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关键词： 质量管理   检验标本   检验标本   不合格率   标本收集转运箱  

摘要： 目的探讨质量管理在降低检验标本不合格率中的重要作用。方法收集2015年4月至2016年3月检验科接收的标本313088例,其中1257例不合格,标本不合格率0.40%,分析总结影响检验标本不合格率的因素,找出要因之一。分为对照组(2016年4月)和试验组(2016年8月),采用全面质量管理的理念,全方位、全员、全过程,多种方法的质量管理。结果经质量控制,检验标本不合格率由对照组的0.35%下降到试验组的0.25%,质量控制前后的检验标本不合格率相比有所下降(P<0.05)。结论质量控制在降低检验标本不合格率中具有很重要的作用,可显著降低检验标本的不合格率,同时经过规范检验标本送检前的采集、运送过程,可提高护理人员的专业素质,也使标本质量得到显著改善。对检验标本送检前进行质量管理,可以有效减少检验标本的不合格率,具有重要的临床价值。

关键词： 细菌学检验   宫颈癌   腔内放疗   局部感染   疗效  

摘要： 目的探讨细菌学检验对宫颈癌腔内放疗合并局部感染患者临床治疗的指导作用。方法将该院2013年9月-2016年10月收治的实施宫腔内放射治疗伴有局部性感染的69例宫颈癌患者为研究对象,按照就医时序数字标号进行双盲随机分组,常规组34例,仅结合患者自身病情变化及体征情况评估感染程度,行经验性抗生素用药;观察组35例,均按细菌学检测规范进行相关病菌培养鉴别及药物过敏性试验,针对患者实际状况进行个体化抗生素用药,评估两组患者抗感染用药效果。结果观察组患者局部感染治疗周期与病情控制时间均明显短于常规组(P<0.05);观察组患者经个体化抗菌用药后治疗总有效率(94.29%)明显高于常规组的73.53%(P<0.05);观察组患者在抗菌用药期间宫腔积液、盆腔炎、分泌物异常增多或血性分泌物等并发症发生率均明显低于常规组(P<0.05)。结论宫颈癌腔内放疗合并局部感染患者可应用细菌学检测方式来明确抗优化菌方案,保证疗效,在短期内抑制病情发展,为肿瘤患者后期治疗提供安全保障,减少并发症的发生。

关键词： 微生物检验   院内感染   控制  

摘要： 文章对比分析是否接受微生物检验的住院患者院内感染发生情况、院内感染程度,探讨微生物检验对院内感染发生率的控制作用。作者认为,微生物检验能够有效控制院内感染,降低其发生率同时还能够减轻院内感染程度。

关键词： 建设工程施工合同   外包   《招投标法》   项目招标   安全压力   政府监管   人民币   建设市场  

摘要： 随着电力建设市场的全面放开,各种施工项目、服务大量外包,社会力量承揽施工的人员、资质、技术、设备、管理、安全等方面的原因,安全压力巨大。随之而来的是,政府有关部门监管力度的不断加大,给发包企业造成很大压力,因此必须对外包加以规范。本文就各种外包形式从政府监管、法律裁判等各种角度,对外包形式的模式进行探讨,提出解决对策。一、施工合同外包的范围《招投标法》第3条第1款的规定,凡是全部或者部分使用国有资金投资或者国家融资的项目,都必须进行招标。《招投标法实施条例》第9条,又对采购人依法能够自行建设、生产或者提供,规定可以不招标。原国家计委《工程建设项目招标范围和规模标准规定》第7条明确规定(计委令第3号),项目的勘察、设计、施工、监理以及与工程有关的重要设备、材料等的采购,施工单项合同估算价在200万元人民币以上的;重要设备、材料等货物的采购,单项合同估算价在100万元人民币以上的;勘察、设计、监理等服务的采购,单项合同估算价在50万元人民币以上的;单项合同估算价低于规定的标准,但项目总投资额在3000万元人民币以上的,必须进行招标。

关键词： ORAL-MOTOR DYSFUNCTION   OROPHARYNGEAL DYSPHAGIA   MANUAL ABILITY   RELIABILITY   GROWTH   PREVALENCE   DISABILITY   CHILDHOOD   CLASSIFY  

摘要： AimTo determine (1) the reproducibility of the Eating and Drinking Ability Classification System (EDACS); (2) EDACS classification distribution in a population-based cohort with cerebral palsy (CP); and (3) the relationships between the EDACS and clinical mealtime assessment, other classifications, and health outcomes. MethodThis was a cross-sectional population-based cohort study of 170 children with CP at 3 years to 5 years (mean 57.6mo, standard deviation [SD] 8.3mo; 105 males, n=65 females). Functional abilities were representative of a population sample (Gross Motor Function Classification System level I=74, II=34, III=21, IV=18, V=23). The EDACS was the primary classification of mealtime function. The Dysphagia Disorders Survey was the clinical mealtime assessment. Gross motor function was classified using the Gross Motor Function Classification System. ResultsEDACS classification had 88.3% intrarater agreement (=0.84, intraclass correlation coefficient=0.95; p<0.001) and 51.7% interrater agreement (=0.36, intraclass correlation coefficient=0.79; p<0.001). In total, 56.5% of children were classified as EDACS level I. There was a strong stepwise relationship between the Dysphagia Disorders Survey and EDACS (r=0.96, p<0.001). Parental stress (odds ratio=1.3, p=0.05) and feeding tubes (odds ratio=6.4, p<0.001) were significantly related to more limited function on the EDACS. InterpretationThe EDACS presents a viable adjunct to clinical assessment of feeding skills in children with CP for use in surveillance trials and clinical practice. A rating addendum would be a useful contribution to the tool to enhance reproducibility.

关键词： evolution   influenza virus   packaging   reassortment   segment mismatch   GENE SEGMENTS   INCREASED PATHOGENICITY   AVIAN H5N1   RNA   H1N1   NEURAMINIDASE   COMPATIBILITY   TRANSMISSION   SWINE   HEMAGGLUTININ  

摘要： Influenza A virus (IAV) RNA packaging signals serve to direct the incorporation of IAV gene segments into virus particles, and this process is thought to be mediated by segment-segment interactions. These packaging signals are segment and strain specific, and as such, they have the potential to impact reassortment outcomes between different IAV strains. Our study aimed to quantify the impact of packaging signal mismatch on IAV reassortment using the human seasonal influenza A/Panama/2007/99 (H3N2) and pandemic influenza A/Netherlands/602/2009 (H1N1) viruses. Focusing on the three most divergent segments, we constructed pairs of viruses that encoded identical proteins but differed in the packaging signal regions on a single segment. We then evaluated the frequency with which segments carrying homologous versus heterologous packaging signals were incorporated into reassortant progeny viruses. We found that, when segment 4 (HA) of coinfecting parental viruses was modified, there was a significant preference for the segment containing matched packaging signals relative to the background of the virus. This preference was apparent even when the homologous HA constituted a minority of the HA segment population available in the cell for packaging. Conversely, when segment 6 (NA) or segment 8 (NS) carried modified packaging signals, there was no significant preference for homologous packaging signals. These data suggest that movement of NA and NS segments between the human H3N2 and H1N1 lineages is unlikely to be restricted by packaging signal mismatch, while movement of the HA segment would be more constrained. Our results indicate that the importance of packaging signals in IAV reassortment is segment dependent. IMPORTANCE Influenza A viruses (IAVs) can exchange genes through reassortment. This process contributes to both the highly diverse population of IAVs found in nature and the formation of novel epidemic and pandemic IAV strains. Our study sought to determine the ext

关键词： drug discovery   DNA-encoded libraries   genetic disease  

摘要： Vertex Pharmaceuticals will pay X-Chem an undisclosed up-front payment as well as milestones as part of a small-molecule drug discovery pact targeting severe, genetic diseases. X-Chem, based in Waltham, Mass., says it will screen Vertex targets against its library of more than 120 billion small molecules tethered to DNA tags that record their synthetic history. Vertex has the option to license leadlike hits. X-Chem already has agreements with AstraZeneca, Bayer, Pfizer, Roche, and other firms.

关键词： Metagenomics   Taxonomic composition   Functional diversity   Environmental inhomogeneity   Statistical testing   METAGENOMICS   RESOURCE  

摘要： One important question in microbiome analysis is how to assess the homogeneity of the microbial composition in a given environment, with respect to a given analysis method. Do different microbial samples taken from the same environment follow the same taxonomic distribution of organisms, or the same distribution of functions? Here we provide a non-parametric statistical "triangulation test" to address this type of question. The test requires that multiple replicates are available for each of the biological samples, and it is based on three-way computational comparisons of samples. To illustrate the application of the test, we collected three biological samples taken from different locations in one piece of human stool, each represented by three replicates, and analyzed them using MEGAN. (Despite its name, the triangulation test does not require that the number of biological samples or replicates be three.) The triangulation test rejects the null hypothesis that the three biological samples exhibit the same distribution of taxa or function (error probability <= 0.05), indicating that the microbial composition of the investigated human stool is not homogenous on a macroscopic scale, suggesting that pooling material from multiple locations is a reasonable practice. We provide an implementation of the test in our open source program MEGAN Community Edition. (C) 2016 The Author(s). Published by Elsevier B.V.