如何保证临床免疫检验的质量

免疫检验工作是医院诊疗工作的重要组成部分，免疫检验的质量直接影响诊断结果和治疗效果。所谓质量是指发出检验结果的准确性。因检验结果的准确性受诸多因素影响，因此，要确保质量，做到尽可能准确无误，需要抓好以下儿个环节，现论述如下。     

双源CT低剂量前瞻性心电触发序列扫描在冠状动脉血管成像的应用

Objective To evaluate low-dose CT coronary angiography with prospective electrocardiogram (ECG)-triggering using dual-source CT scanner.Methods Sixty-eight patients who underwent coronary CT angiography using a dual-source CT scanner were divided into 2 groups: group A (38 cases) and group B (30 cases).Prospective ECG-triggering sequence scan mode was employed for group A.Inclusion criteria included: heart rate <70 bpm, sinus rhythm, and heart rate fluctuation less than 10 bpm.Data acquisition was set at 70% of the RR-interval.Retrospective ECG-gating helical scan was performed for group B.Inclusion criteria included heart rates < 70 bpm and sinus rhythm.The exclusion criteria included heart failure and serious arrhythmias.In both groups, patients with a BMI≥24 kg/m2 were examined with a tube voltage of 120 kV, whereas patients with a BMI <24 kg/m2 were examined with a tube voltage of 100 kV.All images were transferred to a workstation for further processing and analysis.The imaging quality was evaluated.The imaging quality of coronary artery segments were compared with rank sum test between the two groups, and the radiation dose were compared with t test.Results A total of 476 coronary artery segments were evaluated in group A and 372 segments were evaluated in group B.The mean score of imaging quality for coronary artery segments in group A was 3.48±0.59 and that in group B was 3.53±0.58.There was no statistical difference in imaging quality between the two groups (Z=-1.432, P=0.187).The effective dose was on average (2.51±0.54) mSv (range 1.3--3.3 mSv) in group A, whereas on average (14.55±3.54) rosy (range 7.1--20.2 mSv) in group B.There was a statistical difference between the two groups (t=18.484, P=0.000).Conclusions Low-dose prospective ECG-triggering sequence scan in dual-source CT coronary angiography is feasible in patients with low heart rate and regular cardiac rhythm.This scan mode can substantially reduce radiation doses while preserving good diagnostic image quality.     

激光辐照血液疗法治疗缺血性脑血管疾病机制的探讨

光辐照血液疗法包括紫外光辐照血液、激光辐照血液、Ｈｅ Ｎｅ激光血管内照射、氧载体辐照、血磁等血液物理治疗方法。自 2 0世纪 80年代激光辐照血液疗法从国外引入并应用于临床 ,治疗缺血性脑血管病 ,疗效较为显著。许多学者对弱激光治疗缺血性脑血管疾病的作用机理进行了大量的研究。一、缺血性脑血管疾病病理生理变化缺血性脑血管疾病患者多存在高血脂、高血压、糖尿病、高粘血症等易患因素 ,这些因素都可并发血液流变学的异常 ,引起血液黏稠度增加 ,血小板活性增加 ,易形成血栓。同时缺血性脑血管疾病可通过一系列病理生理过程产生大量…     

专业英语词汇强化刺激在专科医学免疫学教学中的应用

近年来．学生的外语水平越来越成为检测学生素质乃至学校办学水平的重要指标之一，而大多数本科以下层次的医学生外语课时少．且尚未开设专业外语课程．这给一些专业课的学习带来诸多不便。为使学员在专业课授课学时内．变专业外语的阻力为动力．在94、95级临床医学大专班的医学免疫学教学过程中．我们采用了专业英语词汇强化刺激和常用词素辨析等探索性实践。收到了预期的效果。     

低剂量辐射的兴奋效应和适应性反应及在肿瘤学方面的研究进展

低剂量辐射(low dose radiation，LDR)对机体的兴奋作用指受到LDR后机体出现的免疫力增强、生育能力提高及对肿瘤的抵抗力加强等效应，适应性反应指小剂量的预先照射能使机体对其后的大剂量照射产生适应，可减轻大剂量照射引起的损伤或后果。目前的研究提示，LDR的预先照射可提高其后大剂量放疗的效果；小剂量的X射线预先愚射，有抑制荷瘤小鼠肿瘤生长趋势，促进荷瘤小鼠的局部放疗效果的作用，而且多次低剂量预照射的效果比一次顶照射好。在恶性淋巴瘤患者中进行临床试验的结果也得出了相同的结论；对高本底地区居民和医疗受照人群如肺结核患者等的流行病学调查也证实，他们总的癌症患病率并没有升高。LDR对肿瘤影响机理尚不清楚。有学者认为免疫功能受低剂量照射所激活是LDR抗肿瘤作用的基础，而更多的学者倾向于认为LDR可激活DNA的修复系统，表现为接受LDR后可使其后接受大剂量照射造成的染色体畸变减少，并通过修复酶活性的检测得到证实。     

肿瘤免疫学研究某些新进展

近年来，随着免疫学基础理论研究的迅速发展，尤其是对人类肿瘤抗原的确认及ＭＨＣⅠ类分子参与的抗原加工和提呈分子机制等的深入研究，肿瘤免疫学基础理论研究以及相应的肿瘤免疫治疗研究均取得了较大进展。由于肿瘤免疫的进展太快且内容十分丰富，本文仅对肿瘤免疫学领...     

免疫调节剂对小鼠实验性单纯疱疹性角膜炎发病的影响

实验组小鼠腹腔分别注射免疫调节剂胸腺五肽(TP5)或环孢霉素(CsA),对照组注射生理盐水(NS),尔后角膜感染单纯疱疹病毒(HSV),造成小鼠实验性单纯疱疹性角膜炎模型。用裂隙灯显微镜观察小鼠角膜上皮、角膜实质、角膜新生血管、结膜和眼睑的病变变化情况。结果:种毒唇4～6天,TP5组角膜上皮和角膜实质病变比NS组严重,差异有显著性,而CsA无此作用。三组小鼠新生血管形成程度差异无显著性。且均在第8天出现高峰。TP5组和CsA组的结膜和眼睑病变,比NS组严重。因此,在临床上,应根据不同病种和不同情况,慎重使用免疫调节剂。