目的 评价A V E-562全自动粪便分析仪在粪便检测中的可靠性.方法 选取2016年11月湖北省中西医结合医院患者的粪便标本作为研究对象,利用A V E-562全自动粪便分析仪及人工镜检法进行检测,评价仪器在粪便检测中的极低浓度标本检出率、污染携带率、有形成分回收率,以及自动分析结果与人工镜检结果的一致性.结果 A V E-562全自动粪便分析仪的极低浓度标本检出率、污染携带率和有形成分回收率分别为90.0%、0.0%和86.4%;A V E-562全自动粪便分析仪检测粪便潜血、红细胞及白细胞的符合率分别为94.0%、95.3%及95.3%,与人工镜检法检测结果符合率较高.结论 A V E-562全自动粪便分析仪检测性能较好,可满足临床粪便检验的需求.

当前，推进公立医院改革是新医改方案确定的五项重点改革内容之一。国家新的医改政策在顶层设计层面提出了公立医院改革方向和任务，一是医院加强管理，切实履行其公共服务职能，即强调完善公立医院的公益性和社会性职能；二是完善分配激励机制，改革医院人事制度，推行聘用制度和岗位管理制度，有效调动医务人员的积极性与创造力，实行以服务质量及岗位工作量为主的综合绩效考核和岗位绩效工资制度。检验科作为医院重要的医技科室，如何结合医院发展战略，挖掘内部管理潜力，调整科室内部管理模式，尽快适应新医改要求，构建一套可操作、合理、科学的绩效管理方法，显得尤为得要。作为现代企业管理实践中成功的管理方法，绩效管理日益被各领域、各行业所认同和接纳［1］，它是指为达成组织目标，通过持续开放的过程，实现组织目标所预期的利益和产出，并推动团队及成员做出有利于目标达成的行为过程。

目的 研究正常晚期妊娠妇女抗凝及纤溶的变化.方法 检测162例正常晚孕妇女和115例来本院健康体检的正常非妊娠妇女的纤维蛋白原、D二聚体及抗凝血酶Ⅲ,并进行对比分析.结果 晚孕组的FIB:(5.313±0.349) g/L,高于正常对照组(P＜0.01).D-二聚体:(0.57±0.25) mg/L,高于正常对照组(P＜0.05).AT-Ⅲ:78.43±10.25％,低于正常对照组(P＜0.05).结论 晚期妊娠妇女血液呈生理性的高凝状态.AT-Ⅲ、FIB、D-D的联合检测对于评价晚期妊娠妇女的凝血功能状态,预测晚期妊娠妇女在分娩过程中发生血栓事件的可能性有重要意义.

目的：回顾我院检验科开展间接免疫荧光法检测抗核抗体（ANA）与免疫印迹法检测特异性抗核抗体谱（ANAs）两种检测结果的对比分析以及两者之间的相关性，并探讨两种方法联合检测在自身免疫性疾病中的应用价值。方法：利用间接免疫荧光法（IIF）和免疫印迹法（LIA）对448份临床就诊患者血清标本同时进行自身抗体的检测，并分析两种方法检测结果的相互关系。结果：在139例间接免疫荧光法ANA阴性中，免疫印迹法抗ANAs抗体有18例阳性，阳性率为12.95％；在309例间接免疫荧光法ANA阳性中，免疫印迹法ANAs有213例阳性，阳性率为68.93％。其余为两者可疑或阴性。结论：在抗核抗体检测中间接免疫荧光法（IIF）筛选易导致以抗SSA、抗SSB和抗R052为主要抗体患者的ANA假阴性，而免疫印迹法（LIA）特异性ANAs的检测因检测的抗体不全面也无法取代ANA的IIF法检测。在临床实际工作中两种ANA的检测方法不能相互取代，应联合应用，而且对自身免疫性疾病的进一步诊断也很有价值。

Objective:To determine the specimens source,infection distribution and drug resistance of Acinetobacter baumannii(ABA)isolated from our hospital from Jan.2008 to Dec.2012 and provide evidence for clinical prevention and treatment of it.Method:Bacterial cultivation,identification and susceptibility testing were performed by the microbiological routine methods.The specimens source and department distribution of 221 ABA had been summarized and analyzed retrospectively,resistance rates of 12 commonly used antimicrobial drug had be counted.Result:182 strains in a total of 221 A.baumannii strains were isolated from sputum accounting for82.4%,followed by pus,drainage incision,blood,and so on.The majority of ABA causing nosocomial infection was observed in ICU(51.5%),followed by respiratory medicine(24.4%),neurosurgery(19.9%)and other departments.Susceptibility results showed that ABA resistant to commonly used antibiotics increased year by year.Resistance rate of cefoperazone/sulbactam was the lowest,followed by imipenem,meropenem.ABA were highly resistant to penicillins,aminoglycosides,fluoroquinolones,aztreonam,piperacillin/tazobactam(90%),and showed multiple drug resistance.Conclusion:Concurrence of nosocomial infection caused by ABA increased year by year.It was highly resistant to common antimicrobials and demonstrated distinct multi-drug resistance.This should lead to clinical attention,especially in ICU and Respiratory Medicine.Improve treatment efficacy and reduce drug-resistant strains by strictly operating aseptic technique of invasive procedures and using antibiotics rational.

目的探讨尿胰蛋白酶原激活肽(TAP)及血淀粉酶(AMY)、C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素(IL)-2、IL-8、肿瘤坏死因子α(TNF-α)对急性胰腺炎(AP)的早期诊断价值。方法 AP患者189例,其中轻型急性胰腺炎(MAP)141例、重型急性胰腺炎(SAP)48例,以其他急腹症患者20例作为对照组,在患者入院时及入院后24、48、72、96h进行上述指标检测,并对结果进行统计学分析。结果各时间点SAP组上述指标水平均高于MAP组及对照组,且MAP组高于对照组(P<0.05)。结论联合检测上述指标对AP早期诊断具有重要参考价值,尤其是尿TAP及血PCT、AMY对SAP的早期诊断意义更大。

Objective:To explore the relationship between common genotypes,multiple infection of human papillomavirus(HPV) in Wuhan area and cervical lesions. Methods:HPV gene chip was used to detect the genotypes of HPV in cervical exfoliated cells of 1 430 women from urban areas of Wuhan city,then 569 women with positive HPV were divided into five groups according to pathological results: chronic inflammation group,cervical intraepithelial neoplasia(CIN) Ⅰgroup,CINⅡ group,CINⅢ group,and cervical cancer group.HPV infection statuses,distributions of HPV genotypes,and multiple infection rates in the five groups were analyzed. Results:Among 1 430 samples,569 samples were found with positive HPV,the total infection rate of HPV was 39.79%(569/1 430).The distributions of high risk HPV subtypes in different group varied,the most common HPV subtypes in CINⅢ group and cervical cancer group were HPV16 and HPV18.A total of 138 cases were found with multiple infection,the detection rates of multiple infection in chronic inflammation group,CIN Ⅰgroup,CINⅡ group,CINⅢ group,and cervical cancer group were 17.48%(54/309),23.70%(32/135),36.07%(22/61),44.44%(20/45),and 52.63%(10/19),respectively.The multiple infection rates in CINⅢ group and cervical cancer group were statistically significantly higher than those in chronic inflammation group,CIN Ⅰgroup,and CINⅡ group(P<0.05). Conclusion:The genotypes and multiple infection of HPV were closely correlated with different cervical lesions in Wuhan area.

目的 通过检测健康人群和肥胖人群的超敏C反应蛋白(hs-CRP)水平比较,探讨成年男性肥胖相关指数中体质量指数(BMI)和腹型肥胖指数腰围(WC)或腰臀比(WHR)与hs-CRP的关系.方法 成年男性体检人群物理检测BMI、WC、血压,采用全自动生化分析仪和化学发光仪检测受试者血hs-CRP、血糖、血脂、胰岛素等相关生化指标,比较BMI和WHR与hs-CRP的关系.结果 BMI≥25组和 BMI＜25组的临床和实验室指标显示,两组间hs-CRP、SBP、TG、FBG、HOMA-IR差异有统计学意义(P＜0.01,WHR≥0.90和WHR＜0.90两组间比较,与BMI组基本相同;回归分析显示,BMI和WHR与hs-CRP(r值分别为0.382、0.314),有良好的正相关性.结论 hs-CRP同成年男性肥胖相关指数BMI和WHR一样与代谢综合征(MS)关系密切,炎性反应可能在MS的发病机制中起重要作用.

目的探讨血浆B型脑钠肽(BNP)水平在慢性心力衰竭患者(CHF)早期肾功能变化中的临床应用价值。方法用免疫荧光法测定485例单纯性心衰,心衰继发肾功能不全,单纯性肾功能不全患者和30例对照组患者血浆BNP、全段甲状旁腺素(iPTH)、胱抑素C(CYC)、尿素氮(BUN)、肌肝(Scr)、血β2微球蛋白(β2-MG)、血N-乙酰-β-D-氨基葡萄糖苷酶(NAG)水平,同时检测上述患者及对照组尿液β2微球蛋白(uβ2-MG)、尿微量清蛋白(uMA)及肾小球滤过率(GRF)。结果血BNP、β2-MG、NAG及uβ2-MG、UMA均在心功能Ⅳ级患者中测定值最高,心功能Ⅲ级及心功能Ⅱ级患者依次降低,以上3组均高于对照组。还发现,CHF伴不同程度肾损害患者BNP水平明显高于单纯性肾功能不全患者,并且,BNP水平越高,其临床治疗及预后越差。结论 BNP在鉴别单纯性肾功能不全及心源性肾功能不全中有重要意义,同时BNP也可指导心源性肾功能不全的临床治疗及监控预后。

OBJECTIVE To approach the constituent ratios and antimicrobial resistance of gram-positive cocci isolated from infectious specimens of hospitalized patients in 2010 and provide experimental basis for clinical use of antibiotics for anti-infection chemotherapy.METHODS Referring to National Guide to Clinical Laboratory Procedures,bacterial culture and identification were performed by the routine methods.The drug susceptibility test was performed by K-B method recommended by CLSI.RESULTS Among the 178 strains of gram-positive cocci isolated,Staphylococcus aureus isolates were the dominant pathogens,accounting for 62.9%,followed by coagulase-negative Staphylococcus(22.5%) and Enterococcus(14.6%);gram-positive cocci were resistant to the most of commonly used antibiotics,the detection rate of methicillin-resistant S.aureus(MRSA) was 60.5%,and no Staphylococcus isolates intermediate or resistant to glycopeptide antibiotics were found.CONCLUSION The clinician should perform the bacterial culture and drug susceptibility testing for the submitted specimens in a timely manner and prescribe antibiotics in accordance with the species of the pathogens and the characteristics of drug resistance.

目的:探讨成年男性肥胖相关指数中体质指数(BMI)和腹型肥胖指数腰围(WC)或腰臀比(WHR)与心血管疾病危险因素的关系,分别比较2种指数在心血管疾病中的影响.方法:成年男性体检人群物理检测BMI、WC、血压,采用全自动生化分析仪和化学发光仪检测受试者血脂、血糖、肌酐、胰岛素等心血管疾病危险因素相关生化指标.结果:BMI≥25组和BMI＜25组的临床和实验室指标显示,2组间SBP、TG、HDL-ch、LDL-ch、FBG、UA、HOMA-IR、DBP、TC、Cr比较差异有统计学意义；WC≥90 cm和WC＜90 cm 2组间比较,与BMI组基本相同；以BMI值为自变量,发生高血压的相对危险度(OR)为1.32,代谢综合征(MS)的OR值为1.54；以WC值为自变量,发生高血压的OR为1.24,MS的OR值为1.36;以是否发生高血压为因变量,行logistic逐步回归分析,调整其他因素后,BMI和WC均为独立危险因素.结论:成年男性肥胖相关指数BMI和WC(或WHR)与心血管疾病关系密切,WC同BMI一样可作为预测心血管疾病的良好指标.

目的:分析非酒精性脂肪肝非肥胖及肥胖人群的血尿酸(SUA)水平变化.方法:体检人群筛选出来的非酒精性脂肪肝非肥胖和肥胖者与正常对照组同时检测血尿酸(SUA)、体重指数(BMI)、腰臀比(WHR)及相关生化指标.结果:非酒精性脂肪肝非肥胖组和肥胖组SUA、BMI、WHR、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三脂(TG)均高于正常组;非酒精性脂肪肝肥胖组SUA水平明显高于非肥胖组(P＜0.05).结论:非酒精性脂肪肝肥胖人群的高水平SUA状态可能与心血管疾病风险有关.

目的研究伴有或不伴有微量清蛋白尿的2型糖尿病(T2DM)患者胰岛素抵抗(IR)的状况,探讨IR对肾损害的影响机制。方法健康对照组26例,T2DM不伴有微量清蛋白尿患者24例(A组),T2DM伴有微量清蛋白尿28例(B组),分别检测其空腹血糖(FBG)、血脂、胰岛素(FINS)、糖化血红蛋白(HbA1C),餐后2 h血糖(PBG),24 h尿微量清蛋白(MAU)。结果 A组、B组与对照组比较除胆固醇差异无统计学意义(P>0.05)外,其余数据差异均有统计学意义(P<0.01);而A组与B组比较,其血糖、血脂水平差异无统计学意义(P>0.05);IR及MAU差异有统计学意义(P<0.01)。结论与尿微量清蛋白正常的T2DM患者相比,伴有微量清蛋白尿的T2DM患者具有更严重的胰岛素抵抗,提示伴有微量清蛋白尿的IR是T2DM发病过程中的重要因素,其T2DM患者的肾血管病变危险性增高的机制可能与IR有关。

Objective To assess the relationship between coronary heart disease(CHD) and biochemical markers of myocardiac injury,such as homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CRP) and brain natriuretic peptide(BNP).Methods The serum levels of cardiac troponin I(cTnI),myoglobin(Myo),Hcy,hs-CRP and BNP were detected by routine biochemistry methods.There were totally 180 patients with CHD(115 males/65 females) included.58 patients of which were defined as acute myocardial infarction(AMI).62 cases were defined as unstable angina pectoris(UAP) and 60 cases were defined as stable angina pectoris(SAP).40 healthy blood donors(20 males/20 females) were chosen as the controls of this study.Results Serum levels of Hcy,hs-CRP and BNP were obviously higher those in the healthy controls(P0.01),and the AMI as well as UPA group had a higher level than that in the SAP group(P0.01).Conclusion Our data indicate that serum levels of Hcy,hs-CRP and BNP could be used to monitor myocardial injury and the development of CHD.

Objective To investigate the clinical significance of the combined determination of serum C-reaction protein(CRP),interleukin-6(IL-6),interleukin(IL-8)and urine trypsinogen activation peptide(TAP)in the severity evaluation of early acute pancreatitis(AP).Methods Serum CRP,IL-6,IL-8 and urine TAP levels were determined in 26 healthy controls,24 patients with mild AP and 21 patients with severe AP.Results The serum levels of CRP,IL-6,IL-8 and urine TAP in severe AP group were significantly higher than those in other groups(P<0.05).Conclusion Serum levels of CRP,IL-6,IL-8 and urine TAP increased as the pathogenetic condition of early AP more severe.The combined detection of the four serum markers could have important application value in the severity evaluation of early AP.

阿司匹林从上世纪70年代起作为抗血小板药物广泛用于心脑血管疾病的二级预防及某些选择性患者的一级预防,有报告[1]称其可以降低25%的心脑血管事件如死亡、心肌梗死、卒中,降低48%的血管搭桥及动脉栓塞事件,减少67%的肺栓塞事件和深静脉血栓事件.

目的:了解武汉地区妇女人乳头瘤病毒(HPV)感染基因分型状况,为宫颈癌早期防治提供理论依据.方法:采用基因芯片技术对武汉地区1444例疑似HPV感染的妇女进行HPV检测.并作基因型别分析.结果:1 444例妇女中共检出HPV阳性者580例,阳性率40.17%.检出高危基因型(HPV16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、73、83和MM4型)511例,约占感染者的88%;检出低危型(HPV6、11、42和43型)69例,约占感染者的12%.在检出类型中单一感染495例,混合型感染85例.结论:HPV高危型与宫颈糜烂发病关系密切,积极控制HPV感染及有效治疗宫颈糜烂在宫颈癌早期防治中具有重要意义;基因芯片技术对HPV分型检测是一种快速、敏感和特异的方法.

目的:探讨血浆B型脑钠肽(BNP)水平在心力衰竭诊断中的临床意义。方法:用免疫荧光(双抗体夹心)法测定186例心力衰竭患者和42例非心力衰竭患者血浆BNP水平。结果:心力衰竭组与非心力衰竭组比较,血浆BNP水平差异有统计学意义(P<0.01);血浆BNP水平随心力衰竭程度的加重(NYHA心功能分级升高)而显著上升,各组间差异均有统计学意义(P<0.01);同组患者中女性血浆BNP水平高于男性(P<0.05)。结论:血浆BNP测定对反映心力衰竭患者的心功能状态可能有一定的参考意义。

目的:观察2型糖尿病(T2DM)肾微血管病变患者纤溶酶原激活剂抑制物-1(PAI-1)、肿瘤坏死因子-α(TNF-α)水平变化及其与糖代谢指标的相关性.方法:T2DM患者125例, 根据24h尿微量白蛋白(UMA)排泄量分为三组:(1) T2DM无肾病组(A组);(2)T2DM早期肾病组(B组);(3) T2DM临床肾病组(C组).平行检测PAI-1、TNF-α和空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA 1c)浓度.结果:(1)各组T2DM患者PAI-1水平均较正常对照组高,C组的PAI-1显著高于A、B组(P<0.01),B组高于A组 (P<0.05).(2) C组的TNF-α显著高于A、B组(p<0.01), B组高于A组(P<0.05).(3)相关分析表明PAI-1与FINS、FBG, TNF-α与HbA1c、FINS具有显著正相关性(P<0.05).结论:PAI-1、TNF-α升高与肾损害有关,可能是T2DM肾病发生的共同危险因素;降低PAI-1、TNF-α活性,对延缓T2DM微血管病变的发生发展有重要作用.

目的:探讨非牛顿流体质控物在全血黏度检测质量控制中的应用。方法:使用nNF非牛顿流体质控物对血液流变学全血黏度检测的1.00S-1和200.00S-12点进行了质量控制检测并分析结果。结果:7月份低切(1.00S-1)的全血黏度均值是21.59mpa.s,标准差是0.85mpa.s,变异系数是3.93%,高切(200.00S-1)的全血黏度均值是2.62mpa.s,标准差是0.13mpa.s,变异系数是4.97%。1-7月质控物检测数据稳定。结论:使用该质控物对SA-6000血液流变学分析仪进行检测,通过质控物检测结果来判定该仪器的稳定性和重复性。也可以判定该仪器的准确性。另外建立全程质量控制也十分必要。