综合性医院住院病人检验标本采集与送检的优化处理

目的:探讨住院病人检验标本采集与送检过程中可能存在的问题,优化检验标本的质量,以提高检验结果的准确性。方法:通过循征医学的方法,分析检验项目的选择、申请单的填写、患者的准备、采样时间的选择、标本采集时的注意点、标本的运送等几个环节对实验结果的影响。结果:住院病人检验标本采集与送检过程的潜在因素会影响检验结果的准确性。结论:要得到准确可靠的实验数据,需要医生和护士的共同协调,共同把好分析前的检验质量关。     

临床检验分析前的质量管理

目的：加强临床实验室分析前的质量控制,确保临床实验室检验质量。方法：建立临床实验室质量管理体系,注重检验医学与临床的沟通,通过循证医学的方法,分析检验项目的选择、申请单的填写、患者的准备、采样时间的选择、标本采集时的注意点、标本的运送等几个环节对实验结果的影响。结果：不符合要求的检验标本在临床检验工作中占有相当的比例,而病区检验标本收集与送检存在的问题尤为严重。结论：要确保分析前检验标本的质量,需要在临床医生、护士和检验人员的共同参与下,才能共同把好分析前的检验质量关。     

临床检验分析前的质量管理

目的:加强临床实验室分析前的质量控制,确保临床实验室检验质量。方法:建立临床实验室质量管理体系,注重检验医学与临床的沟通,通过循证医学的方法,分析检验项目的选择、申请单的填写、患者的准备、采样时间的选择、标本采集时的注意点、标本的运送等几个环节对实验结果的影响。结果:不符合要求的检验标本在临床检验工作中占有相当的比例,而病区检验标本收集与送检存在的问题尤为严重。结论:临床检验分析前的质量控制是整个检验质量控制中非常重要的环节,要做好这一点,需要在临床医生、护士和检验人员的共同参与下,才能共同把好分析前的检验质量关。     

分析前质量控制与临床标本采集、保存、运送关系的原则及注意要点

从临床医生根据病人诊疗需要选择要检测的项目、并开出各类检验申请单、告知患者采集标本前的注意事项、做好采集标本前的一切准备,到标本的合理采集、适时保存、运送中的质量管理即分析前的质量控制。标本采集是直接关系检验结果的基本要素,而且这也正是保证分析前质量控制的关键的、重要环节,如果由临床采集送到检验科的标本已经是不合格的,即使最好的仪器设备,再标准化操作程序,检验人员技术再高,也难以弥补在标本采集过程中引入的误差和错误。全面质量控制也就都变成了一句空话。本文现将各类标本采集的原则及注意要点分别叙述如下。     

临床生化检测分析前的影响因素及质量管理

实验室要获得可靠的测定结果,需要建立一个全面的质量管理体系.全面质量管理是获得准确试验结果的重要保证,而分析前阶段是全面质量管理中一个容易被忽视却非常重要的环节.分析前阶段是指从临床医师选择检测项目,提出检测申请单直到将检测标本送到实验室的过程.这一过程主要包括医师对检验项目的选择,以及检验申请单的填写,患者的准备,标本的采集、储存、运送和接收,这项工作需要医院多部门协作共同完成,针对每一环节都应有具体的质量保证要求.     

完善分析前质量控制 提高检验标本质量

目的:为了加强检验科质量管理,保证检验标本质量,必需完善分析前质量控制。方法:建立分析前质量控制措施,加强与临床医护人员合作,共同制定医生申请、患者准备、标本采集、标本运送等操作规程,以级各种标本采集和运送的影响因素和对策。提高合格标本的送检率。结果:通过分析前质量控制措施的建立和持续改进,不合格标本数量持续下降,有效地提高检验质量。结论:检验人员有必要和临床医护人员学习、了解分析前质量控制内容,将临床科室与实验室作为一个整体来考虑质量控制,共同制定、编写适合于本医院的标本采集手册,提高检验标本质量完善分析前质量控制,为临床提供准确、最佳的结果,保证医疗检验质量。     

采集静脉血标本方法对检验质量的影响及对策

检验质量包括分析前、分析中及分析后三个方面，上述三个环节，任何一个环节处理不好，都会影响检验结果的准确性。分析前质量主要是检验项目选择、患者的准备、标本的采集、标本的贮存和送验等，其主要取决于临床护士能否正确规范地采集和处理血标本，因此，正确采集与送检静脉血标本，也是临床护士的重要工作之一。     

浅谈留取临床检验标本的注意事项

现代检验医学质量控制包括分析前、分析中、分析后三个部分.分析中、分析后检验质量控制已被检验界所重视,如果分析前质量控制做不好,得不到正确的标本,就无从谈起结果正确与否.最主要的是在分析前还存在一些检验人员无法控制的因素,如住院患者标本采集前的准备、标本的采集、贮存及送检过程等.     

检验质量的提高与临床关系

检验科主要工作是利用熟练的检验技术和先进的仪器设备,对各种标本进行正确的分析,为临床诊断和治疗提供准确的实验数据。为达到此目标,必须对分析前、中、后过程进行全面质量控制。文献报道[1],分析前过程占整个检测周期的57.3%,临床对检测结果不满意原因80%可追溯到分析前过程。分析前质量控制的最终目的是收集到合格的标本,这是保证分析工作顺利进行乃至检测结果准确可靠的前提和基础临床医生是诊疗方案的策划者,在为患者开出申请单时,应掌握检验项目的检测原理、临床意义及适应证,还需了解各检验项目的影响因素,如患者生理因素、病理因素、生活环境、生活习惯以及食物和药物因素等[2]。分析前质量控制涉及到患者检验前的准备、标本的采集、检测时间的选择及标本保存、运送等,这些因素都将影响检验结果。为确保标本的合格性,就要求检验科与临床医师、护理人员增进了解和沟通,在基层医院显得尤为重要。我们从5个方面进行阐述,供同道参考。1微生物学检验1.1下呼吸道分泌物(痰培养)的标本采集要求患者清晨留取,留取标本前用清水漱口3次,之后用力咳出。咳痰较困难者可用雾化蒸汽吸入以利于痰的排出,幼儿可用手指轻叩胸骨柄上方以诱发咳痰。标本采集后应立即送检,...     

实验室分析前质量控制与临床

目的 探讨和介绍实验室分析前质量控制与临床的关系和对策.方法 观察从医生开具检验申请单、患者准备、标本采集、标本运送、贮存、分析前预处理等实验室分析前过程中每个环节对检验结果的影响.结果 分析前各环节的质量控制是影响检验结果的重要因素,在可分析出原因的不准确的检验报告中有70%以上来自于分析前阶段.结论 临床实验室要获得准确可靠的检验结果离不开临床医生和护理人员的支持和配合.     

UniPron is A Fully Effective Non-hormonal Reversible Contraceptive in Baboon Model （Papio Anubis）

Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.
Methods Vaginal swabs were obtained before and after UniPron administration, cultured onto appropriate culture media and bacteria identification was done based on type of media used, Gram stain reactions, colony morphology and biochemical tests. Vaginal biopsy tissues were processed using paraffin wax method, stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues. The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations. For efficacy studies, male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages.
Results All the five females （100%） that were treated with UniPron did not conceive and they regained total fertility when the treatment was stopped while all the controls conceived. At a concentration of 40%, UniPron completely immobilized spermatozoa in an in-vitro system. UniPron mechanism of action was by lowering the vaginal pH and on application in baboon, the pH was lowered for at least 3 h after which it went back to normal.
Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV, our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model （Papio anubis）.     

Evaluation of diuretic and laxative activity of hydro-alcoholic extract of Desmostachya bipinnata （L,） Stapf in rats

OBJECTIVE： In continuation to the growing evidence for therapeutical potential of Desmostachya bipinnata （Linn） Stapf, the current pharmacological study was carried out to evaluate the diuretic and laxative activity of its hydro-alcoholic extract in rats. METHODS： The hydro-alcoholic extract of D. bipinnata whole plant was prepared by using Sox- hlet extractor and subjected to analysis by standard preliminary phytochemical tests. Evaluation of both diuretic and laxative activity was carried out using standard methods as reported earlier. Frusemide （20 mg/kg） was served as positive control for diuretic activity and sennosides （10 mg/kg） served as negative control for laxative activity. RESULTS： The hydro-alcoholic extract showed significant diuretic activity and was found to be the most potent in increasing the urinary output at 500 mg/kg when the effect was compared with that of the standard frusemide （P〈0.01）. Moreover, this extract was found to be most effective in increasing urinary electrolyte concentration （Na＋, K＋, and Cl-） at both doses tested. Whereas the results for laxative activity showed minimal increase of feces output at the dose of 500 mg/kg and the increase was negligible when compared with that of the standard drug sennosides. CONCLUSION： Altogether, the above significant findings validate and support its folkloric diuretic use and lend pharmacological credence to the ethno-medical use of this plant in traditional system of medicine, which demands further studies to investigate its active constituents, as well as its use and safety.     

Effect of the disruption of three cytoskeleton components on chondrocyte metabolism in rabbit knee cartilage

Background Chondrocytes＇ phenotype and biosynthesis of matrix are dependent on having an intact cytoskeletal structure.Microfilaments,microtubules,and intermediate filaments are three important components of the cytoskeletal structure of chondrocytes.The aims of this study were to determine and compare the effects of the disruption of these three cytoskeletal elements on the apoptosis and matrix synthesis by rabbit knee chondrocytes in vitro.Methods Chondrocytes were isolated from full-thickness knee cartilage of two-month-old rabbits using enzymatic methods （n=24）.The isolated cells were stabilized for three days and then exposed to low,medium,and high doses of chemical agents that disrupt the three principal cytoskeletal elements of interest：colchicine for microtubules,acrylamide for intermediate filaments,and cytochalasin D for actin microfilaments.A group of control cells were treated with carrier.Early apoptosis was assessed using the Annexin-FITC binding assay by flow cytometry on days 1 and 2 after exposure to the disrupting chemical agents.The components and distribution of the cytoskeleton within the cells were analyzed by laser scanning confocal microscopy （LSCM） with immunofluorescence staining on day 3.The mRNA levels of aggrecan （AGG） and type Ⅱ collagen （Col-2） and their levels in culture medium were analyzed using real-time PCR and enzymelinked immunosorbent serologic assay （ELISA） on days 3,6,and 9.Results In the initial drug-dose-response study,there was no significant difference in the vitality of cells treated with 0.1 μmol/L colchicine,2.5 mmol/L acrylamide,and 10 μg/L cytochalasin D for two days when compared with the control group of cells.The concentrations of colchicine and acrylamide treatment selected above significantly decreased the number of viable cells over the nine-day culture and disrupted significantly more cell nuclei.Real-time PCR and ELISA results showed that the mRNA levels and medium concentrations of AGG and Col-2 were significantly decreased for     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

New Mechanism of Herb-herb Interaction between Ginseng and Trogopterus Based on CYPs in Rat Livers

The study was designed to investigate the potential mechanism of herb-herb interaction between ginseng and Trogopterus （Trg） based on Cytochrome P450 isozymes （CYPs） in rat livers. We estimated the influence on CYP1A2, CYP2E1, and CYP3A1/2 activity caused by ginseng and Trg used in combination. The CYP1A2 and CYP2E1 enzyme activity were induced by ginseng and Trg used in combination. And this induction effect was caused via inducing CYP1A2 and CYP2E1 protein expression which was supposed caused by inducing the gene expression of CYP1A2 and CYP2E1.     

Iloprost inhibits fracture repair in rats

Background Previous studies have shown that prostaglandins （PGs） dramatically stimulate healing processes in bone.However,the effect of prostaglandin l2 （PGI2） on fracture healing remains unclear.To investigate the effect of PGI2,a study on fracture healing process in closed tibia fractures was designed.Methods Thirty-six Sprague-Dawley male rats were randomized into two groups.On the first day,their right tibias were fractured by three-point bending technique.The study group （n=18） received a single injection of 10 μg/kg iloprost for 5 days,while the control group （n=18） received saline solution in the same way.On the 7th,14th and 28th days following the fracture,six rats were sacrificed and their right legs were harvested in each group.The progression of fracture healing was assessed for each specimen by the scores of radiography （by Lane-Sandhu） and histology （by Huo et al）.Results On the 7th day,the radiographic and histologic scores were equal.On the 14th day radiographic total score was 6 and histologic total score was 23 in the iloprost group,whereas radiographic total score was 11 and histologic total score was 33 in the control group.On the 14th day radiographic and histologic scores were significantly decreased in the iloprost group compared to the control group （P 〈0.05）.On the 28th day radiographic total score was 12 and histologic total score was 37 in the iloprost group,whereas radiographic total score was 15 and histologic total score was 40 in the control group.On the 28th day although there was a decrease in radiographic and histologic scores of the iloprost group acording to control group,it was not statistically significant （P 〉0.05）.Conclusion Iloprost delays fracture healing in early stage in rats.     

Effect of Shenfu on the Expression of Bcl-2 and Bax of Intestinal Mucosal Epithelial Cells after Ischemic Reperfusion in Rats

Objective To study the effect of Shenfu on the expression of bax and bcl-2 in small intestinal mucosal epithelial cells after ischemic reperfusion injury and explore the effect of Shenfu on small intestinal mucosal epithelial cells apoptosis. Methods 36 SD rats were randomized into three groups, each consisting of 12 rats： Sham group （S group）, Ischemic reperfusion group （IR group）, Shenfu group （SF group）, Ischemic reperfusion models were made by ligated the superior menseneric artery for 1 hour followed by 2 hrs reperfusion. Histological mucosal damage in each group was graded according to Chiu＇s score. Immunohistochemistry detected the expression of bax and bcl-2, and obtained the optical density （OD） value using a color image pattern analysis system, and then calculated the ratio of bcl-2/bax. TUNEL method measured apoptotic intestinal mucosal epithelial cells, and calculated the apoptotic index. Results There were edema and epithelial impairment in part of villus and the integral was higher in SF group than S group （P〈0.05）, but lower than IR group （P〈0.01）. Compared IR group with S group and SF group, the average OD value of bcl-2 and bax had significant statistic difference （P〈0.01）, and the average OD value of bcl-2 in SF group was higher than in S group （P〈0.05）, meanwhile bcl-2/bax was significantly lower in IR group than in S group and SF group （P〈0.01）, but that was higher in SF group than in S group （P〈0.05）. Apoptotic index in IR group was significantly higher than that in other two groups （P〈0.01）, and that in SF group was higher than in S group （P〈0.05）. Conclusion Shenfu can enhance the expression of bcl-2, decrease the expression of bax, meanwhile increase the ratio of bcl-2/bax, inhibit small intestinal mucosal epithetlial cells apoptosis, and protect small intestine mucosal epithetlial after ischemic reperfusion.     

补肾活血方对PCOS大鼠模型卵巢中PAI-1mRNA表达的影响

目的探讨补肾活血方对大鼠PCOS模型卵巢局部纤溶酶原激活物抑制因子-1（PAI—1mRNA）表达的影响。方法选用未成年24d龄SD雌性大鼠60只,随机分为模型组、克罗米酚组、补肾活血方高剂量组、补肾活血方低剂量组、正常对照组5组。用Bogovich法建立大鼠多囊卵巢病理模型。以克罗米酚为对照。用原位杂交法观察补肾活血方对多囊卵巢大鼠局部PAI—1mRNA的影响。结果模型组卵巢局部PAI—1mRNA存在卵泡膜间质细胞显著增高,用补肾活血方高、低剂量与克罗米酚药后,卵巢局部PAI-1mRNA的表达明显降低．差异具有统计学意义（P〈0．05、P〈0．01）。补肾活血方高剂量组与克罗米酚组比较,差异具有显著统计学意义（P〈0．01）;低荆量组与克罗米酚组比较差异无统计学意义（P〉0．05）,补肾活血方高、低剂量组比较,低剂量组卵泡膜间质细胞上PAI-1的基因表达增高更明显,但二者差异无统计学意义（P〉0．05）。结论PAI-1mRNA可能与多囊卵巢综合征的发病机制有关。以补肾活血立法的补肾活血方能降低多囊卵巢大鼠局部PAI—1mRNA的显著增高表达．降低PAI—1mRNA卵巢局部的作用。提示补肾活血方可能通过PAI—1mRNA途径促进卵巢排卵的机制。     

表皮生长因子受体酪氨酸激酶抑制剂在非小细胞肺癌应用的瓶颈——获得性耐药

以表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI）分子靶向治疗研究为肇始,转化性研究使基础实验和临床实践间的鸿沟迅速填平,改变着人们认识治疗肺癌的视角。无可否认,EGFR-TKI上市后极大地延伸了肿瘤学家治疗肺癌的手段,但不管从临床经验、临床研究数据、分子生物学层面还是文献计量学的角度,     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。