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【Objective】 In an effort to prevent transfusion-transmitted hepatitis B infection, universal HBsAg screening, HBsAg+ MP nucleic acid test(NAT) for HBV and HBsAg + individual(ID) NAT were analyzed for cost-effectiveness. 【Methods】 On the basis of screening data and the documented parameter, the number of window period infections, chronic infections and occult infections was constructed, and cost-benefit analysis was conducted. 【Results】 Of 132 208 donations, the yield rate of ID NAT for HBsAg-/DNA+ (0.11%) was significantly higher than HBsAg+ MP NAT(0.058%). Furthermore, the predicted preventing transfusion transmitted HBV cases by ID NAT is 1.25 times as that by MP-6 NAT, so did the benefits. The cost-benefit of the three screening models were 1∶63.6、1∶28.6 and 1∶53.4. 【Conclusion】 Universal HBsAg in combination with ID HBV NAT screening was the most effective among all screening strategy. It is necessary to applied HBsAg and ID HBV NAT screening for the safety of blood transfusion.
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Objective@#To analyze heavy metal health risks of direct drinking water in primary and secondary schools in Huangpi District, Wuhan, so as to provide reference basis for ensuring drinking water safety of teachers and students.@*Methods@#Cadmium (Cd), Plumbum (Pb) and arsenic (As) in water samples from primary and secondary schools were detected in accordance with the GB/T 5750-2006 "Standard Examination Methods for Drinking Water", water quality was evaluated based on the Quality Standard for Fine Drinking Water(CJ 94-2005). Health risk assessment model was used to evaluate the potential risk of heavy metals in direct drinking water in primary and secondary schools.@*Results@#The unqualified rates of Pb, Cd and As were 0.95%, 1.22% and 0 in 66 primary and secondary schools in Huangpi District, Wuhan. The risk of noncarcinogens related to the direct drinking water of heavy metals (Pb, Cd, As) were less than 1. The range of carcinogenic risks related to the direct drinking water was within the range of 1.07×10 -8 /year -5.58×10 -6 /year which were both within the acceptable level.@*Conclusion@#Concentrations of cadmium, plumbum and arsenic were not found to be significantly elevated as compared to "Quality Standard for Fine Drinking Water" in Huangpi District of Wuhan. Pb and Cd slightly exceeded the standard, with no significant health risk. Water quality and health risk assessment should be strengthened to ensure the safety of drinking water for teachers and students.
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Objective To investigate the genotype and production of toxin A and B of C .difficile clinical isolates collected from Sydney ,Australia .Methods Sixty‐eight C .difficile clinical isolates were collected from Westmead Hospital ,the University of Sydney ,which were genotyped by using PCR‐ribotyping ,and toxin A ,B coding gene tcdA ,tcdB were detected by using PCR meth‐od .Results Thirty‐one PCR‐ribotypes (RTs) were confirmed in the 68 C .difficile clinical isolates ,RT014 (19 .1% ) and RT002 (11 .8% ) were the common genotypes .Sixty‐four of 68 (94 .1% ) isolates contained tcdA and tcdB for toxin A and B .Conclusion The common prevalent PCR‐ribotypes of C .difficile were RT014 and RT002 in Sydney ,most of the C .difficile clinical isolates contained toxin A and B .
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Objective To investigate the genotype and variance of toxin associated genes of moxifloxacin‐resistant Clostridium difficile clinical isolates in Sydney .Methods Twenty‐two moxifloxacin‐resistant Clostridium difficile clinical isolates were collected from Sydney ,which were genotyped by using sequencer capillary gel electrophoresis based PCR‐ribotyping ,and toxin A and B cod‐ing gene tcdA and tcdB ,and binary toxin coding gene cdtA and cdtB were detected by using PCR method .Toxin regulator gene tc‐dC was analyzed by using PCR‐sequencing ,and was aligned with reference sequence of VPI 10463 (Genbank accession number :X92982) ,and the tcdC sequence types of all 22 isolates were identified by using blast tool in NCBI .Results Twenty‐one isolates were genotyped as hypervirulent PCR‐ribotypes 027 (RT027) ,and one isolate as RT078 ;all 22 isolates contained tcdA and tcdB for toxin A and B and cdtA and cdtB for binary toxin (tcdA+ tcdB+ cdtA+ cdtB+ ) .The tcdC sequence types of the 21 RT027 i‐solates belong to sc1 ,and that of the one RT078 isolate belongs to WA39 .Compared with tcdC reference sequence of VPI 10463 ,a consecutive 18 bp deletion (nt341 to 379) and one nucleotide deletion at position 117 were found in the 21 RT027 isolates ,and a consecutive 39 bp deletion (nt330 to 368) and one nucleotide mutation at position 184(C> T) were found in the one RT078 isolate . Conclusion Clostridium difficile hypervirulent RT027 was the common moxifloxacin resistant genotype ;Clostridium difficile hy‐pervirulent RT027 and RT078 clinical isolates contained genes for toxin A and B and binary toxin ,and contained gene sequence mu‐tation in toxin regulator gene tcdC .
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Objective To investigate the effect of fetal hemoglobin( HbF) in improving anemia of women who were β‐thalasse‐mia carriers at childbearing age .Methods 289 cases of women at childbearing age diagnosed as β‐thalassemia carriers in Shenzhen City were enrolled in this study .The high performance liquid chromatography (HPLC) was uesed for quantitative analysis of HbF , and the red blood cell parameters were detected by using the LH750 Automatic blood cell analyzer .The differences of red blood cell parameters between the HbF normal group and the HbF increased group were compared ,and the relationship between the high HbF expression rates and gene mutations were also analyzed .Results Comapred with the HbF normal group ,the hemoglobin (HGB) levels ,mean corpuscular volume (MCV) and the mean corpuscular hemoglobin (MCH) increased significantly ,while the red blood cell (RBC) count reduced ,there were significant differences between the two groups (P0 .05) .There were no significant differnces of rates of HBF high expression between different types of β‐globin gene mutations and the overall rate of HBF high expression (P>0 .05) .Conclusion Compared with the HbF normal group , anemia may improve more significantly in cases of women diagnosed as β‐thalassemia carriers at childbearing age in the HbF in‐creased group ,and there may be no relationship between gene mutations and high expression of HbF .
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Objective To develop a multiplex polymerase chain reaction (PCR )method for detecting and genotyping moxifloxacin-resistant Clostridium difficile (C.difficile)isolates.Methods Specific PCR primers of slpA genotypes gr,hr,fr,gc08 and 078 were designed according to the differences of slpA nucleotide sequences in different C.difficile genotypes,and the house-keeping gene tpi specific PCR primers were also added for the construction of multiplex PCR method.Nine common intestinal normal and pathogenic strains were used to verify the specificity of slpA multiplex PCR for the detection of C.difficile.Forty-six C.difficile reference strains,belonging to 11 slpA genotypes,were used to verify the ability of the multiplex PCR method for dectecting and genotyping.Thirty-nine moxifloxacin-resistant clinical isolates were genotyped by the multiplex PCR,and its clinical value was evaluated by comparing with slpA sequence typing (slpA ST)method.Results All the 9 intestinal normal and pathogenic strains were negative when detected by the multiplex PCR.And tpi of 46 C. difficile reference strains were positive,and 36 strains belonging to slpA genotypes gr,hr,fr,gc08 and 078 were genotyped correctly.Other 10 strains which belonged to other 6 genotypes were non-typeable. Among 39 moxifloxacin-resistant clinical isolates,all were positive of tpi,and 32 isolates were typed correctly by the multiplex PCR method,including 22 slpA genotypes gc08,6 genotypes hr,2 genotypes fr,and 2 genotypes 078,which were consistent with slpA ST.However,7 isolates could not be typed by multiplex PCR,which were identified as other genotypes not included in the multiplex PCR by slpA ST. Conclusions A convenient and rapid multiplex PCR method for the detection of C.difficile is established successfully,which can distinguish among five slpA genotypes.slpA genotype gc08 is the common genotype of moxifloxacin-resistant clinical isolates.
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Objective To investigate the influence of fixed nurse specialists triage to improve the quality of patient triage.Methods Nurses were divided into the fixed nurse specialist triage group (group A) and the out-patient department rotation nursing group (group B),respectively,each group was responsible for triage of patients in clinic of medical department for five days.Then the number of two subdiagnosis error and the average daily working overtime for doctors were compared.Results A total of 3806 patients were in clinic triage in group A,165 patients had triage error.A total of 3812 patients were in clinic triage in group B,308 patients had triage error.The average daily working overtime of doctors in group A was(5.24 ± 0.37)hours,and(8.16 ± 0.58) hours in group B.The errors in triage and working overtime of doctors had significant differences between two groups.Conclusions Fixed specialist nurse triage can significantly improve the quality of patient triage in clinic.
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Objective To evaluate the clinical value of fetal holoprosencephaly complicated with face malformation by two-dimensional(2D) and three-dimensional(3D) ultrasonography.Methods Fetal faces and brains were examined regularly with 3D ultrasonography when they were suspected abnormal with 2D ultrasonography and compaired the diagnoses with postnatal or induced delivery results.Results 11 cases of holoprosencephaly complicated with face malformation were diagnosed using 2D and 3D ultrasonography.Among these cases,there were 4 with single median mostril,2 with proboscis,2 with cheiloschisis,2 with multipte face malformation,1 with arhinia.They were all comfirmed by postnatal or induced delivery.Conclusions 3D ultrasonography provides visualized,three-dimensional,more precise and clearly fetal structure imagine.It has important supplement to 2D ultrasonography.2D ultrasonography combined with 3D ultrasonography can greatly enhance the diagnosis rate to holoprosencephaly complicated with face malformation.