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关键词： 质量控制   免疫检验   变异指数  

摘要： 分析质量控制在临床免疫检验中的作用。方法:我院自2018年1月开展质量控制工作,对比2017年1月~12月和2018年1月~12月免疫检验结果的质量。结果:开展质量控制工作前,免疫检验甲状腺功能变异指数(40.25±10.72)、C-P指数(50.54±20.85)、CEA指数(40.52±14.52)、AFP指数(58.36±24.75)、CA199数(43.48±14.12)、CA125指数(43.48±14.12)、INS(57.25±25.13)、β-HCG指数(52.21±23.61)。开展质量控制工作后变异指数分别为(32.11±8.89)、(36.89±14.78)、(37.52±14.11)、(25.47±13.43)、(32.74±13.88)、(29.11±13.56)、(38.85±24.56)、(35.46±20.89),对比均有统计学差异,P<0.05。结论:临床免疫开展质量控制能够明显提高工作质量,降低变异情况,对于指导临床治疗有重要作用,值得进一步推广应用。

关键词： Anxiety   Selective mutism   Parent-child interaction   Intervention   Behavior therapy  

摘要： Background: The purpose of this study was to evaluate a new therapy for children with selective mutism (SM) that combines Parent-Child Interaction Therapy principles and behavioral techniques. Method: Children aged 4-10 with a primary diagnosis of SM were eligible to participate. Comorbidity was allowed with the exception of autism spectrum disorder, intellectual disability, mania or psychosis. Of 54 potentially eligible participants, 33 met inclusion/exclusion criteria of which 31 families consented (94%). Following assessment, children were waitlisted for an average of 4 months before receiving 16 sessions of weekly therapy at an outpatient psychiatry clinic of a children's hospital in Vancouver, Canada;all children completed treatment. Assessments were conducted at time of referral (baseline), pre-treatment, post-treatment, 3 month follow up, and 1 year follow up. Two did not complete follow up assessments (93% retention). Results: Results showed significant and large (Cohen's d = 1.80) gains in speaking behaviors across contexts from pre- to post-treatment. Gains were maintained at 3-months and 1-year post-treatment. Statistically significant and large improvements were also found in post-treatment teacher and parent reports of child anxiety as well as a behavioral measure of the child speaking to an unknown adult. Parents reported high satisfaction with treatment. None of the potential predictors of treatment response examined were found to be significant. Conclusions: PCIT-SM appears to be an effective treatment for children aged 4-10 with SM.

关键词： Cultural competence   New graduate nurse (NGN)   Cultural diversity awareness   Nurse residency programme  

摘要： Background: Cultural competency has been identified as an essential curricular element in undergraduate and graduate nursing programmes. Supporting successful transition to practice is essential for retaining graduate nurses in the workforce and meeting the demand for cultural diversity in health care services. Objectives: This study aimed to explore the teaching and learning interactions of transition cultural competence from the perspective of mentors of newly graduated nurses in a Taiwanese postgraduate nursing programme. Design: A qualitative design that utilised focus group interviews was adopted for this study. A framework approach a content and thematic analysis strategy was used to analyse the interviews. Setting The study setting consisted of two hospitals in northern Taiwan. Participants: The study participants consisted of 24 new graduate nurse mentors. Methods: Three focus group sessions were conducted (two at a medical centre and one at a district hospital), where the participants were interviewed. Results: Four themes were derived from the data transition process, teaching strategies according to the transition stage, learning after overcoming clinical stress, and awareness of cultural diversity among new graduate nurses. The clinical routine and physical stress of caring for patients did not allow the newly graduated nurses to appropriately demonstrate cultural competence in the first three months. Mentors were only able to provide resources for new graduate nurses when they first started to care for patients in cultural groups. The point of catalysis was when learners finally gained awareness of cultural differences, and, consequently, they could encounter the teaching and learning process. Conclusion: The different learning stages and teaching strategies illustrated the interactive process between new nurses and educators. Facilitating the cultural awareness of learners is a challenge for teachers who provide cultural competence training. This model

关键词： Alzheimer's disease   classification   heterogeneity   high-throughput   machine learning   microglia   morphology  

摘要： The phenotypic changes of microglia in brain diseases are particularly diverse and their role in disease progression, beneficial, or detrimental, is still elusive. High-throughput molecular approaches such as single-cell RNA-sequencing can now resolve the high heterogeneity in microglia population for a specific physiological condition, however, the relation between the different microglial signatures and their surrounding brain microenvironment is barely understood. Thus, better tools to characterize the phenotypic variations of microglia in situ are needed, particularly for human brain postmortem samples analysis. To address this challenge, we developed MIC-MAC, a Microglia and Immune Cells Morphologies Analyser and Classifier pipeline that semiautomatically segments, extracts, and classifies all microglia and immune cells labeled in large three-dimensional (3D) confocal image stacks of mouse and human brain samples. Our imaging-based approach enables automatic 3D-morphology characterization and classification of thousands of individual microglia in situ and revealed species- and disease-specific morphological phenotypes in mouse aging, human Alzheimer's disease, and dementia with Lewy Bodie's samples. MIC-MAC is a precision diagnostic tool that allows a rapid, unbiased, and large-scale analysis of microglia morphological states in mouse models and patient brain samples.

关键词： Women's health   Peripartum mood disorders   Hormones   Cytokines   Developmental disorders   Brain development  

摘要： Pregnancy and the postpartum period are periods of significant change in the immune and endocrine systems. This period of life is also associated with an increased risk of mental health disorders in the mother, and an increased risk of developmental and neuropsychiatric disorders in her infant. The collective data described here supports the idea that peripartum mood disorders in mother and developmental disorders in her infant likely reflects multiple pathogeneses, stemming from various interactions between the immune, endocrine and nervous systems, thereby resulting in various symptom constellations. In this case, testing the mechanisms underlying specific symptoms of these disorders (e.g. deficits in specific types of learning or anhedonia) may provide a better understanding of the various physiological interactions and multiple etiologies that most likely underlie the risk of mental health disorders during this unique time in life. The goal here is to summarize the current understanding of how immune and endocrine factors contribute to maternal mental health, while simultaneously understanding the impact these unique interactions have on the developing brain of her infant.

关键词： ANFO explosives   Diesel   FAMEs   GCMS   FTIR   Chemometrics  

摘要： Ammonium nitrate fuel oil (ANFO) is one of the most favorite explosives used in terrorist attacks. This explosive is a complex mixture of 95-96% ammonium nitrate (AN) and 4-5% liquid hydrocarbons (fuel oil). In this study, we analyze a variety of ANFO explosive mixtures in order to classify their different sources of origin by observing the difference in fuel components. The study was performed by mixing ammonium nitrate with eight different diesel brands collected in Lincoln, UK in two seasons (winter and summer). The samples were extracted using appropriate solvent and extracts were subsequently analyzed in sextuplicate by gas chromatographymass spectrometry (GC-MS) and Fourier transform infrared spectroscopy (FTIR). A classification model was performed using principal component analysis (PCA) and Lineal Discriminant Analysis (LDA). In this study, four fatty acid methyl ester (FAME) contents were observed by GC-MS in all summer samples but found lack in some winter sample resulting in seasonal variation effect. The classification of pre-blast ANFO samples was achieved using GC-MS and FTIR in a combination with PCA/LDA. The results significantly showed the variation of specific diesel components and providing different classification performance among ANFO samples with high classification performance. Therefore, this study can be beneficial in forensic investigation that the use of diesel components are able to classify among different ANFO samples. (C) 2019 Elsevier B.V. All rights reserved.

关键词： 医院感染   微生物检验   应用价值   监测  

摘要： 研究控制医院感染中临床微生物检验与监测的应用价值。方法:以2018年6月-2019年2月本院接诊的感染病患120例为研究对象,并将之利用电脑随机双盲法分成研究和对照两组(n=60)。当中,研究组在感染控制工作中运用微生物检验与监测法,对照组应用常规控制感染法。分析两组感染控制的情况,并对各组的感染程度等指标作出比较。结果:研究组的感染控制率为87.33%,比对照组的65.0%高,组间比较差异显著(P<0.05)。研究组干预后的感染程度轻于对照组,组间比较差异显著(P<0.05)。研究组对感染控制效果的满意度为95.0%,比对照组的76.67%高,组间比较差异显著(P<0.05)。结论:于控制医院感染中合理运用微生物检验与监测法,可有效减少医院感染发生风险,提高临床治愈率,并能为感染者用药方案的制定及调整提供重要指导,建议采纳。

关键词： 医学检验   服务支撑平台   区域医联体   作用分析  

摘要： 看病问题一直是民生最大的问题,对于国家而言,国家稳定性与多方面的因素有关,像收入情况、住房情况、就业情况等,众多因素当中看病问题是其根本。为了更好的解决所存在的问题,设定区域医联体,根据患者病情的情况将其合理安排,让患者集中在一起就医。为了降低临床当中误诊的情况发生,实施服务支撑平台,应用此方式,可以优化资源,提升检验的准确性,可以根据检验结果制定科学、合理的治疗方案,提升治疗的显著性。