Author: Yang Yihui
Unit: Department of Clinical Laboratory, Zhongshan Hospital, Fudan University
For ordinary people, nucleic acid testing is queuing, sampling, and waiting for results. For nucleic acid testers, when the sampling work is completed, their work officially begins.
At midnight, the tired city ended the hustle and bustle, and the new crown virus nucleic acid testing laboratory was still brightly lit and active. Layers of protective equipment wrapped around the tired body, each time fully armed for hours in a negative pressure environment, sweat soaked the overalls and blurred the mask. Repeated wear, strict killing, difficult sweltering heat, silent persistence, this is our daily inspection of people.
A nucleic acid report, a group of testers fighting side by side
Every nucleic acid tester is an "invisible superman", in addition to completing a large number of busy testing work on weekdays, they are also on standby 24 hours a day, ready to confront the sudden outbreak. When I received an urgent screening task, it was often night, and the testing staff had been busy for more than ten hours. In order to win time to curb the spread of the epidemic as soon as possible, they resolutely took up the baton of racing against the virus and threw themselves into nucleic acid testing again. With sweat and persistence, they silently did their best to stop the spread of the epidemic.
Today, let's walk into the "mysterious" nucleic acid testing laboratory together and see the working scene of the "invisible superman" who detects nucleic acids.
Many people think that the instruments of the laboratory department are highly automated, and the results can be produced quickly by placing nucleic acid test samples on the instrument. In fact, many aspects of nucleic acid testing need to be done manually by the testing personnel. Nucleic acid detection involves multiple links, is extremely sensitive, precise and cumbersome operation steps of the experiment, requiring the inspectors wearing protective clothing to work continuously for several hours in a negative pressure environment, concentrate on completing the fine operations, any one step of the small mistakes, will lead to experiment failure, affecting the result reporting time.
Sample reception
Disinfection and bag removal step can not be lacking
The first step a tightly packed sample goes through when it arrives at the lab is sterilization. The inspectors should spray and disinfect the three-layer packaging in turn before they can open the sealed bags one by one, take out the samples, and then sort out and sort, and then enter the information. In the face of massive samples, information must be checked while scanning to ensure zero errors. How many tube samples are how many repeated scans and checking movements, and at the end of the day, the shoulders and necks of the testers are stiff.
Nucleic acid extraction
Pipetting the cap cannot be wrong one step at a time
Next up is the sample work. Massive samples, one by one, screwed, sucked, added, and then screwed on, the hand muscles of the testers always maintained a high degree of tension. This repetitive action not only tests the eyesight, brain power, but also tests the hand power, one can not be wrong, one can not be leaked, but also to avoid cross-contamination. Thousands of samples a day, repeated actions add up to thousands of times, grinding the outer gloves, hand cramps, numb fingers are the norm.
Reagent preparation
No one can have any of the additive pollution
Meanwhile, in another clean, isolated area isolated from sample contamination, inspectors are preparing reagents for subsequent amplification tests. As many samples as there are reagents, and hundreds of pipettings. The prepared reagents are also manually dispensed to a 96-well amplification plate, and finally the extracted nucleic acids of each sample are transferred to the amplification system. The whole process is fully manually packed, the pipetting volume is slightly upgraded, and the operation process requires fast! permit! steady! Also ensure zero pollution!
Hands-on amplification
The running time cannot be less than one second
This is followed by the amplification process, which takes about 2 hours, and once the instrument starts the amplification process, it cannot stop adding new samples in the middle of the way, and must wait until the amplification of this batch is completed before the next batch of samples can be amplified. This is one of the reasons why nucleic acid testing cannot be done on the go. If an instrument malfunction or some special circumstances are encountered, a batch of 91 tube samples should all return to the nucleic acid extraction step and start over.
Results review
Rigorous and realistic can not be wrong
After the amplification program is run, the inspector needs to professionally analyze and interpret the reaction curve generated by the instrument. The baseline setting, the judgment of the yin and yang property control, the response curve of each sample one by one, the original data analysis, and whether the interpretation results are true and reliable, the inspectors need to confirm that it is correct. After this series of professional operations, the results can be published. So far, a single batch of samples (91 samples + 5 negative/positive controls) samples has been preliminarily completed after several hours of testing.
Racing against the virus, the testers work tirelessly!
With the arrival of the Spring Festival, the pressure of daily new crown nucleic acid testing in hospitals is also climbing, with nearly 10,000 tubes of testing for a continuous Sunday, and the number of testing personnel required for 24-hour continuous testing is twice that of usual. In order to cope with the peak of testing, everyone gave up their rest and rejoined the nucleic acid testing work after the day's work.
The inspectors did not dare to drink water before starting work, did not dare to eat too much, for fear of going to the toilet during work, often took advantage of the gap between waiting for samples to take turns to go out to drink saliva, and before they could catch their breath, they continued to fight. After a day's work, disinfection, removal of protective gear, and protective clothing as required, these "invisible supermen" can finally sit down and take a sip of water. At this time, the sweltering isolation gown and protective device were wrapped in layers for several hours after the underwear was wet, after a long period of concentrated work in the negative pressure environment, there was a bit of dizziness and tinnitus, the eyes were often filled with blood, the head and neck were often stiff, and the hand that had just used the "one-handed screw lid stunt" to open thousands of sample lids was often trembling in the hand when holding the water cup.
The high-intensity work mode, although very tired and hard, but these "invisible supermen" are particularly pleased, because all the results are negative, indicating that there is less risk around us, everyone can safely put into work, or can return home as soon as possible to reunite with their families!
COVID-19 nucleic acid testing laboratory, non-stop! During the Spring Festival, the "Invisible Superman" still sticks to the front-line post and guards everyone's health. The epidemic continues, and Zhongshan inspectors will continue to shoulder the mission of doing a good job as scouts on the epidemic prevention and control front and building a firewall to deal with the epidemic. For them, the nucleic acid test report is a barrier to strictly prevent the spread of the virus, and it is also a health shield for every citizen. These "invisible supermen" who are silently dedicated are also the strongest guardians of the city.
Editor: Ren Mileage Reviewer: Xiao Ran