze the precision and accuracy of the Olympus AU5421 automatic biochemical analyzer in order to verify the performance of this detection system declared by the manufacturer.Methods The Precision and Accuracy of User Au-thentication-Guide for Approval Second Edition(CLSI EP15-A2)was used to perform the routine detection on the Olympus AU5421 automatic biochemical analyzer.The systematic precision and accuracy were analyzed.Results Under this experiment condition,the precision and accuracy of the Olympus AU5421 automatic biochemical analyzer was consistent with the performance declared by the manufacturer.Conclusion The Olympus AU5421 automatic biochemical analyzer system has the high precision and good accuracy, and can be better applied in the clinical routine detection.

Objective To evaluate the effect of dexmedetomidine administered locally on the median effective concentration ( EC50 ) of ropivacaine for paravertebral nerve block ( PVNB) . Methods Forty?eight ASA physical status Ⅰ or Ⅱ female patients, aged 20-64 yr, with body mass index<24 kg∕m2 , scheduled for elective unilateral segmental mastectomy under PVNB, were randomly divided into 2 groups ( n=24 each) using a random number table: ropivacaine group ( group R) and ropivacaine mixed with dexmedetomidine group ( group RD) . PVNB was performed at T4 on the operated side guided by ultrasound and nerve stimulator. Ropivacaine 20 ml and a mixture of ropivacaine and 20 μg dexmedetomidine 20 ml were injected locally in group R and group RD, respectively. The concentration of ropivacaine was determined by up?and?down sequential allocation. The initial ropivacaine concentration was set at 0. 35%, and the ratio between the two successive concentrations was 1. 2. The EC50 and 95%confidence interval of ropivacaine were calculated using Dixon?Massey method. Results The EC50 ( 95%confidence interval) of ropivacaine was 0.27% (0.23%-0.30%) and 0.22% (0.18%-0.25%) in group R and group RD, respectively. Compared with group R, the EC50 of ropivacaine was significantly decreased by 19% in group RD. Conclusion Small dose of dexmedetomidine administered locally can significantly enhance the efficacy of PVNB with ropivacaine.

OBJECTIVE To investigate the epidemic situation of vertical dissemination of the Escherichia coli(ECO) and Klebsiella pneumoniae(KPN) isolates producing extended-spectrum beta-lactamases in the hospital.METHODS The fingerprints of the isolates were obtained by pulsed-field-gel-electrophoresis(PFGE),and were analyzed with software Quantity One.RESULTS The similarity of 10 isolates and 7 isolates among the 21 ECO(isolates) from ICU was more than 90%,and 100%,respectively;the similarity of 3 KPN isolates was 100%.The similarity of 9 isolates among the 20 ECO(isolates) was more than 90% and the similarity of 4 isolates among the 6 KPN isolates was more than 90% in the neurosurgery ward.The similar coefficients of 3 isolates and 2(isolates)(among) the 10 ECO isolates from the ward for cadre were more than 90% and 100%,(respectively.) The similar(coefficients) of 2 isolates among the 7 ECO isolates from the gastroenterology ward and 2(isolates)(among) the 18 ECO isolates from the respiratory ward were more than 90%.The isolates whose similarity was more than 90% were also found in other wards.CONCLUSIONS There are vertical disseminations of single clone of ESBL-producing organisms in several wards,especially in the ICU.It is necessary to strengthen the management of(infection)-control.

Objective To understand the clinical distribution characteristics of Acinetobacter baumannii in our hospital and the change situation of drug resistance rates to provide a basis for the clinical rational drug use and the nosocomial infection manage-ment.Methods The Acinetobacter baumannii strains isolated in our hospital from January 2005 to December 2013 were performed the retrospective analysis on its department distribution,specimen distribution and change of drug resistance rates.Results 964 strains of Acinetobacter baumannii were isolated during these 9 years,in which 713 strains were multi-drug resistant.The isolated strains were less during 2005 -2008,which were 30,26,22,19 strains respectively.The isolated strains began to increase during 2009-2010,which were 65,50 strains respectively.The detection rate began to enormously increase from 2011,which were 157, 229,366 strains respectively from 2011 to 2013.The top three departments of the highest isolation rates during these 9 years were ICU,neurosurgery department and respiratory department.The specimen source was always dominated by the respiratory tract specimens,followed by the secretion samples,in recent years,the detection rates of blood,urine and drainage specimens were in-creased to some extent.The drug resistance rates in 13 kinds of drugs totally showed the increasing trend,the resistance rate of par-tial drugs was decreased to some extent.Conclusion Acinetobacter baumannii easily cause nosocomial infections,which is difficult to be eliminated and has high occurrence in the departments centralized with critical patients.The respiratory infection is the main pathogenic type.Its drug resistance is serious,multi-drug resistant and pan-resistant strains have the higher proportion.Clinic should rationally use the drugs based on the drug susceptibility test results,coordinates with the infection control departments for doing disinfection and isolation well and prevent ing the outbreak of nosocomial infections.

Objective To investigate the distribution and antibiotic resistance of clinical Pseudomonas aeruginosa in Yunnan provincal of China in 2014.Methods Pseudomonas aeruginosa were collected from 28 hospitals in Yunnan surveillance of China.All hospitals were carried with the unified solution for bacteria culture,isolation,identification and antibiotic sensitivity tests according to CLSI M100-S24.The data of 2 873 strains pseudomonas aeruginosa were analyzed by WHONET5.6 software.Results 2 873 clinical strains of non-repetitive Pseudomonas aeruginosa isolates,90.36%were isolated from hospitalized patients and 60.32% from sputum,8.42% from urine,8.11% from secretion,4.70% from abscess,2.92% from blood,etc.The sensitive rates of common antimicrobial agents of Pseudomonas aeruginosa in top five were turn amikacin (88.7%),piperacillin/he azole temple (85.0%),tobramycin (83.1%),piperacillin (80.3%) and cefepime (80.1%).59.0% of the Pseudomonas aeruginosa strains were resistant to Aztreonam.20.9%-29.7% of the Pseudomonas aeruginosa strains were resistant to Imipenem,Ceftazidime,Meropenem,Ciprofloxacin and Levofloxacin.The Pseudomonas aeruginosa isolates showed the lowest resistance rate (10.3%-19.9%) to Piperacillin,Gentamicin,Cefepime,Tobramycin,Piperacillin/Tazobactam and Amikacin.Conclusion The antimicrobial susceptibility pattern varies widly with Pseudomonas aeruginosa isolated in Yunnan of China in 2014.Antimicrobial resistance sur-Monitoring the antibiotic resistant trend of Pseudomonas aeruginosa and implementing the nosocomial infection control policy become more important in hospital management setting.

Objective To retrospective analyze the specimens and wards distribution and the drug resistance changes of clinical i‐solated Pseudomonas aeruginosa .Methods 1 114 strains of Pseudomonas aeruginosa were isolated from a variety of clinical speci‐mens for the identification and susceptibility testing by using Microscan Walkaway40 identification and antibiotic susceptibility anal‐ysis system and manual method from 2002 to 2012 .And the results were analyzed .Results In all of the 1 114 isolated Pseudomonas aeruginosa strains ,there were 64 .18% of them from respiratory specimens .Pseudomonas aeruginosa infection occured mainly in the ICU wards (49 .64% ) .From 2002 to 2012 ,the drug resistance rates of Pseudomonas aeruginosa to 19 kinds of antibacterial drugs increased year by year .Conclusion Pseudomonas aeruginosa often causes respiratory tract infection ,and its mechanism of drug resistance is complex .There are few alternative antimicrobial drugs for the treatment of Pseudomonas aeruginosa infection .

Objective To analyze the detected pathogens composition in positive blood culture samples and drug resistance in our hospital from January 2005 to December 2012 in order to accumulate the data information of pathogenic bacteria distribution and drug resistance in bacteremia .Methods The BD9240 and BacT /Alert3D 240 blood culture systems were used to perform the blood culture .The identification of isolated bacteria and the drug susceptibility test were conducted by using Microscan walkaway 40 sys‐tem and the Vitec2 compact system .The Data were analyzed by adopting the Whonet5 .6 software .Results In 1 829 positive bacte‐rial strains by blood culture ,986 strains were Gram negative bacilli ,accounting for 53 .9% ;721 strains were Gram positive coccus , accounting for 39 .4% ;104 strains were fungi ,accounting for 5 .68% .The resistant rate of staphylococcus to vancomycin ,linezolid and teicoplanin was 0% ,which to amoxycillin/clavulanic acid ,rifampicin ,amikacin ,sulfamethoxazole compound and chloramphenicol was lower than 40% .The sensitive of enterococcus to linezolid and teicoplanin was 100% ,but enterococcus faecium was resistant to vancomycin(2 .6% ) .The penicillin resistant rate of Streptococcus was 21 .7% .The resistant rates of E .coli and K lebsiella pneumo‐nia were 0% to imipenem and meropenem ,and less than 22% to amikacin ,piperacillin/tazobactam and cefoxitin .The resistant rates of salmonella to CLSI recommended five kinds of detection drug were less than 6 .5% .The resistant rates of pseudomonas aerugino‐sa were more than 25% to imipenem and more than 25% to meropenem .Conclusion The pathogens spectrum detected by blood culture is widespread .The resistance rates of different bacteria vary widely .

Objective To investigate the relationship between the different ambulatory arterial stiffness index and the markers of renal impairment in order to provide a scientific method for detecting the renal impairment of essential hypertension. Methods Three hundred essential hypertensive patients without overt proteinuria were enrolled. The ABPM was performed and the blood pressure parameters were analyzed in order to estimate the symmetrical ambulatory arterial stiffness index (S-AASI) and ambulatory arterial stiffness index (AASI) . Microproteinuria was measured by urine microalbumin to creatinine (mAlb/Cr)as well as n-acetyl-β-D-glucosaminidase (NAG)to creatinine rate (NAG/Cr). Creatinine clearance (Ccr) and Glomerular filtration rate (eGFR) were estimated from serum creatinine (sCr) . Linear correlations were performed to confirm the independent predictive power of S-AASI and AASI for renal lesion. Results Correlation test showed a significant positively relationship of S-AASI with urine mAlb/Cr (0.708, <0.001), urine NAG/Cr (0.700, <0.001) and sCr (0.229, <0.05) . Ccr (0.601, <0.001) and eGFR (0.309, <0.05) were negatively correlated with S-AASI. On the other hand, AASI was also correlated with urine mAlb/Cr (0.489, <0.001),urine NAG/Cr (0.470, <0.001) and Ccr (0.311, <0.05),but not with the sCr (0.064, >0.05) and eGFR (-0.135, >0.05) . S-AASI seems to get an independent relationship with all of the parameters of renal impairment which could not be detected with AASI. Conclusion This results suggested that S-AASI may be a better approach than AASI to estimate hypertensive renal impairment.