头孢西丁纸片筛选产AmpC酶革兰阴性杆菌

目的评价头孢西丁纸片筛选产AmpC酶革兰阴性杆菌的可靠性.方法头孢西丁纸片抑菌圈直径＜18mm为可疑产AmpC酶株,采用头孢西丁三维试验作为确证实验.结果头孢西丁纸片检测的57株产AmpC酶株中,有27株为非产酶株假阳性率为49.1%(27/57).阴沟肠杆菌、大肠埃希菌和肺炎克雷伯菌的假阳性分别为60%(15/25)、33.3%(6/18)和50%(7/14).有1株产AmpC酶肺炎克雷伯菌漏检.结论头孢西丁纸片筛选产AmpC酶阴沟肠杆菌和肺炎克雷伯菌特异性差,检测大肠埃希菌产AmpC酶株尚可.     

高产β-内酰胺酶革兰阴性杆菌质粒AmpC的检测

目的 了解产β-内酰胺酶革兰阴性杆菌中质粒AmpC的分布,建立特异,灵敏的质粒AmpC检测方法.方法 利用头孢西丁敏感试验筛选出临床分离革兰阴性杆菌中的产酶菌,再经三维试验筛选出高产酶菌,对高产酶菌进行PCR检测质粒AmpC.结果 531株革兰阴性杆菌中有89株产酶菌,其中高产酶菌分别有17株大肠埃希菌,其质粒AmpC阳性的有5株,阳性率29.4%;11株肺炎克雷伯菌,其质粒AmpC阳性的有3株,阳性率27.3%;7株铜绿假单胞菌,其质粒AmpC阳性的有2株,阳性率28.6%;5株阴沟肠杆菌,其质粒AmpC阳性的有1株,阳性率20%.结论 本院高产β-内酰胺酶革兰阴性杆菌中质粒AmpC的阳性率比较高,应引起临床的重视,PCR检测方法灵敏,可靠,值得向临床推广使用.     

头孢西丁纸片筛选产AmpC酶革兰阴性杆菌

目的评价头孢西丁纸片筛选产AmpC酶革兰阴性杆菌的可靠性。方法头孢西丁纸片抑菌圈直径<18mm为可疑产AmpC酶株,采用头孢西丁三维试验作为确证实验。结果头孢西丁纸片检测的57株产AmpC酶株中,有27株为非产酶株假阳性率为49.1%(27/57)。阴沟肠杆菌、大肠埃希菌和肺炎克雷伯菌的假阳性分别为60%(15/25)、33.3%(6/18)和50%(7/14)。有1株产AmpC酶肺炎克雷伯菌漏检。结论头孢西丁纸片筛选产AmpC酶阴沟肠杆菌和肺炎克雷伯菌特异性差,检测大肠埃希菌产AmpC酶株尚可。     

高产β-内酰胺酶革兰阴性杆菌质粒AmpC的检测

目的了解产β-内酰胺酶革兰阴性杆菌中质粒AmpC的分布,建立特异,灵敏的质粒Am-pC检测方法。方法利用头孢西丁敏感试验筛选出临床分离革兰阴性杆菌中的产酶菌,再经三维试验筛选出高产酶菌,对高产酶菌进行PCR检测质粒AmpC。结果531株革兰阴性杆菌中有89株产酶菌,其中高产酶菌分别有17株大肠埃希菌,其质粒AmpC阳性的有5株,阳性率29.4%;11株肺炎克雷伯菌,其质粒AmpC阳性的有3株,阳性率27.3%;7株铜绿假单胞菌,其质粒AmpC阳性的有2株,阳性率28.6%;5株阴沟肠杆菌,其质粒AmpC阳性的有1株,阳性率20%。结论本院高产β-内酰胺酶革兰阴性杆菌中质粒AmpC的阳性率比较高,应引起临床的重视,PCR检测方法灵敏,可靠,值得向临床推广使用。     

革兰阴性杆菌AmpC酶的检测及分析

目的　分析产AmpCβ 内酰胺酶 (简称AmpC酶 )的革兰阴性杆菌检测方法 ,并探讨影响初筛与确诊符合率的因素。方法　采用头孢西丁初筛试验筛选出符合AmpC酶表型筛选条件的菌株 ,再用三维试验确认产AmpC酶菌株并对其进行分析。 结果　 180 1株革兰阴性杆菌中 ,筛选出 32 7株产AmpC酶菌株 ,三维试验阳性菌株 16 1株 ,总检出率 9.0 % (16 1/ 180 1) ,其中阴沟肠杆菌检出最多 (71株 ) ,且头孢西丁和头孢吡肟抑菌圈直径中位数 (P50 )分别为 6 .7和 2 0 .4mm。结论　产AmpC酶菌株已成为医院感染的重要病原菌 ,且以阴沟肠杆菌为主 ;确认产AmpC酶菌株中 ,头孢西丁抑菌圈直径越小 ,头孢吡肟越敏感 ,初筛与确诊符合率越高。     

三维试验检测革兰阴性杆菌ESBLs及AmpC酶

目的了解革兰阴性杆菌中产超广谱β-内酰胺酶(ESBLs)、染色体头孢菌素酶(AmpC)的分布及分离率。方法准确鉴定菌株,采用底物为头孢噻肟的三维试验,测定菌株中ESBLs及AmpC酶。结果临床分离175株革兰阴性杆菌中产ESBLs 49株,阳性率28.0%,包括阴沟肠杆菌、大肠埃希菌、克雷伯菌属、鲍曼不动杆菌、铜绿假单胞菌和弗劳地枸橼酸菌。产AmpC酶22株,阳性率12.6%,包括阴沟肠杆菌、鲍曼不动杆菌、铜绿假单胞菌、产酸克雷伯菌。其中阴沟肠杆菌产ESBLs及AmpC酶分离率均居首位(分别为55.6%、33.3%)。3株铜绿假单胞菌同时产AmpC酶和ESBLs。结论我院产ESBLs菌以阴沟肠杆菌、大肠埃希菌、肺炎克雷伯菌为主。产AmpC酶以阴沟肠杆菌、鲍曼不动杆菌、铜绿假单胞菌为主。超超广谱β-内酰胺酶(SSBLs)菌株在医院有流行。     

三维试验检测革兰阴性杆菌ESBLs及AmpC酶

目的了解革兰阴性杆菌中产超广谱β-内酰胺酶（ESBLs）、染色体头孢菌素酶（AmpC）的分布及分离率。方法准确鉴定菌株,采用底物为头孢噻肟的三维试验,测定菌株中ESBLs及AmpC酶。结果临床分离175株革兰阴性杆菌中产ESBLs 49株,阳性率28.0%,包括阴沟肠杆菌、大肠埃希菌、克雷伯菌属、鲍曼不动杆菌、铜绿假单胞菌和弗劳地枸橼酸菌。产AmpC酶22株,阳性率12.6%,包括阴沟肠杆菌、鲍曼不动杆菌、铜绿假单胞菌、产酸克雷伯菌。其中阴沟肠杆菌产ESBLs及AmpC酶分离率均居首位（分别为55.6%、33.3%）。3株铜绿假单胞菌同时产AmpC酶和ESBLs。结论我院产ESBLs菌以阴沟肠杆菌、大肠埃希菌、肺炎克雷伯菌为主。产AmpC酶以阴沟肠杆菌、鲍曼不动杆菌、铜绿假单胞菌为主。超超广谱β-内酰胺酶（SSBLs）菌株在医院有流行。     

快速筛查革兰阴性杆菌β内酰胺酶

目的应用Cica-Beta-Test试剂盒快速筛查革兰阴性杆菌β内酰胺酶:超广谱β内酰胺酶(ESBILs)、金属β内酰胺酶(MBLs)和染色体介导头孢菌素酶(AmpC酶),为临床抗感染治疗提供耐药依据。方法收集2010年1月至2011年3月上海交通大学医学院附属仁济医院临床分离革兰阴性杆菌共110株,其中头孢噻肟和(或)头孢他啶不敏感大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌各20株,多重耐药鲍曼不动杆菌20株和阴沟肠杆菌30株。其中大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌用美国CLSI推荐方法确证产ESBLs;对鲍曼不动杆菌用聚合酶链反应(PCR)法检测其MBLs和AmpC酶耐药基因;对阴沟肠杆菌用表型筛选法(三维试验法)检测其AmpC酶;对所有菌株应用Cica-Beta-Test试剂盒快速筛查ESBLs、MBLs和AmpC酶。根据检测结果对试剂盒进行评估。结果应用Cica-Beta-Test试剂盒检测110株临床分离菌未发现假阳性,确诊试验总符合率为92.0%(92/100),其中与PCR法比较检测MBLs和AmpC酶结果符合率为100%;与CLSI推荐ESBLs双纸片确诊试验比较,符合率为86.7%(52/60)。30株阴沟肠杆菌用AmpC酶表型筛选法比较符合率为86.7%(26/30)。结论 Cica-Beta-Test试剂盒可对各种革兰阴性杆菌产生的β内酰胺酶进行筛查及初步分型,简便、快速,灵敏度高,准确率高,尤其能对CLSI未推荐方法的耐药革兰阴性杆菌进行β内酰胺酶快速筛查意义更大。     

医院感染中革兰阴性杆菌AmpC β-内酰胺酶产酶率分析

目的 了解华东医院的医院感染病原菌中革兰阴性杆菌产AmpC β-内酰胺酶的情况.方法 用改良的头孢西丁三维试验检测持续高产AmpC β-内酰胺酶.结果 华东医院的医院感染病原菌中革兰阴性杆菌产持续高产AmpC β-内酰胺酶的产酶率为7.20%,其中阴沟肠杆菌、弗劳地枸橼酸杆菌和黏质沙雷菌产酶率高,分别为36.85%、33.34%和33.34%.结论 华东医院的医院感染菌株产酶率较高,应引起临床高度重视.     

革兰阴性杆菌AmpC酶的检测及分析

目的 分析产AmpC β-内酰胺酶(简称AmpC酶)的革兰阴性杆菌检测方法，并探讨影响初筛与确诊符合率的因素。方法 采用头孢西丁初筛试验筛选出符合AmpC酶表型筛选条件的菌株，再用三维试验确认产AmpC酶菌株并对其进行分析。结果 1801株革兰阴性杆菌中，筛选出327株产AmpC酶菌株，三维试验阳性菌株161株，总检出率9．0％(161／1801)，其中阴沟肠杆菌检出最多(71株)，且头孢西丁和头孢吡肟抑菌圈直径中位数(P50)分别为6．7和20．4mm。结论 产AmpC酶菌株已成为医院感染的重要病原菌，且以阴沟肠杆菌为主；确认产AmpC酶菌株中，头孢西丁抑菌圈直径越小，头孢吡肟越敏感，初筛与确诊符合率越高。     

Three-dimensional coronary arteriography

In this paper we present a new imaging technique for three-dimensional (3-D) X-ray coronary arteriography. The goal is to provide in near to real-time a 3-D representation of the coronary arterial tree, helpful to better understand its topology and locate the possible lesions. The 3-D reconstruction of the coronary arteries is obtained from a set of X-ray conic projections acquired during a rotation of the imaging chain around the patient. Images are taken before and after injection of contrast agent. A subset of mask and opacified images is selected, corresponding to the same phase in the cardiac cycle. These images are subtracted and corrected for geometric distortion. The reconstruction is performed by using a two-step non-parametric detection/estimation method. Due to heart motion and propagation of the contrast agent, the number of available projections is very small. Typically 4 or 6 projections are available if the opacification is stable during 2 or 3 cardiac cycles and when using a biplane acquisition system. High resolution 512³ reconstructions of the coronary arteries from a cadaver heart are presented, with a voxel size of 0.4 mm. The 3-D reconstruction provides a good 3-D representation of the global structure, even with a number of projections as small as 4.     

Three-dimensional speckle tracking

Two-dimensional speckle tracking is a useful technology. Nevertheless, it has some limitations because the heart has three dimensions. The recent development of three-dimensional speckle tracking technology provides a new diagnostic tool. By using this new method, a more complete and probably accurate evaluation of global and segmental left ventricular function may be performed. Three-dimensional speckle tracking is a promising tool to provide new insights into left ventricular function.     

Three-dimensional ultrasound imaging

The objective of this article is to provide scientists, engineers and clinicians with an up-to–date overview on the current state of development in the area of three-dimensional ultrasound (3-DUS) and to serve as a reference for individuals who wish to learn more about 3-DUS imaging. The sections will review the state of the art with respect to 3-DUS imaging, methods of data acquisition, analysis and display approaches. Clinical sections summarize patient research study results to date with discussion of applications by organ system. The basic algorithms and approaches to visualization of 3-D and 4-D ultrasound data are reviewed, including issues related to interactivity and user interfaces. The implications of recent developments for future ultrasound imaging/visualization systems are considered. Ultimately, an improved understanding of ultrasound data offered by 3-DUS may make it easier for primary care physicians to understand complex patient anatomy. Tertiary care physicians specializing in ultrasound can further enhance the quality of patient care by using high-speed networks to review volume ultrasound data at specialization centers. Access to volume data and expertise at specialization centers affords more sophisticated analysis and review, further augmenting patient diagnosis and treatment.     

Three-dimensional extended field-of-view ultrasound

Three-dimensional (3-D) extended field-of-view ultrasound creates a mosaic view from a set of volumes acquired from a dedicated 3-D ultrasound machine combined with a position tracker. A simple compounding technique can be used to combine the volumes together using only the position measurements, but some misalignment remains. Two different registration methods were developed to correct these errors in the overlapping regions. The first method divides the overlap into smaller blocks and warps the blocks to best align the features. The second method is similar, but uses rigid body registration of the blocks. Experiments in vitro and in vivo showed that block-based registration with warping produced the most reproducible results and the greatest increase in similarity among the overlapping regions. It also produced the best reconstruction accuracy, with a mean distance error of 0.4 mm measured across 101.78 mm in a phantom, representing 0.4% error.     

心肌细胞的三维培养

背景：由于三维培养可以再现组织细胞的体内生长情况,它已经成为研究肿瘤的耐药性、侵袭性和肿瘤微环境的重要平台。目的：总结归纳了心肌细胞三维培养的研究进展及存在的问题。方法：应用计算机检索CNKI和Pubmed数据库中1994年1月至2012年1月关于心肌细胞三维培养的文章,在标题和摘要中以“三维培养,心肌细胞”或“Three-dimensionalculture,Cardiaccell”为检索词进行检索。选择文章内容与心肌细胞三维培养有关者,同一领域文献则选择近期发表或发表在权威杂志文章。初检得到828篇文献,根据纳入标准选择关于心肌细胞三维培养的36篇文献进行综述。结果与结论：寻找满足要求和易于操作的种子细胞是心肌细胞三维培养的关键环节,而种子细胞的空间立体生长要求有支架的依附,支架使种子细胞间形成适宜的空间分布和细胞联系,并可以提供信号诱导细胞的生长和分化。心肌细胞三维培养为心肌修复提供了一个新的思路,虽然此方面研究已取得了很大进展,但仍有很多问题亟待解决,使三维培养的心肌组织血管化是今后研究的主要方向。     

Three-dimensional magnetic resonance imaging

Three-dimensional surface reconstruction images of the heart and great vessels can be produced from contiguous sequences of ECG-triggered MR scans in patients with congenital heart disease. The methods allow separation of the epi- and endocardial surfaces and definition of the enclosed blood volumes on a slice-by-slice basis. Surface reconstruction images have value in communicating the results of MR examinations to clinicians in cases where cardiac morphology is unusually complex; in depicting intracardiac defects, size, and location; and in aiding the study of pulmonary venous drainage. This method can be practical in studying cardiac morphologic abnormalities and especially in planning cardiac surgery.     

Three-dimensional ultrasonography of hydrocephalus

We examined two infants with hydrocephalus using three-dimensional (3-D) ultrasonography. One infant had congenital hydrocephalus with a ventriculoperitoneal shunt. On 2-D ultrasonography, the shunt tube was shown only as “a point.” However, on 3-D ultrasonography, we could easily see the three-dimensional position of the shunt tube, which was situated in the lateral ventricle. The other patient had hydrocephalus associated with an arachnoid cyst. We could understand the complex shape of the cyst and distinguish it from the third ventricle using 3-D ultrasonography. Thus, 3-D ultrasonography imaging is more useful than 2-D ultrasonography imaging in evaluating hydrocephalus.     

婴儿心脏三维超声信息采集及重建的方法学研究

目的　建立婴儿心脏三维超声信息采集及重建的方法。方法　正常婴儿１３ 例,选择采集途径、采样密度、空间分辨力、灰阶阈值、透明度及探头频率６ 个因素,应用正交试验设计主效应分析法（Ｌ１８３７）,以三维重建效率（Ｅ） 为考核指标,评价各因素的重要性并制订优化方案。结果　按各因素平均极差排序：空间分辨力＞ 采样途径＞ 透明度＞ 灰阶阈值＞ 采样密度＞ 探头频率;各因素Ｋ值最大值分别位于：空间分辨力１００ ％ 、采样途径经剑突下、透明度３０ 、灰阶阈值２０ 、采样密度１°及探头频率２－７ＭＨｚ。结论　兼顾重建的三维细致度因素,婴儿心脏超声三维图像重建方案应为：以３－５ＭＨｚ 探头经剑突下每隔１°进行二维超声信息采集,采集时设置空间分辨率为１００％ ,重建时分别设置灰阶阈值及透明度为２０、３０。