Objective To analyze and study the relationship of fasting plasma glucose (FPG) indicators with age, gender and community in Jinyun, in order to provide data support for the establishing of blood sugar health management team under the background of county and township medical alliance. Methods With township hospitals as centers, FPG was sampled from villagers for centralized testing and software analysis. Results The abnormal rates of the FPG in male villagers were higher than that in female villagers in the young and middle-aged group (P ＜ 0. 01), while the abnormal rates of the FPG in male villagers were lower than that in female villagers in elder group (P ＜ 0. 01). With the increase of age, the abnormal rate of FPG in male and female increased significantly (P ＜ 0. 01). Based on the cluster analysis of the abnormal FPG rates in the 17 towns of Jinyun, the abnormal rates of young and middle-age group in Dayang, Qili and Qianlu were higher than that in other towns. In the elderly group, the abnormal rate was the highest in Dayang, followed by Dongfang and Fangxi. Conclusion The elderly female in Jinyun are the key prevention and treatment population. Different age groups have their own high incidence of abnormal blood sugar, and should be treated differently.

Objective To observe the practicability of heparin lithium plasma in the emergency biochemistry analyses.Methods 330 blood specimens were collected with non-anticoagulant tube and heparin lithium tube,and to simultaneously detect emergency biochemistry:K,Na,C1,Ca,P,Mg,GLU,UREA,CR,UA,AMY,CHE,LDH,CK,CK-MB.The paired t test and correlation analysis were performed on the serum and plasma samples of each item.Results There was no statistical significance on the differences in Na,C1,P,Mg,GLU,CR,UA,AMY,CHE(P ＞0.05).There was statistical significance on the differences of K,Ca,UREA,LDH between the two groups(r =0.955,0.933,0.998,0.991,P ＜ 0.05).And there was statistical significance on the differences of CK,CK-MB between the two groups(r =0.548,0.164,P ＜ 0.05).Conclusion Serum could be replaced by plasma with heparin lithium in testing K,Na,C1,Ca,P,Mg,UREA,CR,UA,GLU,AMY,CHE,but LDH,CK,CK-MB.

目的：缙云县人民医院ICU早发与晚发性呼吸机相关性肺炎（ventilator-associated pneumonia， VAP）病原菌特点及耐药性情况。方法对本院ICU使用机械通气>48小时的住院患者VAP发生情况进行调查，比较早发性VAP （机械通气≤4天）与晚发性VAP （机械通气≥5天）病原菌感染及其耐药情况。结果145例VAP 中，早发性VAP 63例，晚发性VAP 82例，两者病原菌均以革兰阴性杆菌为主，且肺炎克雷伯菌发生率最高。随着机械通气时间延长，肺炎克雷伯菌及其它主要病原菌耐药率明显增高，多重耐药的肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌、洋葱伯克霍尔德菌、金黄色葡萄球菌发生率明显增高。结论本院ICU早发与晚发VAP中肺炎克雷伯菌是最常见的病原菌，晚发性VAP中多重耐药菌明显增加。

目的：发现重症监护病房（ICU）患者病原菌的分布、流行趋势、耐药性变化，以便更好地指导临床治疗。方法收集本院2011年8月至2013年7月ICU患者标本833例，严格按《临床检验操作规程》及相应仪器、试剂操作方法对合格标本进行细菌学培养、鉴定及药敏试验。结果833例送检标本，阳性479例，阳性率为57.5％。共检出病原菌496株，其中革兰阴性（G-）杆菌占84.5％、真菌占8.7％、G+球菌占6.8％。G-杆菌主要为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌、嗜麦芽寡养食单胞菌、洋葱伯克霍尔德菌，各菌的耐药率差异显著。结论 ICU患者病原菌以G-杆菌占优势，病原菌耐药性有明显差异。临床上应及时取样作细菌培养，根据药敏试验合理使用抗生素，尤其对住院时间较长且持续感染者更不能盲目用药。

目的：分析比较不同生化分析仪（直接法和间接法）测定乳糜血清钾、钠、氯的结果，为临床选择提供参考。方法选择美国强生VITROS 350干式生化仪（直接法）、Medica Easylyte电解质仪（直接法）、Hitachi7600全自动生化分析仪（间接法）分别对50例外观正常血清和50例外观脂浊血清进行钾、钠、氯结果测定。结果直接电极法组间钾、钠、氯结果比较，差异均无统计学意义（ P＞0.05）。间接电极法钾的检测结果与直接电极法（两种）比较，差异无统计学意义（ P＞0.05）；间接法钠和氯的检测结果均低于两种直接法，差异有统计学意义（均 P＜0.05）。结论对临床脂浊标本进行钾、钠、氯测定时，宜选用直接电极法，并重视实验前的标本质量控制。

目的探讨儿童心肌酶谱的正常参考值范围,为临床提供更可靠的诊断依据。方法将2011年4月~11月在缙云县人民医院和景宁县人民医院进行新医保体检的1030名健康儿童分成三个年龄组,与同时期的健康成人组326例一起进行心肌酶检测,并对结果进行统计分析。结果研究发现,年龄越小,心肌酶越高。~3岁组心肌酶参考值范围:CK男32~204、女27~176,CK-MB 12~44,LDH 187~367,AST 22~53;~6岁组心肌酶参考值范围:CK男32~204、女27~176,CK-MB 5~37,LDH 182~326,AST 14~42;7~15岁组心肌酶参考值范围:CK-MB 3~31,LDH 136~284,CK和AST同成人标准。结论儿童心肌酶值较成人的高,建立儿童心肌酶谱正常参考值范围很有必要。

目的 调查基层医院ICU非发酵革兰阴性杆菌医院感染状况及耐药性,以指导临床合理使用抗菌药物.方法 回顾2007年1月～2009年12月医院ICU所分离的非发酵革兰阴性杆菌,纸片扩散(κB)法进行药敏试验.结果 3年中共分离到非发酵革兰阴性杆菌191例,其中呼吸道感染165例,血液感染;10例,其它部分感染16例,最多见的依次是不动杆菌属63株(33.0%),铜绿假单胞菌56株(29.3%)和嗜麦芽窄食单胞菌51株(26.7%);不动杆菌属对碳青酶烯类敏感率最高,铜绿假单胞菌对阿米卡星、妥布霉素、环丙沙星、头孢哌酮/舒巴坦,保持良好的敏感性,复方新诺明对嗜麦芽窄食单胞菌敏感率为94.1%,头孢哌酮/舒巴坦为51.1%.结论 非发酵革兰阴性杆菌是基层医院ICU感染的主要病原菌,耐药性呈增加趋势,应合理使用抗菌药物及加强细菌耐药性监测.

离子选择电极法(ISE)K/Na/Cl分析,因其测定流程简便快捷、测定结果准确可靠而广泛应用于临床各实验室.但各电解质分析仪因样本用量大、管路易污染、电极易受干扰等特殊性.实际操作过程中,应加强对仪器的维护保养工作[1].笔者通过对多种品牌电解质分析仪的使用和了解,得出比较综合、系统的对ISE法电解质分析仪的使用保养与故障排除方法.

随着检验医学的快速发展,全自动生化分析仪及测定试剂盒目前已广泛应用于各生化实验室.但在实际应用中.试剂间的化学交叉污染现象难以避免[1-3].其主要表现为初测的异常结果经复检又正常,或某一项目在组合测定时与单项测定时结果差异大.

OBJECTIVE To investigate pathogen distribution and their antibiotic sensitivity in pulmonary infection of hospitalization and provide references for clinical treatment.METHODS Collect 570 pulmonary infection patients of hospitalization,all the qualified samples were isolated to be identified with routine methods.RESULTS In 570 patients,499 pathogen were be detected.The ratio of gram negative bacilli was 55.11%,gram positive bacilli was 22.04%,fungus was 20.84%.The rates of drug sensitivity of gram negative bacilli to carbapenems and amikacin were quite high,to First and second generation cephalosporin and amoxicillin are very low.That's of gram positive bacilli to Teicoplanin and Vancomycin and Fusidate acid were all 100%,there are different sensitivity in others.CONCLUSIONS The most frequently isolated pathogens were gram negative bacilli in pulmonary infection,but pathogen distribution and their antibiotic resistance were changed in evidence.It must sampling and incubate bacilli in time for clinical treatment,and standardize applying antibiotic by the results of drug sensitivity.

目的了解男女泌尿生殖系支原体感染的构成比及药物敏感结果的差异,为临床提供必要的治疗参考。方法使用支原体培养鉴定药敏试剂盒对泌尿生殖道标本进行支原体培养,检测解脲支原体(UU)和人型支原体(MH),并对590例支原体培养>104CCU/ml的阳性标本进行男女对比统计分析。结果317例女性与273例男性支原体感染在构成比上无统计学意义,均以单一UU感染最多,其次为UU及MH感染,单一MH感染最少;药敏方面,两性支原体感染对强力霉素、四环素的敏感率无显著性差异(P>0.05);但对交沙霉素、克拉霉素、美满霉素、阿奇霉素、帕司沙星、罗红霉素和左氧氟沙星7种常用抗生素,女性敏感率显著低于男性,差异具有统计学意义(P<0.05或P<0.01)。结论两性感染的支原体在构成比上一致,以单一UU感染为主,但在药物敏感率上,女性敏感率显著低于男性,更易产生耐药。

Objective:To investigate the variance of regular drug resistance of Pseudononas aeruginosa to guide drug treatment in clinic.Methods:The susceptibility to regular antibiotics was detected in 520 P.aeruginosa strains.Then its variance was analyzed.Results:The resistance of P.aeruginosa to 3G Cephalosporins and Penicillins has been increased year by year,and that to Aminoglycosides was quite stable.Conclusion:The drug resistance of P.aeruginosa has become a more serious problem than before.The monitoring of drug resistant P.aeruginosa could guide rational treatment in clinic and reduce the spread of the strains which produce enzyme.