MR imaging in assessing cardiovascular interventions and myocardial injury

Performing an MR‐guided endovascular intervention requires (1) real‐time tracking and guidance of catheters/guide wires to the target, (2) high‐resolution images of the target and its surroundings in order to define the extent of the target, (3) performing a therapeutic procedure (delivery of stent or injection of gene or cells) and (4) evaluating the outcome of the therapeutic procedure. The combination of X‐ray and MR imaging (XMR) in a single suite was designed for new interventional procedures. MR contrast media can be used to delineate myocardial infarcts and microvascular obstruction, thereby defining the target for local delivery of therapeutic agents under MR‐guidance. Iron particles, or gadolinium‐ or dysprosium‐chelates are mixed with the soluble injectates or stem cells in order to track intramyocardial delivery and distribution. Preliminary results show that genes encoded for vascular endothelial and fibroblast growth factor and cells are effective in promoting angiogenesis, arteriogenesis, perfusion and LV function. Angiogenic growth factors, genes and cells administered under MR‐guided minimally invasive catheter‐based procedures will open up new avenues in treating end‐stage ischemic heart disease. The optimum dose of the therapeutic agents, delivery devices and real‐time imaging techniques to guide the delivery are currently the subject of ongoing research. The aim of this review is to (1) provide an updated review of experiences using MR imaging to guide transcatheter therapy, (2) address the potential of cardiovascular magnetic resonance (MR) imaging and MR contrast media in assessing myocardial injury at a molecular level and labeling cells and (3) illustrate the applicability of the non‐invasive MR imaging in the field of angiogenic therapies through recent clinical and experimental publications. Copyright © 2007 John Wiley & Sons, Ltd.     

Surgery residents recognized less frequently over time by medical students: A twelve year study of the Arnold P. Gold Humanism and Excellence in Teaching Award

Background

There is a decreasing institutional percentage of surgical resident recipients of The Arnold P. Gold Humanism and Excellence in Teaching Award over time. The hypothesis was that this trend was a national phenomenon.

基于 ＩＳＯ１５１８９ 开发临床实验室试剂管理系统

目的 开发满足ISO15189认可要求的临床实验室试剂管理系统，为试剂的精细化管理提供对策。方法 本系统采用B/S系统架构，软件功能由JAVA语言实现，MySQL 5.7为应用数据库，Redis 3.2.100为缓存数据库。软件后台底层架构使用SpringMVC+SpringJDBC架构技术，通过SnakerFlow进行流程控制管理。结果 建立了临床实验室标准化试剂管理系统，实现了供应商管理、物资管理、采购管理、库存管理、预警提醒、温湿度实时监控、库存盘点等功能。结论 该系统不仅满足试剂使用的各种需求，而且紧扣ISO15189认可条款，为试剂的标准化管理提供高效的解决方案。     

伤寒血清学快速诊断胶乳试剂的研制及应用

为寻求更简便、快速的伤寒病血清学诊断方法，以Ｓ．ｔｙｐｈｉ０９０１菌株脂多糖（ＬＰＳ）致敏胶乳，研制出伤寒血清学快速诊断胶乳试剂（ＬＰＳ－Ｌａｔｅｘ）。检测６９份确诊伤寒病患者血清，阳性率为９１．３％；高于肥达反应阳性率（７９．７％）。分别以肥达反应、间接血凝试验、ＬＰＳ－Ｌａｔｅｘ三种方法检测５６２份疑似伤寒病患者血清，总符合率为９３．４１％。表明ＬＰＳ－Ｌａｔｅｘ法诊断伤寒病简便、快速，有较高敏感性和特异性。     

The clinical advances of fluorine‐2‐D‐deoxyglucose – positron emission tomography/computed tomography in urological cancers

Fluorine‐18 labeled fluorine‐2‐D‐deoxyglucose (FDG) is the most frequently used positron emission tomography (PET) probe but it has certain limitations when used in urological cancers. The introduction of co‐registered PET and computed tomography (PET/CT) represents a major advance in technology and FDG‐PET/CT has now become the new standard. The diagnostic performance of FDG‐PET and PET/CT depends on the metabolic activity of tumor tissue, which is generally low in primary renal cell and prostate cancers and often in their metastatic deposits. In contrast, both seminomatous and nonseminomatous germ cell tumors are characterized by upregulated glucose metabolism with subsequently increased FDG uptake in tumor sites. Generally, the metabolic activity provides accurate information regarding the presence of a viable tumor, except in patients with residual mature teratoma. Although bladder cancer demonstrates sufficiently increased FDG uptake, primary tumors are difficult to identify due to the renal excretion of FDG. The accuracy of FDG‐PET/CT in metabolically active metastases is generally higher compared to conventional CT except for identifying small lung deposits. With disease progression and subsequent de‐differentiation of prostate cancer, castrate resistant disease is more likely to present with lesions that have increased glucose metabolism.     

胶体金免疫层析法检测鼠疫F1抗原的研究

目的 研究胶体金免疫层析试纸条检测鼠疫F1抗原的敏感性和特异性.方法通过鼠疫F1抗原单克隆抗体(F1MAb)捕捉F1抗原的胶体金免疫层析(GICA)试纸条,检测308只强毒鼠疫耶尔森菌(鼠疫菌)感染鼠脏器标本和225份对照鼠(达乌尔黄鼠217只,小白鼠5只,豚鼠3只)标本,同时用鼠疫反向间接血球凝集试验(RIHA)微量法和细菌培养做平行检测.结果 225只对照鼠鼠疫细菌学检验及GICA和RIHA的F1抗原检测均为阴性,GICA和RIHA在1×108 cfu/ml水平上未发现与近缘假结核耶尔森菌有交叉反应.GICA、RIHA对鼠疫菌检测灵敏性为2.5×105、2.0×105cfu/ml;检测F1抗原灵敏性为1、10 μg/L.GICA与细菌学检验符合率为97.94%(522/533),Kappa值=0.959,阳性检出率组间比较,差异无统计学意义(x2=0.36,P＞0.05);与RIHA符合率为97.94%(522/533),Kappa值=0.959,阳性检出率组间比较差异有统计学意义(x2=9.09,P＜0.05).308只实验鼠样本细菌培养阳性284只,284份细菌培养阳性标本中,GICA有280份检测阳性,阳性率为98.59%,高于RIHA[阳性率为96.13%(522/533)],两组比较差异有统计学意义(x2=5.14;P＜0.05).GICA的敏感度为98.59%(280/284),特异度为97.19%(242/249),阳性预测值为97.56%(280/287),阴性预测值为98.37%(242/246),Youden指数为0.9578.结论 GICA检测鼠疫F1抗原敏感特异,快速简便,是鼠疫早期快速诊断中有应用价值的检测技术.     

应用划痕标记染料示踪技术检测草苁蓉甲醇提取物对大鼠肝癌细胞功能的影响

目的:通过划痕标记染料示踪实验,初步筛选出对大鼠肝癌细胞GJIC功能有较强恢复和促进作用的草苁蓉甲醇提取物药物终浓度.方法:大鼠肝癌细胞随机分为5个组:分别为1个对照组、4个实验组.4个实验组加入草苁蓉甲醇提取物药物终浓度分别达到0.25g/L、0.5g/L、0.75g/L、1.0g/L.结果:大鼠肝癌细胞经草苁蓉甲醇...     

纳米金层析免疫法快速检测黄热病病毒

目的:探索快速、简便、高效、灵敏、低廉地检测黄热病病毒感染的方法。方法:用纳米金免疫层析试验原理研制了一种快速诊断试纸。将制备的纳米金颗粒用SPA标记形成金-SPA复合物,其复合物结合在聚酯膜上制成金标结合释放垫;通过基因工程技术在大肠杆菌中克隆和表达黄热病E蛋白,经纯化的抗原蛋白被固定在硝酸纤维素膜上,然后滴加待测血清,样品中的病毒抗体通过免疫反应与膜上的抗原蛋白结合,待其渗过膜片后,与金-SPA复合物结合形成肉眼可见的红色线条。结果:用已确证的21份黄热病阳性血清和30份阴性血清进行了试验,该快速检测方法与ELISA方法无显著差异。结论:该检测方法不需任何仪器,仅凭肉眼即可判定结果,整个检测过程不超过5min。与传统的ELISA法相比,具有方便快速、成本低廉、应用范围广等优点。     

新疆维吾尔自治区医疗卫生机构医用耗材和检验试剂集中采购工作进展

目的:为完善我国医疗卫生机构医用耗材和检验试剂集中采购工作提供参考。方法:结合我区实际情况,积极进行实地调研,开展以政府为主导、自治区为单位的医疗卫生机构医用耗材和检验试剂集中采购工作,并进行分析总结。结果与结论:通过课题调研,在汲取医疗卫生机构医用耗材和检验试剂网上集中采购工作经验的基础上,应逐步扩大医疗卫生机构检验试剂、低值医用耗材采购范围,积极探索高值医用耗材集中采购办法,规范医疗卫生机构医用耗材和检验试剂采购行为,保证医用耗材和检验试剂质量,降低医疗成本,使群众得到实惠。