UF-1000i全自动尿有形成分分析仪对尿路感染的诊断价值

Objective To evaluate the application value of UF-1000i automated urine formed elements analyzer in the diagnosis of urinary tract infection. Methods 150 urine specimens were analyzed using the UF-1000i in parallel with detection of leukocyte, yeast-like fungus, and bacteria. These detection results were collected for evaluation of urinary tract infection and scatter grams were recorded. At the same time, these samples were cultured for bacterial identification, which results were compared with that of the UF-1000i. The clinical diagnose criteria of the UTI was performed as golden standard. As compare with results obtained with UF-1000i, the sensitivity and specificity of UF-1000i for diagnosis of urinary tract infection were evaluated, and the consistency were analyzed among scatter grams, bacterial culture and final diagnosis. Results The statistical results from 146 specimens showed that the positive rate of UF-1000i was 32. 9% (48/146), the positive rate of urine culture is 28. 8% (42/146). There was no significant statistical difference found (χ2 = 1.79 ,P = 0. 18 )and Kappa test showed a considerable consistency (K = 0. 775 6). The UF-1000i detection results showed the sensitivity 76. 0% ( 38/50 ), specificity 89. 6% ( 86/96 ), positive predictive value 79. 2% ( 38/48 ) and negative predictive value 87. 8% ( 86/98 ), respectively. The distribution of coccus and bacilli obtained from the UF-1000i testing was basically in accordance with the results of bacterial culture. Conclusion The "UTI-information" of UF-1000i is very important for the diagnosis of urinary tract infections.     

双J管生物被膜菌临床特性及其相关基因研究

[目的]研究双J管生物被膜菌的临床分布,对抗生素的耐药特性及粪肠球菌相关基因与生物被膜形成的关系.[方法]收集本院92例患者双J管.筛选生物被膜菌株和相应浮游菌株;浮游菌与双J管生物被膜菌在MH培养基上作耐药性分析;生物被膜阳性菌在泊洛沙姆培养基和普通MH培养基上作耐药差异性分析.实时荧光定量PCR方法对生物被膜菌组和浮游菌组细菌中ebpA、gelE两种与生物被膜形成相关的基因表达进行检测.[结果]92例患者双J管中筛选出生物被膜菌41株,阳性率为45%;生物被膜菌与相应的浮游菌比较,在普通MH培养基上药敏结果相似,无统计学差异（P＞0.05）;生物被膜菌在Poloxamer培养基和MH培养基上药敏结果差异有统计学意义（P＜0.05）,且前者耐药性更强.生物被膜菌组ebpA,gelE表达量分别是浮游菌组的2019倍和1/138.[结论]本院双J管生物被膜菌在临床上以肠球菌属和葡萄球菌属为主;生物被膜菌与浮游菌耐药性无见明显差异, Poloxamer培养基可模拟出生物被膜菌的生存环境,而且对药物的耐受性更强.ebpA与促进生物被膜形成有关,gelE与抑制生物被膜形成有关.     

UF-1000i全自动尿有形成分分析仪对尿路感染的诊断价值

Objective To evaluate the application value of UF-1000i automated urine formed elements analyzer in the diagnosis of urinary tract infection. Methods 150 urine specimens were analyzed using the UF-1000i in parallel with detection of leukocyte, yeast-like fungus, and bacteria. These detection results were collected for evaluation of urinary tract infection and scatter grams were recorded. At the same time, these samples were cultured for bacterial identification, which results were compared with that of the UF-1000i. The clinical diagnose criteria of the UTI was performed as golden standard. As compare with results obtained with UF-1000i, the sensitivity and specificity of UF-1000i for diagnosis of urinary tract infection were evaluated, and the consistency were analyzed among scatter grams, bacterial culture and final diagnosis. Results The statistical results from 146 specimens showed that the positive rate of UF-1000i was 32. 9% (48/146), the positive rate of urine culture is 28. 8% (42/146). There was no significant statistical difference found (χ2 = 1.79 ,P = 0. 18 )and Kappa test showed a considerable consistency (K = 0. 775 6). The UF-1000i detection results showed the sensitivity 76. 0% ( 38/50 ), specificity 89. 6% ( 86/96 ), positive predictive value 79. 2% ( 38/48 ) and negative predictive value 87. 8% ( 86/98 ), respectively. The distribution of coccus and bacilli obtained from the UF-1000i testing was basically in accordance with the results of bacterial culture. Conclusion The "UTI-information" of UF-1000i is very important for the diagnosis of urinary tract infections.     

产超广谱β内酰胺酶肺炎克雷伯菌中质粒头孢菌素基因型研究

肺炎克雷伯菌是医院内感染相关的常见细菌之一，对抗生素耐药主要原因是产生了各种β内酰胺酶。为了解我院肺炎克雷伯菌中β内酰胺酶编码基因存在情况，我们进行了相关基因的检测，现将结果报道如下。     

外科感染的病原菌调查与分析

目的研究外科感染中常见的微生物种类和分布，为临床明确诊断以及合理应用抗生素提供必要的依据。方法应用标准的微生物方法检测了脓肿、继发性腹膜炎、坏死性筋膜炎和坏死性组织创口4类外科脓液标本的微生物分布，并同时进行需氧菌和厌氧菌的检测。结果外科感染通常有包括需氧菌和厌氧菌的多种菌。被分离出的常见细菌为大肠埃希氏菌、金黄色葡萄球菌、克雷伯菌属某些种、铜绿色假单胞、脆弱类杆菌和消化链球菌某些种。结论在外科感染治疗中，对金黄色葡萄球菌、革兰氏阴性需氧菌及厌氧菌等不同病原菌的感染应采取与其相适应的治疗策略。     

鲍曼不动杆菌的耐药表型及耐药基因的表达

目的分析临床分离的鲍曼不动杆菌的耐药表型及耐药基因的表达状况. 方法用K-B琼脂扩散法检测鲍曼不动杆菌耐药率,以ESBLs确证实验和三维试验检测鲍曼不动杆菌的超广谱β-内酰胺酶（ESBLs）、AmpC酶产酶情况与变化. 结果临床感染鲍曼不动杆菌的ESBLs与AmpC酶检出率分别为1.4%、71.0%,对常用抗生素的耐药率从23.3%～59.1%,对亚胺培南的耐药率最低,为12.8%. 结论临床院分离的鲍曼不动杆菌流行株主要是产AmpC酶株,且呈多重耐药.     

运用"唤醒意识法"在临床见习课中培养医学生的主体性

现代教育培养的人应该是具有主体性的人,在临床见习课中运用“唤醒意识法”来培养医学生的主体性,起到了较好的效果。本文就“唤醒意识法”的运用方法和步骤进行了初步探索。     

SPG4基因的遗传学研究

遗传性痉挛性截瘫(hereditary spastic paraplegia,HSP),又称为家族性Strümpell-Lorrain病,是一种具有临床及遗传高度异质性的神经系统遗传病,患病率为2/10万～9.6/10万,表现为缓慢进展的双下肢无力及痉挛性截瘫.根据遗传方式不同HSP可分为常染色体显性遗传、常染色体隐性遗传和X-连锁隐性遗传,以常染色体显性遗传最常见.目前已经发现40个HSP基因位点,已克隆19个疾病基因.其中spastin基因突变所致的遗传性痉挛性截瘫4型(spastic paraplegia-4,SPG4)约占常染色体显性遗传的HSP的40%.基因检测是诊断该病的金标准,有助于早期诊断、症状前诊断及产前诊断.动物模型的研究对揭示HSP的分子病理机制有重要作用,本文就SPG4基因的遗传学研究作一概述.     

尿路感染生物被膜菌临床分布及耐药性研究

目的筛选尿路感染生物被膜菌,了解其临床分布,进而通过生物被膜菌与浮游菌耐药差异性分析,探讨细菌生物被膜对抗生素的耐药特性,以及初探生物被膜菌在体内较“真实”的耐药性。方法收集120例导尿管相关尿路感染（UTIs）患者导尿管和尿液标本,筛选生物被膜菌株和相应浮游株,对生物被膜半定量检测,药敏实验分析生物被膜菌株和相应浮游菌在普通MH培养基上耐药性差异以及生物被膜阳性菌在泊洛沙姆（Poloxamer,F-127）培养基和普通MH培养基上耐药差异性的分析。结果120例UTIs患者导尿管中筛选出生物被膜菌48株,阳性率为40％;生物被膜菌与相应的浮游菌在普通MH培养基上药敏结果相似,差异无统计学意义（P〉0．05）;生物被膜菌在Poloxamer培养基和MH培养基上药敏结果差异有统计学意义（P〈0．05）,且前者耐药性更强。结论本院尿路感染生物被膜菌在临床上以葡萄球菌属和肠球菌属为主;生物被膜菌与浮游菌在体外耐药性分析未见明显差异,推测Poloxamer培养基有可能表现生物被膜菌较真实的对药物的耐受情况,其耐受性更强。