Objective ELISA syphilis enzyme analysis(TP-ELISA) results for the gray zone two step after the replacement .To explore the suitability of syphilis detection procedures ,reduce misdiagnosis .Methods Randomly choose 50 288 cases of serum screening for syphilis enzyme linked immunosorbent assay ;in grey area of the sample ,then rapid plasma reagin test (RPR) and Treponema pallidum particle agglutination test(TPPA) for validation .According to disease and age groups ,statistics of anti TP an-tibody gray area ratio .Results 50 288 serum samples ,after TP-ELISA method to screen grey area in the early results of 61 cases . The highest age of grey area rate in different ages was more than 61 years old .Conclusion TP-ELISA detection still exist certain false positive ,set reasonable grey area ,the gray zone within the sample confirmation test has important clinical significance .

Objective To investigate and evaluate the comparison results of five items of hepatitis B in ELISA by using water bath box and rapid incubation .Methods 92 patients with hepatitis B in our hospital from June 2012 to June 2013 were randomly se‐lected and 184 cases of healthy physical examination were randomly selected as the controls .The water bath and rapid incubation were adopted to conduct ELISA for simultaneously detecting 5 items of hepatitis B in samples .Results The results of two groups had higher positive coincidence rate .The average OD value of specimens in the water bath was higher .But the specimen S/CO value in the fast average incubation was higher ,its co value was higher than that of the water bath .Conclusion The rapid incubation can be introduced for improving the work efficiency in the daily work ,but the specimen with weak reactiveresult needs to be re‐de‐tected by using the water bath and making records .The fast incubation device is best for only use of the HBsAg reaction ,because the other four reaction process time is shorter ,and there are some non‐conformity results .

Objective To investigate the effect of dexmedetomidine added to ropivacaine administered locally on prevention of tourniquet?related hypertension in the patients undergoing total knee arthroplast. Methods Ninety patients of both sexes, aged 58-74 yr, weighing 60-78 kg, of American Society of Anesthesiologists physical statusⅠ?Ⅲ, scheduled for elective unilateral total knee arthroplast, were randomly divided into 3 groups ( n=30 each) using a random number table: ropivacaine group ( group R) , dexmedetomidine added to ropivacaine administered locally group ( group D + R ) , and dexmedetomidine administered intravenously + ropivacaine group ( group Div+R ) . Femoral nerve block:0.5% ropivacaine 15 ml was injected in group R; the mixture ( 15 ml) of 0. 5% ropivacaine 20 ml plus dexmedetomidine 60 μg was injected in group D+R; 0.5% ropivacaine 15 ml was injected in group Div+R. Lateral femoral cutaneous nerve block: 0.5% ropivacaine 5 ml was injected in group R; the mixture 5 ml was injected in group D+R; 0.5% ropivacaine 5 ml was injected in group Div+R. General anesthesia was induced after the end of nerve block. In group Div+R, dexmedetomidine was infused as a bolus of 0.5 μg∕kg over 10 min starting from anesthesia induction, followed by an infusion of 0.4 μg·kg-1 ·h-1 until 30 min before the end of surgery. A tourniquet was applied and inflated ( 266-304 mmHg) within 90 min. Before induction of anesthesia ( T0 ) , and at 0, 15, 30, 45, 60, 75 and 90 min after the tourniquet was inflated ( T1?7 ) , mean arterial pressure and heart rate were recorded. The occurrence of hypertension, hypotension, tachycardia and bradycardia was recorded when the tourniquet was inflated. Agitation was assessed and scored after removal of the endotracheal tube. The time for recovery of breathing, emergence time, and time for removal of the endotracheal tube were recorded. Results Compared with group R, the mean arterial pressure and heart rate were significantly decreased at T1?7 in D+R and Div+R groups, the incidence of hypertension and tachycardia was decreased, the incidence of bradycardia was increased, and agitation score was decreased in D+R and Div+R groups ( P<0.05 or 0.01) . There was no significant difference in the parameters mentioned above between group D+R and group Div+R (P>0.05). There was no significant difference in the time for recovery of breathing, emergence time, and time for removal of the endotracheal tube between the three groups ( P>0.05 ) . Conclusion Dexmedetomidine added to ropivacaine administered locally can exert effect on prevention of tourniquet?related hypertension in the patients undergoing total knee arthroplast, and the effect is similar to that of dexmedetomidine administered intravenously.

BACKGROUND:Epidural analgesia has been considered a gold standard for postoperative analgesia in the lower limbs. Its outcomes are accurate and adverse reactions are few, so it can be used in the clinic. However, this method has adverse reactions such as hypotension and urine retention. Low molecular weight heparin should be used after operation, which can increase the possibility of epidural hematoma, and limits its application to epidural analgesia in the clinic. At present, few studies concerned ultrasound guided continuous fascia iliaca compartment block technology.
OBJECTIVE:To evaluate the efficacy of postoperative pain relief and the joint rehabilitation between a continuous fascia iliaca compartment block and a continuous epidural analgesia for patients undergoing total hip arthroplasty.
METHODS:A total of 60 patients undergoing a selective total hip arthroplasty were assigned to continuous fascia iliaca compartment block group and continuous epidural analgesia group (n=30). Al patients in both groups received a pre-fluence before general anesthesia. Continuous fascia iliaca compartment block group were injected with 0.25%ropivacaine 30 mL via iliac fascia gap. Continuous epidural analgesia group received 0.20%ropivacaine 10 mL via epidural catheter, indwel ing catheter. When the analgesic effect was identified, anesthesia intubation was carried out. After operation, medicine was given via iliac fascia and epidural analgesia pump in both groups respectively. Postoperative analgesia in single dose was not given. If pain could not be endured, analgesia would be rescued (parecoxib 20-40 mg/time) according to pain degree. Visual analogue scale scores, supplemental analgesia of parecoxib, complication of anesthesia, Harris hip joint scores, day of first walk, and duration of hospital stay were recorded.
RESULTS AND CONCLUSION:No significant difference in visual analogue scale scores, supplemental analgesia, Harris hip joint scores and duration of hospital stay was detected. Day of first walk was earlier in the continuous fascia iliaca compartment block group than in the continuous epidural analgesia group. The complications were apparently lower in the continuous fascia iliaca compartment block group than in the continuous epidural analgesia group. These data indicated that after total hip arthroplasty, two kinds of analgesia methods could provide satisfactory postoperative outcomes. Hip joint was perfectly recovered. However, the complications of continuous fascia iliaca compartment block were less, and helpful to patients’ early off-bed activities, and could be considered as a good choice for analgesia after total hip arthroplasty.

Objective:To explore the application value of patient data-based real-time quality control (PBRTQC) in enhancing the effectiveness of internal quality control (IQC) management.Methods:From the PBRTQC real-time quality control intelligent monitoring platform integrated with the laboratory information system (LIS), a total of 35,631 test results of red blood cell (RBC) count, white blood cell (WBC) count, and dehydroepiandrosterone sulfate (DHEA-S) were collected from patients of the Department of General Xi'an Area Medical Laboratory Center from August 1, 2023, to April 1, 2024. The platform was used in patient data distribution characteristics test, EWMA real-time quality control chart procedure establishment, performance validation, effect evaluation, best procedure selection, and real-time operation. The performance evaluation indexes of the best PBRTQC procedure establishment, the cut-off limit range, weighting coefficient, cumulative mean, standard deviation (SD), coefficient of variation ( CV) of the EWMA real-time quality control chart, and the cumulative mean, SD, and CV of its internal quality control data in the same period were counted, and at the same time compared with the quality target (1/3TEa). Coefficient of variation analyses were performed to compare the quality control status of PBRTQC and conventional internal quality control in the presence of warning or alarm prompts based on quality control process records, and alarm messages. Results:The evaluation indexes of the optimal procedures for RBC count, WBC count, and DHEA-S were the probability of error detection (Ped) between 93%-97% and greater than 90%, the false positive rate (FPR) between 0.0%-0.5%, the false negative rate (FNR) between 3.0%-7.0%, and the average number of the patient sample until error detection (ANPed) between 5-11, which is in line with the optimal quality control efficacy quality requirements for the PBRTQC procedure. The patient outcome cut-off concentrations for the optimal procedure EWMA quality control charts ranged from RBC count (3.92-5.16)×10 12/L, WBC count (4.28-7.50)×10 9/L, and DHEA-S (830-2 160) μg/L; (2 160-4 210) μg/L. The weighting coefficients were 0.05, 0.03, and 0.03, respectively. The real-world application of the EWMA real-time quality control charts showed stable and excellent analytical performance of the measurement system, such as out-of-control alarm: RBC count, 1 true alarm, Ped of 95.85%, and FPR of 0%. The cumulative CV of EWMA was less than the quality target; the cumulative CV of DHEA-S was 7.66% and 9.47%, respectively, and the cumulative CV of low level was greater than the quality target (8.33%), and the cumulative CV of high and low levels were 4.12% and 6.25%. Conclusion:The PBRTQC EWMA method can monitor the patient data - in real-time and continuous way. It can also dynamically identify and provide early indication of small changes in analytical performance during the analysis process, and can be used as a supplement to quality control products to improve the efficacy of laboratory quality management.