Circulating microRNAs (miRNAs) have been confirmed to play an important role in biological processes,such as cell proliferation,differentiation and apoptosis.Founded on the high stability and minimal invasiveness,circulating miRNAs could be applied to the clinical practice as biomarkers.There are many technological approaches and platforms for circulating miRNAs detection but without a consistent protocol.Meanwhile,there are various factors affecting circulating miRNAs detection.In this review,technical factors and preanalytical factors in the circulating miRNA profiling are explored.

Objective To determine the change of tumor bed volume during whole breast irradiation by repeated computed tomography scanning and to analyze the dosimetric impact of boost-planning on different CT images. Methods From July 2008 to Jan 2009, sixteen patients with early-stage breast cancer underwent breast conservative surgery (BCS) were enrolled in the study. All patients received whole breast irradiation and tumor bed boost, no adjuvant chemotherapy was given. Two additional CT scans were acquired in addition to the planning CT ( CT1 ), one in the course of radiotherapy ( CT2 ) and the other before the boost (CT3). Tumor beds were contoured in all CT images. Three-dimensional conformal radiotherapy planning for tumor bed boost was done on CT1 and CT3 respectively. Results The mean tumor bed volume on CT1, CT2 and CT3 were 49.5 cm3, 25.6 cm3 and 22. 2 cm3 ( F = 5. 63, P = 0. 007 ),respectively. Further analysis found statistically significant difference between CT1 and CT2 ( q = 0. 03, P =0. 010), CT1 and CT3 ( q = 0. 01, P = 0. 004), but not between CT2 and CT3 ( q = 1.00, P = 0. 333 ). The average reduction of tumor bed volume from CT1 to CT3 was 43.4%. A reduction of 20% or above was found in 88% of the patients ( n = 14), 50% or above in 38% of the patients (n = 6). In the boost-planning, the volume of the ipsilateral breast receiving 100% prescribed dose (V100%) on CT1 and CT3 was 183.5 cm3 and 144. 5 cm3, respectively ( t = 3.06, P = 0. 008 ). Conclusions Volume of tumor bed is dynamically reduced in the course of whole breast irradiation after BCS, with more important reduction in the early weeks after the beginning of irradiation. A second CT scan before tumor bed boost is warranted.

OBJECTIVE To study the situation of central supply department and discuss the management of it.METHODS The hygienic monitoring results of sterile room in central supply department from 2007 to 2008 were invectigated.RESULTS The hygienic eligible rate of air,environment and objects was 91.1-97.2%.The qualified rate of sterilized packet was 99.2-100%.The eligible rate of humidity and temperature in disinfection chamber was 92.3% and 88.8%,respectively.CONCLUSIONS To consummate management measures and manage strictly sterilization procedure,assigning special person for the duty and attention to every details which easy tobe contaminated.all these measures mentioned above are the important countermeasures to quarantee environmental quality.

OBJECTIVE To discuss the effect of preventive medication for preventing incision infection before cesarean.METHODS Patients with cesarean section accepted parturients were divided in 2 groups randomly: group A(medicine before operation) and group B(no medicine before operation),and infection rate were observed after operation.RESULTS The incision infection rate of group A was 3.8%,and that of group B was 9.3%(?2=6.00,P

OBJECTIVE To investigate the pollution of venous indwelling needle and to discuss the preventive measures.METHODS A retrospective investigation was conducted on the results of germ culture of venous indwelling needle and the problems in nursing manipulation.RESULTS The total positive rate of venous indwelling needle cultures isolated from 2006 to 2007 was 20.2%,the positive rate in 2007 was lower than that in 2006(?2=7.66,P

OBJECTIVE To investigate the drug-resistant genes in Acinetobacter baumannii(ABA) isolated from Shaoxing and the relationship among them to supply evidences for tracing the source of epidemiology.METHODS Nineteen drug-resistant genes were detected by PCR in 39 strains of ABA.RESULTS TEM-gene was found positive in 13 strains of ABA(33.3%),OXA-23 group-gene was in 20 strains(51.3%),aac(3)-Ⅰ gene was in 23 strains(64.1%),aac(6′)-Ⅰ gene was in 25 strains(64.1%),ant(3″)-Ⅰ gene was in 29 strains(74.4%) and qacE△1-sul1 gene was in 32 strains(81.2%).The others were not found in all 39 isolates detected.Clonial transmitted phenomenon was existed.CONCLUSIONS The carrier rate of TEM,OXA-23group,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ and qacE△1-sul1 genes is high in ABA.ABA can induce clonial transmitted hospital infection.

OBJECTIVE To study the antibiotic resistance of Staphylococcus isolated from the burn patient wounds. METHODS The sensitivity to 14 common antimicrobial agents was deteded by K-B method. MRSA and MRCNS were detected by cefoxitin disk;the inducible resistance to clindamycin was detected by D-test. RESULTS There were 378 strains of Staphylococcus isolated from the burn patient wounds. The isolation rates of Staphylococcus epidermidis,S. aureus and S. haemolyticus were 43.1%,41.6% and 11.1%. Antibiotic resistance rate to vancomycin,teicoplanin,minocycline,rifapin and nitrofurantoin was 0.0-19.0%,the resistance rate to other antibiotics was 54.1-100.0%. The detection rate of MRSA was 81.5%,the detection rate of MRCNS among S. epidermidis and S. haemolyticus was 55.6% and 66.7%. The total positive rate of D-test was 48.2% in Staphylococcus which were sensitive to clindamycin but resistant to erythromycin. The positive rate of S. aureus,S. epidermidis and S. haemolyticus were 49.1%,44.2% and 57.1%. CONCLUSIONS Staphylococcus are ones of the important pathogens which make burn wound infection happen and the antimicrobial resistance is increasingly severe. The high positive results of MRSA and D-test make great trouble to therapy,and that should have taken more attention of clinic.

OBJECTIVE To investigate the drug-resistance and aminoglycoside modifying enzymes (AME) in Acinetobacter baumannii (ABA) isolated from ICU. METHODS K-B method was conducted to detect the sensitivity to 14 common antibiotics of 291 strains of ABA isolated from 2005 to 2007;PCR was used to detect AME genes of partial bacteria isolated in 2005. RESULTS The drug-resistance rates of 13 kinds of antibiotics were 33.0-91.8%,but cefoperazone/sulbactam was low (12.7%). The rate of amikacin,gentamicin and tobramycin was 41.2%,61.2% and 61.5%. Twenty-three ABA strains were AME gene positive from total 27 ABA strains and the total positive rate was 74.4%.We found 21 strains with aac(3)-Ⅰ (77.8%),23 strains with aac(6′)-Ⅰ (85.2%) and 23 strains with ant(3″)-Ⅰ (85.2%). Two strains were found to have 2 kinds of AME genes,21 strains had 3 kinds of AME genes. The rest of ABA strains had not AME genes. CONCLUSIONS ABA isolated from ICU has strong drug-resistance rate and a high carrier rate,it is a critical area of preventing and controlling hospital infection.

OBJECTIVE To analyze the distribution and drug-resistance of Klebsiella pneumoniae isolated from clinic in the past two years to help doctors to use antibiotic reasonably.METHODS To detect the drug-resistance of 470 strains of K.pneumoniae to 15 kinds of antimicrobial agents were detected by K-B method,and the AmpC ?-lactamase and ESBLs were detected through the way of 3-D test.RESULTS ICU and burn department were found where had the highest isolation rate,and sputum and wound that had the highest detection rate.Sensitivity test results showed that the resistance rate of K.pneumoniae to penicillins,first and second-generation cepholosporins,fluoroquinolones and sulfamethoxazole compound was high(51.1-88.3%),and resistance rate to the third and fourth-generation cephalosporins was high,too(32.6-40.4%).All strains were sensitive to imipenem,but two of them were resistant to meropenem.ESBLs were found in 152 strains,the detection rate was 32.3%,AmpC was found in 29 strains,the detection rate was 6.2%.Both of them were found out in 21 strains.CONCLUSIONS The lower respiratory tract infection is the most common one.The ICU and wound ward are the high-risk places ward of infection.Detection rate and drug resistance are increasingly severe,clinic and laboratory should make concerted efforts to reduce nosocomial infection and strengthen information feedback.

OBJECTIVE To analyze the drug-resistance of Enterobacter cloacae isolated from clinic in the past two years.METHODS The drug-resistance by K-B method,and to perform 3-D test to detect AmpC ?-lactamase and ESBLs were detected.RESULTS One hundred and six strains of E.cloacae was detected.Burn department were the wards which had the highest detection rate.Sputum,wound,bile and drainage fluid had the highest positive rate.Sensitivity test results showed that the resistance rate to penicilins,Ⅰ,Ⅱ-generation cephalosporins and cefoxitin of E.cloacae was the highest,and the resistance rate to the third,and fourth-generation cephalosporins was 24.5-50.9%.The detection rate of ESBLs and AmpC was 27.4% and 40.6%,respectively.Twenty three strains produced both of them.CONCLUSIONS The detection rate and drug resistance of E.cloacae are increasing severely.Laboratory should pay more attention to their detections and surveillance so as to control hospital infection of E.cloacae.