实时辐射数据对介入手术人员辐射暴露的影响

目的 了解医务人员辐射暴露情况,为介入手术医务人员,提供实时辐射剂量监测数据。方法 选择2019年9月—2022年3月在介入手术室参与心脏手术的医务人员96人次作为研究对象。按时间进展进行分组,干预组43人次,对照组53人次。干预组研究对象在手术过程中,提供实时剂量监测数据;对照组研究对象按常规流程进行手术。比较2组研究对象的平均术中辐射剂量率。结果 干预组研究对象的中位辐射剂量率为88.80 μSv/h,对照组研究对象的中位辐射剂量率为188.40 μSv/h。干预组较对照组研究对象,辐射剂量率明显降低,差异有统计学意义（U = 637.000,P = 0.000）。结论 为介入手术医务人员提供实时剂量监测数据,可有效降低医务人员职业辐射暴露,改善医务人员的职业辐射防护。     

时点实时预约挂号的实践与思考

预约挂号是医院管理服务系统中基于人性化理念提出的,是对医院门诊服务流程的创新和调整,科学组织开展时点实时预约挂号工作,能有效帮助门诊患者高效率参与就医活动,医院的门诊服务效率也会得到显著的提升。该文对时点实时预约挂号的实践应用情况、管理方法以及实践应用效果进行了系统的探究,希望能为门诊服务流程进行进一步优化,实现对门诊就医环节的有效精简,在为患者提供高质量服务的同时,争取保障门诊服务能够得到患者群体的认同和肯定。     

西安市134例百日咳疑似病例不同标本百日咳鲍特菌检测阳性率比较

目的比较百日咳疑似病例鼻、咽和鼻咽拭子标本百日咳鲍特菌(Bordetella pertussis,Bp)检测阳性率。方法选择西安市两家医院2018年1-7月134例百日咳疑似病例,同时采集鼻、咽和鼻咽拭子标本,进行Bp分离培养和实时荧光定量聚合酶链反应核酸检测。结果百日咳疑似病例的Bp检测总阳性率为44.78%(60/134),其中鼻、咽、鼻咽拭子阳性率分别为36.57%、32.09%、39.55%(χ²=1.64,P=0.440);发病后0-7d、8-14d、15-21d、22-28d、29d采样的阳性率分别为23.33%、64.52%、63.89%、42.86%、23.33%(χ²=22.13,P=0.000)。鼻、咽、鼻咽拭子Bp核酸检测阳性率分别为36.57%、32.09%、39.55%(χ²=1.64,P=0.440);分离培养阳性率分别为0.00%、0.00%、4.59%(Fisher精确概率法,P=0.036)。在Bp核酸阳性病例中鼻和/或咽、鼻和/或鼻咽、咽和/或鼻咽拭子阳性分别占93.33%、91.67%、100%(Fisher精确概率法,P=0.080)。结论百日咳疑似病例鼻、咽和鼻咽拭子Bp检测总阳性率相当;核酸检测阳性率以鼻咽拭子最高,组合采样可提高Bp核酸检测阳性率;分离培养仍建议选择鼻咽拭子。     

宁河区手足口病肠道病毒检测及流行特征分析

目的了解手足口病(HFMD)病原学特点及主要流行特征,为HFMD疫情的控制和常规监测提供可靠的数据。方法选取2017年1月-2019年12月天津市宁河区医院肠道门诊及儿科住院部HFMD病例的粪便样本382份进行检测。采用实时荧光定量PCR法,对手足口病毒进行分型检测。结果 2017年1月-2019年12月宁河区HFMD年均发病率为31.83/10万;2019年发病率最高为34.00/10万;2017年发病率最低为29.25/10万。在382份粪便标本中,肠道病毒分型EV、EV71、CV-A6、CV-A10、CV-A16阳性检出率分别为15.71%、5.24%、56.81%、1.83%、20.41%,其中CV-A6型阳性率高于其他分型。男孩病毒核酸阳性检出率高于女孩,25岁的年龄段检测阳性率最高,发病高峰集中在78月和10月。结论近三年宁河区HFMD发病分型以CV-A6感染为主,多无典型临床症状,无重症病例。因HFMD主要通过呼吸道的飞沫及粪便传播,传播速度相对较快,需进一步加强辖区内HFMD检测和宣传力度,培养孩子良好的卫生习惯,减少发病患儿与他人的玩具和日常用品之间的直接接触,做到早发现、早医治、早隔离,从而减少辖区内HFMD的发病率。     

运动强度对幼龄大鼠海马VEGF及其受体Flk-1 mRNA表达的影响

为了研究不同强度跑台运动对5周龄大鼠海马表达血管内皮生长因子(vascular endothelial growth factor,VEGF)和胎肝激酶-1(fetal liver kinase-1,Flk-1)受体mRNA水平的影响,5周龄雄性SD大鼠被随机分为对照组和小强度、中等强度、大强度3个跑台运动组,并通过定量real-time PCR技术,观察不同强度跑台运动1周后大鼠海马内VEGF和Flk-1mRNA表达的影响。采用3-磷酸甘油醛脱氢酶(glyceraldehyde-3-phosphate dehydrogenase,GAPDH)作为管家基因内参,以样品中所测得的VEGF和Flk-1基因拷贝数除以该样品中内参基因拷贝数进行校正后,各组动物海马内VEGF mRNA相对水平分别是:对照组为2740±2229,小强度运动组为3599±2386(P<0.05),中等强度运动组为1654±1136,大强度运动组为1572±1071。各组动物海马内Flk-1mR-NA相对水平分别是:对照组为147±47,小强度运动组为281±182(P<0.01),中等强度运动组为208±100;大强度运动组为54±31。以上结果提示,大鼠海马内VEGF和Flk-1mRNA的表达受运动的调节,且与运动强度有关。小强度跑台运动可对VEGF和Flk-1mRNA的表达产生促进作用,而大强度运动则不影响VEGF和Flk-1mRNA的表达。     

Detection of Mycoplasma pneumoniae in serum specimens from patients with mycoplasma pneumonia by PCR

There are few data on detection of Mycoplasma pneumoniae from blood, serum or plasma, and systematic studies on this diagnostic approach in community-acquired pneumonia (CAP) are scarce. Compared to testing respiratory specimens, this approach has the advantages that it is less dependent on proper specimen collection, serum is easily stored and handled, and the pathogen is detected in a primary sterile site, where colonization can be ruled out. In this study, acute-phase serum specimens from 29 patients of Vienna University Hospital (treated between 11/1994 and 6/2004; female: 14, male: 15; median age: 31 years, range: 15-66 years) with CAP and serologically verified M. pneumoniae infection, who had not received anti-mycoplasma therapy prior to serum collection, were tested for M. pneumoniae by conventional PCR and real-time PCR. Conventional PCR yielded negative results for all specimens, but real-time PCR detected M. pneumoniae in 15/29 patient sera (52%). These findings indicate that M. pneumoniae is present in the bloodstream of a substantial proportion of patients with mycoplasma pneumonia. Despite the possible adherence of M. pneumoniae to human erythrocytes, the pathogen can be detected from serum, if a method with enhanced sensitivity is applied. However, the negative predictive value of PCR from serum with regard to etiological diagnosis is low. With regard to the potential clinical benefit of blood-based PCR diagnosis of mycoplasma pneumonia the diagnostic accuracy of this approach using either serum or whole-blood specimens should be addressed by large-scale studies.     

Quantitative evaluation of extracellular glutamate concentration in postischemic glutamate re-uptake, dependent on brain temperature, in the rat following severe global brain ischemia

Changes in brain temperature are known to modulate the marked neuronal damage caused by an approximately 10-min intra-ischemic period. Numerous studies have suggested that the extracellular glutamate concentration ([Glu](e)) in the intra-ischemic period and the initial postischemia period is strongly implicated in such damage. In this study, the effects of intra-ischemic brain temperature (32, 37, 39 degrees C) on [Glu](e) were investigated utilizing a dialysis electrode combined with ferrocene bovine serum albumin (BSA), which allows oxygen-independent real-time measurement of [Glu](e). This system allowed separate quantitative evaluation of intra-ischemic biphasic glutamate release from the neurotransmitter and metabolic pools, and of postischemic glutamate re-uptake in ischemia-reperfusion models. The biphasic [Glu](e) elevation in the intra-ischemic period did not differ markedly among intra-ischemic brain temperatures ranging from 32 to 39 degrees C. Intra-ischemic normothermia (37 degrees C) and mild hyperthermia (39 degrees C) markedly inhibited [Glu](e) re-uptake during the postischemic period, although the intra-ischemic [Glu](e) elevation did not differ from that during intra-ischemic hypothermia (32 degrees C). It was assumed that normothermia or mild hyperthermia in the intra-ischemic period influences intracellular functional abnormalities other than the intra-ischemic [Glu](e) elevation, thereby inhibiting glutamate re-uptake after reperfusion rather than directly modulating intra-ischemic [Glu](e) dynamics.     

改良分子信标—实时PCR快速检测副溶血弧菌

目的 :建立改良分子信标 -实时 PCR检测副溶血弧菌的快速方法 ,应用于副溶血弧菌食物中毒的快速诊断和海产品检验。方法 :根据 Gen Bank公布副溶血弧菌的耐热直接溶血毒素基因 (TDH)的保守序列 ,设计一对引物和改良分子信标探针 ,用 FAM荧光剂标记探针的 5′,并进行特异性和灵敏度分析 ;同时以 11种细菌作对照 ,建立改良分子信标检测副溶血弧菌的实时 PCR反应体系 ,应用于副溶血弧菌食物中毒快速诊断和食品微生物检测。结果 :检测 12种细菌 ,只有副溶血弧菌有荧光信号 ,与其他细菌无交叉反应 ,DNA灵敏度为 16 6 .6 fg/ μl,菌液灵敏度为 6 9cfu/ ml或 6 cfu/ PCR反应体系。改良分子信标 -实时 PCR反应体系检测 4 0株副溶血弧菌均出现特异的荧光信号 ,无干扰。对 3起细菌性食物中毒共 4 8份样品和 10 0份海产品进行检测 ,9份副溶血弧菌实时 PCR阳性 ,其中 7份副溶血弧菌细菌培养阳性 ,其余样品都为阴性。检测时间仅需 2 h。结论 :改良分子信标 -实时 PCR检测体系快速、灵敏度高 ,特异性强 ,可用于副溶血弧菌食物中毒的快速诊断 ,为食源性疾病的分子流行病学调查提供新的检测手段     

实时荧光定量PCR法检测MTHFR C677T基因多态性方法的建立和应用

目的:建立一种准确、快速、自动化程度较高的检测亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性的方法,并观察中国北方健康人群中MTHFR C677T基因频率。方法:应用MGB探针的原理建立MTHFR C677T基因多态的检测方法,与传统PCR-RFLP方法作对照,共检测标本88例,并计算各基因型频率。结果:荧光定量方法可以快速完成MTHFR C677T基因多态性的检测,检测结果得到传统PCR-RFLP方法的证实。88例北京汉族正常人群MTHFR基因的各种基因型频率为25％、42％和33％。结论:该方法准确、检测效率高,适用于临床实验室及流行病学调查研究。     

实时定量PCR检测体外诱导条件下小鼠骨髓基质细胞S100mRNA表达水平变化

目的:检测S100 mRNA含量,初步探讨骨髓基质细胞体外诱导条件下向雪旺细胞样细胞分化的可能性。方法:采用差速贴壁的方法分离、培养小鼠骨髓基质细胞。经β-ME,ATRA,Forskolin,bFGF,PDGF,HRG体外诱导后,利用实时定量PCR检测S100 mRNA水平的变化。结果:诱导后,骨髓基质细胞S100 mRNA水平上升,诱导前后水平变化有统计学意义(P<0.05)。结论:实时定量PCR检测S100 mRNA含量具有较高的灵敏度和特异性。体外诱导后骨髓基质细胞S100 mRNA表达量增多。