目前医院检验科已普遍采用自动生化分析仪,手工检测已经成为历史,生化检验中重点工作是对所检验指标做出确的评价。因此,临床生化检验实验课内容也要做出相应的调整,笔者对实验课内容作了修改和补充,分别设计了每次实验课的具体内容和课程目标,从而改变了过去只简单地对手工操作技能的反复训练的实验模式,以适合现代临床实验室要求的工作。

目前医院检验科生化检验中手工检测已经成为历史,自动生化分析仪完成了绝大部分的工作,工作人员的重点工作是对所检验指标的方法学性能做出很好的评价,并在检测过程中采取质量控制手段。医学检验专业的临床生化检验实验课内容也理应做出相应的调整,为此我们对实验课内容作了较大的修改和补充,以适合现代临床实验室工作的要求。

OBJECTIVE To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on plasma ET, CGRP and serum IL-6, S100beta during craniotomy. METHODS Fifty patients scheduled for neurosurgery were randomly divided into TAES group (n=25) and control group (n=25). TAES (2/100 Hz, 8-12 mA) of bilateral Hegu (LI 4)-Quchi (LI 11), Zusanli (ST 36)-Sanyinjiao (SP 6) was administrated for patients of TAES group starting 30 min before anesthesia till the end of the operation. Anesthesia of the patients was maintained with sevoflurane inhalation and intermittent intravenous injection of boluses of sulfenany and vecurnium bromide. Jugular venous blood samples were taken at preanesthesia (T0), 1 hour after craniotomy (T1), closure complete (T2), 24 hours (T3) and 48 hours (T4) after operation respectively for detecting contents of plasma endothelin (ET), calcitonin gene-related peptide (CGRP) and serum interleukin (IL)-6, S100beta with radioimmunoassay and enzyme linked immunosorbent assay separately. RESULTS Compared with control group, plasma ET at T2, serum IL-6 at T1 S100beta at T1 and T4 in TAES group all decreased significantly (P < 0.01, 0.05), while serum IL-6 at T3 increased remarkably (P < 0.05). It suggests that after TAES, CGRP/ET was improved, favoring cerebral microcirculation to reduce surgery-induced cerebral injury. There were no significant differences between two groups at different time courses in plasma CGRP concentrations (P > 0.05). CONCLUSION TAES can regulate plasma CGRP/ET and serum IL-6, lower serum S100beta level, which may contribute to its effect in relieving craniotomy-induced brain injury.

Objective:To establish a sensitive,accurate,specific method to determine a small quantity of alcohol in serum with stable reagents by catalysis of alcoholic oxidase.Methods:To analyze alcohol by two points rate method after optimizing reaction system and the assay parameter of automatic analyzer using alcoholic oxidase coupling peroxydase.Results:The linearity was up to 2 000 mg/L.The within-run RSD was lower than 2.81%,run-to-run RSD was lower than 4.51%.The average recovery was 100.7%.Comparing this method(Y) with gas chromatography(X),we obtained the regression equation Y=0.996X+3.58,r=0.981.The assays showed no interference from as much as 159.1 μmol/L bilirubin,14.31 mmol/L of triglyceride and 5.8 g/L of hemoglobin.Conclusion:The two points rate method we established to determine alcohol is highly sensitive,accurate,and specific,and it is especially adapt to determine light excess alcohol concentration of sample from the person who was suspected to have drunk alcohol justnow.

目的:建立一种试剂稳定性好、结果可靠、适用于各级医院使用,尤其适用于急诊检验的血清胆碱酯酶活性的测定方法.方法:以碘化丁酰硫代胆碱作底物,在pH＜6.o和稳定剂存在条件下,用硫酸奎尼丁作终止剂,建立一种手工的测定方法.研究稳定剂对结果的影响,对试剂的稳定性和方法学进行评祄.结果:试剂稳定性:室温可稳定1个月;与速率法(自动生化分析)比较:Y(手工)=0.4023X(自动生化分析)+174.97,r=0.9987;线性范围可达314～8824 U/L.批内CV:2.40%,批间CV:3.13%.结论:本法准确性高,操作方便,不需特殊仪器,试剂稳定性好,适合急诊检验,尤其适合小规模的医院使用,有望代替纸片法.同时也适用于自动生化分析.

目的 建立一种快速、简便、高灵敏测定血清铁的新方法.方法在非离子型表面活性剂聚氧乙烯月桂醚(Brij-35)及聚氧乙烯异辛基苯基醚(TritonX-100)存在下,用水溶性试剂2-(5-硝基-2-吡啶偶氮)-5-[N-正丙基-N-(3-磺酸丙基)氨基]苯酚(简称Nitro-PAPS)作显色剂直接光度法测定血清铁.结果该方法测定血清铁,显色络合物最大吸收波长为590 nm,线性范围达107.4 μmol/L,表观摩尔吸光系数为1.03×105L/(mol/cm).回收率为97.9%～102.2%,批内变异系数(CV) 为2.4%～3.5%,批间变异系数(CV) 为2.9%～3.7%,与亚铁嗪分光光度法比较相关良好, Y＝0.992X +0.12,r=0.9883,P>0.05.85名健康成年人血清铁含量为(11.2～28.4) μmol/L (±2s).结论该法血清用量少,不必去蛋白,具有操作快速、简便、结果灵敏可靠等优点,适用于血清铁的手工测定和自动分析。

铁是人体必需的微量元素,血清铁的测定对临床各种疾病的辅助诊断具有重要的意义.目前<全国临床检验操作规程>中推荐的亚铁嗪分光光度法测定血清铁[1],灵敏度低,血清用量大,操作步骤繁,操作时间长,难以推广.

目的 评价自动生化分析仪测定血清白蛋白的线性关系。方法 用WHO推荐配方的BCG试剂，在试剂量／标本量比例(R／S)等于及小于200时测定，应用NCCLS评价方案评价线性。结果 R／S83时线性不佳(F＞F0.05)，R／S135时线性关系较好(F0.01＞F＞F0.05)，R／S200时线性良好(F＜F0.05)。但用纯白蛋白溶液做线性实验发现，即使R／S200，线性关系仍不好，在R／S135和83时，线性更差。结论 用自动生化分析仪测定血清白蛋白，采用的R／S至少应在135左右，最好接近200；在血清和牛血清白蛋白溶液中，白蛋白与BCG的反应性不同，应引起重视。

目的:建立一种可用于血源筛查检测梅毒螺旋体特异性抗体的方法. 方法:采用重组表达的梅毒螺旋体表面膜蛋白P47和P15作为抗原建立酶联免疫吸附试验(ELISA)法,与甲苯胺红卡片试验(TRUST)法对比检测了75例梅毒病人和127例相关疾病以及1061例献血员的血清,不符合者用螺旋体血球凝集试验(TPHA)法验证. 结果:ELISA与TPHA结果完全符合,TRUST法有6例假阴性和4例假阳性.结论:ELISA法检测梅毒螺旋体特异性抗体具有敏感性高、特异性好、自动化程度高、易于标准化等优点,适合血源筛查和临床梅毒病人确诊试验用.