提高医学实验室标本分析前质量控制方法的探讨

目的:探讨提高医学实验室标本分析前质量控制的方法。方法:根据《医学实验室质量和能力专用要求》(ISO15189)的分析前质量管理内涵并结合我院实验室实际情况,对流程再造前、后发生的总标本差错数进行对比分析。结果:通过完善实验室信息管理系统(LIS)的功能、实验室内部流程改造、对临床护士的培训等方面工作,流程再造前后有显著性差异(P<0.05)。结论:合理的分析前质量控制方法可提高医学实验室检测质量。     

临床检验前和检验后阶段的管理

临床实验室长期致力于检验质量,已使其产生错误发生率的西格玛水平为4~5,其超过大多数其他医疗领域。然而,对检验前及检验后阶段错误率的更深的理解及他们对患者潜在的伤害已导致加强对实验室的要求,要求实验室对其直接控制之外的活动承担更大的责任。认可机构有对检验外阶段有效管理的相关要求。有各种免费在线资源可用来帮助管理检验外阶段,国际临床化学及检验医学联合会实验室差错和患者安全工作组最近发表的质量指标和提出性能水平提供了特别有用的基准数据。通过建立在现有的质量管理经验、定量的科学背景及对信息技术的精通,临床实验室适合在实验室范围外在减少差错和提高患者安全方面发挥更大的作用。     

加强医学研究生实验操作中的生物安全防护

标准化管理是医学实验室发展的趋势,生物安全建设已成为医学实验室发展不可缺少的环节。实验室生物安全更是保证实验研究的科学性以及保护被实验因子免受污染的必要条件。医学研究生在实验研究过程中不可避免地会接触到生物危险因子,因此对医学研究生进行实验室生物安全知识及技能培训是实验室生物安全建设的重要组成部分。本文就医学研究生实验室生物安全知识及技能培训进行初步的研究和探讨。     

浅谈高校临床医学实验室建设与管理

在高校进行教学、实验和人才培养过程中,医学实验室发挥着举足轻重的作用。然而,传统临床医学实验室模式不能适合高校的发展,更不能满足社会和市场的需要。本文通过对传统医学科研实验室的管理模式进行改革,并积累了很多实践经验。因此,高校医学实验室应该加大管理力度,改进实验室管理模式,统一医学科研实验设备,以此提高医学教学质量,减少资源浪费。     

传染病医院临床实验室的特点及管理对策

目的:结合传染病医院临床实验室自身的性质和特点探讨其有效的管理对策.方法:结合本院的实际情况,从生物安全、质量控制、人员设备、制度以及信息化管理五个方面采取一系列的管理对策,完善传染病医院临床实验室的管理工作.结果:加强并完善了我院临床实验室的管理工作,保证了临床检验质量,成效显著.结论:抓好以上五个环节的管理,是提高医疗质量的重要保障,有助于实现临床实验室管理的规范化、科学化、信息化.     

二代基因测序数据管理和大数据平台在精准医学中的应用

精准医学集合了多种数据,包括组学、临床、环境和行为等,是对疾病进行个性化治疗、预防和管理的科学。随着基因测序费用的大幅下降,人们对肿瘤等疾病的认识从传统病理到分子水平的飞跃等,相关科学的发展和普及推动了精准医学的诞生和发展,将更加深远地影响着人类的健康。本文介绍了精准医学的概念、目的及应用,介绍了二代DNA测序技术在精准医学中的应用,认为基因组学数据、样本管理、数据质量控制标准以及数据管理平台等是实现精准医学的基础,智能化精准医疗将是来的发展方向。进行展望的同时,也认为基因组学海量数据的规模特点、各种健康应用在推动数据管理平台的发展的同时,也对其演进提出了挑战。     

浅谈医院感染控制在医学实验室管理中的重要作用

目的:对于医院感染控制的检测,可以降低疾病的发生率.在临床实践中,医务人员已普遍认识到降低感染率能够有效预防各种疾病的产生,这就对实验室的管理工作提出了更高的要求.本文旨在探讨医院的感染控制在医学实验室管理中的作用.方法:通过对我院在2008-2011年对患者由于感染而患病的患者进行人数统计,对统计结果进行分析,得出感染率,从感染率中找出感染率降低的原因,评估医院感染控制在医学实验室管理中的重要作用.结果:通过统计分析,发现我院在这些年的感染率由2.59％降到2.09％,实现这些变化的原因是实施了新的感染诊断实施标准,同时,感染控制工作的好坏也直接影响到医学实验室的管理工作.结论:控制感染是降低疾病产生的重要因素,做好医学实验室的管理工作能够降低感染率,二者是一种反馈与制约的关系,可见医院感染控制对医学实验室的管理工作的重要性.     

提高检验医学本科实习生综合素质探讨

随着生物医学技术、计算机技术、物理化学技术的迅速发展,临床医学对检验医学提出了更高的要求。作为实验室工作人员,在保证结果准确的基础上,还应对临床医生及病人提出的疑问给予合理、正确地解释。此外,还应该具备和临床医生进行交流,以及合理处理病人投诉的能力。五年制检验医学本科生是检验医学的主力军,培养高素质的检验医学本科生,对检验医学的发展将起关键性作用。     

提高检验医学本科实习生综合素质探讨

随着生物医学技术、计算机技术、物理化学技术的迅速发展,临床医学对检验医学提出了更高的要求。作为实验室工作人员,在保证结果准确的基础上,还应对临床医生及病人提出的疑问给予合理、正确地解释。此外,还应该具备和临床医生进行交流,以及合理处理病人投诉的能力。五年制检验医学本科生是检验医学的主力军,培养高素质的检验医学本科生,对检验医学的发展将起关键性作用。     

开展多学科双向性转化型研究

虽然转化型研究已被提出数年,但一般强调的是基础理论研究联系临床医学或预防医学的问题并在一定程度上予以解决。实现多学科、双向性转化型研究(multidisciplinarybidirectionaltranslationalresearch),如加强基础医学与临床医学、预防医学及实验诊断学等多学科之间的相互交叉,将可促进转化型研究向更高、更深层次发展。在医学及生命科学中,一个常用的词是从实验室到临床(frombenchtobed),实际上基础研究不仅应解决患者的疾苦,还应着眼于预防疾病、环境卫生、卫生经济学等多学科的问题。而双向性则指从临床到实验室(frombedtobench),即在解决问题的同时,又可基于临床医学、预防医学等出现的新问题,进一步设计基础研究课题并进行实验室研究。例如,根据人类免疫缺陷病毒酶与蛋白酶的分子结构设计并生产了多种抗病毒药物,这些药物用于临床,延缓了艾滋病患者的生命,但是又出现了耐药问题。结合医学实践,细致分析在中国哪些患者容易出现耐药性,为何出现耐药,耐药性与患者的服药依从性、遗传因子、免疫力、有无合并感染及生活习性间有无相关性等,这就需要基础研究者从临床到实验室,结合多学科进行调查与研究。研究结果还需再在临床或现场做考证。如此循环及螺旋式上升,各相关学科均可得到发展;还有利于民生,提高与改善人民的健康水平.....     

白蚁与动物及微生物的共生类型及其机制

综述了白蚁螱客的主要种类、共生关系及相关机制的研究进展。白蚁螱客中,已报道的动物种类达170种。在与动物的共生关系中存在偏利共生（宾主共栖和异种共栖）、互利共生和无关共生三种;在与微生物的共生关系中,存在与内生菌（原生动物、细菌、真菌和放线菌）和外生菌（蚁巢伞菌等）间的互利关系。指出了白蚁与螱客研究中存在的问题,给出了解决方案,并提出了今后可能的研究热点或方向,为白蚁的综合利用（如纤维素酶）及今后研究物种间的协同进化提供了基础资料。     

New amino-dithiaphospholanes and phosphoramidodithioites and their rhodium and iridium complexes

New sulfur derivatives of phosphoramidite ligands were synthesized and the impact of the sulfur unit on the spectroscopic properties of their rhodium and iridium complexes was investigated. The new ligands Bn₂NPSCH₂CH₂S^a(P-S^a) (Bn = benzyl, 4), Bn₂NPSCHCHS^a(CH₂)₃C^aH₂(P-S^a)(C^a-S^a) (6) and Bn₂NP(4-XC₆H₄OMe)₂ (X = S, 7a; X = O, 7b) were converted to the rhodium and iridium complexes trans-[Rh(CO)Cl(L)₂] (L = 4, 6, 7), [RhCl(COD)(L)] (L = 4, 6, 7), [IrCl(COD)(7a)] and [IrCl₂Cp∗(6)]. For comparison, some phosphoramidite complexes of these formulations also were synthesized. The new metal complexes were spectroscopically analyzed. For the carbonyl complexes, the ν_CO IR stretching frequencies were lower than for the corresponding phosphite and phosphoramidite ligands. The ¹J_PRh coupling constants for the rhodium complexes with the new ligands were also smaller than for the respective phosphoramidite and phosphite complexes. Finally, the ¹J_PSe coupling constants of the selenides of the new ligands were lower than those of the phosphoramidite ligands but higher than for PPh₃. The spectroscopic data reveal that the new thio ligands 4, 6 and 7a are more electron donating than phosphites and phosphoramidites but less electron donating than PPh₃.     

Astrocytes and Synaptosomes Transport and Metabolize Lactate and Acetate Differently

Astrocytes transport the monocarboxylate acetate, but synaptosomes do not. The reason for this is unknown, because both preparations express monocarboxylate transporters (MCT). The transport and metabolism of lactate, another monocarboxylate, was examined in these two preparations, and the results were compared to those for acetate. Lactate transport is more rapid in astrocytes than in synaptosomes, but of lower affinity (Kms of 17 and 4 mM, respectively). Lactate (0.2 mM) is metabolized to CO2 more rapidly in synaptosomes than in astrocytes (rates of 0.37 and 0.07 nmol x mg protein(-1) x min(-1), respectively). The reason for this is unclear, but cellular differences in lactate dehydrogenase isotype expression may be involved. Acetate is metabolized to CO2 more rapidly in astrocytes than in synaptosomes (rates of 0.43 and 0.02 nmol x mg protein(-1) x min(-1), respectively). This is likely due to cellular differences in the expression of monocarboxylate transporter subtypes.     

Rapporteur report: Basics and technology and metrology and standards

The first and second sessions of the Workshop focussed on the basics of ultrasound and infrasound, their applications in both industry and medicine, and metrology and protection standards for ultrasound applications.     

Relative and combined effects of ethanol and protein deficiency on strontium and barium bone content and fecal and urinary excretion

To elucidate accumulation of minerals in human iliac arteries with aging, the content of minerals was analyzed by inductively coupled plasma atomic emission spectrometry. Bilateral common, internal, and external iliac arteries of 16 men and 8 women, ranging ages from 65 to 93 yr, were examined. It was found that an extremely high accumulation of calcium and phosphorus occurred in the common iliac artery at old age, being higher than that of the internal and external iliac arteries. It should be noted that the accumulation of calcium and phosphorus is the highest in the common iliac artery among the human arteries examined to date. Regarding sexual differences, the content of calcium and phosphorus in the common and internal iliac arteries was higher in women than in men, whereas their content in the external iliac artery was lower in women than in men.     

Prostaglandin and thromboxane production by human and guinea-pig macrophages and leucocytes

The ability of partially purified human and guinea-pig haematogenous cell populations, when cultured in vitro, to metabolise arachidonic acid (AA) has been studied. Supernatants from 24 hour cell culture have been subjected to analysis for products of AA metabolism by gas chromatography with electron-capture detection.The cell types studied were human peripheral blood monocytes (both glass adherent and non-adherent), neutrophils, eosinophils and leukemic leucocytes; thoracic duct lymphocytes and lung alveolar macrophages. From the guinea-pig, induced and non-induced macrophage or neutrophil enriched peritoneal exudate populations, lymph node cells, peritoneal eosinophils and peripheral blood platelets were examined. Supernatants were assayed for the presence of PGE₂, PGD₂, PGF_2α, TXB₂ and 6-keto-PGF_1α. In all types studied PGE₂ and TXB₂ were the major products formed. The identification of PGE₂ and TXB₂ was confirmed by GC/MS with multiple ion monitoring.The results have been compared with other reports and their possible significance discussed in relation to the proposed role of prostaglandins as mediators and modulators in immunopathology.     

Chemokines and cytokines: axis and allies in asthma and allergy

Allergic asthma can be precipitated by many factors. For the atopic person, fungus, pollen, dust mites, cockroach antigens, and diesel exhaust are all agents that may trigger an allergic attack. Cytokines and chemokines are integral mediators of fungal asthma. From the earliest time points, they recruit and activate the cells required for the clearance of fungus as well as being critical factors involved in the immunopathology of this disease. In the final analysis, it is clear that these mediators can act to the benefit or the detriment of the host.     

Oxidation and nitration of ribonuclease and lysozyme by peroxynitrite and myeloperoxidase

In spite of the many studies on protein modifications by reactive species, knowledge about the products resulting from the oxidation of protein-aromatic residues, including protein-derived radicals and their stable products, remains limited. Here, we compared the oxidative modifications promoted by peroxynitrite and myeloperoxidase/hydrogen peroxide/nitrite in two model proteins, ribonuclease (6Tyr) and lysozyme (3Tyr/6Trp). The formation of protein-derived radicals and products was higher at pH 5.4 and 7.4 for myeloperoxidase and peroxynitrite, respectively. The main product was 3-nitro-Tyr for both proteins and oxidants. Lysozyme rendered similar yields of nitro-Trp, particularly when oxidized by peroxynitrite. Hydroxylated and dimerized products of Trp and Tyr were also produced, but in lower yields. Localization of the main modified residues indicates that peroxynitrite decomposes to radicals within the proteins behaving less specifically than myeloperoxidase. Nitrogen dioxide is emphasized as an important protein modifier.