The using status quo and analysis of POCT glucose meter / 中华检验医学杂志

Objective To investigate the problems during using, standard and quality management of the POCT glucose meters in hospital, to analyze the solutions, and to provide reference data for improving the test level of POCT in hospital.Methods The amount, brand and application of portable glucose meters in the hospital were obtained by 3 rounds of surveillance from May to July in 2013.All of those glucose meters were taken part in external quality assessment of Clinical Laboratory Center of National Health and Family Planning Commission.The test results of those glucose meters were compared with that of automatic biochemical analyzer, the comparison results were then analyzed.Results The POCT glucose meters possessed 5 brands in our hospital, and the amount and type of glucose meters in some clinical departments were often changed.When 4 brands which were detected as quality control samples by ministry of health, the accuracy of detection results of 3 concentration of brand Ⅲ were substandard, the CV% of two levels were 11.9%and 10.1%respectively, the remaining 3 brands were in line with the requirements.The qualified percentages of 3 times of comparison were 85.0%, 92.0%and 97.4%.Conclusions The hospital should select the brand of portable glucose meters reasonably, correct use of glucose meters, and it is very necessary to build indoor and interstitial quality evaluation system, at the same time, suggesting the hospital to establish the POCT quality management team, to carry out the instrument comparison periodically, so to guarantee the accurate, reliable results of POCT in hospital.

Laboratory diagnosis of rarely filamentous fungi / 军事医学

Objective To investigate the laboratory diagnosis of filamentous fungi which are rarely seen in clinical practice.Methods Five strains of fungi were isolated from clinical samples and initially identified by the morphological method.Total DNA of fungi was extracted and amplified by the PCR method using universal primers of ITS2-ITS4 gene, respectively.The PCR products were sequenced and the obtained sequences were then analyzed by the blastn program incorporated in NCBI.Results The five strains of fungi were diagnosed as Scedosporium apiospermum,Schizophyllum commune,Scopulariopsis brevicaulis,Rhizopus stolonifer,and Fusarium solani.Conclusion The laboratory diagnosis of filamentous fungi which rarely occur in clinical practice should integrate various methods,including morphological, microbiological,and molecular biological methods.

Suggestions on the diagnostic criteria of childhood obstructive sleep apnea hypopnea syndrome / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the sleep architecture and hypoxia and clinical features of habitual snoring children with an obstructive sleep apnea-hypopnea index (OAHI) 1 to 5.</p><p><b>METHOD</b>The polysomnographic data of 267 children aged from 2 to 16 years with habitual snoring were analyzed retrospectively, and the clinical features were analyzed in 108 of the children. The recruited children were divided into primary snoring group (PS group, OAHI≤1), obstructive sleep apnea hypopnea syndrome (OSAHS) group (1<OAHI≤5 and obstructive apnea index≤1), lowest oxygen saturation (LSpO2≤0.92) and OSAHS group (OAHI>5 or dostructive apnea index>1, LSpO2<0.92).</p><p><b>RESULT</b>The oxygen desaturation index of the intermediate OSAHS group (3.8±0.4) was significantly higher than that of PS group (1.6±0.1) (χ2=34.5, P<0.01). The LSpO2 of intermediate OSAHS group was significantly lower than that of PS group (89(87,91) vs. 93(91,94), χ2=40.2, P<0.01). Comparing to the PS group, the non-rapid eye movement 1 ratio (N1%) was significantly higher (19.0±1.2 vs. 14.2±0.1, χ2=14.1, P<0.01), and the non-rapid eye movement 3 ratio (N3%) was significantly lower (24.4±1.0 vs. 29.0±1.1, P<0.01) in the intermediate OSAHS group. The pediatric questionnaire score intermediate OSAHS group was higher than PS (0.41±0.19 vs. 0.28±0.14, χ2=8.52, P=0.01). The adenoids-nasopharynx ratio was higher than that of PS group (0.70±0.07 vs. 0.62±0.10, χ2=8.96, P=0.01). The hypertrophy of tonsil was higher than PS group (2(1,2) vs. 1(1,2), χ2=7.95, P<0.05).</p><p><b>CONCLUSION</b>Hypoxia and abnormal sleep structure are present in HS children with an OAHI of 1 to 5, and they also have the clinical features of OSAHS.</p>

Main pathogenic bacteria and drug resistance in Affiliated Hospital of Academy of Military Medical Sciences between 2012 and 2013 / 军事医学

Objective To investigate the flora distribution and drug resistance status in the Affiliated Hospital of Academy of Military Medical Sciences so as to provide experimental data for clinical doctors to use antibiotics more efficiently.Methods The clinical data of pathogenic bacterial infections over nearly one year in our hospital were retro -spectively analyzed .Results There were 3815 strains of pathogenic bacteria isolated from the sample .The percentage of Gram-positive strains was 36.4%while that of Gram-negative bacteria was 63.6%.The most common bacteria were Esche-richia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus epidermidis.In terms of drug tolerance , Enterobacteriaceae remained highily sensitive to carbapenems .The total resistance rate was 2%-5%.The resistance rate of A.baumannii to meropenem and imipenem was 60%.There were still a few pan-drug resistant strains among K.pneumoniae,A.baumannii and P.aeruginosa,but there were no drug resistant strains to vancomycin , tige-cycline and linezolid in Staphylococcus.The resistance rate of Enterococcus faecium to vancomycin was 9%.The bacteria were distributed predominantly in ICU ,Department of Hematology and Department of Oncology .The samples were mainly composed of phlegm specimens .Conclusion The high distribution in the three departments mentioned above is largely re-lated to the diseases being treated .The specimens from the lower respiratory tract show more types of bacteria that are mostly drug-resistant, and the isolating rate of vancomycin resistant Enterococcus and carbapenems resistant K.pneumoniat is com-paratively high .

Biomechanical research of calcium phosphate cement in fixating distal radius fractures / 中国矫形外科杂志

[Objective]To test the biomechanical effects of calcium phosphate cement in fixating distal tadius fractures,and to provid biomechanical foundation for clinical treating distal tadius fractures.[Method]A models of 18 human distal radius fracture of adult upper limbs specimen were made and randomly divided into three groups:fixed with Kirschner wire(Kirschner group),CPC(CPC group),and CPC combined with Kirschner wire(combination group).Wrist joint was vertically loaded with 98 N,and palmar flexion with dorsal extention motion was dimulated,which range of movement was from palmar flexion 5?to dorsal extention 30? and frequency was 2000 cycles.Displace data of distal radius were measured by sliding caliper at every 500 cycles,we had tested Young' s modulus of two samples of CPC.[Result]Multiple factor variance analysis was used,Kirschner group and others had significantly statistical difference(P0.05).[Conclusion]CPC can provide enough fixation strength for distal radius fracture with bone defect and Young' s modulus of CPC is about 30 MPa,which is between those of cancellous bone and compact bone.