三种梅毒血清学检验方法在临床中的应用

目的：筛选有效的检测试剂,提高临床诊断符合率。方法：选取2011年12月-2012年12月的职业健康体检10286例标本,采用对酶联免疫吸附试验（ELISA）、甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶颗粒凝集试验（TPPA）3种血清学检测方法进行梅毒诊断,并作结果分析。结果：ELISA法检出阳性标本675例中,经TPPA确证阳性657例,阳性符合率97.33%。TRUST法检出阳性424例,均经TPPA确证阳性;而ELISA筛查阳性而TRUST阴性的标本有7.17%的假阳性结果。结论：建议3种检测方法结合应用能更有效提高梅毒临床诊断符合率。     

临床甲状腺癌基因检测报告解读的现状与思考

基因测序是实现肿瘤精准医疗的基础手段,可辅助肿瘤诊断、判断患者预后、指导靶向药物治疗等。近年来,基因测序技术已广泛应用于甲状腺癌的临床诊治工作中。但截至目前,不同医疗中心对基因测序适应证的把控、报告解读水平,以及各测序平台的检测结果可靠性参差不齐。本文通过分析基因检测在甲状腺癌诊治中应用的现状与问题,结合笔者个人临床经验,探讨基因检测在甲状腺癌诊治全程管理中的特殊性及其价值。     

平板运动试验在PCI术后疗效评价中的作用

目的:探讨平板运动试验在经皮冠状动脉治疗术(PCI)后疗效评价中的作用。方法:选择行PCI术的患者36例,所有患者于PCI术前均已经冠状动脉造影检查确认其病变冠脉管腔狭窄或闭塞大于70%。分别于术前(5.0±1.9)d及术后(4.8±2.6)d行平板运动试验,比较两者的运动时间、运动做功量、最大心率及最大心率—血压乘积。结果:患者PCI术后行平板运动试验的运动时间、运动做功量、最大心率及最大心率—血压乘积均较术前明显提高。结论:PCI能够有效改善患者心功能,提高运动耐量,通过平板运动试验可有效评价PCI术后疗效。     

Cost-effectiveness of HIV counseling and testing in US prisons

The prevalence of human immunodeficiency virus (HIV) in correctional facilities is much higher than in the general population. However, HIV prevention resources are limited, making it important to evaluate different prevention programs in prison settings. Our study presents the cost-effectiveness of offering HIV counseling and testing (CT) to soon-to-be-released inmates in US prisons. A decision model was used to estimate the costs and benefits (averted HIV cases) of HIV testing and counseling compared to no CT from a societal perspective. Model parameters were HIV prevalence among otherwise untested inmates (1%); acceptance of CT (50%); risk for HIV transmission from infected individuals (7%); risk of HIV acquisition for uninfected individuals (0.3%); and reduction of risk after counseling for those infected (25%) and uninfected (20%). Marginal costs of testing and counseling per person were used (no fixed costs). If infected, the cost was $78.17; if uninfected, it was $24.63. A life-time treatment cost of $186,900 was used to estimate the benefits of prevented HIV infections. Sensitivity and threshold analysis were done to test the robustness of these parameters. Our baseline model shows that, compared to no CT, offering CT to 10,000 inmates detects 50 new or previously undiagnosed infections and averts 4 future cases of HIV at a cost of $125,000 to prison systems. However, this will save society over $550,000. Increase in HIV prevalence, risk of transmission, or effectiveness of counseling increased societal savings. As prevalence increases, focusing on HIV-infected inmates prevents additional future infections; however, when HIV prevalence is less than 5%, testing and counseling of both infected and uninfected inmates are important for HIV prevention.     

64排螺旋CT在肠道及肠系膜损伤中的应用价值

目的：研究使用64排螺旋CT检查肠道系统,并进行损伤程度的判断。方法：任意抽选本院肠道系统损伤病人68例,运用64排CT检查病人肠道损伤情况。结果：在CT影像中,有27例病人出现肠管增厚及肠壁血肿情况,有10例病人腹腔中存在游离气体,10例病人肠道系膜出现水肿及淤血情况,21例病人肠道内粘膜血肿。结论：使用64排螺旋CT为病人肠道进行检查,能够准确判断出患者肠道系统中出现损伤的部位以及具体损伤程度,因此64排CT用于检测肠道系统损伤具有极高的价值。     

腹腔镜手术机器人应用质量与安全评价标准体系研究

腹腔镜手术机器人能提高操作精度,缩短手术用时,患者出血少,恢复速度快。近年来,国产创新手术机器人的研发取得了显著成果,但目前国内外缺乏相关评价标准,增加了临床应用的风险。为科学评价腹腔镜手术机器人的应用质量与安全,急需研究建立质量检测与评价标准。该研究从控制系统、图像质量、机械精度、电气安全4个维度优选评价指标。在控制系统方面选取软件功能检测规范指标;在图像质量方面选取图像质量检测规范指标;在机械精度方面选取机械臂检测规范指标;在电气安全方面选取设备外观检测规范和产品故障预防与维护控制规范两个指标。通过验证试验研究合理可行的检测与评价方法,为腹腔镜手术机器人的应用质量与安全评价提供依据,填补国内外腹腔镜手术机器人相关标准方面的空白。     

医疗器械检验检测现状及发展趋势探索

目的 该文旨在迎接我国医疗器械检验检测行业的新业态和新挑战,探索行业的未来发展方向。方法 在概述 医疗器械检验检测行业现状的基础上,采用专家访谈和线上问卷的方式,调研40家医疗器械检验检测机构及相关企事业单位, 重点关注科技创新能力和形式、行业发展瓶颈等重要问题。结果 通过整理和分析调研数据,得出行业发展的5个积极趋势： 完善机构整体布局,加强区域特色中心建设;完善第三方合作研究组织和第三方评审机构的准入与监管机制;鼓励科技创新, 优化人才队伍,赋能检验检测技术高质量发展;构建医疗器械安全监管信息化共享平台;加强在用医疗器械设备的安全监测。 创新之处 采用专家访谈和循证研究的方法,获取客观可靠的数据,为行业发展趋势的研究和探索提供了有力的依据。     

Normative Reference Values and Validity for the 30-Second Chair-Stand Test in Healthy Young Adults

BackgroundClinicians often use physical performance tests (PPT) to measure performance measures in sports since they are easy to administer, portable, and cost-efficient. However, PPT often lack good or known psychometric properties. Perhaps, the 30-second chair-stand test (30CST) would be a good functional test in athletic populations as it has been shown to demonstrate good psychometric properties in older adults.Hypothesis/PurposeThe purpose of this study was to determine normative values for and concurrent, convergent and discriminative validity of 30CST for healthy young adults aged 19-35 years.Study DesignCross-sectionalMethodsEighty-one participants completed this study. All participants performed two trials of 30CST, 5-times sit-to-stand (5xSTS), and lateral step-up test (LSUT). Investigators used the International Physical Activity Questionnaire Leisure Domain (LD-IPAQ) to divide participants into insufficiently or sufficiently active groups based on the weekly metabolic equivalent of task per the Physical Activity Guidelines for Americans.ResultsParticipants (Mean + SD age, 25.1 ± 3.4 years; body height, 1.71 ± 0.09 m; body mass, 72.6 ± 16.1 kg; females 47) performed an average of 33.0±5.4 30CST repetitions. The 30CST performance was negatively associated with 5xSTS (r=-0.79 p=0.01) and positively associated with LSUT performances (r=0.51, p=0.01) when using Pearson correlations. In addition, the sufficiently active group performed significantly greater 30CST repetitions than the insufficiently active group (mean difference = 2.5; p=0.04).ConclusionsIn addition to finding a reference value for 30CST performance in young adults, investigators found that the 30CST displayed concurrent and convergent validity in assessing functional lower extremity (LE) muscle strength and discriminated between those with sufficient and insufficient physical activity levels. Training and rehabilitation professionals could use the 30CST for testing functional LE muscle strength for athletes in pre-season or during rehabilitation. Future investigators should perform studies to determine if 30CST predicts sport performance.Level of EvidenceLevel 2