两种方法检测乙肝HBsAg效果对比

目的 :考察胶体金联免疫吸附与酶联免疫吸附试验的灵敏度与特异性。方法 :用乙肝表面抗原胶体金联免疫吸附试剂 (GCISA)和酶联免疫试剂 (ELISA)检测各种肝炎病人血清 90 9份 ,正常人血清 173份及乙肝表面抗原质控标准品。结果 :GCISA和ELISA分别检出 773和 770份阳性样品 ,总符合率为97 0 %。检测乙肝表面抗原质控标准品 ,GCISA的灵敏度为 1ng/ml,ELISA为 1～ 2ng/ml,且两种方法都只与HBsAg有特异反应 ,与乙肝病毒核心抗原、e抗原无交叉反应。结论 :GCISA检测血清中的HBsAg特异性强 ,灵敏度与ELISA一致 ,在检测单份样品时较ELISA简单快速 ,观察结果直观 ,不需仪器设备。     

检验科局域网在室内质量控制中的应用研究

 目的使用患者标本检验结果的均值绘制室内质控图来观察结果准确性的变化.方法应用临床检验信息系统软件对2002年6～9月20项生化检验数据进行统计分析,计算患者标本检验结果的均值并绘制室内质控图.结果患者检验结果均值呈正态分布且稳定变化,质控图可以灵敏的反映结果准确性的变化.结论患者结果均值质控法可以用来检查临床标本检测的准确度水平,控制与质控血清无关的重要误差因素,是室内质控的重要补充手段之一.     

对昆明地区人群乙肝标志物及模式的调查分析

为了解昆明地区近年来乙肝病毒的感染情况,我们对来我院门诊及住院病人的3402例血清样本,进行了乙肝标致物“二对半”检测结果分析如下。1 材料与方法 检测对象:有工人、农民、机关干部、学生和个体劳动者。3402例血样中门诊占25％(部分体检人员),内科占30％,外科占45％(术前必查)。男1860例,女1542例。年龄最大82岁,最小3岁。试剂和方法:采用ELISA法,试剂盒由厦门新创科技有限公司提供。操作严格按说明书要求进行,检测同时带阴阳性对照及质控参照物。     

用ELISA评价胶体金测试卡检测乙型肝炎病毒血清标志物两对半的性能

目的用酶联免疫吸附法（ELISA）评价胶体金测试卡检测乙肝两对半的性能。方法选用ELISA检测乙肝表面抗原（HbsAg）阴性100例,阳性者200例,用胶体金测试卡和ELISA分别检测乙肝两对半对比结果和检测用时。结果胶体金测试卡单个标本的检测时间为25min,而ELISA的为1h。100例HbsAg阴性标本除2例HbcAbELISA检测阳性而胶体金测试卡检测阴性外,其他结果均相同。200例HbsAg阳性标本中,胶体金测试卡法检测6例HbsAg阴性,符合率97．0％;9例HBeAb检测阴性,符合率92．9％;7例HbcAb检测阴性,符合率96．5％。结论胶体金测试卡与ELISA相比。不需要特殊设备,易于观察结果,快速检测单个标本,操作简便,特异性较高,能满足急诊的需要。     

不同程度的溶血对ELISA一步法检测HBsAb的影响

目的探讨不同程度溶血标本对ELISA一步法检测HBsAb结果的影响。方法分别用已知HBsAb和HBsAb阳性的血标本．人为造成不同程度的溶血，同时用ELISA一步法进行HBsAb检测，用酶标仪检测标本OD值，通过对检验结果的观察，分析溶血标本对ELISA一步法检测的干扰程度。结果以标本的OD：cut off≥1为阳性进行结果判读。结果当样本中游离血红蛋白≥8g／L时，对ELISA一步法检测有明显的影响，可造成结果假阳性。结论用ELISA一步法进行HBsAb检测时，如样本游离血红蛋白≥8g／L时，要重新取样进行复查。     

酶联免疫法与金标法检测抗-HIV的比较

目的 观察ELISA(间接法、双抗原夹心法)快速诊断金标法(胶体金免疫分析技术)在检测抗-HIV中试剂质量比较,并分析其原因。方法 用2001年卫生部免疫检验室间质评HIV质控血清10份,其中6份为阳性血清(经Weet-Blot确诊),用两厂家生产的ELISA间接法、双抗原夹心法、金标法做比较。结果 两厂家生产的ELISA间接法一份阳性标本不能检出,但两厂家生产的ELISA双抗原夹心法和金标法阳性检出率为100％。结论 试剂的质量对保证大量的献血员、高危人群的HIV筛查工作至关重要。     

应用病人标本数据进行尿液干化学分析室内质控

目的　建立和应用病人标本数据进行尿液干化学分析室内质量控制。方法　随机收集 6 0个工作日 15 17例门诊病人尿液干化学分析九个项目的检测结果 ,分别计算出每天每个项目的阴性率 (PN) ,采用百分位数区间计算法 ,统计出各项目 95 %置信限区间范围 ,建立本室质控参数。结果　运用该法建立的各项目质控图 ,连续监测 3个月尿分析结果效果满意。结论　该法能有效地监控尿液干化学分析的质量 ,可作为尿液分析室内质控的一种方法应用。     

初筛实验室检测HIV抗体以S/CO值进行室内质控的探讨

目前大多数基层医院对艾滋病抗体初筛实验都应用ELISA法检测HIV抗体,但许多检验工作者对如何进行HIV抗体定性质控并不重视。现将我们用S/CO值进行室内质控的体会报告如下。1材料和方法1·1仪器与试剂(1)中国航天工业总公司CF-5000酶标仪。(2)北京普朗新技术有限公司DNX-9620型电脑洗板机。(3)北京金豪制药有限公司产HIV1 2型抗体诊断试剂盒(ELISA法)。1·2方法(1)外部对照的制备:使用同一批号的试剂盒,对同一批号的阳性对照血清积攒混合,然后经3000r/min离心15min去除蛋白沉淀,56℃加热30min灭活处理,强阳性血清对倍稀释后,即可…     

ELISA法用于患者输血前检测Tp设置灰区的意义

目前检测梅毒抗体的方法较多,选择合适的方法对于准确判断患者输血前感染状况至关重要。酶联免疫吸附试验(ELISA)检测梅毒螺旋体特异性抗体被认为是受血者输血前梅毒检测的常规方法[1]。但由于ELISA方法本身的局限性以及不同试剂的灵敏性和特异性的差异,在实际检测中存在假阳性和假阴性结果。以试剂盒阳性判断值(cut off)上下一段区域设定为灰区,对OD值落在灰区内的标本进行重新检测从而得出准确结果,直接关系到患者的诊断、治疗和输血安全,有利于防范医疗纠纷。1资料与方法1.1标本来源:2008-01~2009-06本院住院患者首次输血前血清标本6 807份,标本无溶血、脂血。1.2仪器:瑞士HAM ILTON公司,M icrolab AT P lus2全自动加样系统;M icrolab FAME全自动酶免处理系统。1.3试剂:ELISA试剂购自英科新创(厦门)公司和北京万泰生物药业公司;TPPA试剂为日本富士瑞必欧株式会社产品。抗-Tp质控品由全军血液监督检定中心提供。1.4方法:所有标本均经ELISA试剂常规检测。OD值落在灰区的标本37℃水浴箱孵育15 m in后重新离心,分别用原批号试剂和另一种试剂双孔复检...     

Monica质控图用于HBsAg室内质控的探讨

我们在做ＨＢｓＡｇ室内质控的工作中，用Ｍｏｎｉｃａ质控图控制质量收到了既能监测精密度、又能监测准确性的效果，现将方法和结果报告如下。１材料和方法１１材料室内质控血清（ＨＢｓＡｇ）２ｎｇ／ｍｌ，由北京市临床检验中心提供，测定吸光度值为０３左右。Ｈ...     

普瑞博思在胃肠钡餐造影检查中的应用

目的总结和评价普瑞博思在胃肠钡餐造影检查中的应用价值。材料与方法203例在胃肠钡餐造影中服用普瑞博思,其中195例是全胃肠道钡餐造影检查,采取常规服药法;8例在上消化道中采取机动服药法。结果在195例服普瑞博思后有192例在3小时内完成了全胃肠道检查。服药后30～60分钟检查小肠最佳,90～150分钟检查结肠最理想。8例幽门不开放在服药后7例十二指肠充盈。206例仅有1例出现可忍受的阵发性腹痛,不良反应率小于0．5％。结论普瑞博思是一种服用方便、安全、高效的胃肠道促动力药,在胃肠钡餐造影检查中应用它,可以缩短检查时间,提高工作效率和检查质量。     

The effect of quality assurance on flight nurse documentation

This study was developed to evaluate if a structured quality assurance program has an effect on nursing documentation. A randomized, retrospective audit of records was conducted from 1985 to 1989, and in November 1987, a structured QA program was initiated for flight nurses. Each chart was audited for completeness of 69 elements from seven categories: administrative information, patient history, physical exam, management plan, vital signs, medications and intravenous access. A comparison of audit results was conducted before and after the QA program was initiated. A total of 224 charts were audited, 123 before the QA program and 101 after. There was statistically significant improvement in 4 of 13 administrative, 5 of 7 history, 21 of 31 physical exam, 2 of 6 management, 2 of 2 vital signs, 0 of 4 medication, and 0 of 6 intravenous access elements. Twenty-five of 35 categories that did not show improvement had initial completion rates greater than 90 percent. The significant improvement in documentation by flight nurses after a formal QA program was initiated lead the authors to conclude that QA benefits air medical programs by providing a mechanism to improve documentation.     

A new concept in radiology QA in a large setting

Determining film quality has traditionally been carried out through review and evaluation of exam retakes. At best, such a system will tell which exam areas the technologist repeated most. Kaiser Permanente Northwest has 80 radiologic technologists and 30 radiologists who rotate through film reading. The program developed at Kaiser is directed toward general diagnostic film quality only and uses the services of two full-time quality assurance (QA) technologists. Working together, the radiologist and QA staff have created a standard of diagnostic image quality. A QA radiologist representative is available to work with the QA technologist if inconsistencies are raised. Every other month, a QA technologist makes a random selection for review of 50 exams performed by each technologist. These evaluations cover view rather than exam, with each view judged on its own merit. The purpose is to look for recurring problems in the technologist's performance. Copies of the review sheet go to each technologist's supervisor who forwards a copy to the technologist. Technologists can request help to understand why certain films meet or fail to meet quality standards. The QA technologists are available to give one-on-one help, and they also offer classes and demonstrations. In turn, radiologist fill out quality control (QC) slips as they read exams. The slips help to educate and correct specific problems, and are a direct communication link between radiologist and technologist. The QA program places importance on having the proper tools for taking quality films. The program also provides several levels of accountability although QA technologists are not responsible for its enforcement. Instead, they give feedback to supervisors who enforce performance levels. An appeals process is also in place. The program helps keep image quality acceptable to both hospital radiologists and customer requirements in the industry. In turn, the technologists use it to further their professional development.     

Achieving CT Regulatory Compliance: A Comprehensive and Continuous Quality Improvement Approach

Computed tomography (CT) represents one of the largest sources of radiation exposure to the public in the United States. Regulatory requirements now mandate dose tracking for all exams and investigation of dose events that exceed set dose thresholds. Radiology practices are tasked with ensuring quality control and optimizing patient CT exam doses while maintaining diagnostic efficacy. Meeting regulatory requirements necessitates the development of an effective quality program in CT. This review provides a template for accreditation compliant quality control and CT dose optimization. The following paper summarizes a large health system approach for establishing a quality program in CT and discusses successes, challenges, and future needs.     

320层容积CT冠状动脉血管造影的护理

目的:探讨320层容积CT冠状动脉造影检查中相关的护理因素。方法:对620例(男380例,女240例,平均年龄58.4±9.2岁)临床怀疑冠心病行320层CT冠状动脉造影检查的患者在检查前、检查过程中及检查后采用有效的护理流程进行严格的护理,并对相关图像资料进行回顾性分析。结果:620例患者中605例(97.5%)的图像能满足影像学评价。在2480支冠状动脉分支中1级血管分支共1709支(68.9%),满足诊断要求的血管分支共2390支(96.4%)。结论:严格和有效的护理流程是320层容积CT冠脉造影检查成功和提高图像质量的重要保证。     

Bowel preparation for CT colonography

Bowel preparation represents an essential part of CT colonography, as the accuracy of the exam is strongly related to the adequacy of colonic cleansing, and a poor bowel preparation may compromise the diagnostic quality even despite optimization of all other acquisition parameters. Residual stool and fluid in the large bowel may affect the interpretation of the exam and may increase the number of false positives and false negatives. In this regard, the majority of patients having undergone CT colonography state that bowel preparation is the most unpleasant part.     

Evaluation of CRT images of digitized film angiographs

X-ray sheet film images of the test chart, the vascular phantom and angiography were digitized at sampling pitch of 0.2 mm and 0.15 mm using film digitizer TFR-01 (Toshiba) and transferred to a device for image storage and display system with 1635-line display monitor (TDF-500AS, Toshiba). Comparison of image qualities between film- and CRT-images was performed in fundamental and clinical studies. Resolution of the test chart image of conventional radiography was worse on CRT than on the original film, although it was improved when film image was digitized at resolution of 0.15 mm/pixel in comparison with that at resolution of 0.2 mm/pixel. Moiré stripes which occurred due to interference were found on CRT images taken using a grid technique. On CRT images of X-ray sheet film using direct magnification technique moiré stripes were not produced because of non grid technique, and the resolution approached that of the original film. In the study using vascular phantom, the optimal image on CRT could be obtained by various image processing procedures, and image quality on CRT with resolution of 0.15 mm approached that of original film. In case of direct magnification CRT images were superior to film images. Subtraction image of the vascular phantom at resolution of 0.2 mm/pixel was obtained on CRT and compared with film subtraction image. On conventional subtraction CRT image moiré stripes impaired the image quality in comparison with the film subtraction. However, magnification subtraction image of the vascular phantom on CRT was superior to the film subtraction. The results obtained in the test chart studies and phantom studies were also confirmed in clinical studies using various kind of angiograms. In addition, ROC study using clinical angiograms showed no significant statistical differences between the original film and CRT image even with 0.2 mm matrix size. Angiographic image on CRT at resolution of 0.15 mm/pixel or less is available for clinical use in place of conventional film image.     

血浆尾加压素Ⅱ在慢性阻塞性肺疾病的表达及其意义

 目的 通过检测慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者血浆尾加压素Ⅱ(urotensin Ⅱ,UⅡ)的水平,研究UⅡ与COPD病情的相关性,以及在COPD发病机制中的作用。方法 选取COPD急性加重期、稳定期患者及健康人对照,采用酶联免疫吸附试验法检测血浆UⅡ水平,同时测定肺功能、血气分析、血常规等相关指标。采用SAS6.12统计软件行统计学分析。结果 急性加重期组[(45.70±3.82)ng/ml]与稳定期组[(27.76±3.96)ng/ml]比较,血浆UⅡ水平升高,且均高于健康对照组[(14.48±2.38)ng/ml],差异有统计学意义(P＜0.01),血浆UⅡ水平与FEV1.0％、FEV1.0/FVC％、PaO₂呈负相关。结论 UⅡ随COPD患者病情的加重而增加,有可能参与COPD缺氧、气道阻塞及炎性反应的病理生理变化,导致COPD病情进一步恶化。     

Essentials of radiation oncology chart design.

Medical Dosimetrists are commonly called upon to participate in the design of radiation oncology treatment records. The Medical Dosimetrist is uniquely qualified to provide input in the areas of treatment planning, simulation and delivery documentation. An idealized chart can facilitate the planning and delivery of quality patient care and lead the user to document such care. This publication outlines the essential minimum requirements for inclusion in a radiation oncology treatment chart. Conventional treatment record keeping has been by hard-copy documentation. Paperless treatment record models are presently being tested for efficacy. Either approach should seek to: maintain quality of patient care, enhance communication, and provide integrity in documentation.