The European I-MOVE Multicentre 2013–2014 Case-Control Study. Homogeneous moderate influenza vaccine effectiveness against A(H1N1)pdm09 and heterogenous results by country against A(H3N2)

BackgroundIn the first five I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe) influenza seasons vaccine effectiveness (VE) results were relatively homogenous among participating study sites. In 2013–2014, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in six European Union (EU) countries to measure 2013–2014 influenza VE against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. Influenza A(H3N2) and A(H1N1)pdm09 viruses co-circulated during the season.MethodsPractitioners systematically selected ILI patients to swab within eight days of symptom onset.We compared cases (ILI positive to influenza A(H3N2) or A(H1N1)pdm09) to influenza negative patients. We calculated VE for the two influenza A subtypes and adjusted for potential confounders. We calculated heterogeneity between sites using the I² index and Cochrane's Q test. If the I² was <50%, we estimated pooled VE as (1 minus the OR) × 100 using a one-stage model with study site as a fixed effect. If the I² was >49% we used a two-stage random effects model.ResultsWe included in the A(H1N1)pdm09 analysis 531 cases and 1712 controls and in the A(H3N2) analysis 623 cases and 1920 controls. For A(H1N1)pdm09, the Q test (p = 0.695) and the I² index (0%) suggested no heterogeneity of adjusted VE between study sites. Using a one-stage model, the overall pooled adjusted VE against influenza A(H1N1)pdm2009 was 47.5% (95% CI: 16.4–67.0).For A(H3N2), the I² was 51.5% (p = 0.067). Using a two-stage model for the pooled analysis, the adjusted VE against A(H3N2) was 29.7 (95% CI: −34.4–63.2).ConclusionsThe results suggest a moderate 2013–2014 influenza VE against A(H1N1)pdm09 and a low VE against A(H3N2). The A(H3N2) estimates were heterogeneous among study sites. Larger sample sizes by study site are needed to prevent statistical heterogeneity, decrease variability and allow for two-stage pooled VE for all subgroup analyses.     

实验性心肌损伤与能量代谢关系的实验研究

本实验从病理、生化和电生理三个角度对异丙基肾上腺素所致心肌损伤与能量代谢的关系进行了研究。研究结果表明，异丙基肾上腺素确使心肌产生损伤，并随着时间的延长，损伤面积逐步扩大。损伤心肌辅酶Ｑ１０含量．全血ＡＴＰ，ＡＤＰ含量都显著降低，表明能量代谢发生障碍。也损伤心肌钙离子通道。复方丹参和辅酶Ｑ１０对心肌确有保护作用，使心肌损伤面积缩小，心肌匀浆和线粒体中琥珀酸脱氢酶活性，辅酶Ｑ１０含量和全血ＡＴＰ，ＡＤＰ含量都显著增高。钙离子通道也有明显的改善，说明这两种药物对心肌有明显的保护作用．为这种药物的临床应用提供了实验依据。     

Expression of EspA in Lactococcus lactis NZ9000 and the detection of its immune effect in vivo and vitro

Enterhemorrhagic Escherichia coli (EPEC), an important cause of severe infantile diarrheal disease in many parts of the developing world, produced several recently described virulence determinations. Several of its virulence factors are secreted by type III secretion including EspA, which forms filamentous structures on bacterial surface bridging to the host cell’s surface. These structures on bacterial surfaces may deliver other virulence factors directly into the host cell from EHEC. In this study, EspA was expressed in Lactococcus lactis NZ9000 (L. lactis NZ9000). BALB/C mice were immunized by recombinant EspA, and mice sera were assayed for the disruption of E. coli O157:H7 interaction with the host cell. BALB/C mice which were immunized with recombinant EspA produced specific antibody titers, and the difference between the control group and the immune group is marked (P<0.05). The polyclonal mice antisera blocked E. coli O157:H7-induced host cell actin rearrangement and could label E. coli O157:H7 EspA filaments in vitro. Our present findings suggest that L. lactis may be a good candidate to produce oral vaccine, and thus entertains the possibility of developing EspA-oral vaccine in the defense of E. coli O157:H7 infection.     

基于ISO15189的临床实验室电子记录系统的设计和应用

目的 分析基于ISO15189的临床实验室电子记录系统的设计和应用。方法 利用SpringBoot+SpringMVC技术框架进行构建,采用JAVA等编程语言和MySQL 5.7数据库技术搭建Web平台,基于Apache/Nginx/Caddy应用服务器,设计研发临床实验室电子记录系统。结果 临床实验室电子记录系统包含ISO15189中管理要求和技术要求相关的电子表格和审批流程。在管理要求部分主要包括对文件的修订、不符合项的识别以及对管理评审等方面;技术要求部分主要包括在日常工作中所需的人员、设备设施以及在检验前中后期等的技术要求。结论 临床实验室电子记录系统实现了表格的规范填写,文档与数据的高效记录,可以追溯整个检验周期,查找更为有针对性,极大地提高了工作效率。     

ICF与ISO 9999辅助产品分类法

“assistive products”这一新名词来自于2001年WHO发布的《International Classification of Functioning，Disability and Health》（ICF）中文版《国际功能、残疾和健康分类》环境因素的第一章中，并被定义为“为改善残疾人功能状况而适配的或专门设计的任何产品、器具、设备或技术”，近期已被国际标准化组织（International Organization for Standardization，ISO）ISO／TC173采纳并加入到最新版本国际标准ISO9999：2005的名称、定义和内容中。     

ISO15189认可现场评审引发的对细胞形态学检验问题的思考

笔者作为现场评审组长参与了中国国家实验室国家认可委ISO15189认可(下简称认可)对北京6个奥运会定点医院检验科的现场评审.2年的认可准备,加速了这些实验室标准化、规范化进程,提高了技术素质、管理能力和学术水平,使这些单位学科发展至少向前推进了2～3年.但在细胞形态学检验方面还有些不足,发现的不符合项包括:(1)血细胞分析仪的血涂片复检率过低;(2)缺乏适用本实验室使用仪器的筛选标准;(3)识别细胞形态的基本功较差;(4)从事形态学检查工作岗位的编制设置不足.笔者分析产生的原因有:(1)科主任对形态学检验的临床价值认识不足是主观原因;(2)工作量大、检验人员少、临床要求出报告急,使检验科不能规范进行镜检是客观原因;(3)没有正确使用仪器作筛选手段是技术原因.笔者同时提出了提高形态学检验质量的措施,包括:(1)强化细胞形态学检验重要性的宣传,加紧培植技术队伍;(2)更新理念,提高检验人员技术素质.     

Biological Safety Evaluation and Surface Modification of Biocompatible Ti–15Zr–4Nb Alloy

We performed biological safety evaluation tests of three Ti–Zr alloys under accelerated extraction condition. We also conducted histopathological analysis of long-term implantation of pure V, Al, Ni, Zr, Nb, and Ta metals as well as Ni–Ti and high-V-containing Ti–15V–3Al–3Sn alloys in rats. The effect of the dental implant (screw) shape on morphometrical parameters was investigated using rabbits. Moreover, we examined the maximum pullout properties of grit-blasted Ti–Zr alloys after their implantation in rabbits. The biological safety evaluation tests of three Ti–Zr alloys (Ti–15Zr–4Nb, Ti–15Zr–4Nb–1Ta, and Ti–15Zr–4Nb–4Ta) showed no adverse (negative) effects of either normal or accelerated extraction. No bone was formed around the pure V and Ni implants. The Al, Zr, Nb, and Ni–Ti implants were surrounded by new bone. The new bone formed around Ti–Ni and high-V-containing Ti alloys tended to be thinner than that formed around Ti–Zr and Ti–6Al–4V alloys. The rate of bone formation on the threaded portion in the Ti–15Zr–4Nb–4Ta dental implant was the same as that on a smooth surface. The maximum pullout loads of the grit- and shot-blasted Ti–Zr alloys increased linearly with implantation period in rabbits. The pullout load of grit-blasted Ti–Zr alloy rods was higher than that of shot-blasted ones. The surface roughness (Ra) and area ratio of residual Al₂O₃ particles of the Ti–15Zr–4Nb alloy surface grit-blasted with Al₂O₃ particles were the same as those of the grit-blasted Alloclassic stem surface. It was clarified that the grit-blasted Ti–15Zr–4Nb alloy could be used for artificial hip joint stems.     

Physico-Chemical Investigation of Endodontic Sealers Exposed to Simulated Intracanal Heat Application: Hydraulic Calcium Silicate-Based Sealers

The aim of this study was to gain information about the effect of thermal treatment of calcium silicate-based sealers. BioRoot RCS (BR), Total Fill BC Sealer (TFBC), and Total Fill BC Sealer HiFlow (TFHF) were exposed to thermal treatment at 37 °C, 47 °C, 57 °C, 67 °C, 77 °C, 87 °C and 97 °C for 30 s. Heat treatment at 97 °C was performed for 60 and 180 s to simulate inappropriate application of warm obturation techniques. Thereafter, specimens were cooled to 37 °C and physical properties (setting time/flow/film thickness according to ISO 6876) were evaluated. Chemical properties (Fourier-transform infrared spectroscopy) were assessed after incubation of the specimens in an incubator at 37 °C and 100% humidity for 8 weeks. Statistical analysis of physical properties was performed using the Kruskal-Wallis-Test (P = 0.05). The setting time, flow, and film thickness of TFBC and TFHF were not relevantly influenced by thermal treatment. Setting time of BR decreased slightly when temperature of heat application increased from 37 °C to 77 °C (P < 0.05). Further heat treatment of BR above 77 °C led to an immediate setting. FT-IR spectroscopy did not reveal any chemical changes for either sealers. Thermal treatment did not lead to any substantial chemical changes at all temperature levels, while physical properties of BR were compromised by heating. TFBC and TFHF can be considered suitable for warm obturation techniques.