电化学发光免疫分析定量检测血清抗HBs的临床意义

目的探讨电化学发光免疫分析技术（ECLIA）定量检测乙型肝炎病毒表面抗体（抗-HBs）的临床意义。方法用ECLIA和酶联免疫吸附法（ELISA）对质控品和680例临床血清标本同时进行测定,对两种方法的结果经Х^2检验,进行比较分析。结果ECLIA检测灵敏度为2．0mIU／ml,,ELISA法灵敏度为20mIU／mL,两种检测方法检测103例正规乙肝疫苗接种患者抗-HBs的阳性检出率分别为ECLIA 83．5％、ELISA 60．1％;对已确诊肝炎患者577例的标本检测,ELISA法漏俭率为4．3蟛;对溶血标本的测定ECLIA法优于ELISA法。结论ECLIA是目前较好的定量检测抗-HBs的新技术,在乙型肝炎的诊断、疗效观察和预后判断等方面有重要的临床意义。     

时间分辨荧光免疫法和电化学发光法检测AFP的比较

目的对时间分辨荧光免疫分析法（TRFIA法）国产试剂盒与电化学发光免疫分析法（ECLIA法）检测血清AFP作比较分析。了解两种方法特点。方法分别采用国产TRFIA法试剂盒与ECLIA法检测正常人50例、肝癌患者40例血清AFP的含量;用高、中、低3种浓度AFP标准品采用两种方法进行批内测定,n=10,观察重复性,所得结果计算CV值：将高值标准品血清（250ng／ml）按1：1比例加入每份正常对照组血清中,肝癌组病人血清与生理盐水按1：1稀释后再按1：1比例加入高值标准品血清（250ng／ml）,每份检测2次（TRFIA法）取平均值,计算回收率。结果肝癌组AFP值（TRFIA法：558±319．10ng／ml;ECLIA法：552．31±302．67ng／ml）明显高于正常组（TRFIA法：6．51±5．42ng／ml;ECLIA法：6．32±5．14ng／m）（P〈0．05）,两种方法结果无显著差异（P〉0．05）,其相关系数为0．9150,测定结果呈正相关。高、中、低3种浓度标准品的重复性试验TRFIA法与ECLIA批内变异系数分别低于7．9％和3．1％,后者优于前者,两种方法略有不同,无明显差异（P〉0．05）。回收试验结果,TRFIA法回收率在92．3％～103．9％。结论国产TRFIA法试剂盒和ECLIA法检测AFP相比较具有良好的相关性。灵敏度和稳定性也较好．可应用于临床血清AFP检测。     

Cobas E602电化学发光免疫分析仪检测HBcAb结果分析

目的 通过Cobas E602电化学发光免疫分析法（ECLIA）与酶联免疫吸附法（ELISA）对临床标本对比检测分析,探讨ECLIA检测HBcAb的结果意义模式,为临床提供科学的指导意义,同时确保同一实验室内同一项目结果的一致性.方法 收集60例患者标本,用ECLIA法分别同时测定原倍血清和1∶30稀释后血清,与临床常用的ELISA法测定1∶30稀释后血清的结果进行对比统计分析.结果 ECLIA法测得原倍血清的HBcAb阳性率（48.3%）明显高于ECLIA法和ELISA法测定1∶30稀释后血清阳性率（35.0%和38.3%）,两者差异有统计学意义（χ2=8.53,P〈0.01）,两种方法同时测定原倍血清和1∶30稀释后血清中的HBcAb阳性符合率分别为93.4%和91.4%,差异无统计学意义（χ2=1.29,P〉0.05）.结论 ECLIA法定量测定乙肝时,HBcAb测定标本必须用1∶30稀释后的血清,确保同一实验室内ECLIA法与ELISA法检测结果的一致性.     

酶联免疫法与电化学发光法检测AFP肿瘤标志物结果的对比分析

目的分析和对比酶联免疫法(ELISA)与电化学发光法(ECLIA)检测患者血清中肿瘤标志物甲胎蛋白(AFP)的结果。方法分别用ELISA法与ECLIA法对60例样本中的血清AFP含量进行检测。结果两种方法均能较准确地反映血清中游离AFP的含量,ELISA法与电化学发光法比较相关系数大于0.99,显示高度相关;二者做成对双样本均值分析的t检验,在95%的可信程度下,双尾检验的P=0.298 0,说明使用国产ELISA法与ECLIA法结果差异无统计学意义。结论 ELISA法与ECLIA法在检测AFP结果上有较高的一致性,作为肿瘤标志物的检测具有较高的实用价值。     

实验室两种方法检测血清AFP结果的比较

目的：了解电化学发光免疫法（ECLIA）的优越性。方法：采用ECLIA和放射免疫法,平行测定了50例临床血清标本的甲胎蛋白（AFP）含量。结果：两种方法的相关性良好（r=0．996,P〈0．01）,回收率均在95％以上,但在线性试验和灵敏度检测中,ECLIA法优于RIA法。结论：ECLIA更适用于临床检测。     

ELISA法和电化学发光免疫法检测血清HBsAg结果比较分析

目的对酶联免疫吸附试验（ELISA）和电化学发光免疫法（ECLIA）检测血清中的乙型肝炎病毒表面抗原（HBsAg）结果进行比较分析。方法采用ELISA和ECLIA 2种方法分别检测8 913例血清中的HBsAg。结果 ELISA法和ECLIA法检测出的总阳性数和总阳性率分别为519例占5.82%,451例占5.06%;以ECLIA法为参照,ELISA法假阴性率为0.67%,假阳性率为1.43%,相对敏感性为88.3%,相对特异性为98.5%二者的符合率为97.9%;403例阳性标本用ECLIA法复检,ELISA法的假阳性率为11.9%,相对敏感性为100%,相对特异性为50%,二者的符合率为88.1%;116例弱阳性标本用ECLIA法复检,ELISA法的假阳性率为69%,相对敏感性为100%,相对特异性为50%,二者的符合率为31%;8 394例阴性标本用ECLIA法复检,ELISA法的假阴性率为0.71%,相对敏感性为50%,相对特异性为100%,二者的符合率为99.3%。结论血清HBsAg ELISA法检测存在一定的假阴性率和假阳性率,敏感性和特异性较ECLIA法差,且随HBsAg浓度变化较大。ECLIA法快速、准确、敏感性、特异性更高。     

多肿瘤标志物芯片检测法与化学发光分析法的对比研究

目的：了解多肿瘤标志物蛋白芯片法与电化学发光免疫分析（ECLIA）所测肿瘤标志物结果的符合性。方法：蛋白芯片法与ECLIA检测相同标本的阳性率较高的6项肿瘤标志物,比对两种方法的符合性。结果：糖类抗原19—9（cA19-9）,甲胎蛋白（AFP）,总前列腺特异性抗原（PSA）,糖类抗原125（cA125）等4项指标,两方法间比较差异无统计学意义（P〉0．05）;癌胚抗原（CEA）和铁蛋白（Ferritin）指标两方法间比较差异有统计学意义（P〈0．05）。结论：蛋白芯片法与ECLIA检测cA19—9,AFP,PSA,CA125的特异性和灵敏度相近;CEA和Ferritin指标检测的符合性较差,可能与检测方法、参考值标准等存在差异有一定关系。     

电化学发光免疫分析法和酶联免疫吸附法检测人类免疫缺陷病毒抗体效果评价

目的探讨罗氏电化学发光免疫分析法（ECLIA）在检测抗人类免疫缺陷病毒（HIV）抗体中的临床应用及意义。方法采用ECLIA法及酶联免疫吸附试验（ELISA）二种方法分别对同一血清标本检测抗HIV抗体，并进行比较。结果通过对初筛10260例（其中HIV感染者25例）HIV检测，ECLIA法临界值与ELISA法吸光度彬临界值（OD／CO），2种方法的阳性符合率为100％。ECLIA法特异性为100％，ELISA法特异性为93．5％。结论ECLIA法具有较好的特异度与灵敏度，且具快速、自动化程度高及可减少院内感染可在医院推广应用和临床研究。     

应用尿液检测CEA的探讨

1材料与方法1.1检测对象及标本收集对86例癌症患者同时采集血液和尿液标本1．2方法采用CEA－ELISA法2结果86例血液与尿液标本，CEA阳性率，分别为60·4％（52／86）和58．1％（50／86），其尿液试验敏感性为96．2％，特异性100％，与血清测定结果基本一致。（P＞0、05）。3讨论尿液检测CEA的主要优点是标本采集简便，不受饮食影响，无需时间限制，且无损伤，被检者易于接受，更有利于进行系列测定指示判断疗效，提供复发的证据。我们应用ELISA法对86例肿瘤患者的血清及尿液进行检测，血清CEA的阳性检出率为60．4％，尿液CEA阳性…     

电化学发光法检测抗环瓜氨酸肽抗体的方法学评估

[目的]对电化学发光（ECLIA）法检测抗环瓜氨酸肽（CCP）抗体进行方法学评价。[方法]用ECLIA法和酶联免疫吸附（ELISA）法分别检测192例类风湿关节炎（RA）患者、56例其它风湿性疾病患者以及100例健康对照患者血清中的抗CCP抗体；评估ECLIA法检测抗CCP抗体的精密度、回收率、诊断敏感性、特异性及与ELISA法的相关性。[结果]ECLIA法检测抗CCP抗体的批内、批问变异系数分别为0．9％～1．8％、1．7％～2．4％；回收率为96．7％～98．6％；对RA的诊断敏感性和特异性分别为72．9％、98．7％；与ELISA法检测的一致率达96．7％。[结论]ECLIA法检测抗CCP抗体的精密度要明显高于ELISA法、对RA诊断的敏感性、特异性都很高。能仪器自动化，整个测定时间仅为20min，能很好得满足临床诊断和研究的要求。     

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。     

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.

     

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。     

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.