尿液10项肾损伤标志物检测试剂的性能评价

摘要:目的对尿液 10项肾损伤标志物检测试剂进行性能评价,并评估其临床适用性。方法对北京利德曼公司尿液a1 微球蛋白(u-a|MG)、总蛋白(u-TP)、免疫球蛋白G(u-IgG) 、微量清蛋白(u-Alb)、中性粒细胞明胶酶相关脂质运载蛋白(u-NGAL)、半胱氨酸蛋白酶抑制剂C(u-CysC).视黄醇结合蛋白(u-RBP)、β2微球蛋白(u-β2MG)、N-乙酰-β-D-氨基葡萄糖苷酶(u-NAG).、转铁蛋白(u-Trf)检测试剂盒进行性能评价。正确度和精密度验证参考美国临床和实验室标准协会(CLSI)EP15-A3,验证物质采用ERM-DA470k、ERM-DA471、B2M-NIBSC等参考物质及纯度物质;线性验证参考CLSI EP06;抗干扰能力参考CISI EP07;不同检测系统间比对参考CISI EP09。结果正确度方面,10 项标志物检测试剂测定标准物质在低值、中值、高值的偏倚分别为-2.69% ~4.67%、-3.60% ~3.33% .-2.38% ~3.02%;不精密度方面,重复性以不精密度表示,在低值和高值处分别为1.90%~5.43%、0.63% ~2.42%,室内不精密度为2.27%~5.63%、1.09%~3.41%,均满足临床要求;10项尿液标志物线性范围在0.06~4.40 mg/L至21.83~2 146.77 mg/L之间。抗干扰方面,u-1 MG、u-Alb、u-β2MG、u-Trf 、u-CysC、u-NAG分别在血红蛋白终浓度≤8 g/L、≤8 g/L、≤4 g/L、≤4 g/L、≤2g/L、≤1 g/L时,未受到明显干扰(百分偏差≤+ 10%) ,而u-TP、u-IgG、 u-RBP、u-NGAL在血红蛋白终浓度≥0.125 g/L时即受干扰。不同检测系统间偏差超出临床允许范围。结论尿液 10项肾损伤标志物的正确度、精密度、线性范围和抗血红蛋白干扰能力满足临床需要,不同检测系统间标志物测量结果可比性欠佳。     

基于代谢组学分析的18-三体妊娠羊水差异代谢物

摘要:目的通过 非靶向代谢组学方法分析18-三体( trisomy 18,T18) 妊娠母体羊水样本,探索其差异代谢物。方法采用病 例-对照研究,以8例18-三体妊娠母体羊水样本为病例组,40例正常胎儿母体羊水样本为对照组,采用气相色谱飞行时间质 谱技术( GC-T0F/MS)检测两组羊水样本。采用主成分分析(PCA)和正交偏最小二乘法判别分析(OPIS-DA)模型分析代谢谱 差异,通过单维统计分析寻找差异代谢物。结果PCA 和OPLS-DA模型分析均显示病例组与对照组之间无明显分离趋势。 通过单维分析在两组间共发现5种差异代谢物,分别为甘油醛、葡萄糖酸、硫酸吲哚酚.磷酸盐和泛酸(P<0.05)。结论羊水 代谢组学证实18-三体妊娠存在多种代谢物水平的差异,为疾病的发生机制的探索提供了更多研究思路。     

Grading Gliomas Capability: Comparison between Visual Assessment and Apparent Diffusion Coefficient (ADC) Value Measurement on Diffusion-Weighted Imaging (DWI)

Background: To compare diagnostic accuracy between DWI visual scale assessment and ADC value measurement of solid portion of the tumor in grading gliomas. Methods: This retrospective study included 38 patients who had pathologically proven gliomas between January 2013 and August 2018 with 18 low grade and 20 high grade tumors. All patients underwent MRI and biopsy. Two readers reviewed DWI visual scale independently. Disagreement was resolved by consensus. One reviewer measured ADC value of entire solid part of the tumor in single axial slice with greatest dimension of tumor which was chosen by consensus. Two data sets of visual scale and ADC value were analyzed and comparison of diagnostic accuracy in glioma grading was done by using area under the curve (AUC) of receiver operating characteristic curve (ROC). Results: Visual scale and ADC value could be used to distinguish between low and high grade gliomas with a statistically significant difference. (P-value 0.002 and <0.001). Almost all high grade gliomas had visual scale 5. The sensitivity, specificity, PPV NPV and accuracy were 50%, 100%, 100% , 64.3%,73.68% respectively. The cutoff level for the ADC value was determined to be 1119.48 x10-6 mm2/s in differentiation between low and high grade gliomas with the sensitivity, specificity, PPV, NPV, accuracy of 90%, 88.89% , 90%, 88.9% and 89.47% respectively. There was no statistically significant difference(P-value = 0.163). Conclusion: Both Visual scale and ADC value were capable of differentiating between low and high grade gliomas. Although visual scale may not replace ADC measurement, larger scale prospective study is needed for validate this initial result.     

Knowledge,Attitudes, and Practices Regarding Cervical Cancer Screening among HIV-infected Women at Srinagarind Hospital: A Cross-Sectional Study

Introduction: In recent years, the lives of HIV-infected patients in Thailand have improved significantly due to continuous advances in treatment. However, the rate of cancer related to HIV infection (especially cervical cancer) is likely to increase. Although the World Health Organization (WHO) recommends Papanicolaou testing in all HIV-infected women, few of these patients receive this kind of screening in Thailand. Therefore, we conducted this study to evaluate the knowledge, attitudes, and practices of these patients with regard to cervical cancer screening. Materials and Methods: This cross-sectional study was conducted in HIV-infected women aged 18-65 years from April to November 2019 via a self-administered cervical cancer screening questionnaire, which consisted of four parts: demographic data, knowledge, attitudes, and practices. Results: Three hundred HIV-infected women were recruited. Most of the participants had good attitudes toward screening and practiced adequate screening (75.3% and 71.3%, respectively). However, only 62 participants (20.7%) demonstrated adequate knowledge. The crucial factors that were associated with adequate screening practice were age 40-49 years-old (AOR =3.26, 95%CI=1.02-10.37), CD4 cell count (AOR = 3.41, 95%CI = 1.29-8.99), having been advised about cervical cancer screening (AOR= 6.23, 95%CI 1.84-21.07), and attitude toward screening (AOR= 5.7, 95%CI = 2.23-14.55). The major reasons for not undergoing screening were embarrassment (41.86%), lack of symptoms (41.86%), fear of the results (36.04%), and fear of pain (36.04%). Conclusion: The reasons for inadequate testing were disregard and misconceptions about the procedure. To prevent invasive cervical lesions in HIV-infected women, health care providers should inform these patients about the importance of regular cervical cancer screening.     

Determinants of Tobacco Use among Children of a Rural Village in India: An Exploratory Qualitative Study

Background: Tobacco is one of the leading causes of preventable deaths. It is both a major social and health problem. According to National Sample Survey Organization of Government of India about 20 million children of ages 10-14 are estimated to be tobacco-addicted. There are grave consequences of tobacco both socially and also on health thus it is of utmost importance to understand the factors leading to its use and to plan strategies to reduce its intake. However, the health implications of this social issue in a rural context have not been explored. Aims and Objective: this study makes an attempt to explore the health and social implications of tobacco usage by the children below the age of 14 years in hamlet. Materials and Methods:  The present study employed a qualitative study design. Data was collected using focus group discussion and in-depth interview of key informants. Thematic analysis for exploring the explicit and implicit meanings within the data was done. The themes which emerged were knowledge about tobacco and the various products available, children and parents’ tobacco use and habits, the health and social implication of tobacco use, reasons for tobacco use by the children. Results: It was found tobacco use by the children was very common in the community. Parent, peer pressure, sibling pressure were found to be playing important role in the initiation of tobacco habit by the child. Further illiteracy and lack of awareness was also lead to tobacco use among children. Conclusion: The study identifies education and awareness of parents about the ill-effects of tobacco play an important role as parents act as role model for their children, thus equal stress should be laid in improving the parental habits. Even raising the prices of tobacco products can help in controlling this habit.     

Genome-wide bioinformatics analysis of FMN,SAM-I,glmS, TPP,lysine, purine,cobalamin, and SAH riboswitches for their applications as allosteric antibacterial drug targets in human pathogenic bacteria

Objectives: A constantly growing number of antibiotic-resistant strains of human pathogenic bacteria is an acute problem. Prolonged illnesses and increasing mortality worldwide mean that there is an urgent need to develop novel antibacterial drugs based on new targets and mechanisms of action. We present in silico analyses of bacterial riboswitches that may be suitable as antibacterial drug targets.

Methods: Most bacterial riboswitches are allosteric cis-acting gene control elements located in the 5?-untranslated region of messenger RNAs. Riboswitches sense specific metabolites and regulate the synthesis of some essential cellular metabolites in many pathogenic bacteria but are not found in humans. We present a complete and comprehensive genome-wide bioinformatics analyses of the suitability of eight riboswitches as antibacterial drug targets in various pathogenic bacteria.

Results: Based on our in silico analyses, we classify the riboswitches in four different groups based on their suitability to be used as antibacterial drug targets. We have estimated that FMN, SAM-I, glmS, TPP, and Lysine riboswitches are promising targets for antibacterial drug discovery.

Conclusion: This research enables us to focus antibacterial drug discovery research only on those riboswitches whose inhibition will result in suppression of the growth of certain pathogenic bacteria.