血液病患者对健康教育需求的调查与分析

目的　探讨血液病患者及家属对健康教育的需求。方法　选择 4 35例患者填写调查问卷 ,同时随机选择 4 35例患者家属进行了解 ,对结果进行处理。结果　患者及家属对健康教育的需求很高 ,主要集中在治疗、自我保健等方面。结论　针对不同患者的个体差异制订不同的健康教育内容 ,提高了护理质量 ,使患者受益 ;增强了护理人员专业素质 ;建立了新型的护患关系。     

胃镜下探条或自制气囊扩张治疗贲门失弛缓症疗效的对比研究

目的对比分析胃镜下应用探条或自制气囊扩张治疗贲门失弛缓症的疗效。方法1998年1月～2007年12月，胃镜下治疗贲门失弛缓症45例，其中应用自制气囊扩张22例（自制气囊组），应用探条扩张23例（探条组），比较2组疗效。结果探条组23例扩张1～9次，平均3．6次；自制气囊组22例扩张1～6次，平均2．3次。2组术中及术后均无并发症发生。首次治疗费用探条组（1542．57±281．30）元，自制气囊组（861．91±176．48）元（t=9．671，P=0．000）。扩张后3个月的疗效2组差异无显著性[探条组显效14例（61％）、有效8例（35％）、无效1例（4％），自制气囊组显效15例（68％）、有效5例（23％）、无效2例（9％），Z=-0．351，P=0．726]。扩张后6个月的疗效2组差异有显著性[探条组显效5例（22％）、有效3例（13％）、无效15例（65％），自制气囊组显效10例（45％）、有效7例（32％）、无效5例（23％），Z=2．564，P=0．010]。结论胃镜下应用探条和自制气囊扩张治疗贲门失弛缓症安全、简便，患者恢复快，尤其自制气囊扩张器设备简单，就地取材，疗效肯定，在基层医院具有良好的推广价值。     

Probe selection algorithm for oligonucleotide array-based medium-resolution genotyping

Medium-resolution genotyping has the goal of distinguishing different subgroups instead of each element in a group. An oligonucleotide array provides an inexpensive, high-throughput method to identify differences in DNA sequence among individuals, which is fundamental for genotyping. As the cost and difficulty of designing and fabricating the oligonucleotide array dramatically increase with the number of probes used, it is therefore important to have a design with a minimum number of probes meeting the requirement of medium-resolution genotyping. The first algorithm for designing and selecting probes for oligonucleotide array-based medium-resolution typing is reported. The goal in deriving the algorithm was to select a minimum number of probes from a large probe set on the premise of minimum loss of resolution. The algorithm, which was based on entropy, conditional entropy and mutual information theory, was used to select the minimum number of probes from a large probe set. The algorithm was tested on a human leukocyte antigen (HLA) sequence data set. Thirty probes were selected from 390 probes for HLA-A, and 60 probes were selected from 767 probes for HLA-B. Although the number of probes was reduced by almost ten times, the distinguishability was reduced only a little, by 0.45% (from 99.90% to 99.45%) for HLA-A and 0.27% (from 99.84% to 99.57%) for HLA-B, respectively. This is a satisfactory and practical result.     

优化的贴片型测量探头及其生物医学应用研究

采用时域有限差分（FDTD）法结合遗传算法（GA）优化设计了适用于浅表生物组织高频测量的宽带同轴贴片探头，并用该探头测量了人体背部1～7GHz频带内的反射特性。优化设计出的圆形同轴贴片探头具有轴对称特点，辐射近场在生物组织中透人深、反射系数的频率响应特性好。所获得的人体背部反射特性的测量结果将为背部浅表组织电特性的重建提供有利的依据。     

Agreement between CBNAAT,liquid culture and line probe assay for detection of Mycobacterium tuberculosis and anti-tubercular drug resistance in extrapulmonary samples

PurposeCartridge based nucleic acid amplification test (CBNAAT) has been endorsed by the WHO as the screening test for diagnosing extrapulmonary tuberculosis (EPTB). In the present study we report the agreement between CBNAAT (Xpert MTB/RIF), liquid culture (LC) and line probe assay (LPA) for diagnosis of Mycobacterium tuberculosis and detection of drug resistance among EPTB cases.MethodsThe EP samples were subjected to CBNAAT (Xpert MTB/RIF, Cepheid, USA) and wherever possible, to LC (MGIT 960, Becton Dickinson, USA) followed sequentially by first line and second line-LPA (FL-LPA, SL-LPA, Hain Lifescience, Germany) on the isolates.ResultsTotal 566/4080 (13.9%) EP samples were detected positive for M. tuberculosis on CBNAAT. Aspirates from lymph nodes were most often positive (11/30; 36.6%), followed by pus (240/873; 27.5%) and CSF samples (166/104; 15.8%). The detection of M. tuberculosis was more in adults than children except in tissue biopsy samples. Rifampicin resistance was also higher among adults except CSF in which resistance was more in children. Total 185 of 566 (32.7%) CBNAAT positive and 770 of 3510 (21.9%) CBNAAT negative samples could be cultured of which 110/185 (59.4%) and 33/770 (4.3%) respectively turned positive. FL-LPA and SL-LPA of 143 culture isolates showed that 27 isolates had drug resistance, of which 3 (2.1%) were XDR, 11 (7.7%) were Pre-XDR (FQ) and 13 (9.1%) were MDR. Of these 27 resistant isolates, 12 were negative by CBNAAT and two were mislabeled as Rifampicin sensitive or indeterminate based on the unique RpoB gene mutation patterns on LPA. The positive and negative agreements between LC and CBNAAT for detection of M. tuberculosis were 67.1% and 92.7% respectively and between LPA and CBNAAT for rifampicin resistance detection were 98.9% and 92.9% respectively.ConclusionsFor EPTB, CBNAAT should be accompanied with LC wherever possible irrespective of the CBNAAT result.     

短声作为刺激声进行同侧声反射阈测定之临床价值

目的 :确定短声可代替纯音作为刺激声作同侧声反射阈测定 ,并了解探测音频率对声反射阈的影响。方法 :应用 GSI33 型中耳分析仪 ,对正常志愿者 2 3例 46耳作不同探测音频率的纯音及短声刺激率 10 0次 / s及180次 / s的同侧声反射阈测定。结果 :声反射阈 2 2 6 Hz探测音时 5 0 0 Hz、10 0 0 Hz、2 0 0 0 Hz分别为 ( 84.35±6 .96 ) d B、( 84.6 5± 5 .93) d B、( 87.96± 6 .36 ) d B;6 78Hz探测音时分别为 ( 93.13± 6 .5 4) d B、( 92 .70± 6 .33) d B、( 93.35± 5 .99) d B;10 0 0 Hz探测音时分别为 ( 86 .5 2± 4.72 ) d B、( 87.48± 5 .0 0 ) d B、( 88.30± 6 .16 ) d B。短声刺激率 10 0次 / s及 180次 / s同侧声反射阈 2 2 6 Hz探测音时分别为 ( 89.78± 6 .83) d B、( 92 .0 7± 7.42 ) d B;6 78Hz探测音时为 ( 90 .44± 6 .76 ) d B、( 90 .6 5± 6 .38) d B;10 0 0 Hz探测音时为 ( 88.0 4± 6 .87) d B、( 88.6 9± 7.49) d B。 6 78Hz探测音 ,声反射阈高于 2 2 6 Hz及 10 0 0 Hz。结论 :低刺激率的短声作为刺激声并未出现赝象 ,可作为进行同侧声反射阈测试的刺激声     

Determination of microviscosity and location of 1,3-Di(1-pyrenyl)propane in brain membranes

We determined the microviscosity of synaptosomal plasma membrane vesicles (SPMV) isolated from bovine cerebral cortex and liposomes of total lipids (SPMTL) and phospholipids (SPMPL) extracted from SPMV. Changes in the microviscosity induced by the range and rate of lateral diffusion were measured by the intramolecular excimerization of 1,3-di(1-pyrenyl)-propane (Py-3-Py). The microviscosity values of the direct probe environment in SPMV, SPMTL and SPMPL were 38.17, 31.11 and 27.64 cP, respectively, at 37°C and the activation energies (E_a) of the excimer formation of Py-3-Py in SPMV, SPMTL and SPMPL were 8.236, 7.448 amd 7.025 kcal/mol, respectively. Probe location was measured by polarity and polarizability parameters of the probe Py-3-Py and probe analogues, pyrene, 1-pyrenenonanol and 1-pyrenemethyl-3β-hydroxy-22,23-bisnor-5-cholenate (PMC), incorporated into membranes or solubilized in reference solvents. There existed a good linear relationship between the first absorption peak of the¹L_a band and the polarizability parameter (n ²−1)/(2n ²+1). The calculated refractive index values for SPMV, SPMTL and SPMPL were close to 1.50, which is higher than that of liquid paraffin (n=1.475). The probe location was also determined by using a polarity parameter (f−1/2f¹). Here f=(ε−1)/(2ε+1) is the dielectric constant function and f'=(n ²−1)/(2n ²+1) is the refractive index function. A correlation existed between the monomer fluorescence intensity ratio and the solvent polarity parameter. The probes incorporated in SPMV, SPMTL, and SPMPL report a polarity value close to that of 1-hexanol (ε=13.29). In conclusion, Py-3-Py is located completely inside the membrane, not in the very hydrophobic core, but displaced toward the polar head groups of phospholipid molecules, e.g., central methylene region of aliphatic chains of phospholipid molecules.     

Nucleic acid analysis of antibiotic resistance

The past 15 years the field of molecular biology and especially DNA technology has developed rapidly. This did not leave microbiology unaffected. DNA sequencing and the use of DNA probes led to new insights in the evolution and spread of antibiotic resistance genes. It became clear that resistance determinants often show partial homology even when species are not closely related. DNA probes have established their value as epidemiological tools and currently efforts are being made to introduce them into routine diagnostics.     

新型TaqMan-MGB探针法检测耐甲氧西林金黄色葡萄球菌

目的探讨新型MGB探针在耐甲氧西林金黄色葡萄球菌快速检测中的临床应用价值。方法以TaqMan-MGB探针技术为基础,用已克隆的mecA基因作参比品,实时检测临床标本和阴性参考品。结果所建立方法的最低检测限度为1个基因拷贝/反应,在100~109范围内,CT值(C代表Cycle,T代表阈值)同DNA量的对数呈线性关系;用该方法检测20例MRSA培养阳性的临床标本,结果均为阳性;用该方法检测20个非MRSA细菌株,结果均为阴性。结论所建立的方法适用于临床MRSA快速诊断。