2006—2008年全国梅毒血清学检测室间质评结果分析

目的 探讨性病实验室检测分级质量管理体系,提高各级实验室梅毒血清学检测水平。方法 2006—2008年,中国疾病预防控制中心性病控制中心参比实验室每年在全国选择部分医疗卫生机构作为参评单位,发放5份血清质控品和相应的结果回馈表,要求各参评单位在规定的时间内进行检测和回报结果。参比实验室进行统计分析,并将质评结果反馈给各参评单位。 结果 质评活动开展3年来,参加省份由17个发展到31个,参加单位由23个上升到145个。2006—2008年,各参评单位满分率分别为79.9%、36.8%、57.6%;合格率分别为95.7%、88.2%、89.7%。结论 通过3年来质评活动的开展,各参评实验室的梅毒血清学检测水平有了一定提高。     

2007-2009年全国淋球菌耐药监测实验室药敏试验室间质评结果分析

目的了解全国淋球菌耐药监测点药敏试验的检测水平,分析其影响因素及存在的问题,以提高我国淋球菌耐药监测点实验室药敏试验检测的质量.方法采用特快专递的方式,将质评样本集中统一发放到全国各淋球菌耐药监测点,由中国疾病预防控制中心性病控制中心将同报结果与预期结果进行比对分析.并将考评结果集中反馈给各参评单位.结果 2007-2009年间共发放室间质评考核样本35组,每组3份样本,合计105份,总回报率为88.57%(93/105).全国共有13个淋球菌耐药监测点参加了室间质评活动,3年间参评单位数分别为9、9、13,合格单位数分别为6、7、11.质评考核成绩的总合格率为77.42%(24/31).淋球菌的药敏检测结果符合率:提高的有质粒介导的产青霉素酶淋球菌、染色体介导的环丙沙星以及大观霉素耐药淋球菌;降低的有质粒介导的高度耐四环素淋球菌和染色体介导的头孢曲松耐药淋球菌.结论经过3年的室间质评,全国淋球菌耐药监测实验室药敏试验的整体检测质量得到了提高,其中产青霉素酶淋球菌、环丙沙星和大观霉素的药敏检测结果的符合率提升较快,而头孢曲松及质粒介导的高度耐四环素淋球菌的药敏检测质量有待提高.     

2007-2009年全国淋球菌耐药监测实验室药敏试验室间质评结果分析

目的了解全国淋球菌耐药监测点药敏试验的检测水平,分析其影响因素及存在的问题,以提高我国淋球菌耐药监测点实验室药敏试验检测的质量.方法采用特快专递的方式,将质评样本集中统一发放到全国各淋球菌耐药监测点,由中国疾病预防控制中心性病控制中心将同报结果与预期结果进行比对分析.并将考评结果集中反馈给各参评单位.结果 2007-2009年间共发放室间质评考核样本35组,每组3份样本,合计105份,总回报率为88.57%(93/105).全国共有13个淋球菌耐药监测点参加了室间质评活动,3年间参评单位数分别为9、9、13,合格单位数分别为6、7、11.质评考核成绩的总合格率为77.42%(24/31).淋球菌的药敏检测结果符合率:提高的有质粒介导的产青霉素酶淋球菌、染色体介导的环丙沙星以及大观霉素耐药淋球菌;降低的有质粒介导的高度耐四环素淋球菌和染色体介导的头孢曲松耐药淋球菌.结论经过3年的室间质评,全国淋球菌耐药监测实验室药敏试验的整体检测质量得到了提高,其中产青霉素酶淋球菌、环丙沙星和大观霉素的药敏检测结果的符合率提升较快,而头孢曲松及质粒介导的高度耐四环素淋球菌的药敏检测质量有待提高.     

2007-2009年全国淋球菌耐药监测实验室药敏试验室间质评结果分析

目的了解全国淋球菌耐药监测点药敏试验的检测水平,分析其影响因素及存在的问题,以提高我国淋球菌耐药监测点实验室药敏试验检测的质量.方法采用特快专递的方式,将质评样本集中统一发放到全国各淋球菌耐药监测点,由中国疾病预防控制中心性病控制中心将同报结果与预期结果进行比对分析.并将考评结果集中反馈给各参评单位.结果 2007-2009年间共发放室间质评考核样本35组,每组3份样本,合计105份,总回报率为88.57%(93/105).全国共有13个淋球菌耐药监测点参加了室间质评活动,3年间参评单位数分别为9、9、13,合格单位数分别为6、7、11.质评考核成绩的总合格率为77.42%(24/31).淋球菌的药敏检测结果符合率:提高的有质粒介导的产青霉素酶淋球菌、染色体介导的环丙沙星以及大观霉素耐药淋球菌;降低的有质粒介导的高度耐四环素淋球菌和染色体介导的头孢曲松耐药淋球菌.结论经过3年的室间质评,全国淋球菌耐药监测实验室药敏试验的整体检测质量得到了提高,其中产青霉素酶淋球菌、环丙沙星和大观霉素的药敏检测结果的符合率提升较快,而头孢曲松及质粒介导的高度耐四环素淋球菌的药敏检测质量有待提高.     

全国2008年沙眼衣原体检测室间质量评价结果分析

为了解全国各级性病防治、诊疗机构性病实验室沙眼衣原体(CT)抗原检测质量水平,通过邮寄方式向参加室间评价的性病检测实验室发放沙眼衣原体质控样品,对回报检测结果进行评价分析.参评单位包括省级CDC中心实验室/皮肤病防治研究所(29家);国家级性病监测点(75家);自愿参加的各级综合医院及皮肤性病防治机构(28家);在132个参评单位中,67.42%(89/132)检测实验室回报结果与预期结果完全相符,考核成绩为优秀;15.15%(20/132)考核成绩为合格;13.64%(18/132)考核成绩为一般;3.79%(5/132)考核成绩为不合格.省级中心实验室、自愿参加的各级性病实验室以及国家级性病监测点实验室的合格率分别为93.10%(27/29)、96.43%(27/28)和73.33%(55/75).省级中心实验室和自愿参加的各级性病实验室CT检测水平普遍较高,但少数国家级性病监测点实验室检验水平有待提高.     

2007-2009年全国淋球菌耐药监测实验室药敏试验室间质评结果分析

目的了解全国淋球菌耐药监测点药敏试验的检测水平,分析其影响因素及存在的问题,以提高我国淋球菌耐药监测点实验室药敏试验检测的质量.方法采用特快专递的方式,将质评样本集中统一发放到全国各淋球菌耐药监测点,由中国疾病预防控制中心性病控制中心将同报结果与预期结果进行比对分析.并将考评结果集中反馈给各参评单位.结果 2007-2009年间共发放室间质评考核样本35组,每组3份样本,合计105份,总回报率为88.57%(93/105).全国共有13个淋球菌耐药监测点参加了室间质评活动,3年间参评单位数分别为9、9、13,合格单位数分别为6、7、11.质评考核成绩的总合格率为77.42%(24/31).淋球菌的药敏检测结果符合率:提高的有质粒介导的产青霉素酶淋球菌、染色体介导的环丙沙星以及大观霉素耐药淋球菌;降低的有质粒介导的高度耐四环素淋球菌和染色体介导的头孢曲松耐药淋球菌.结论经过3年的室间质评,全国淋球菌耐药监测实验室药敏试验的整体检测质量得到了提高,其中产青霉素酶淋球菌、环丙沙星和大观霉素的药敏检测结果的符合率提升较快,而头孢曲松及质粒介导的高度耐四环素淋球菌的药敏检测质量有待提高.

Abstract：

Objective To make a nationwide external quality assessment for drug sensitivity testing of Neisseria gonorrhoeae, analyze the problems in and factors associated with the drug sensitivity testing, and to enhance the quality of drug sensitivity testing of N. gonorrhoeae at different monitoring sites. Methods Samples were uniformly delivered to monitoring sites by express mail service. Test results were analyzed in the National Center for STD Control, and the evaluation results were fed back to these monitoring sites. Results A total of 105 quality control samples were delivered from 2007 to 2009, with a response rate of 88.57% (93/105). Thirteen monitoring sites were enrolled in the external quality assessment, including 9 laboratories in 2007, 9 in 2008 and 13 in 2009. The total percentage amounted to 77.42% (24/31) for qualified laboratories during the 3 years, including 6 laboratories in 2007, 7 in 2008 and 11 in 2009. The coincidence rate increased for the detection of penicillinase-producing N. gonorrhoeae (PPNG), N. gonorrhoeae with chromosome-mediated ciprofloxacin resistance, and N. gonorrhoeae with chromosome-mediated spectinomycin resistance, and declined for the detection of N. gonorrhoeae with plasmid-mediated high level tetracycline-resistance (TRNG) and N. gonorrhoeae with chromosome-mediated ceftriaxone resistance. Conclusions The 3-year external quality assessment reveals an improvement in the overall quality of drug sensitivity testing of N. gonorrhoeae at national monitoring sites; the accuracy is improved markedly for the detection of PPNG, N. gonorrhoeae with resistance to spectinomycin and ciprofloxacin, but is needed to increase for the detection of ceftriaxone-resis- tant N. gonorrhoeae and TRNG.     

2011～2013年广东省珠海市性病监测点性病检测能力分析

目的：通过持续开展性病监测点实验室室间质量评价活动,动态掌握珠海市性病监测点实验室性病检测能力的整体水平,发现实验室间存在的差异,促进性病监测工作质量的提高。方法：2011～2013年间每年组织一次全市性病监测点实验室进行室间质量评价,质评项目为衣原体抗原、梅毒螺旋体血清、性病常规阅片、支原体培养鉴定、淋球菌培养鉴定,每项目各5份样本,要求各实验室在规定时间内检测和回报检测结果,统计得分情况和各项目的符合率,对三年的检测结果进行比较分析。结果：2011～2013年间珠海地区性病监测点实验室性病检测水平连续3年成绩均在良好水平,已通过规范化建设的13家性病实验室3年操作水平（ SI）≥0的有9家,占69.2％;未通过规范化建设的8家性病监测点实验室3年操作水平（ SI）≥0的有1家,占12.5％;不同实验室操作水平比较,存在统计学差异（ P ＝0.024）;检测结果平均符合率均在80％以上,其中非梅毒螺旋体抗体定性试验和梅毒螺旋体抗体定性试验的平均符合率较高,分别为94.4％和97.0％。结论：通过规范化建设的性病实验室检测水平较高且结果较稳定,规范化性病实验室的建设和管理必须具有持续性,才能有效促进性病检测质量的不断提高。     

球形马拉色菌是马拉色菌毛囊炎患者皮损毛囊内的主要菌种

目的 确定引起马拉色菌毛囊炎的主要菌种,比较皮损毛囊内和毛周表面皮肤菌种是否一致,患者性别、年龄、病情与分离菌种的关系。方法 菜子油培养基培养,根据形态及生理生化特点进行鉴定。结果 从毛周表面皮肤分离的319株菌中鉴定出合轴马拉色菌247株(77.43%)、糠秕马拉色菌40株(12.54%)、球形马拉色菌27株(8.46%)、钝形马拉色菌5株(1.57%);从毛囊内分离的314株菌中鉴定出球形马拉色菌252株(80.25%)、合轴马拉色菌57株(18.15%)、糠秕马拉色菌4株(1.27%)、钝形马拉色菌1株(0.32%),菌种构成差异有显著性(P<0.01)。毛囊内菌种构成与患者的性别和年龄有关,与病情无关。毛囊内和毛周表面皮肤同时阳性的279株中菌种不一致204株,菌种一致75株。结论 马拉色菌毛囊炎毛囊内的主要菌种为球形马拉色菌,其表面皮肤则以合轴马拉色菌为主。     

2013年云南省梅毒血清学实验室质量考核分析

目的了解2013年云南省性病实验室梅毒血清学检测能力的总体情况,分析存在问题并及时纠正。方法向各参评实验室发放5份考核样本,进行梅毒螺旋体抗原血清试验和非梅毒螺旋体抗原血清学试验(定性和定量),汇总分析各实验室的结果,对影响考核优秀率的影响因素进行单因素Logistic回归分析。结果 618家实验室参评,其中优秀占80.10%(495/618),良好为5.99%(37/618),合格为13.75%(85/618),不合格为0.16%(1/618)。单因素Logistic回归分析显示机构类别和医院性质是影响考核优秀率的影响因素。开展两类梅毒血清学检测实验室梅毒螺旋体抗原血清试验总体符合率100%,非梅毒螺旋体抗原血清学定性试验和定量试验的总体符合率分别为100%和77.82%。结论需加强性病实验室的规范化建设,完善梅毒血清学检测项目,加强人员培训,以进一步提高梅毒检测能力。     

淋球菌对抗生素耐药性研究

目的:研究广州地区2001年度分离的淋球菌对青霉素、四环素、壮观霉素、头孢曲松和环丙沙星的耐药性。分析耐药菌株的流行特点。方法:采用琼脂稀释法测定菌株对5种抗生素的最小抑菌浓度(MIC),判断敏感性按WHO西太区淋球菌耐药性监测统一标准。用纸片酸度法检测产青霉素酶淋球菌(PPNG)菌株。结果:153株淋球菌中检出127株对青霉素耐药(83.0％),产青霉素酶淋球菌(PPNG)占17.0％(26/153);四环素耐药129株(84.3％);其中质粒介导高度耐四环素淋球菌菌株(TRNG)占总数的24.1％(37/153);环丙沙星耐药117株(76.5％),其中92株同时对青霉素和四环素有耐药性,三重耐药占60.1％;壮观霉素和头孢曲松敏感性最高,分别为100.0％和81.0％。结论:淋球菌对青霉素、四环素和环丙沙星耐药率较高;壮观霉素和头孢曲松敏感,应作为临床的首选药物。     

Comparisons of in vivo and in vitro photosensitivities and DNA repair in fibroblast and keratinocyte cells

Summary Minimal erythema dose of ultraviolet light correlated significantly with the UV-sensitivity of fibroblast cells from 5 patients with xeroderma pigmentosum, 13 patients with keratinocytic neoplasms of the skin, and 21 control subjects, but not with that of cells from 6 patients with photosensitive dermatitis. In unscheduled DNA synthesis after UV irradiation, the number of grains per nucleus was much less in keratinocytes than in fibroblasts, but the relative doseresponse relationship was similar. This indicates that keratinocytes can also be used in vitro UV-sensitivity studies.Supported in part by a Grant for Cancer Research from the Ministry of Education, Science and Culture of Japan     

Antimicrobial effects of phototherapy and photochemotherapy in vivo and in vitro

Summary We investigated the antimicrobial effects of phototherapy and photochemotherapy in vivo and in vitro. First, Staphylococcus aureus samples were obtained using stamp agar medium from inflammatory lesions of 29 adult patients with atopic dermatitis before and after a single photochemotherapy. Therapy was oral PUVA (30 mg 8-methoxypsoralen, 8MOP plus 5 J/cm²UVA), topical PUVA (0·3% 8MOP plus 200mJ/cm²UVA) or UVB (80mJ/cm²) irradiation. The number of S. aureus on the lesions was significantly reduced, even after a single treatment with all therapies. Reductions (mean± SD) were 69·3 ± 26.9%, 76·3 ± 31·3% and 83·8 ± 18·5%. respectively. Secondly, we investigated the effect of PUVA (0·001% 8MOP plus 10, 20, 30, 40, or 50 mJ/cm²UVA) and UVB (10, 30, 50, or 100 mJ/cm²) irradiation on the proliferation of S. aureus in vitro. PUVA and UVB treatment markedly inhibited the proliferation in a dose-dependent manner. These results seem to indicate the possibility that the antimicrobial effect of UV radiation contributes to successful photochemotherapy in patients with atopic dermatitis.     

Desmoplakin I and II in acantholytic dermatoses: preservation in pemphigus vulgaris and pemphigus erythematosus and dissolution in Hailey-Hailey's disease and Darier's disease

Desmoplakin I and II are important components of the attachment plaque of the desmosome which mediates cell to cell adhesion, in epithelial cells. In this study we used well-characterized antibody against desmoplakin I and II immunohistochemically and immunoelectron microscopically on two cases of pemphigus vulgaris and one case of pemphigus erythematosus and two cases each of Hailey-Hailey's disease and Darier's disease. In the normal human epidermis the desmosomes were demonstrated in a dotted pattern along cell periphery. In pemphigus vulgaris and pemphigus erythematosus acantholytic cells and the perilesional cells exhibited normal dotted pattern along the cell periphery. In Hailey-Hailey's disease and Darier's disease, the dotted pattern is lost in acantholysed and perilesional areas and anti-desmoplakin I + II positive proteins were observed diffusely in the cytoplasm. Immunoelectron microscopical findings correspond to these light microscopical observations. It is concluded that in autoimmune acantholytic disease such as pemphigus vulgaris and pemphigus erythematosus, desmoplakins are intact even in acantholytic cells, whereas in genodermatoses such as vulgaris and pemphigus erythematosus, desmoplakins are intact even in acantholytic cells, whereas in genodermatoses such as Hailey-Hailey's disease and Darier's disease primary or secondary abnormalities abnormalities of desmosomes may be involved in their pathogenesis.     

Iron in finger-nails and in the liver

The mean iron content of finger-nails of 113 apparently normal subjects was found to be 67.6 μg/g dry nail (±43.7). There was no age or sex variation. No relationship was found between the concentration of iron in finger-nails and that stored in the liver.