Y HOC VIET NAM THANG 6 - SO 1/2015 chay may nhd nen viec ram mau la tot hdn. Tuy
nhien can nang cao ky nang kham lamsang de cd su' tien lu'dng tdt hdn tru'dc khi phau thuat.
Nhff vay mffc do di ddng tren iam sang lien quan vdi mffc dp dinh khi npi soi d" bung (p <
0,01). Ket qua nay phu hdp vdi ket qua ciia Nguyen Binh An khi nghien cffu dieu tn phau thuat npi soi u nang buong truhg trong 6 thang dau nam 2008.
V. KET LUJSkN
Hoan canh phat hien u: nam 2001 den kham vi CO trieu chffng dau tffc bung dffdi chiem ty le cao; nam 2010 phat hien UBT nhd kham phu khoa djnh ky chiem ty le chii yeu. Ti le chan doan dung vi tri u tren lam sang lan lu'dt la:
97,5% (2001); 93,2% (2010).
TAI LIEU T H A M KHAO
1. Nguyen Binh An (2008), "Nhan xet vie ket qua dieu trj u nang buong trdng bSng phau thuat npi
soi tai Benh vien Phu san Trung iTOng trong 6 thang dau nam 2008", Luan van thac sy y hoc.
Tri/dng dai hoc Y Ha Ngi.
2. D6 Ngpc Lan ( 2 0 0 3 ) , "Nghien cffu ap dung plilu thuat npi soi cat u nang buong trffng lanh tinh tai vien bao ve ba me va tre sd sinh", Luan van tot nghiep Bac sy chuyen khoa cap 2. Tru'dng daihpcYHaNgi.
3. Nguyen Tru'dng Nam - Thongke.info , "Xac dinh cd mau nghien cffu", Vien nghien ciiU y hgc xa hoi, tr. 5.
4. I'i Thj Bach Nhtf ( 2 0 0 4 ) , "Nghien cffu doi chieu cac chan doan tru'dc mo, trong mo vc(i chan doan giai phau benh cac khoi u buong trtrtig", Luan van Tien sy Y hpc.Tru'dng Oai hpc Y Ha Ngi.
5. Nguyen Thj Ngpc Phu'dng va cpng s^
(2002), "Chan doan va dieu tri khoi u buong triihg tai benh vien phu san Tff Du nSm 2001", Noi san San phu khoa, Hpi Phu san Viet Nam, So dSc biet nhan d|p hpi nghi toan qudc hpi Phu san Viet Nam khoa 9 ky liop thff 5, Oa Ning, tr. 73-83.
PHAT HIEN DONG THCXI BACILLUS ANTHRACIS VA YERSINIA PESTIS BANG KY THUAT MULTIPLEX PCR TREN CAC MAU
MOI TRiraNG GAY NHIEM GlA DINH
Nguyen Th^i Sffn*, Bui Tien Sy**, Dinh Thi Thu Hang*'
T 6 M TATMuc tieu: Nghien ciiu xac dmh ddng thdi Bacillus anthracisva Yersinia pestis trongjnau moi tru'dng gia djnh (mau dat, nu'de va thffc pham) cd gay nhiem vi khuan bSng ky thuat PCR da moi.
Vat li^u va phu'dng phap: Chiing B. anthads Bai va Y. pestlsypi lu\j giff tai Hpc vien Quan y. Canh khuan vi khuan 0,5 McFarland du'pc bat hoat 121''C/20 phiit tn/dc khi tien hanh tao moi tru'dng gia djnh. Thuc hien phan iiYig PCR da moi du'dc thiet ke toi uXi xac djnh dong thdi vi khuan B. anthracis va Y.
* Benh vien Quan y 103, Hgc vien Quan y
** Khoa Sinh hgc phan id, Benh vien Trung udng Quan doi 108
*** Tmng tam NC Y Dude hgc Qjan sd, Hgc vien Quan y Chiu trach nhiem chinh: Nguyen Thai Son Email; [email protected] Dt; 982040796 Ng^y nhan bai: 13/4/15
Ngay phan bien khoa hoc: 4/5/15 Ngay duyet bai: 11/5/15
pestistxonq cac m l u moi tru'dng gay nhiim, san pham PCR du'dc giai trinh ty' trUc tiep va phan tfch b5ng phan mem Bioedit, Geneious R7 va cong cu Blast.
Ket qua v i ket lu$n: Da thiet lap thanh cong mo hinh gay nhiem mdi tru'dng gia dinh (mau dat, nu'de va thi/c phSm). Phan img PCR da mdi d§ phat hien dong thdi B. anthacisv'a Y. pestlstren ba loai mw tru'dng, trong do mau nude va thUc phSm cho phep phat hien ca hai loai vi khuan nay d nong dp thap hdn so vdi mau dat.
TWkhda: Moi trudng; PCR da moi; Vi khuan djch hach; Vi khuan than.
S U M M A R Y
SIMULTANEOUS DETECTION OF BACILLUS ANTHRACIS A N D Y E R S I N I A PESTIS
FROM THE A R T I F I C I A L L Y INFECTED E N V I R O N M E N T SAMPLES
BY MULTIPLEX PCR Objectives: To engage a mutoplex PCR (mPCR) for identifying simultaneously Bacillus anthracis and
92
Y HOC VIET NAM THANG 6 - SO 1/2015 Yersinia pestis from artificially infected environment
samples.
Materials and methods: B. anthacis Bai and Y.
pestis Ypl strains were inactivated at 121°C/20 minutes and then infected in soil, food, water samples.
A previous optimized multiplex PCR for determining B.
anthracis va Y. pestis were performed, positive PCR products were separately extracted from agarose gel and used for direct sequencing. Obtained sequences were analyzed by Bioedit and Geneious R7 soltwares, and Blast tools.
Results and conclusion: We succeed to establish models of artificially infected environment samples including soil, water and food. Both B.
anthacis and Y. pestis were specifically determined by mPCR and confirmed by sequencing.
Keywords: Bacillus anthracis; Environment;
Multiplex PCR; Yersinia pestis.
I. OAT VAN o l
Trffc khuan than {Bacillus anthracis B.
anthracis) va djch hach {Yersina pestis - Y.
pestis) la hai loai vi kliuan gay benh nguy hiem cd kha nang gay djch trong cpng dong cd the bi ldi dung trd thanh vu khi sinh hpc. Theo Trung tam phong ngira va kiem soat djch benh Hoa Ky (CDC) va To chffc Y te the gidi (WHO), trong cac tac nhan sinh hpc cd nguy cd cao sff dung cho muc dich khiing bd, vi khuan than va djch hach dffdc danh gia la nguy hiem nhat. Sd dT hai loai vi khuan nay la Iffa chpn hang dau cho tan cong khiing bo bdi chung dffdc xep trong nhdm A - nhdm tac nhan sinh hpc tPi nguy hiem co kha nSng lay truyen manh tff ngffdi sang ngffdi tao thanh cac vu djch ldn, ty le tff vong cao. Benh djch do nhdm t6c nhan nay de gay tam ly hoang mang va roi loan trong xa hoi.
O Viet Nam, benh than van con xuat hien rai rac d cac tinh mien nui phfa Bac nhff Sdn La, Dien Bien, Lai Chau,... Con vi khuan djch hach van ton tai tren mpt so loai gam nham d khu yffc Tay Nguyen [6]. Vi vay, ngoai chan doan bang cac phffdng phap kinii dien, chiing ta cung can cd phffdng an ffng phd nhanh, kjp thdi trong viec phdng chdng khiing bo sinh hpc. Phat hien cac vi khuan nay tff cac benh pham d ngffdi da dffdc nghien cffu ky va cd nhieu tai lieu hffdng dan ca trong nffdc va quoc te [4, 5]. Tuy nhien, phat hien cac vi khuan nguy hiem nay tff mau moi trffdng phffc tap nhff dat, thffc pham la mot khd khan va cd it t^i lieu ve van de nay. Vdi vi khuan than, mot thach thffc nu^ la phan biet B.
anthracis vdi cac loai gan gui nhff Bacillus
thurlnglensisva Bacillus cereus thffdng cd lan trong mdi tru'dng [2]. Xuat phat tff ly do dd, nhdm tac gia da nghien cffu kha nang phat hien dong thdi hai tac nhan B. anthracis va K pestis bang mPCR trong cac mau mdi trffdng gay nhiem gia dinh (mau dat, nu'de, thffc pham) tien tdi khao sat kha nang ap dung ciia bp kit nay tren thffc te.
II. OOlUrpNGVA PHU'aNG PHAP NGHIEN CChj 2.1. Odii tu'dng nghien cu'u.
Hai chiing vi khuan B. anthacis Bai va Y.
pesh's Ypl dpc Iffc IUXJ giff tai "Ngan hang chiing va gen" ciia Hpc vien Quan y da dffdc xac djnh cd day du doc Iffc bang PCR va thff nghiem tren dpng vat (chuot nhat trang).
2.2. Phu'dng phap nghien cu'u.
- Chuan bj canh khuan: Canh khuan dffdc pha tff khuan lac thuan trong nu'de muoi sinh ly dat nong dp ~10^ vi khuan/ml (tffdng dffdng 0,5 I^cFarland), dffdc bat hoat 121°C/20 phiit dam bao chet hoan toan vi khuan lan bao tff.
Tao mdi trffdng gay nhiem gia djnh va tach chiet ADN: Thffc hien d mpt khu thff nghiem biet lap, gom mau dat, nffdc va thffc pham dffdc gay nhiem canh khuan vdi nong dp biet trffdc (Pha loang tff ndng dp gdc theo cd sd 10 tff 10^ -10'' vi khuan/ml).
2.2.1. Tao moi trWdng dit gay nhiem Mau dat vffdn dffng trong 2 khay cd kfeh thffdc (60x 40x 30 cm), ky hieu fan Iffdt la Bai, Ba2 (vi khuan than). Vdi khay Bai la mau dat binti thffdng (khdng gay nhiem), Ba2 gay nhiem canh khuan vi khuan than. Tffdng tff, mau dat sff dung trong thff nghiem vi khuan djch hach ky hieu lan luyt la Yl, Y2 v4 BYl, BY2 la mau hon hdp.
Thffc hien phun len be mat dat 10 ml mau/khay (khay sd 2), de yen 24 gid cho mau lang deu xuong be mat. Sff dung dung cu lay mau dat be mat, khoang 5g, bd sung io ml nffdc cat, lac deu tao huyen djch dat, xff ly tach ADN tdng so theo quy trinh nha san xuat (Norgen soil ADN Isolation kit - Canada).
2.2.2. Tao mil trWdng nWdc giy nhiim Lay nffdc ho dffng trong 2 binh (the tich 50 lit) ky hieu lan Iffdt la Ba3, Ba4 (vi khuan than).
Vdi binh Ba3 la mau nffdc binh thffdng, Ba4 gay
nhiem canh khuan vi khuan than. Tffdng tff, mau
nffdc sff dung trong thff nghiem vi khuan dich
hach k^ hieu lan Iffdt la Y3, Y'4 va BY3, BY4" la
mau hon hop.
Y HOC VIET NAM THANG 6 - SO 1/2015 Thffc hien phun len be mat nffdc 10 ml
mau/binh (Ba4, Y4, BY4), de yen 24 gid. Tien hanh lay 2 mau nghien cffu la mau nffdc be mat va mau nu'de d day. Mau nu'de be mat dffdc thu bang bOm tiem 20ml (each mat nu'de 3-5 cm), ly tam 6000 rpm/15 phiit, thu can va tien hanh tach ADN (Norgen's Urine DNA isolation kit). Vdi mau nu'de d mat day du'dc lay bang dung cu mau nu'de chuyen dung (Cole-parmer- My), sau do tien hanh tffdng tff nhi/ mau nu'de be mat.
2.2.3. Tao mil trWdng thwc phim giy nhiim
Chuan bj 1 suat cdm binh dan cd day du 4 loai thffc pham (cdm, thjt ldn, dau phu, rau mudng) chia deu vao 2 hop xdp, ky hieu @n Iffdt la Ba5, Ba6 (vi khuan than). Vdi hop Ba5 la mau thffc pham binh thffdng, Ba6 gay nhiem canh khuan vi khuan than. Tffdng tff, mau thffc pham sff dung trong thff nghiem vi khuan djch hach ky hieu lan Iffdt la Y5, Y6 va BY5, BY6 la mau hon hdp.
Bing 1: Cac moi sff dung trong nghien cffu,
Thffc hien phun len be mat mau thffc pham 1 ml mau/ hop (Ba6, Y6, BY6) dam bao trai deu len ca 4 loai thffc pham. Tien hanh lay 20g nghien thanh hon djch, xff ly tach ADN (Norgen's Food DNA Isolation kit). C^c mau ADN tong sd diTdc kiem tra nong dp va dd tinh sach bang Nanodrop.
- Phat hien vi khuan than va djch hach bang mPCR Thu'c hien mPCR de phat hien B. anthracisva Y. pestis tff cac mau mdi trffdng gay nhiem gia djnh sff dung quy trinh mPCR phat hien khuan than va djch hach da xay dffng [ 1 ] . Chi tiet trinh tff cac cap mdi the hien d bang 1. Chu trinh nhiet: Bien tinh 94°C/4 phut, tiep theo la 32 chu ky '(94°C/1 phut; 5 6 ^ / 4 5 giay^; 72''C/5a giay), sau dd hoan thanh keo dai chuoi d 72° trong 10 phiit. San pham mPCR dffdc dien di kiem tra tren gel agarose 1,5% TBE 6,5X; nhupm ethidium brpmide va quan sat bang he thpng sol gel Dolphin-DOC.
T e n m o i 1 T r i n h t i r ( 5 ' - 3 ' ) | Kich t l i i r d c ( b p )
B. anthracis
v r r A F l / R l p a g A F l / R l capAFl/Rl
CTGTAAGCCCTGTCGTCGAA-F CCrCGCGCACMCMIMCI-R AAATGGAGCACGGCTTCTGA-F AGCCrGTATCCACCCTCACT-R TGACGATGACGATGGTTGGT-F GCTTCCTGTCTAGGACrCGG-R
222 751 610
V. pestis
y p o F l / R l p l a F l / R l c a f F l / R l
GGATGAGATAACGCGGGTGT-F AGAGAATCGTGATGCCGTCC-R CGGGATGaGAGTGGAAAGT-F ATTACCCGCACTCCTTTCGG-R CGCTTACTCTTGGCGGCTAT-F GCTGCAAGTTTACCGCCnT-R
103 438 271 Cac bang tren ban gel dien di co l<ich thu'dc
tu'dng ijlng viSi cac bang dSi chu'ng du'dng du'dc tien hanh tinh sach bang l<it Genejet gel purification kit (Thermosclentific), giai trinh tir.
Su' dung phan mem Bioedit va Geneious R7 de xi ly so lieu va cong cu Blast tren NCBI de khang djnh ket qua.
III. KET QUA NQHICN cij'u vA BAN LUAN
3 . 1 . Xac d j n h B. anthracis tit m l u m d i t r u ' d n g g a y n h i i m .Tach chiet ADN de phat hien vi khuan tir mau moi tru'dng dac biet la mau dat thudng kem
theo vdi viec thu nhan cac axit humic va axit folic - la nhiing chat ire che Taq polymerase va cac enzyme han che. Do vay, viec tach chiet ADN til moi tru'dng doi hoi mat nhieu thdi gian va kha phifc tap nham loai trie cac chat u'c che nay.
Trong nghien cifu ciia Gulledge J.S va cong si/, tac gia da khang dinh cac phu'dng phap tach ADN khac nhau khong tao ra ADN on djnh phi) hdp vdi phan iJng PCR trif khi ADN dUdc tinh sach dam bao sau khi tach chiet[5]. Mot trong nhiTng nguyen nhan lam am tinh d hau het cac tru'dng hdp doi vdi cac gen plasmid ciia vi khuan than tach ttf mau dat da xir ly hoac chua qua xif
\j la cd qua nhieu cac vi sinh vat khac d trong
Y HOC VIET NAM THANG 6 - SO 1/2015
mau thff. Nong dp ADN qua cao d cac vi sinh vat nay se ffc che canh tranh vdi sff bat cap cua primer vao trinh tff dfch eua vi khuan than tff bao tff von thffdng la nong dp rat thap.
Wawrik va cpng sff cho rang moi loai kit tach chiet ADN phii hpp vdi tffng loai dat nhat djnh [7]. Trong nghien effu nay, loai dat thanh phan Hinh 1: Ket qua dien di san pham phan ffng
chu yeu la mun cat, vi vay chiing tdi Iffa chpn bp kit tach chiet "Norgen's soil ADN Isolation kit".
Vdi mau mdi tru'dng nu'de va thffc pham gay nhiem, nhdm nghien cffu sff dung cac bd kit tu'dng ffng cho tffng loai mdi tru'dng ciia hang Norgen - Canada.
1^ la thang chuan lOQbp. BaO la ADN tach tff canh thang nudi vi khuan than; Bai, Ba3 va Ba5 lan Iffpt la ADN tach tff mau thu thap tff mdi trffdng dat, nffdc va thffc pham; Ba2, Ba4 va Ba6 la ADN tach tff cac mau mdi trffdng tffdng img gay nhiem vi khuan than.
Ket qua mPCR cho thay mau ADN kha tinh sach khi khong xuat hien nhieu smear tren cac dffdng chay dien di (Hinh 1). Vdi mau chuan dffdng BAO ludn cho hinh anh dien di sac net ca 3 gen dich la vrrA, capA va pagA cd kich thffdc tffdng ffng la 222, 610 va 751 bp. Ky thuat tach chiet dam bao ket qua am tinh vdi vi khuan than d cac mdi trffdng khong gay nhiem. Oieu nay khang djnh qua trinh tach chiet va phan ffng PCR dffdc thffc hien dam bao, khdng cd hien tffdng nhiem clieo trong tach chiet va loai bd dffdc cac chat ffc che (thffdng cd trong cac mau phffc tap nhff dat va thffc pham). Tren mau gia dinh gay nhiem ciia thffc pham va nffdc cho hinh anh bang dac hieu cho ca 3 trinh tff dich, d mau dat
gay nhiem cho ket qua dffdng tfnh nhffng hinh anh bang dien di md hdn so vdi tff thffc pham va nffdc. Bieu nay chffng td ket qua tach chiet ADN vl khuan than d cac mau dat khd hdn tff mau thffc pham va nu'de.
3.2. Xac djnh Y. pestis tii mau mdi tru'dng lay nhiem.
Ket qua mPCR xac djnh Y. pestis cho thay sff
dung cac bp kit Norgen- Canada tffdng iffig cho
tffng loal moi trffdng cho phep tach chiet thanh
cdng ADN vl khuan djch hach tff moi trffdng gia
dinh gay nhiem cho dat, nu'de va thffc pham
(Hinh 2). O trffdng hdp mau moi trffdng gay
nhiem va mau chuan dffdng tach tff canh thang
vi khuan dich hach deu xuat hien 3 bang dien di
dac hieu tu'dng ffng vdi 3 gen dfch ypo2088, pla
va cafl. Trong khi dd ADN tach tff cac mau mdi
trffdng dat, nu'de va thffc pham tffdng ffng
khdng gay nhiem deu cho ket qua am tfnh vdi
dong thdi ca 3 gen dfch nay.
Y HOC VIET NAM THAHG 6 • SO 1/2015
M la thang chuan lOObp. YO la ADN tach tff
canh thang nudi vi khuan djch hach; Yl, Y3 va Y5 lan lu'dt ia ADN tach tff mau thu thap tff mdi tru'dng dat, nu'de va thu'c pham; Y2, Y4 va Y6 la ADN tach tff cac mlu mdi tru'dng tu'dng ffng gay nhiim vi khuan dieh hach.
3.3. Xac dinh ddng thdi B. anthracis Ma Y. pestistii mau moi tru'dng.
De xac djnh kha nang phat hien ddng thdi B.
anthracis va Y. pestis tff eae mau mdi tru'dng.
nhdm nghien cffu da thffc hien cae mPCR tren mau ADN tach tff cac mau mdi tru'dng du'dc gay nhiem hon hdp ea hai tac nhan tren. Ket qua mPCR cho thay cae san pham mPCR dac hieu cho dong thdi B. anthracis va Y. pestis deu xuat hien d eac mau BYO, BY2, BY4, BY6 la eae mau ADN tach chiet tff canh thang va cac mlu moi tru'dng gay nhiem vdi ea hai vi khuan nay (Hinh 3).
Hinh 3: Ket qua dien di iham mPCR phat hien dong thdi B. anthracis va Y. Pestis:
M ta thang chuan lOObp BYO la ADN tach tff hon hdp canh thang vi khuan than va dich hach;
BYl, BY3 va BY5 lan Iffdt la ADN tach tff mau dat, nffdc va thffc pham; BY2, BY4 va BY6 la ADN tach tff cac mau mdi trffdng tffdng ffng gay nhiem vi khuan than va djch hach.
Vdi mau nffdc va thffc pham, ket qua dien di khdng xuat hien bang phu nao, trong khi vdi mlu dat xuat hien them mpt so bang phu, dieu nay chffng td d mdi trffdng dat cd nhieu loai ADN tap nhiem cd the bat cap khong dac hieu vdi cac c^p mdi xac djnh vi khuan than va djch hach.
Pha loang tff nong dp canh khuan goc theo cd so 10 tff 10^ den 10^ vi khuan/ml, gay nhiem len mdi trffdng, tien hanh tach chiet ADN va kiem tra bang cac phan uhg mPCR xac djnh dong thdi B. anthracis va Y. pestis. Ket qua cho thay, so Iffdng vi khuan B. anthacis thap nhat phat hien dffdc bang mPCR tren mau dat, nffdc, thffc pham I3n Iffdt la khoang 60, 25, 25 vi khuan/phan uhg. So sanh tren K pestis chi sd nay la thap hdn, tffdng imq la 40, 20, 20 vi khuan/phan ffng. Vdi cac mau mdi trffdng dong gay nhiem ca hai tac nhan, mPCR cung cho ket qua phat hien tffdng tff nhff vdi nhffng mau gay nhiem ddn le tiihg tac nhan. Ket qua nay cung tffdng dffdng trong cong bd cua Batra va CS phat hien dong thdi nhieu tac nhan, trong dd B.
anthracis va Y. pestis du'dc phat hien d so Iffdng 50 vi khuan/phan ffng [3].
De khang djnh cho ket qua ciia PCR da moi, cac bang dien di dac hieu cho B. anthracis Mh Y.
pestis dffdc cat va tinli sach, giai trinh tff va phan tl'ch trinh tff. Ket qua cho thay tat ca cac trinh tff deu thudc cac gen dac trffng tffdng uhg ciia vi khuan than (vrrA, pagA, capA) va vi khuan djch hach {ypo2088, pla, cafl).
V. KET LUAN
Chung tdi da tao thanh cdng ba loai moi trffdng gia djnh gay nhiem vi khuan B. anthracis
va Y. pestis (dat, nffdc, thffc pham). LTng dyng ky thuat PCR da moi cho phep phat hien dong thdi vi khuan B. anthracis va Y. pestis trong cac mau mdi tru'dng gay nhiem gia djnh, trong do mau nffdc va thffc pham cho phep phat hien ca hai loai vl khuan nay d nong dp thap hdn so vdi mau dat.
Ldi cam dn: Cdng trinh nay dffdc hoan
thanh nhd sff tai trd kinh phi ciia Chffdng trinh
Cdng nghe Sinh hpc phyc vu an ninh, quoc
phdng do Bp Qudc Phdng cliii tri thong qua
nhiem vu "Nghien cffu che tao kit PCR da moi
xac djnh nhanh dong thdi hai tac nhan vi khuan
than va djch hach". Ma so: 2013.75.58.
Y HOC VIET NAM THANG 6 - SO 1/2015 TAI LIEU T H A M KHAO
1. 5 Nguyen Van An, va CS. Thiet ke va toi Uu hoa piian ffng multiplex PCR chan doan dong thdi vi khuan than va vi khuan dich hach. Tap chi Y DUdc hgc Quan sU. 2015, 41(4).
z. Be, Nicholas A., Thissen James B., Gardner Shea N., et al. Detection of Bacillus anthracis DNA in Complex Soil and Air Samples Using Next- Generation Sequencing. PLoS ONE. 2013, 8(9):
pp.e73455.
3. Batra, S. A., Krupanidhi S., and Tuteja U. A sensitive & specific multiplex PCR assay for simultaneous detection of Bacillus anthracis, Yersinia pestis, Burkholderia pseudomallei &
Brucella species. Indian J Med Res. 2013, 138;
pp. 111-6.
Guarner, J., Jernigan J. A., Shieh W. J., et ai.
Pathology and pathogenesis of bioterrorism- related inhalationai anthrax. Am J Pathol. 2003, 163(2): pp 701-9.
Gulledge, J. S., Luna V. A., Luna A. J., et al.
Detection of low numbers of Bacillus anthracis spores in three soils using five commercial DNA extraction methods with and without an enrichment step. J AppI Microbiol. 2010, 109(5):
pp. 1509-20.
Pham, H. V., Dang D. T., Tran Minh N. N., et al. Correlates of environmental factors and human plague: an ecological study in Vietnam, Int : Epidemiol. 2009, 38(6): pp. 1631-41.
Wawrik, B., Kerkhof L., Kukor J., et al. Effect of different carbon sources on community composition of bacterial ennchments from soli.
App! Environ l^icrobJol. 2005, 71(11): pp. 6776-83.
DANH GIA MirC DO CAI THIEN SITC NGHE DON AM CUA BENH NHAN SAU CAY DIEN CU'C 6 c TAI
T61V! TAT
Myc tieu: nghien cffu ngudng nghe__(3cJn am ciia benh nhan sau cay dien cffc 6c tai (OCOT) tai Benh vi|n Tai Miii Hong TW. Phu'c^ng phap: nghien cffu mo ta cat ngang du'dc tien hanh tren 30 tre nghe kem nang hoac diec trUdc ngon ngff khong co dj tat khac kem theo va da du'dc cay DCOT tai Benh vien Tai Mui Hong TW tff thang 9/2012 den thang 4/2014. Cac thong so danh__gia chii yeu la ngu'dng nghe trUdc phau thuat cay OCOT va ngu'dng nghe dOn am sau cay OCOT. Ket qua: sffc nghe tru'dc khi phau thuat co 28 benh nhan diec sau ca 2 tai, ngUSng nghe trung binh 3 tan sd 500Hz, lOOOHz, 2000Hz (PTA) > 90dB, 2 benh nhan co diec sau 1 tai con tai doi dien nghe kem nang vdi PTA tff 70dB-90dB. NguSng nghe sau phau thuat vdi PTA2 (trung binh ngu'dng nghe 500Hz, lOO'OHz, 2000Hz, 4000Hz) deu dUdi 45dB trong do PTA2 tff 25 ; 35 dB chiem 70,1%. Ket luan: Phau thuat cay OCOT la mot phu'dng phap hieu qua giup tre bi nghe kem nang hoac diec trUdc ngon ngff co the lay lai dupe sffc nghe dOn am gan nhi/ tre binh
*Benh vien Tai Mui Hong TW
** Bd mon Tai Mui Hong Dal hoc Y Ha Ngi Chju trach nhiem chinh: Pham Tien Dijng Email: [email protected] Dt: 0912265975 Ngay nhan bai: 13/4/2015
Ngay phan bien khoa hoc: 20/5/2015 Ngay duyet bai: 29/5/2015
Pham Tien Dung*, Cao Minh Thanh**
thu'dng, do la cd sd de hgc nghe, noi tien tdi hoa nhap vdi cong dong.
Tff khoa: dien ci/c 6c tai.
EVALUATION OF PURE TONE THRESHOLD OF PATIENT AFTER COCHLEAR IMPLANT Objective: to study the pure tone threshold of patients after cochlear implant (CI) at National ENT hospital. Method: the cross section study evaluated the hearing threshold of 30 CI recipients from 9/2012 to 4/2014 at National ENT Hospital who were the children having pre-language bilateral severe to profound hearing loss. Results: pure tone heanng test were carried out to assess the Pure Tone Average (PTA) of 3 frequencies 500, 1000, 2000Hz before the operation and Pure Tone Average (PTA2) of 4 frequencies 500, 1000, 2000, 4000Hz post operation.
Pre-operative PTA showed that 28 patients had bilateral profound hearing loss; only 2 patients had severe hearing loss in one ear and profound hearing loss in other ear. Post- operative showed that 100%
PTA2 in the ear of CI was inferior 45dB in which PTA2 from 25dB to 35dB occupied 70,1%. Conclusion: CI helps the children with severe to profound hearing loss to recover the hearing level near the normal children so that help them learn hearing and speaking.
Keywords: coch\eBr implant
