两种气体灭菌剂灭菌效果及评价方法

目的：探讨医院气体灭菌效果和检测方法，以保证灭菌质量。方法：对本院常用的两种低温气体灭菌剂环氧乙烷和甲醛，采用枯草杆菌黑色变种芽胞生物指示管分别选择不同时间和不同方法进行灭菌效能检测。结果：环氧乙烷全自动灭菌(全过程16h)和甲醛催化法灭菌≥2h均可达到灭菌要求，而甲醛催化法灭菌时间少于2h和甲醛自然挥发法灭菌均达不到灭菌水平。结论：环氧乙烷生物指示管可应用于甲醛气体的灭菌检测；环氧乙烷全自动灭菌和甲醛催化法灭菌可用于不耐热、不耐湿的手术器械灭菌。     

Occlusal caries detection in permanent molars according to WHO basic methods, ICDAS II and laser fluorescence measurements

This epidemiological study aimed to compare the diagnostic outcome of the WHO criteria, ICDAS II criteria, laser fluorescence measurements, presence of plaque and roughness as activity scores on occlusal fissures and buccal/palatal pits of the first permanent molars. The study involved 311 children between 8 and 12 years of age from the Ennepe-Ruhr District in North Rhine-Westphalia, Germany. The surface-related caries status was registered according to the WHO basic method criteria (1997). Additionally, pit and fissure sealants, the ICDAS II visual criteria, the DIAGNOdent reading, plaque retention and surface roughness were documented. Caries experience was 1.0 (+/-2.5) DMFS. About 70% of the examined students had no obvious dentin caries in the permanent dentition (DMFS = 0). Sealants were registered on 1.4 (+/-1.7) occlusal fissures and 0.4 (+/-0.9) palatal/buccal pits. Noncavitated caries lesions were recorded as ICDAS II score 1-4 on 1.8 (+/-1.6) fissures and 1.5 (+/-1.4) pits. The comparison of the diagnostic methods suggests a relationship between higher ICDAS II scores/DIAGNOdent values and a proportional increase in the occurrence of plaque as well as in the number of rough surfaces. In conclusion, this study showed the diagnostic potential of the ICDAS II criteria in comparison to the traditional WHO criteria by means of the noncavitated caries lesions additionally detected. The DIAGNOdent use in field studies that already apply detailed visual criteria seems to bring limited additional information. While the presence of plaque provides information for the caries activity assessment more work is required to provide information about the contribution of surface roughness.     

实时荧光PCR快速同时检测从业人员沙门菌和志贺菌结果分析

目的 了解双重实时荧光PCR快速同时检测从业人员沙门菌和志贺菌的效果.方法 采集从业人员肛拭子样本,用双重实时荧光PCR法检测沙门菌和志贺菌,检出的疑似阳性样本按国标法进行培养鉴定.结果 采用双重实时荧光PCR反应体系共检测从业人员39 974人次,荧光PCR检测出沙门菌阳性41份,阳性率1.22‰,培养法检测出31份,阳性率为0.78‰,沙门菌荧光PCR检测法的灵敏度为100％,特异性为99.95％.荧光PCR检测出志贺菌10份,阳性率为0.25‰,培养法检测出3份,阳性率为0.08‰,志贺菌荧光PCR法的灵敏度为100％,特异性为99.98％.从样品处理到检测结果仅需要时间2h～ld.结论 双重实时荧光PCR检测体系快速、灵敏度高、特异性强,可用于从业人员体检的快速诊断和肠道传染病的初筛,为肠道传染病的分子流行病学调查提供新的检测手段.     

Molecular pathology of haemophilia A in Turkish patients: identification of 36 independent mutations

Haemophilia A is an X-linked recessive bleeding disorder caused by heterogeneous mutations in the factor VIII gene. In an attempt to reveal the molecular pathology of Turkish haemophilia A patients, the coding sequence of the gene, excluding a large portion of exon 14, was amplified from genomic DNA and subjected to denaturing gradient gel electrophoresis prior to DNA sequencing. Fifty-nine haemophilia A patients were included in the study with severe, moderate and mild phenotypes observed in 24, 15 and 16 patients, respectively. Factor VIII activity and clinical phenotypes were not available for four patients. A total of 36 independent mutations were found, with a mutation detection efficacy of 61%. The mutations that were reported for the first time include 20 point mutations, one 8-bp insertion (TCAAGATA) in exon 4 and one large deletion greater than 2.8 kb involving exon 14. The novel point mutations were composed of three nonsense (Ser681Ter, Cys2021Ter and Gln2113Ter), one splicing error (IVS-1G-->A), 15 missense mutations (Lys48Asn; Leu-98Phe; Thr118Ala; Cys248Tyr; Glu456Lys; Asp560Ala; Tyr664Cys; Phe679Leu; Gly691Trp; Asp1769His; Val1857Leu; Gly2026Gln; Arg2163Pro; Asp2288Ala; and Arg2304Leu) and a T deletion in exon 25 that caused a frameshift followed by a stop codon. All missense mutations except Val1857Leu, which maintained a conserved nonpolar R group, occurred at amino acids conserved among four species and were most probably pathogenic. In addition, two sequence changes (IVS3-9C-->T) and (Leu2230Leu) were also detected in patients carrying Val1857Leu and Phe679Leu missense mutations, respectively. Identification of mutation origins in eight sporadic cases revealed an equal sex ratio of mutations.     

细菌性食物中毒回顾性检测分析

目的探讨细菌性食物中毒的检测过程,为基层卫生部门细菌性食物中毒检测提供一定参考。方法①实时荧光PCR细菌鉴定。②选择性平板直接分离培养,筛选优势菌落进行细菌鉴定。③选择性增菌后分离培养、细菌鉴定。结果综合三种检测实验结果,18起食物中毒中16起检出致病菌,检出率为88.9%;其中13起食物中毒当天检出致病菌,另1起第三天检出致病菌。结论应用该检测过程大大缩短检出时间,且检出率极高。     

血库在安全输血中的重要性

为了全面发展安全输血事业，除了血液中心或血站与此有非常重要的关系外，血库也是一个极其重要的环节。本文从配血样本的严格把关；技术操作的规范化；科学合理用血；记录与核对；输血前的病毒检验几术方面阐述了安全血液与血库的关系，强调血库的重要性，以全方位保证临床输血安全。     

惠州市同型β地中海贫血夫妇的胎儿产前地贫基因诊断分析

目的研究惠州市同型β地贫夫妇的胎儿地贫携带率、基因突变类型和分布特点。方法 116对夫妇均为轻型β-地中海贫血基因突变者,在孕早期取胎儿绒毛组织,孕中期取脐血或羊水,孕晚期取脐血;对羊水细胞和绒毛组织进行原位培养,脐血进行血液学和血红蛋白分析,分别采用培养前后的组织或脐血进行β地中海贫血基因检测。结果 116例胎儿中检出重型β-地中海贫血胎儿27例(23.28%);检出地贫携带者56例(48.28%)。共检出11种突变基因,21种基因型,居前4位的依次是:CD41-42(26.51%)(22/27+56)、IVS-Ⅱ-654(14.46%)(12/27+56)、CD-28(10.84%)(9/27+56),CD17(6.02%)(5/27+56);其中,单突变杂合子9种,56例(67.47%)(56/27+56),双突变杂合子10种,24例(28.92%)(24/27+56),突变纯合子2种,3例(3.61%)(3/27+56),另外,检出少见位点突变CD14-15和CD41-42/43各1例。结论本研究描述了惠州市同型β地贫夫妇的胎儿地贫的发生率和基因突变谱,为制订本地区地贫的防治工作提供科学依据。     

结肠癌肝转移的螺旋CT特征及临床价值

目的 评价螺旋CT对于结肠癌肝转移术前检出与可切除性评估价值。方法 螺旋CT扫描对100例肝转移病例进行术前分期，层厚5mm，重建间隔5mm；以2．0～3．0ml／s速率静脉注入100ml含碘造影剂后60～70s后开始扫描。螺旋CT征象与手术及病理所见按病灶逐一对照。结果 触诊与病理学检查揭示了184个肝转移灶，螺旋CT扫描正确预测了其中的156个，总体检出率84．8％，阳性预测值96．0％，假阳性率3．8％(7／184)。在72例患者的76例次手术中，71例次为可治愈切除，可切除率为93．4％(71／76)。病例五年生存率为54．2％。结论 螺旋CT扫描应被看作是结肠癌肝转移的标准或最佳术前检出方法.