目的 探讨FOCUS-PDCA循环法在提高输血申请单合格率中的意义.方法 将本院2017年1-3月输血申请单合格率作为对照组,运用“FOCUS-PDCA”循环法,于2017年4-6月对本院输血申请单合格率进行持续改进.结果 通过FOUCS-PDCA循环输血申请单规范填写平均合格率由65.7％上升至91.4％,2组相比x2=169.09,P＜0.05.不规范例数明显减少,由303例减少至87例.结论 运用FOUCS-PDCA循环法明显提高了输血申请单合格率,在临床输血质量管理方面起到了重要作用,值得推广应用.

Objective To investigate the infection situation of Mycoplasma pneumonia(Mp) in patients with community-acquired respiratory tract infection and the molecular drug resistance mechanisms of macrolide,and to analyze the relationship between 23SrRNA gene mutation site of isolates resistant to Mp and drug resistance phenotype.Methods A total of 400 throat swab specimens of community-acquired respiratory tract infection were cultured to isolate Mp,the clinical isolates were identified by nested polymerase chain reaction,and the in vitro antibiotic sensitivity test was performed for identifying macrolide-resistant isolates through the minimal inhibitory concentration(MIC).The sequences of macrolide-resistant 23SrRNA gene were detected.The sequences were compared to the corresponding sequences of M129.The relationship between mutation site and drug resistance phenotype was analyzed.Results A total of 50 Mp were isolated from 400 throat swab specimens.Of the 50 isolates,32 isolates were susceptible to macrolide,and 18 isolates were resistant to macrolide.The 18 clinical isolates appeared mutation A2063G,A2064G and A2067G,separately.A2063G showed 14 ring macrolide resistance.A2064G showed 14 and 16 ring macrolide resistances.A2067G showed josamycin resistance.Conclusions Mp to macrolide resistance is serious,and the mutation of 23SrRNA gene is a predominant mechanism that contributes to the macrolide resistance.Through the analysis of 23SrRNA gene mutation site and drug resistance phenotype,the clinical Mp drug resistance situation is obtained.The theoretical guidance for reasonable selection and application of antibiotics is provided.

目的 评价POCT法检测C反应蛋白的精密度及特异度,并与两种不同检测系统进行方法 比对分析,探讨各系统之间检测C反应蛋白是否具有可比性.方法 采用POCT法检测血清C反应蛋白的水平,观察与BNP特定蛋白仪及OLYMPUS AU640检测结果 的相关性,并评价POCT检测系统的精密度及特异度.结果 POCT法高、中、低三个浓度的批内和批间精密度分别为5.3%和7.9%、6.2%和7.1%、3.7%和4.6%,与人IgG和白蛋白未见明显的交叉反应.当C反应蛋白＞0.5ng/mL时,POCT法检测结果 与其他两种检测系统相关性较好(r=0.959,0.946,P均＜0.05).结论 POCT法检测C反应蛋白具有良好的精密度及特异度,且与BNP特定蛋白仪及OLYMPUS AU640 检测结果 具有良好的相关性.

科学合理的输血能够挽救患者生命,反之则危害生命.输血的安全性和有效性取决于2个要素:①血液和血液制品是安全的,成本合理,数量上满足临床需要;②临床合理应用血液和血制品[1].从2000年10月1日<临床输血技术规范>实施以来,我院成分输血比例逐年上升,但成分血液的不合理使用仍然存在,将红细胞悬液与新鲜冰冻血浆混合起来合成人工全血输给患者,及将血浆用于提高患者血浆蛋白含量,以致于出现新的不合理用血.

目的:了解孕妇血清同型半胱氨酸(Hcy)水平与妊娠高血压综合征的关系。方法:将检测对象分为3组:妊娠高血压综合征组患者42例(A组),其中轻度妊高征组25例(A 1组),中、重度妊高征组17例(A 2组);正常晚期孕妇组30例(B组);正常育龄妇女组30例(C组),采用循环酶法检测各组血清Hcy水平。结果:A组与B组及C组血清Hcy水平比较,差异有显著性(P<0.01);A 2组血清Hcy水平高于A 1组,差异有显著性(P<0.01);B组与C组Hcy水平比较,差异无显著性(P>0.05)。结论:同型半胱氨酸与妊娠高血压综合征发病及病情发展密切相关。

目的对孕妇孕中期AFP/β-HCG二联筛查实验结果进行统计分析,评价其临床应用价值。方法采用金标全定量检测方法,应用相应分析软件计算唐氏综合征(DS)与神经管畸形(NTD)的风险率。结果DS筛查高危率5.88%;NTD筛查高危率0.48%,3例NTD高危孕妇经B超检查确诊为神经管畸形。结论普遍进行孕中期产前筛查,可减少出生缺陷,提高出生人口素质。

自动生化仪广泛应用于临床检验工作中,因其具有准确性高、精密度好及灵活性和高效率,而在临床检验中承担大部分的常规工作,成为实验室必备的检验设备,但使用中出现的若干问题,影响检验结果的准确性,要保证生化检验结果的准确性,必须加强自动生化仪应用的管理.笔者就自动生化仪应用的管理体会报告如下.