流感快速诊断检测在发热门诊应对流感中的应用及防控措施

目的 通过对类流感病例进行流感快速诊断检测来辅助诊断,以了解流感的流行特征、人群的发病情况、为治疗和护理提供针对性的措施。方法 对我院2017.12~2018.3月的类流感快诊采样病例资料做回顾性分析。结果 流行性感冒在人群分布、临床表现等方面均有一定的规律和特征。结论 流感快速诊断检测是一项快速诊断流感的辅助检查,护士的采样规范性是提高检测结果正确性的关键。通过检测结果可以为流感患者提供有效的治疗和护理措施,避免流感病毒的传播,为流感疫情的防控起到一定的作用。     

细菌外毒素在脓毒症发病中的意义

脓毒症是严重创伤、休克、外科大手术后常见的并发症,进一步发展可导致脓毒性休克、多脏器功能障碍综合征（ＭＯＤＳ）等,已成为危重患者的重要死亡原因之一。临床流行病学分析显示,Ｇ＋菌感染所致脓毒症的发病率逐年上升,至九十年代已达脓毒症发病率的３０％～５０％,且常常与Ｃ－菌脓毒症同时发生、协同致病［１］。业已明确,外毒素是Ｇ＋菌和某些Ｇ－菌感染的重要致病因子,与脓毒症的病理生理过程密切相关。本文拟就几种重要细菌外毒素在脓毒症发病中的作用及其机理研究进展作－简要介绍。１外毒素的结构与作用特点 细菌外毒素多…     

细菌快速裂解方法研究

16Ｓ 2 3ＳｒＲＮＡ基因是位于 16ＳｒＲＮＡ基因与 2 3ＳｒＲＮＡ基因之间的区间序列 ,具有较好的保守性和相对的可变性 ,被认为是细菌鉴定的合适部位[1,2 ] 。我们认为能否快速有效地扩增该区间 ,聚合酶链反应 (ＰＣＲ)扩增前的标本处理是关键。故比较了 3种裂解细菌的方法。一、材料与方法1 菌株、人类基因组ＤＮＡ及病毒株来源 :革兰阳性 6个菌种 ,包括金黄色葡萄球菌、表皮葡萄球菌等共 19株 ;革兰阴性 2 1个菌种 ,包括大肠埃希菌、肺炎克雷伯菌、绿脓假单胞菌等共 40株。以上菌株由浙江省临床检验中心及结核病防治中心提供 ,保存于我…     

脓毒症研究现状

脓毒症(sepsis)是严重创伤、烧伤及大手术后常见的并发症。美国每年有近75万脓毒症患者．每天有近500名患者死于严重脓毒症，死亡率约为30％，在欧洲每年估计有15万人死于脓毒症。我国尚缺乏详细的临床流行病学资料，据推算每年可能有300万例患者发生脓毒症。脓毒症表现出的患病率高、死亡率高、治疗费用高的三高现象已经构成对人类健康的严重威胁和经济发展的巨大负担。本文就近年来脓毒症的发病机制、诊断及治疗等方面的一些进展作一概述。     

脓毒症相关性脑病研究现状

脓毒症相关性脑病是脓毒症一种常见并发症,患者出现弥散性脑功能障碍,其严重程度从短暂的、可逆的脑病到严重的、不可逆的脑损伤不等.本文对其临床症状、可能的发病机制及治疗对策进行概述.     

脓毒症与基因多态性相关性研究现状

脓毒症是由感染引起的全身炎症反应（SIRS）,是严重创伤、休克、外科大手术后常见的并发症,可导致脓毒性休克和多脏器功能障碍综合征（multipleorgan dysfunctin syndrome,MODS）,是当今危重病医学领域的研究焦点。脓毒症发生的根源是机体炎症反应失控,炎性递质瀑布样释放,造成组织损伤。     

细菌微量快速生化鉴定方法学研究

目的建立细菌微量快速生化鉴定系统,用于临床实验室细菌学的快速诊断。方法应用所研制的27种微量快速生化反应试剂与传统试管方法检测208株临床分离菌及8种质控菌株生化反应符合率,依据杭州24 h的JY Z-15E及JY Z-11E肠杆菌生化编码鉴定管的项目要求组合了该法的肠杆菌15种(RE 15n)及肠杆菌11种(RE 11n)生化鉴定试验条,用208株临床分离菌及8种质控菌菌株进行鉴定试验。结果27种细菌微量快速生化反应试剂与传统试管法生化反应总符合率为93.5%~100%。对208株临床分离菌及8株质控菌的菌种鉴定,其完全符合率15种(RE 15n)为99.9%,11种(RE 11n)为100%。8种质控菌株鉴定完全正确。结论用细菌微量快速生化反应系统鉴定细菌,具有简单、快速的特点,无需特殊设备,成本低廉,所得结果准确、可靠,能够满足临床需要。     

急诊脓毒症患者早期筛查生物标志物的研究现状与展望

脓毒症是一种源于感染,以炎症反应和免疫功能紊乱为演变特征,表现为多脏器功能障碍且具有高度异质性的综合征。脓毒症生物标志物是指病原微生物侵入机体后,在生理、生化、免疫和遗传等方面表达出可测量的指标,用于定量评估机体防御反应状态和病理生理过程,并可用于早期筛查急诊脓毒症患者。新型生物标志物表现出良好的诊断潜力,可能是早期诊断脓毒症患者的突破点。不同类型生物标志物的动态监测和联合评估,可能是脓毒症患者早期筛查的重要举措;另外,生物标志物的床旁即时检验技术为急诊早期筛查脓毒症提供了一种快速、高效、便捷的检测方法。本文阐述了数种不同类型生物标志物早期筛查急诊脓毒症患者的研究现状,以期为构建急诊脓毒症患者早期筛查模型提供依据,从而能更早、更快、更准确地筛查急诊脓毒症患者。     

细菌苯丙氨酸脱氨酶快速纸片法检测

细菌苯丙氨酸脱氨酶快速纸片法检测淮阴市妇产儿童医院检验科（２２３０００）魏红，赵旺胜，童明庆目前，绝大多数细菌的生化反应需１８～２４ｈ，有的甚至７２ｈ以上，这不仅延长了细菌鉴定时间，而且也延迟了疾病的诊断和治疗。我们参照国内外有关文献［１，２］，试制...     

细菌快速鉴定与合理使用抗生素的相关性

自从使用抗生素后已使很多感染性疾病得到了治疗，手术后感染得到了控制。但是抗生素在临床的广泛应用对医院感染控制也带来种种不利的影响，细菌耐药性不断增强。医院细菌室重要工作之一就是及时给临床提供微生物方而的信息，指导临床合理使用抗生素。细菌室在接种患者标本分离培养24h，既可给临床提供一些非常重要的信息，又给临床合理使用抗生素提供科学的依据。     

生物标记物在全身性感染中的诊断价值

全身性感染是重症医学科的常见病及多发病,一旦合并脏器功能不全,病死率非常高。早期合理的治疗可以明显降低全身性感染患者的预后,然而,由于缺乏特异性的临床症状及体征,使得全身性感染的早期诊断十分困难。机体发生感染后,生物标记物往往在临床症状体征出现之前就发生改变,有助于全身性感染的诊断。然而,单一的生物标记物的诊断价值均较有限。动态观察生物标记物的变化以及联合多种生物标记物则有助于提高生物标记物的诊断价值。临床医生必须熟悉各种生物标记物的特点,才能做出准确的诊断。本文主要针对生物标记物在全身性感染中的诊断价值进行阐述。     

金标法快速梅毒血清检测的评价

目的评价金标抗密螺旋体抗体胶体金快速检测试剂盒(SD syphilis 3.0)检测梅毒螺旋体抗体的可行性。方法运用金标快速SD syphilis 3.0试验与血浆反应素环状卡片试验(TRUST)和梅毒螺旋体明胶颗粒凝集试验(TPPA)平行检测168份高危可疑梅毒血清。结果168份高危可疑梅毒血清中,金标快速SD syphilis3.0、TRUST、TPPA阳性检出率分别为66.08%(111/168)、61.91%(104/168)、69.05%(116/168);以TPPA结果为标准,金标快速SD syphilis 3.0试验的敏感性为93.97%(109/116),特异性为98.20%(109/111)。结论金标快速SD syphilis 3.0检测梅毒抗体操作简便,具有一定的敏感性和特异性,在排除假阳性假阴性情况下是现场检测或单个患者梅毒确诊值得推广的方法。     

金标法快速梅毒血清检测的评价

目的评价金标抗密螺旋体抗体胶体金快速检测试剂盒（SD syphilis 3.0）检测梅毒螺旋体抗体的可行性。方法运用金标快速SD syphilis 3.0试验与血浆反应素环状卡片试验（TRUST）和梅毒螺旋体明胶颗粒凝集试验（TPPA）平行检测168份高危可疑梅毒血清。结果168份高危可疑梅毒血清中,金标快速SD syphilis3.0、TRUST、TPPA阳性检出率分别为66.08%（111/168）、61.91%（104/168）、69.05%（116/168）;以TPPA结果为标准,金标快速SD syphilis 3.0试验的敏感性为93.97%（109/116）,特异性为98.20%（109/111）。结论金标快速SD syphilis 3.0检测梅毒抗体操作简便,具有一定的敏感性和特异性,在排除假阳性假阴性情况下是现场检测或单个患者梅毒确诊值得推广的方法。     

Influenza vaccine effectiveness in primary school children in Japan: a prospective cohort study using rapid diagnostic test results

A low-cost, prospective cohort study using the results of rapid diagnostic test performed at local clinics was conducted to estimate influenza vaccine effectiveness (VE) in school children (6–12 year-olds). All children in four primary schools in Tsuchiura City, Ibaraki, Japan were enrolled (n = 2607). Vaccination status and other risk factors were obtained with a baseline questionnaire. Participants were encouraged to visit a clinic to have a rapid test when they developed an influenza-like illness during the winter season in 2006–2007, and 88.6% of those who reported influenza to the school had been tested. The result of the test was obtained with another questionnaire. The attack rate of influenza A and B was 5.4% and 11.9%, respectively. Logistic regression was used to model the association between influenza vaccination and rapid-test-confirmed influenza after adjusting for potential confounders. Influenza VE was calculated as (1– adjusted odds ratio) × 100. VE for total influenza was 21% (95% confidence interval −8 to 42), which was a combination of VE for influenza A (44%, 8–66) and VE for influenza B (5%, −37 to 34). Among several possibilities that would account for rather low VE estimates in this study, low sensitivity of the rapid test, and differential propensity to seek vaccination or medical care between the vaccinated and nonvaccinated were considered to be important. This study was able to estimate influenza VE at very low cost with high specificity in case ascertainment by collecting the readily available data on influenza rapid test with questionnaires.     

The clinical utility of a near patient care rapid microarray-based diagnostic test for influenza and respiratory syncytial virus infections in the pediatric setting

We evaluated the potential clinical utility of an automated near patient molecular assay Verigene Respiratory Virus Plus (RV+) and rapid immunochromatographic antigen tests (RIAT) in the pediatric setting for diagnosis of influenza and respiratory syncytial virus infections when testing was performed by the pediatrician seeing the patient. Overall, with respect to influenza virus, sensitivity and specificity for RIAT were 70.8% and 100%, respectively, compared to 100% and 96.2%, respectively, for RV+. For respiratory syncytial virus, sensitivity and specificity for RIAT were 78.9% and 100%, respectively, compared to 100% and 100%, respectively, for RV+. When RIAT and RV+ sensitivity for influenza virus was compared based on the time the patient presented after onset of fever, the sensitivity of RIAT at 6 hours was 37.5% compared to 100% for RV+. At 12 hours, RIAT improved to 60.9%. This study confirms the clinical utility of RV+ in the pediatric setting.     

Causes of false-positive HIV rapid diagnostic test results

HIV rapid diagnostic tests have enabled widespread implementation of HIV programs in resource-limited settings. If the tests used in the diagnostic algorithm are susceptible to the same cause for false positivity, a false-positive diagnosis may result in devastating consequences. In resource-limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie-breaker algorithms, can leave a false-positive diagnosis undetected. We propose that heightened CD5⁺ and early B-lymphocyte response polyclonal cross-reactivity are a major cause of HIV false positivity in certain settings; thus, test performance may vary significantly in different geographical areas and populations. There is an urgent need for policy makers to recognize that HIV rapid diagnostic tests are screening tests and mandate confirmatory testing before reporting an HIV-positive result. In addition, weak positive results should not be recognized as valid except in the screening of blood donors.     

Field evaluation of a dual rapid Human Immunodeficiency Virus and treponemal syphilis rapid test in community-based clinics in Los Angeles and New York

Introduction

Dual human immunodeficiency virus/syphilis rapid diagnostic devices can play an important role in prevention efforts. The field performance of the INSTI Multiplex HIV-1/HIV-2/Syphilis Antibody Test (Multiplex) was evaluated.

Influenza viral load and rapid influenza diagnostic tests in children and adults

We compared children and adults with regard to rapid influenza test sensitivity and viral load. Specimen volumes were measured, rapid tests were conducted, and viral load was determined. There was no difference between children and adults in test sensitivity or viral load, but children had higher specimen volumes.