提高临床医学生微生物检验 见习教学质量的探索与实践

临床微生物室见习是临床医学专业学生了解微生物检验的重要窗口,提高其见习教学质量,使其认识到微生物检验在感染性疾病诊治中的作用。除了系统介绍临床微生物检验的工作内容及流程外,我们更注重临床医生与微生物检验的密切联系,强调临床医生对微生物检验前质量控制的重要性。案例教学法联合问题导向教学法,将临床感染病例与微生物检验紧密结合。举例讲解临床医生该如何正确解读微生物检验报告结果,从而合理选择抗菌药物进行有效的抗感染治疗。最后提醒临床医学生注意生物安全及医院感染的发生。通过我们的见习教学,临床医学生表示获益颇丰,意识到微生物检验对感染性疾病诊治的重要作用。     

局部脑缺血－再灌注大鼠行为和运动功能的动态观察

采用定量的方法动态观察局部脑缺血－再灌注大鼠的行为和运动能力,旨在为缺血性脑损伤行为评价提供敏感的指标。用直径０．２ｍｍ的尼龙线经颈内动脉可逆性插入到大脑前动脉,建立局部脑缺血－再灌注大鼠模型。术后１、２、４、８、２４、４８ｈ观察神经症状。运动能力的评价采用握－引测验、网屏测验和转棒测验,在术后１、２、３、７、１４ｄ进行。主要结果如下：该模型的偏瘫很快消失,术后４ｈ就难以用肉眼观察出运动的异常。而提尾悬空试验的阳性体征持续到术后３ｄ,转棒的成绩在术后１周恢复正常。握－引和网屏测验未能显示出肌力的异常,应考虑设计更完善的方法以排除干扰因素。上述结果提示提尾悬空和转棒测验是评价脑缺血大鼠运动缺陷的简便、客观且较敏感方法。     

体重指数干预对体检中心高脂血症的影响

目的探讨体重指数干预对体检中心高脂血症的影响。方法将500例在我院体检中心检出高脂血症患者随机分为对照组和干预组各250例,对照组给予体检中心护理常规进行护理,干预组在对照组基础上给予体重指数干预,观察比较两组干预前后体重指数和血脂水平。结果干预前两组体重指数、血脂水平比较差异无统计学意义(P0.05);干预后6个月,干预组体重指数下降水平高于对照组,血脂水平优于对照组,两组比较差异有统计学意义(P0.01)。结论体检中心对检出的高脂血症患者实施积极有效的体重指数干预措施,对控制患者体重、预防肥胖及高脂血症的转归具有重要作用。     

Incident air kerma to absorbed organ dose conversion factors for breast and lung in PA thorax radiography: The effect of patient thickness and radiation quality

PurposeConverting the measurable quantities to patient organ doses in projection radiography is usually based on a standard-sized patient model and a specific radiation quality, which are likely to differ from the real situation. Large inaccuracies can therefore be obtained in organ doses, because organ doses are dependent on the exposure parameters, exposure geometry and patient anatomy. In this study, the effect of radiation quality and patient thickness on the organ dose conversion factors were determined.MethodsIn this study, the posterior–anterior projection radiograph of the thorax was selected in order to determine the effect of radiation quality (tube voltages of 70–130 kV and total filtrations of 3 mmAl to 4 mmAl + 0.2 mmCu) and patient thickness (anterior–posterior thicknesses of 19.4–30.8 cm) on the breast and lung dose conversion factors. For this purpose, Monte Carlo simulation programs ImpactMC and PCXMC were used with computed tomography examination data of adult male and female patients and mathematical hermaphrodite phantoms, respectively.ResultsCompared to the reference beam quality and patient thickness, the relative variation range in organ dose conversion factors was up to 74% for different radiation qualities and 122% for different patient thicknesses.ConclusionsConversion factors should only be used with comprehensive understanding of the exposure conditions, considering the exposure parameters, exposure geometry and patient anatomy they are valid for. This study demonstrates that patient thickness-specific and radiation quality-specific conversion factors are needed in projection radiography.     

Biological half-time in rats exposed to nickel monosulfide (amorphous) aerosol by inhalation

This study reports the biological half-time of amorphous nickel monosulfide(NiS(A)) aerosol retained in rat lungs. Wistar male rats were exposed to NiS(A) aerosols (mass median aerodynamic diameter: 4.0 μm) for a single 4 h exposure, or for 7 h/d, 5 d/wk for 1 mo. The average exposure concentrations were controlled at 107 mg/m³ for the single exposure and at 8.8 mg/m³ for the repeated exposures by a dust generator consisting of a continuous fluidized bed with an overflow pipe and a screw feeder. After the exposures, the nickel contents in the rat organs, blood, and urine were measured and histopathological examinations were performed. The biological half time of NiS(A) in rat lungs was 20 h, which was extremely shorter than 21 mo of green nickel oxide (NiO(G)). There were no malignant tumors in any of the exposure groups.     

Nematospiroides dubius: mechanisms of host immunity. I. Parasite counts, histopathology, and serum transfer involving orally or subcutaneously sensitized mice

The immune response of mice sensitized to Nematospiroides dubius by 2 different procedures was studied. Worm counts, histopathology and serum transfers were employed as parameters of comparison between the 2 sensitization groups.The profile of the parasite elimination curve over 16 days postchallenge, was strikingly different for orally and subcutaneously sensitized mice. The precipitous reduction in parasite burden of the orally sensitized (OS) group was evident 24 hr after challenge, and was essentially completed by Day 7. Conversely, there was no significant reduction in the parasite population of subcutaneously sensitized (SS) mice until Day 3, and a considerable number of worms persisted in this group until Day 16, at which time both OS and SS animals had comparable levels of parasitism.Histopathologic observations of the small intestine revealed fewer active granulomatous lesions in OS mice when compared to their SS counterparts. However, the composition and size of the granulomas encapsulating the smaller histotropic larval stages were similar in both sensitization groups. In SS animals, large numbers of eosinophils were commonly observed enveloping medium sized worms in the intestinal tunica muscularis after Day 5.Serum transfer demonstrated the presence of growth suppressing antibody in the sera of both sensitization groups. In addition, significantly fewer worms could be recovered from OS serum recipients.     

紫癜性肾炎早期诊断进展

本综述对近几年有关过敏性紫癜性肾炎早期诊断的实验室指标进行了总结,以期对临床工作提供数据资料。     

Physical examination of the potential tissue donor, what does literature tell us?

European Tissue Banks should carry out a physical examination as a part of the donor selection procedure. This is one of the obligations concerning donation and procurement mentioned in the European Commission directives on tissue banking. As the directives do not give any further specification on the content or on the procedure of the physical examination, a search of literature was done in order to find more information. Although data in literature generally remain quite vague, it was possible to set up a list of items which should be looked at during physical examination. This list can be used temporarily until further information is gathered from an international survey and from a risk assessment analysis.     

实验猴主要细菌性感染疾病的病理特点分析

目的通过对实验猴细菌性感染疾病脏器病理改变的观察和分析,完善实验猴病理检测资料,为实验动物病理检测标准的制定提供依据。方法选取86例实验猴按5种必检细菌性感染疾病（沙门菌病;志贺菌病;结核杆菌病;小肠结肠炎耶尔森菌病;空肠弯曲菌病）病原种类分组,对脏器标本进行病理剖检,HE染色观察记录病变,建立实验猴必检细菌性疾病病理检测资料。结果病理检测结果显示：沙门菌病表现为伤寒肉芽肿,结核杆菌病表现为结核肉芽肿,小肠结肠炎耶尔森菌病表现为纵行溃疡、急性炎及化脓性肉芽肿;志贺菌病、空肠弯曲菌病表现为急性炎和表浅溃疡。结论感染5种必检细菌的实验猴分别表现出不同的病理变化,病理检测对疾病的分析诊断有重要价值,检测结果补充了实验猴细菌性疾病病理检测资料,为制定实验动物病理检测指南提供了相关依据。     

The cancer cell secretome: A good source for discovering biomarkers?

Cancer is a leading cause of death. Early detection is usually associated with better clinical outcomes. Recent advances in genomics and proteomics raised hopes that new biomarkers for diagnosis, prognosis or monitoring therapeutic response will soon be discovered. Proteins secreted by cancer cells, referred also as “the cancer cell secretome”, is a promising source for biomarker discovery. In this review we will summarize recent advances in cancer cell secretome analysis, focusing on the five most fatal cancers (lung, breast, prostate, colorectal, and pancreatic). For each cancer type we will describe the proteomic approaches utilized for the identification of novel biomarkers. Despite progress, identification of markers that are superior to those currently used has proven to be a difficult task and very few, if any, newly discovered biomarker has entered the clinic the last 10 years.