肿瘤标志物蛋白芯片用于肿瘤筛查的实用性研究

目的探讨肿瘤标志物蛋白芯片(C12)快速检测系统进行肿瘤早期筛查及诊断的实用性。方法应用C12检侧系统,对2011年11月至2015年12月在奉城医院健康体检人群和临床检验标本中涉及高危人群的血清10 736例,进行12种常见肿瘤标志物(AFP、CEA、CA125、CA15-3、CA19-9、CA242、NSE、fPSA、PSA、β-HCG、HGH、Ferritin)定量检测,并对结果进行统计分析。结果 10 736例标本中共检出阳性967例,其中男496例,阳性检出率4.62%(496/10 736);女471例,阳性检出率4.39%(471/10 736);967例阳性标本经临床病理学确诊为肿瘤患者473例,阳性诊断率48.91%(473/967)。结论 C12检测系统联合检测多种肿瘤标志物,减少了多项目分别单一检测的繁琐流程,达到快速检测多项指标的目的,对提高肿瘤的检出率及恶性肿瘤的早期快速筛查具有一定的临床价值。     

Pharmacoeconomics as a tool for the synthesis of available information on drugs

Data on refundable pharmaceutical drugs are numerous and of various kinds. The clinical approach and the economic approach could be used together. This new approach allows for not only the synthesis but also the structuring of all the available information. The new information obtained is involved in decision trees.     

TCOMs as a screening tool for hyperbaric oxygen therapy.

Transcutaneous oximetry (TcPO2), often referred to as TCOM, is a noninvasive measurement of oxygen tension in the tissue via a heated electrode. TCOMs can be used prior to beginning hyperbaric oxygen (HBO) treatment to determine if the patient has adequate blood flow to the wounded area to benefit from HBO. A case study of how it can be used in a problematic wound is presented.     

基于DNA杂交CD式微流控芯片筛查苯丙酮尿症方法的建立

目的 建立一种基于往复流的DNA杂交CD式微流控芯片技术,用于PKU基因突变快速筛查.方法 设计并加工一种具有12个微通道的CD式微流控芯片,芯片采用PDMS-玻璃双层结构,分别含有微通道和水凝胶结合探针区.探针区包括R243Q、V245V和空白对照.将PAH外显子7扩增产物加入芯片的进样孔,在离心力的作用下进入杂交微通道区.芯片在离心机中交替旋转或暂停从而进行杂交反应.杂交后将芯片置于荧光显微镜下观察结果并分析荧光信号.评价该方法检测特异性、检测限及重复性.对30例疑似PKU孕妇DNA标本进行检测,并将检测结果与测序比较.结果 利用基于往复流的DNA杂交CD式微流控芯片只需1.5μl样品,杂交时间为15 min,杂交检测限为0.7 ng/μl.对于PKU患者组与健康对照组,芯片检测结果与测序结果一致.挑选不同批次的5张芯片及每张芯片内5个微通道重复检测同一V245V突变PKU患者DNA标本,结果均为阳性,说明重复性较好.对30例疑似PKU孕妇标本进行检测,筛查出4例携带V245V突变,1例携带R243Q突变.结论 建立了一种基于往复流的DNA杂交CD式微流控芯片检测PKU基因突变的方法,该方法简便、快速、高灵敏,可以用于PKU产前筛查.     

Prealbumin measurement as a screening tool for protein calorie malnutrition in emergency hospital admissions: a pilot study.

OBJECTIVE: To examine the effectiveness of prealbumin measurement as a routine diagnostic test for protein calorie malnutrition (PCM) in emergency admissions. DESIGN: Cohort study. SETTING: Canadian tertiary care hospital. PATIENTS: A total of 147 consecutive patients admitted through the emergency department, excluding psychiatric admissions, for whom a serum sample was sent to the chemistry laboratory. OUTCOME MEASURES: (1) Albumin and prealbumin levels to diagnose PCM; (2) length of stay (LOS), in-hospital mortality, and nutritional supplementation in patients with PCM; and (3) cost analysis of using prealbumin level as an admission screening test for PCM. RESULTS: Twenty-four per cent of the patients had at least mild PCM (prealbumin level < 160 mg/L). Albumin level (< 35 g/L) had a sensitivity of 50% and specificity of 95% in identifying PCM. The mean LOS in the patients with PCM was 16 (standard deviation 18) days, compared with 8 (SD 12) days in the patients without PCM (p < 0.0002). The in-hospital mortality rate was 17% in patients with PCM compared with 4% in patients without PCM (p < 0.02). Only 42% of patients with PCM received nutritional supplementation. Cost analysis of screening with prealbumin level projected a saving of $414 per patient screened. CONCLUSIONS: PCM is underdiagnosed in current clinical practice and is associated with an increased LOS and mortality rate. Prealbumin is a biochemical marker that could be used as a cost-effective screening test to identify patients with PCM who may benefit from nutritional supplementation.     

Assessment of a food frequency questionnaire as a screening tool for low fat intakes

This study tested the ability of a self-administered food frequency questionnaire (FFQ) to identify women with low fat intakes. FFQs were completed by 95 control participants of a dietary trial at a mean of 2.9 ± 0.8 years post-randomization. Subjects were selected in approximately equal numbers from women who were low-fat eaters (⩽30% of energy from fat) and high-fat eaters (>30% of energy from fat). Percentage energy from fat derived from food records and FFQ were similar in both the low- and high-fat eaters. Percentage of energy from carbohydrate and total grams of carbohydrate (low-fat eaters only) were slightly higher measured by FFQ than by food records, and percentage of energy from protein was slightly lower. The correlation between nutrient intake measured by FFQ and food records for the whole group was 0.74 for percentage of energy from fat, 0.50 for total fat, 0.59 for percentage of energy from carbohydrate, 0.43 for total carbohydrate, 0.53 for percentage of energy from protein, 0.27 for total protein, and 0.32 for energy intake. Correlations were slightly lower when the low-and high-fat eaters were examined separately. The area under the receiver operating characteristic (ROC) curve, 0.83, was significantly above 0.5 (p < < 0.001), indicating that the FFQ discriminated between low- and high-fat eaters significantly better than chance. The FFQ cutoff point of 30% of energy from fat had a true positive rate of 0.63 and false positive rate of 0.24. The use of this cutoff point for screening would result in the loss of 36% of potential subjects and an estimated increase in baseline percentage of energy from fat intake of 2.3 percentage points.     

Reliability of repetitive dynamic strengths as a screening tool for manual lifting tasks

Recent studies have shown that maximal dynamic strengths (MDSs) of individuals are superior and more reliable predictors of their maximum safe lifting capacity compared to maximal static strengths. The evidence, however, is based on studies that have investigated only infrequent lifting activities, i.e. lifting only a few times a day and with complete recovery from fatigue between successive lifts. It remains to be seen if MDSs are also as highly correlated to lifting capacity for frequent lifting tasks i.e. tasks that do not allow complete recovery from fatigue between successive lifts.The study reported here was conducted to determine the degree of affinity between MDSs and lifting capacities of individuals for frequent and infrequent lifting tasks. In addition, the hypothesis that lifting capacity for frequent manual lifting tasks will be more highly correlated to dynamic strength values which take into account the effect of repetition related fatigue, instead of MDSs, was tested.The results overwhelmingly supported the hypothesis. We therefore concluded that repetitive dynamic strength (RDS) is a more accurate measure of an individual's lifting capacity for frequently performed tasks, than maximal static or dynamic strengths, and deserves recognition as a reliable pre-employment screening tool for frequently performed manual lifting tasks. The experimental evidence also indicated that manual lifting tasks performed once every minute or less frequently are strength oriented while those per formed three times a minute or more frequently are not.     

Recombinant green fluorescent protein-expressing human cytomegalovirus as a tool for screening antiviral agents

A recombinant human cytomegalovirus (AD169-GFP) expressing green fluorescent protein was generated by homologous recombination. Infection of human fibroblast cultures with AD169-GFP virus produced stable and readily detectable amounts of GFP signals which were quantitated by automated fluorometry. Hereby, high levels of sensitivity and reproducibility could be achieved, compared to those with the conventional plaque reduction assay. Antiviral activities were determined for four reference compounds as well as a set of putative novel cytomegalovirus inhibitors. The results obtained were exactly in line with the known characteristics of reference compounds and furthermore revealed distinct antiviral activities of novel in vitro inhibitors. The fluorometric data could be confirmed by GFP-based flow cytometry and fluorescence microscopy. In addition, laboratory virus variants derived from the recombinant AD169-GFP virus provided further possibilities for study of the characteristics of drug resistance. The GFP-based antiviral assay appeared to be very reliable for measuring virus-inhibitory effects in concentration- and time-dependent fashions and might also be adaptable for high-throughput screenings of cytomegalovirus-specific antiviral agents.     

Development of a screening tool to assess risk of tardive dyskinesia

This article gives an overview of antipsychotic medication and of tardive dyskinesia (TD). It examines the research available on TD as it relates to people with a learning disability (PWLD). The evidence identifies that specific groups of people are at an increased risk of developing TD. It also shows that 45-50% of PWLD who are treated with antipsychotic medication will be affected by TD. The evidence is used in the formulation of an assessment tool designed for use by the community learning disability nurse to identify an individual's risk of developing TD before commencing medication. Litigation in the USA has led to a $6.7 m award for sound, clinically effective practice and evidence-based interventions requires that practitioners are accountable for their practice, but are also seen to transform existing services in a way which improves the delivery of quality interventions and care.     

Diffusion-weighted MRI as a screening tool of stroke in the ED

This report describes a novel imaging technology for the evaluation of stroke patients. Diffusion-weighted magnetic resonance imaging can visualize hyperacute ischemic stroke which cannot be seen on computed tomography; moreover, it only takes few minutes to scan. We believe that diffusion-weighted magnetic resonance imaging, rather than routine computed tomography, should be considered when the emergency physician evaluates a patient with acute ischemic stroke.     

The smiley as a simple screening tool for depression after stroke: a preliminary study

In Hong Kong, there is a paucity of evidence to support which tool is superior in measuring depression after stroke (DAS). A simple, non-language-based, culturally neutral, non-verbal and easy to apply tool that is not highly dependent on training will be desirable. OBJECTIVES: The present study aimed to examine the clinical utility of three smiley pictures in detecting DAS for older Chinese patients at 1 month after first-ever ischemic stroke. METHODS: This was a cross-sectional study. A total of 253 stroke patients were interviewed by a research nurse at 1-month follow-up. RESULTS: Taking Diagnostic and Statistic Manual (DSM IV) as the gold standard, the measurement properties of emoticon (sad) in terms of sensitivity, specificity, positive and negative predictive values, as well as Kappa's value were found comparable to Geriatric Depression Scale (GDS). The emoticon (happy) demonstrated a highly significant inverse relationship with all depression assessment tools (p<0.001). It was also found that the emoticon (flat) could capture 98% of all depressed subjects identified by DSM IV, although its predictive values were less satisfactory. CONCLUSIONS: The smiley pictures seemed to fulfil the requirements for early and prompt screening among older patients. Cultural implication regarding emotions dissipation among Chinese patients should be further studied.