丙型肝炎病毒不同编码区重组抗原在抗体检测中的应用

目的　探讨丙型肝炎病毒 (HCV)不同编码区重组蛋白片段的免疫反应性及其在抗体检测中的应用。方法　分别以 4种HCV单片段抗原 (C、NS3、NS4或NS5 )检测抗 HCV抗体阳性血清 ;以 4种单片段抗原的混合物 (MIX)检测抗 HCV抗体阳性血清、大学生体检血清和抗 HCV抗体阴性质控血清。结果　 90份抗 HCV抗体阳性血清中共有 75份可与一种或多种单片段抗原反应 ,阳性率分别为 70 .0 % (C)、6 1.1% (NS3)、5 2 .2 % (NS4 )、4 4 .4 % (NS5 ) ,其中仅与C、NS3、NS4和NS5一种抗原发生反应的分别有 8份、1份、2份和 3份血清标本 ;90份抗 HCV阳性血清经MIX抗原检测 ,阳性率为 83.3% (75 / 90 ) ;10 0份大学生血清和39份阴性质控血清经混合抗原检测均阴性。结论　HCV不同编码区重组蛋白片段有不同的免疫反应性 ,在发展抗 HCV抗体诊断试剂时 ,应采用各种不同编码区的混合抗原。     

HCV分片段抗原EIA与重组免疫印迹法分析检测HCV抗体的比较研究

【目的】探讨国产丙型肝炎病毒(HCV)分片段抗体试剂的敏感性和特异性,为丙型肝炎的早期诊断和替代昂贵的进口重组免疫印迹法确认试剂(HCV RIBA3.0)提供实验依据。【方法】用HCV分片段抗体试剂检测经确认的标本中HCV-C、NS3、NS4、NS5抗体并与HCV RIBA3.0比较。【结果】82份样品中80份判定为阳性,阳性率为97.56%,2份判定为可疑,为2.4%,40份阴性样品中有2份判定可疑,为5.00%。【结论】国产分片段抗体检测试剂检测HCV抗体,与美国第三代RIBA3.0试剂的检测符合率基本一致,有低价高效的临床实用价值。     

HCV单片段抗原EIA与常规EIA检测丙型肝炎病毒抗体的比较

目的比较国产重组HCV单片段抗原酶免疫(EIA)检测试剂与国产第三代HCV常规抗体(EIA)检测试剂的敏感性和特异性。方法利用基因工程技术重组表达的HCV单片段(HCV-C、NS、NS4、NS)EIA检测试剂和常规EIA试剂检测国家第三代抗-HCV血清考核盘(40份阳性和40份阴性血清样品)及20份不符血样，对检测结果进行统计分析。结果HCV单片段EIA检测试剂总符合率100％，常规试剂为96．2％。结论HCV抗体单片段试剂可作为对HCV常规EIA试剂检测不符血样的确认试剂。     

金标渗透法快速检测血清中丙型肝炎病毒抗体

采用基因工程技术克隆表达了丙型肝炎病毒（HCV）－Core-Ns3-Ns4优势表位嵌合抗原，研制出金标渗透法快速检测丙型肝炎病毒抗体试剂，与抗丙型肝炎病毒抗体酶联免疫检测试剂（HCV－ELISA）和重组免疫印迹分析检测试剂（HCV－RIBA3.0)进行了比较，其特异性、敏感性均达到了ELISA试剂水平。     

抗HCV分片段酶联免疫检测试剂的临床评价

在克隆表达了丙型肝炎病毒不同区抗原（HCV－C、NS－3、NS－4、NS－5）的基础上，研制出抗HCV抗体分片段酶联免疫检测试剂。对该试剂特异性、灵敏度进行了临床评价。结果显示该试剂具有良好的特异性和灵敏度。     

长春地区17，000献血员初复检抗HCV阳性标本中不同功能区抗体的状况及试剂改进的建议

[目的] 对献血员初检和复检抗HCV阳性及可疑血液标本同步进行不同功能区抗体状况的分析研究，以期发现问题和为今后的改进提供依据。[方法] 用两种国产抗HCVEIA检测试剂和一种进口试剂对长春地区17，000献血员进行筛选，检测出80份阳性样品，再用抗HCV单片段旁证试剂检测、同步分析四种抗体的反应强度和分布状况。[结果] HCV-Core、NS3、NS4、NS5均为阳性的26份，HCV-C^ NS3^ NS4^ 的11份，HCV-C^ NS3^ NS5^ 的9份，HCV-C^ NS3^ 的10份，HCV-C^ NS4^ 的3份，HCV-NS3^ NS5^ 的1份，HCV-NS4^ NS5^ 的1份，而Core^ ，NS3^ ，NS4^ 单独阳性分别为10、8、1。[结论] 根据抗HCV不同功能区抗体的分布状况，提示抗HCV检测试剂中两种国产试剂均可能存在着个别的漏检现象，主要是NS3抗体；建议国产试剂尚需提高和改进HCV非结构区抗原，尤其是NS3抗原，同时也应改进NS4抗原。     

蛋白芯片检测丙型肝炎病毒分片段抗体

目的用蛋白芯片的方法检测丙型肝炎病毒(HCV)分片段抗体。方法利用生物芯片技术和化学发光技术将高度纯化的抗原HCV Core、NS3、NS4、NS5以特定微阵列固定在固相载体上,用化学发光免疫法检测抗HCV Core、抗HCV NS3、抗HCV NS4和抗HCV NS5。结果174份血清中HCV抗体阳性87份,HCV抗体阴性87份,其中献血员33份,非丙型肝炎的其他肝病患者39份,非肝病者15份。87例雅培公司的AxSYM(微粒子发光)检测抗HCV阳性患者中,蛋白芯片检出阳性85份,阳性率为97.70%;在174份标本中,蛋白芯片检出阳性标本88份,其中抗HCV阳性87份,阳性率98.86%;抗HCV NS3检出49份,阳性率为55.68%;抗HCV NS4检出68份,阳性率为77.27%;抗HCV NS5检出37份,阳性率为42.05%;抗HCV Core检出69份,阳性率为78.41%。结论蛋白芯片显示较高的敏感性和特异性,具有临床实用价值。     

献血人群中丙型肝炎病毒第1高变区抗体检测及意义

目的研究丙型肝炎病毒(HCV)第一高变区(HVR1)抗体检测在献血者血液筛查中的意义。方法采用融合F4HVR1抗原检测不同血清样本中的抗-HVR1的存在情况,并与现有C、NS3、NS4、NS5抗体进行比较。结果在HCV-RNA阳性样本中,HVR1抗体的阳性率为96.8%;在90份可疑HCV感染血清中HVR1抗体的阳性率为61.1%,与C区、NS3区接近,高于NS4区、NS5区(P<0.05),共检测出4份单独HVR1抗体阳性血清。结论在现有HCV诊断试剂基础上,对献血人群进行HCV-HVR1抗体的检测可以提高血液筛查灵敏度,减少HCV的经血传播。     

国产抗丙型肝炎抗体检测试剂盒灰区范围的设置

目的设置上海地区临床实验室常用的4种国产抗丙型肝炎病毒(HCV)抗体(简称抗HCV)检测试剂的灰区范围。方法收集抗HCV临床初检阳性样本656例,分别用荣盛、新波、科华和科美4家国产抗HCV检测试剂进行复检,分别计算初检不同S/CO值范围的复检率;选择抗HCV初、复检结果不一致的弱阳性样本338例,采用确认试验[重组免疫印迹法(RIBA)]进行确认,对RIBA结果为不确定的样本采用实时荧光定量聚合酶链反应(PCR)检测HCV RNA。以RIBA和HCV RNA结果作为金标准,绘制受试者工作特征(ROC)曲线,探讨其最佳临界S/CO值。以95%真阳性和95%真阴性S/CO值确定4种国产抗HCV检测试剂阴、阳性灰区范围。结果 4种国产抗HCV检测试剂的阴性复检符合率均90%,S/CO值均12.01;阳性复检符合率均95%。荣盛、新波、科华及科美4种国产试剂检测抗HCV的最佳临界S/CO值分别为1.31、2.48、3.22和4.32。分别以95%真阳性率和95%真阴性率确定4种国产抗HCV检测试剂的阳性和阴性临界值,得出荣盛、新波、科华及科美4种国产抗HCV检测试剂S/CO值的灰区范围分别为0.6~1.3、0.7~2.5、0.7~4.0和0.7~4.3。结论确认了上海地区4种常用国产抗HCV检测试剂的最佳临界S/CO值,为临床提供了4种抗HCV检测试剂的灰区范围。     

HCV抗原检测与HCV-RNA和HCV抗体检测的比较研究

目的 评价丙型肝炎病毒核心抗原(HCV抗原)、丙型肝炎病毒抗体(HCV抗体)及丙型肝炎病毒RNA(HCV-RNA)三种检测方法在丙型肝炎实验室诊断中的作用.方法 HCV抗原采用双抗体夹心法;HCV-RNA采用实时荧光定量PCR技术(RT-PCR),HCV抗体采用酶联免疫技术(间接法),对44例HCV抗体阳性标本进行HCV抗原和HCV-RNA检测.结果 在HCV抗体阳性标本中,HCV抗原阳性检出率为43.2％,HCV-RNA阳性检出率为82.5％;在HCV-RNA阳性标本中,HCV抗原阳性检出率为45.5％.结论 三种丙肝标志物中,实时荧光定量PCR技术检测HCV-RNA是判断丙肝感染最可靠的方法而HCV抗原诊断丙肝,仍有54.5％的漏检率,其应用于临床还有距离.所以在没有条件应用实时荧光定量PCR技术检测HCV-RNA的医院,在用HCV抗原对HCV抗体阳性标本进行确认,来判断HCV既往感染或现症感染时,应结合肝功能指标及临床表现以明确诊断.     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。     

Quality and suitability of antimicrobial discs: theoretical and practical sources of error and variability

ABSTRACT

Introduction: The use of antimicrobial discs remains one of the main methods for assessing antibiotic activity. Most discs are made to one of three main standards (FDA, WHO, DIN); these all describe an assay method for assessing the quality of discs using a linear method. Theory predicts a curved relationship, and this is backed up in many cases in practice. In such cases, the assays are potentially invalid. Other sources of uncertainty arising from the manufacturing processes employed are also discussed.

Areas covered: This includes error arising from applying FDA, WHO, and DIN standards, the manufacturing techniques employed, and variation in the materials used in production. The need for a specification that relates directly to the use of the discs is also discussed.

Expert opinion: Manufactured discs, some of which may be out of specification due to curvature and other sources of error, have been used to establish quality zone sizes. Quality zone sizes have then been used to measure the quality of discs. This circular quality system where there is no quantitative check is potentially unsafe. In the many decades of their use, there has been no comprehensive check on the quality of manufactured discs using quantitative, validated assays.