Table of Content

16 March 2012, Volume 27 Issue 3

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Primary application of free fetal DNA from maternal plasma in prenatal diagnosis

ZHU Yan;XU Keqian;WANG Xiaochun

2012, 27(3):  159-162. 

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Objective　To investigate the feasibility of free fetal DNA from maternal plasma in noninvasive prenatal diagnosis. Methods　Free fetal DNA was extracted by column seperation from 46 maternal plasma， and nested polymerase chain reaction (PCR) was used to amplify the SRY gene， and ATL1 gene specific sequence was amplified as an internal control. Results　The SRY gene sequence was detected in 26 maternal plasmas from 28 pregnant women with male fetus. In 17 maternal plasmas from 18 pregnant women with female fetus， only the ATL1 gene sequence was detected. The sensitivity was 92.9％（26/28），the specificity was 94.4%（17/18）， and the coincidence rate was 93.5％（43/46）. Conclusions　Free fetal DNA from maternal plasma analysis is a noninvasive prenatal diagnosis and has the advantages of sensitivity and specificity， and it can improve in the clinical application.

The correlation investigation of the genotyping of human papillomavirus with cervical lesion

SONG Lijun;CHEN Chunli;LUO Shugui

2012, 27(3):  163-166. 

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Objective　To study the status of 21 genotypes of human papillomavirus (HPV) infection in women of western Guangdong and the relationship between HPV genotypes and different grade cervical lesion. Methods　A total of 5 556 cases were detected for HPV DNA types by DNA flow through hybridization and gene chip (HybriMax)， and cervical biopsies were used for pathological diagnosis in 677 cases. Results　Among 5 556 cases， 901 cases were HPV positive (16.2%). The HPV subtype infection rate in top 5 were HPV 52， 16， 58，53 and 11 in turn.There were statistical significance among the HPV positive rates in different age groups（P<0.05）.Old women (≥51 years old) showed the highest HPV infection rate. The constituent ratio of high risk HPV(HRHPV) types was the highest in 4150 years old group（P<0.05）. The detection rate of HPV increased with the severity degree of cervical lesion（P<0.05）.Multiple HPV type infection rate was the highest in high grade squamous intraepithelial lesion (HSIL)group（P<0.05）. The detection rates of HPV16, 58 and 33 increased with the severity degree of cervical lesion（P<0.05）. Compared with low grade squamous intraepithelial lesion (LSIL )group， the odds ratios(OR)of HSIL group were 3.391(2.038－5.643),2.409(1.188－4.888) and 2.362(1.081－5.161)respectively. Conclusions　The popular HPV subtypes in western Guangdong are HPV 52， 16， 58，53 and 11. The detection of HPV genotypes is of great significance for early diagnosis and prognosis of cervical lesion. HPV 16， 58 and 33 are more oncogenic than other HPV types. HPV16 is the most oncogenic genotype.

The simulation study of immunomagnetic separation method for the detection of Shigella species

SHENG Yueying;CHEN Hongyou;ZHANG Xi;ZHUANG Yuan;CHEN Min

2012, 27(3):  167-170. 

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Objective　To evaluate specific enrichment reactions of immunomagnetic beads of Shigella, and to provide the technical basis for establishing immunomagnetic separation method for the detection of Shigella species. Methods　Pure cultures of Shigella species(except Shigella boydii) and nontarget bacteria (Escherichia coli， Enterobacter aerogenes， Acinetobacter baumannii， Klebsiella pneumoniae， Vibrio fluvialis and Staphylococcus epidermidis) were used to calculate specific and nonspecific capture efficiencies of the immunomagnetic beads by counting the colony. Interference experiments were designed to evaluated the specific enrichment reaction of the immunomagnetic beads, which was performed by adding the immunomagnetic beads into the suspensions of the mixtures with 104 cfu/mL Escherichia coli and different concentrations of target bacteria. The beads were used to capture the Shigella from the milk powder samples which were preenriched for 3 and 6 h and fecal samples. The possibility of using immunomagnetic separation method to detect Shigella was evaluated. Results　The capture efficiency of immunomagnetic beads was above 30% to the pure cultures of Shigella dysenteriae， Shigella flexneri and Shigella sonnei, and the nonspecific capture efficiency of 6 nontarget bacteria was below 3%. The data of the interference experiments showed that immunomagnetic separation method had 100 fold increasing in the detection sensitivity in comparison with conventional testing methods. The results of the tests of artificially inoculated milk powder and fecal samples showed that the detection limits could reach 101 cfu/25g and 101 cfu/mL by immunomagnetic separation method, and the detection rate of the target bacteria increased. Conclusions　Immunomagnetic beads have some specific capture and enrichment reactions to Shigella dysenteriae, Shigella flexneri and Shigella sonnei, and it should be applied into routine diagnostic determinations.

Investigation on the clinical significance of combining determination of C reactive protein and serum iron parameters for the rHuEPO treatment of renal anemia

LI Xiangling;WANG Yanqiang;ZHAO Xuelan;GUO Zhentao;LI Jiacun;XIAO Qin

2012, 27(3):  171-173. 

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Objective　To investigate the clinical application significance of combining determination of C reactive protein （CRP） and serum iron parameters for the recombinant human erythropoietin (rHuEPO) treatment of renal anemia(RA). Methods　All 75 patients with RA were classified intoⅠ(CRP>8 mg/L, 37 patients) and Ⅱ(CRP≤8 mg/L, 38 patients) groups， and administrated rHuEPO at dose of 80120 U/kg for a week(2 times). Before the treatment， red cell indices［red blood cell (RBC), hemoglobin (Hb), hematocrit (HCT) and reticulocyte counting percentage (RET%)］， iron metabolism parameters［serum transferrin receptor(sTfR), serum iron (SI), transferrin saturation (TS%) and serum ferritin (SF)］ and CRP were measured. The iron metabolism parameters after the treatment 8 weeks and red cell indices after 2，4 and 8 weeks were measured, and the results were analyzed statistically. Results　The 2 groups′ sTfR and CRP before the treatment were different statistically（P<0.05）. After the treatment， red cell indices and sTfR in groupⅡ increased, and SF decreased. Compared with before treatment group and after treatment groupⅠ， there were significant differences （P<0.05）. There was negative correlation between CRP and Hb（r=-0.55，P<0.01）， and positive correlation between CRP and SF（r=0.65，P<0.01） in groupⅠ. In groupⅡ, sTfR and Hb were positively correlated （r=0.71，P<0.01）, and sTfR and SF were negatively correlated （r=-0.48，P<0.05）. Conclusions　CRP combined with serum iron parameters can guide the application of rHuEPO, and has clinical significance in evaluating and predicting the effect of rHuEPO in the treatment of renal anemia.

Dopamine and dobutamine interference in some biochemical assays

ZHANG Jun;QIN Qin;DU Dahai;LI Wenjie;ZHANG Jianrong;SHEN Qian

2012, 27(3):  174-177. 

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Objective　To evaluate dopamine and dobutamine interference in 6 biochemical assays ［creatinine(Cr)， uric acid(UA)， glucose(Glu)， total cholesterol(TC)， triglyceride(TG) and glycated serum protein(GSP)］ based on the peroxide and peroxidase reaction principle. Methods　Sera containing different concentrations of dopamine or dobutamine (100.00,50.00,25.00,12.50,6.25,3.13 and 1.57 μg/mL) were prepared. Cr,UA,Glu,TC,TG and GSP were measured on a Hitachi 7600 automatic biochemical analyzer(Hitachi 7600). Cr, UA and Glu were measured on a VITROS 5.1 FS dry type biochemical analyzer(VITROS). The interference of each concentration drug was calculated. Results　The measured 6 assays′ results decreased gradually with the increasing of the drug concentration. The negative interference of 5 assays (except GSP) measured on the Hitachi 7600 was <10% in the drug concentration ≤1.57μg/mL. The nagative interference of Cr and UA measured on the VITROS was >10% in the drug concentration ≥50 μg/mL. There was no significant interference(<10%) of Glu measured on the VITROS in all the different drug concentrations. Conclusions　Dopamine and dobutamine in the drug concentration ≥1.57 μg/mL have significant negative interference of biochemical assays (Cr, UA, Glu, TC, TG and GSP) on Hitachi 7600. The biochemical assays measured on the VITROS are less interfered by the drugs than those on the Hitachi 7600.

Developement a method for urine and cerebro-spinal fluid proteins by salicylsulfonic acid teturbidimetry in automatic biochemical analyzer

XIAO Chunhai;HUANG Minjie;WU Juanfang;ZHAO Yifan;SHEN Yuping

2012, 27(3):  178-180. 

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Objective　To evaluate and improve the method for detecting urine and cerebrospinal fluid proteins by sulfosalicylic acid turbidimetry using automatic biochemical analyzer. Methods　The improved sulfosalicylic acid turbidimetry using automatic biochemical analyzer(I-SS assay) and its parameters were established. The precision，linear range and recovery rate were evaluated and compared with the traditional sulfosalicylic acid turbidimetry(T-SS assay). Results　The withinrun and betweenrum coefficients of variation(CV) were 1.2%-1.5% and 2.1%-3.5%. The linear range was 0.037-2.38 g/L. The recovery rate was 85.6%-109.2%. The correlation with the T-SS assay was Y I-SS = 0.980 4X T-SS +0.010 8， and the correlation coefficient (r) was 0.982. Conclusions　The I-SS assay is sensitive and accurate, and it is suitable to automatic biochemical analyzer.

Correlation between serum AHSG levels and gestational diabetes mellitus

ZHANG Ming;ZHANG Yiming;CHAO Haojie;WEI Ziwen

2012, 27(3):  181-184. 

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Objective　To observe the variations of serum levels of alpha 2-HSglycoprotein(AHSG) in pregnant women with different types of glucose intolerance and the correlation with plasma glucose, blood lipid metabolism and insulin resistance. Methods　Totally，135 pregnant women with 36-41 weeks of gestation were classified into 3 groups according to the results of 75 g oral glucose tolerance test(OGTT)：gestational diabetes mellitus(GDM)group: 45cases，gestational impaired glucose tolerance (GIGT)group: 45 cases and normal glucose tolerance (NGT)group:45 cases.The levels of fasting AHSG，fasting plasma glucose (FPG)，fasting insulin(FINS) and fasting blood lipid ［total cholesterol(TC), trigly ceride(TG),high-density lipoprotein cholesterol(HDL-C) and low-density lipoprotein cholesterol(LDL-C)］ were measured, and the values of body mass index(BMI),homeostasis model assessment insulin resistance(HOMA-IR) index and hemeostasis model assessment beta (HOMA-β) index were calculated. Results　The serum levels of AHSG in GDM group, GIGT group and NGT group were 150.2±20.0, 131.9 ±16.0 and (124.0±15.0) μg/mL, respectively. There was a statistical significance among the 3 groups（P<0.05）. The levels of FPG，TG，LDL-C and FINS were significantly higher in GDM group than those in NGT group（P<0.05, P<0.01），and the levels of HDLC were significantly lower in GDM group than those in NGT group（P<0.05）. The levels of TG and FINS were significantly higher in GDM group than those in GIGT group（P<0.05, P<0.01），and the levels of TG,LDL-C and FINS were significantly higher in GIGT group than those in NGT group（P<0.05, P<0.01）.The levels of TC had no significant difference among the 3 groups（P>0.05）. The HOMA-IR indices increased gradually, and the HOMA-β indices decreased gradually among the 3 groups with statistical significance (P<0.05).Furthermore，serum AHSG levels had positive relationship with BMI，TG,FINS and HOMAIR ［the coefficients of correlation （r） were 0.406, 0.503, 0.533 and 0.612, P<0.05］,negative relationship with HDL-C and HOMA-β(r=-0.321 and -0.589, P<0.05), and no relationship with FPG and TC(r=0.058, 0.095, P>0.05). Conclusions　AHSG plays an important role in the metabolism of plasma glucose and blood lipid in GDM women, and AHSG is involved in insulin resistance and aggravates the suffering of beta cells. AHSG is closely related with the cause of GDM.

The determination of serum transthyretin chemical modification by capillary electrophoresis combined with MALDI-TOF/MS analysis

ZHANG Wenliang;SONG Lin;LI Youxin;WEI Dianjun;HU Kesheng;SUN Xuguo

2012, 27(3):  185-188. 

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Objective　To establish a combined method for analysis of serum transthyretin(TTR) chemical modification using capillary electrophoresis (CE) with matrixassisted laser desorption ionizationtimeofflight mass spectrometry (MALDI-TOF/MS) analysis. Methods　Enzymelinked immunosorbent assay (ELISA) was used to determine serum TTR in 20 senile systemic amyloidosis (SSA) patients and 20 healthy subjects. Serum TTR was separated by CE. Determination of TTR chemical modification was analyzed by MALDI-TOF/MS. Results　The levels of serum TTR was (0.25±0.04)g/L in control group and (0.26±0.03)g/L in SSA patients, and there was no significant difference between control group and SSA patients(P>0.05). The chemical modification of TTR found 4 TTR chemical modification peaks, as native-TTR ［masstocharge ratio (m/z): 13 750.86±1.48］, sul-TTR (m/z ratio: 13 830.63±2.76), cys-TTR (m/z ratio: 13 871.70±2.70) and cysgly-TTR (m/z ratio: 13 919.00±14.77) by MALDI-TOF/MS analysis. Conclusions　The combined method of CE with MALDI-TOF/MS analysis can be used directly to determine the chemical modification of TTR.

The clinical significance of detecting urinary neutrophil gelatinase-associated lipocalin in SLE kidney disease

WU Yehong;ZHAO Rongping;XU Yanping

2012, 27(3):  189-191. 

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Objective　To investigate the clinical significance of urinary neutrophil gelatinase-associated lipocalin (NGAL) in kidney damage of systemic lupus erythematosus (SLE) patients. Methods　The urine of 124 SLE patients and 30 healthy subjects were collected. The urinary microalbumin (Alb) was detected by rate nephelometry. According to the results of Alb, the SLE patients were classified into 3 groups (Group A, B and C). The 30 healthy subjects were as the control group. The NGAL was detected by enzyme immunoassay quantitatively. Results　The urinary NGAL in Group A, B and C of SLE patients and control group were 3.51±0.49, 5.48±0.98, 7.89±1.71 and 3.37±0.31 μg/L. There was no statistical significance of urinary NGAL between Group A(Alb<30mg/L) and control group（P>0.05）. There was statistical significance of urinary NGAL between Group B (Alb: 30-100 mg/L) and control group（P<0.01）. There was statistical significance of urinary NGAL between Group C (Alb: 100-500 mg/L) and control group（P<0.01）. There was statistical significance of urinary NGAL among Group A, B and C（P<0.05）.The positive correlation about the Albu and urinary NGAL was 0.84 in SLE patients. Conclusions　Urinary NGAL increases when Alb rises，and urinary NGAL can be used to judge SLE patients with tubular interstitial function damage.

Preliminary study on the value of short message service timely reporting of positive blood cultures for bacterial diagnosis and treatment of bloodstream infections

JIANG Xiaofei;TIAN Yueru;LIU Hong;RUAN Feiyi

2012, 27(3):  192-194. 

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Objective　To find a reasonable indicator to evaluate the value of reducing the time to report the positive blood culture results, and understand the clinical value of timely reporting of positive blood culture results by short message service. Methods　With the statistics method χ2 test, the disparities in age, bloodstream infection pathogens, blood culture positive rate and 30 d mortality of 2 groups before and after the reporting positive blood culture results by short message service were compared. Results　The disparities in age, bloodstream infection pathogens and blood culture positive rate of the 2 groups were not statistically significant, but the disparity in 30 d mortality of the 2 groups was statistically significant (P<0.05). Conclusions　Short message service timely reporting of positive blood culture results are valuable for clinic.

Clinical application of determining serum TPOAb in the diagnosis of autoimmune thyroid diseases

LI Yuesong;ZHU Yani;YIN Zhengfang;PU Hongbo;CHEN Yongwei;BAO Jiandong

2012, 27(3):  195-198. 

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Objective　To investigate the clinical application of determining serum antithyroid peroxidase antibody (TPOAb) in patients with autoimmune thyroid diseases. Methods　Serum TPOAb were measured by electrochemiluminescence immunoassay in 130 patients with Graves disease, 117 patients with Hashimoto′s thyroiditis, 43 patients with lymphocytic thyroiditis, 29 patients with subacute thyroiditis, 34 patients with thyroid goiter, 24 patients with thyroid differentiated cancer and 63 controls. The receiver operating characteristic (ROC) curve was calculated， and the concentrations of serum TPOAb and the positive rate were compared among the groups. Results　The area under the ROC curve was 0.867，the cutoff value was 33.51 IU/mL， and the sensitivity and specificity were 82% and 89% at this cut-off value. The concentrations and positive rate of TPOAb had statistical significance among the groups (H=170.203，P<0.05，χ2=236.593，P<0.05). The concentrations and positive rate of TPOAb had significant difference between the group of autoimmune thyroid diseases and the group of non-autoimmune thyroid diseases(P<0.002 4). However, it had no significant difference between the groups of autoimmune thyroid diseases (P>0.002 4). Conclusions　The determination of serum TPOAb has an important value for the diagnosis of autoimmune thyroid diseases.

Diagnostic significance of lipoarabinomannan antigen in pleural fluid for tuberculous pleurisy

WANG Fang;YUE Jun;PENG Rong

2012, 27(3):  199-201. 

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Objective　To investigate whether the determination of lipoarabinomannan (LAM) antigen in pleural fluid may be used as an indicator for the diagnosis of tuberculous pleurisy. Methods　Double antibody sandwich enzymelinked immunosorbent assay(ELISA) was performed to detect LAM antigen in 96 pleural fluid samples (46 patients with tuberculous pleurisy and 50 patients with nontuberculous pleurisy). Results　The positive rate of LAM antigen in pleural fluid with tuberculous pleurisy group was 54%， and the positive rate in pleural fluid with nontuberculous pleurisy was 22%. There was a statistical difference between them(P<0.05). Conclusions　LAM antigen could be used as a new indicator for the diagnosis of tuberculous pleurisy.

Studies on the value of human serum levels of human epididymis protein 4 in patients with gynecological pelvic lesions

LI Duofu;WU Cailiang;DU Jing;CUI Xueli

2012, 27(3):  202-205. 

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Objective　To investigate the clinical value of human epididymis protein 4（HE4）on diagnosing gynecological pelvic lesions. Methods　The HE4 and carbohydrate antigen 125(CA125) levels in sera from 133 patients with gynecological pelvic lesions （ovarian cancer: 7 cases，intrauterine tumor: 40 cases， benign ovarian disease: 34 cases and benign uterus disease: 52 cases）and 43 healthy women （as the control group）were determined by enzymelinked immunosorbent assay (ELISA) and chemiluminescence immunoassay, respectively.The patients were classified according to the postoperative pathology results. The control group′s 〖AKx-D〗±2s was as the normal reference range, and the HE4 and CA125 levels were used to evaluate the sensitivity and specificity on diagnosing gynecological pelvic malignant lesions. Results　The threshold values of serum HE4 and CA125 in the control group were 55.86 pmoL/L and 35 kU/L respectively.The levels of serum HE4 and CA125 had no statistical significance in the patients with benign ovarian disease, benign uterus disease and the control group（P>0.05）, and the levels of serum HE4 and CA125 in patients with ovarian cancer were significantly higher than the normal reference range and those in patients with intrauterine tumor, benign ovarian disease, benign uterus disease and the control group(P<0.01). The levels of serum HE4 in patients with intrauterine tumor were significantly higher than the normal reference range and those in patients with benign ovarian disease, benign uterus disease and the control group(P<0.05). However, the levels of serum CA125 had no significant difference in the 4 groups（P>0.05）.The levels of serum HE4 and CA125 had positive correlation［coefficient of correlation（r)=0.467 and 0.380，P<0.05］in the patients with ovarian cancer and intrauterine tumor, but there was no correlation among the other 3 groups. The positive rates of HE4 and CA125 in patients with ovarian cancer, intrauterine tumor, benign ovarian disease, benign uterus disease and the control group were 100.00％, 71.43％; 37.50％, 30.00％; 14.70％, 11.76％; 19.23％, 32.69％ and 2.32％, 2.32％ respectively. The sensitivities of HE4 and CA125 to ovarian cancr were 100.00％ and 71.43％，the specificities were 82.35％ and 85.29％，the positive predictive values were 53.85％ and 50.00％，and the negative predictive values were 100.00％ and 93.50％. The area under the receiver operating characteristic(ROC) curve（AUC）of HE4 was bigger than that of CA125 in patients with ovarian cancer（P<0.01）. Merging the ovarian cancer group and the intrauterine tumor group as pelvic malignant lesion group, the diagnostic sensitivities of HE4, CA125 and HE4+CA125 were 46.80％, 36.17％ and 54.41%，the specificities were 82.60％, 75.58％ and 47.22%, the positive predictive values were 59.50％, 44.74％ and 49.33%，and the negative predictive values were 74.00％, 68.42％ and 52.31%. Conclusions　Besides the serum level of HE4 is helpful in the diagnosis of ovarian cancer and intrauterine tumor， the levels of HE4 will increase in a part of benign gynecological pelvic lesion.

Roche E170 full-automatic electrochemistry luminescence immunity analyzer remaining reagent recycle analytics

MA Hongxia;CAO Weijuan;ZHANG Xuemei;YANG Lin

2012, 27(3):  206-209. 

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Objective　To investigate the feasibility of recycle of remaining reagent in Roche E170 automatic electrochemiluminescence immunoassay.  Methods　Alpha fetoprotein(AFP), carcino-embryonic antigen(CEA), carbohydrate antigen(CA)199, CA153 and CA125 in specific sera were detected by remaining reagents and original reagents. The precision， accuracy and recovery rate of remaining reagents were analyzed. The mean values and correlation of the 5 items in 3 different concentrations of sera (low, middle and high levels) were compared by 2 kinds of reagents.  Results　The within-run and between-run coefficients of variation (CV) of the 5 items measured by remaining reagents in low and high levels of sera met the related standard. The accuracy was within the allowance range. The recovery rate was variable from 90% to 110%. Comparing the results of the original reagents with the remaining reagents， there was no statistical significance of 3 different levels of the 5 items (P>0.5).  Conclusions　The remaining reagent can be recycled by Roche E170 automatic electrochemiluminescence immunoassay， which also can ensure the quality of measurement and the reduction of the cost.

Changes of leukocytes scatter plot in children with infectious mononucleosis

WU Ziwen

2012, 27(3):  210-212. 

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Objective　To observe the scatter plot of atypical lymphocyte in children with Epstein-Barr virus (EBV) infection, and to investigate their change and clinical significance in the disease.  Methods　The infected children treated in Children′s Hospital of Fudan University from January to April in 2010 were enrolled. According to the infection of EBV and the typical scatter plot, the children were classified. The relation of the groups were observed.  Results　There were 102 children aged 0 to 11 years old in the study. The anti-EBV antibody positive group included 45 cases, and the scatter plot of atypical lymphocyte group included 45 cases. Both anti-EBV antibody positive and scatter plot of atypical lymphocyte group included 31 cases. Through the chi-square test, the difference of the anti-EBV antibody positive rate between children who had atypical lymphocyte and children who had normal peripheral blood cells was detected (P<0.01).  Conclusions　The scatter plot in hematology analyzer for the detection of atypical lymphocyte has important secondary significance when diagnosing the acute EBV infection.

Effects of Factor Ⅻ Polymorphism on the coagulation and fibrinolysis in patients with venous thrombosis

XIE Yaosheng;XIE Haixiao;WANG Mingshan;NIU Zhenzhen;JIN Yanhui

2012, 27(3):  213-216. 

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Objective　To investigate the influence of factor Ⅻ(FⅫ) polymorphism on the coagulation and fibrinolysis in patients with venous thrombosis. Methods　The activity of plasma factor Ⅻ（FⅫ∶C）, fibrinogen（FIB）, D-dimer（D-D）, factor Ⅷ（FⅧ∶C）, von Willabrand factor（VWF）, the activity of plasminogen（PLG∶A）, the activity of plasma antithrombin（AT∶A） and the activity of protein C（PC∶A）were measured by onestage recalcification clotting time assay, immunoturbidimetry assay and chromogenic substrate method in 75 patients with venous thrombosis and 60 healthy controls. The 46th basyl polymorphism at promoter regions in FⅫ gene was analyzed by direct sequencing. Results　The rate of 46TT polymorphism in patients with venous thrombosis was higher than that in control group, and the FⅫ∶C of the 46TT patients was obviously lower than those of the 46CT and 46CC patients and control group（P<0.05）. In 46TT group， AT∶A was lower than that in control group，but the FIB, D-D, FⅧ∶C and VWF were higher（P<0.05）. There were no significant differences in above parameters among the various FⅫ polymorphism groups with venous thrombosis（P>0.05）, and there were also no differences in PLG∶A and PC∶A among these groups（P>0.05）. Conclusions　The FⅫ gene 46TT polymorphism is obviously increased in patients with venous thrombosis, and it will cause the decreasing of FⅫ. There are no statistical significances in the parameters of the coagulation and fibrinolysis at each FⅫ polymorphism group with venous thrombosis.

Survey analysis on the routine reference intervals of peripheral blood determination among 2 408 healthy children in Shanghai

GAO Yuan;YANG Jianmin;WANG Huan;MA Zhan;ZHANG Hong

2012, 27(3):  217-220. 

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Objective　To survey and analyze the routine reference intervals of peripheral blood determination among healthy children. Methods　A total of 2 408 healthy children from 2 to 6 years old were classified into several groups (2-，3-，4- and 5-)，and the white blood cell，red blood cell，hemoglobin，hematocrit，mean corpuscular volume， mean corpuscular hemoglobin， mean corpuscular hemoglobin concentration of peripheral blood were determined. Reference intervals were obtained by statistical analysis of the parameters among the different age groups. Results　Among the different age groups， the white blood cell was statistically significant (P<0.05). However， separate reference intervals were not estimated, unless the difference was at least 25% between the subclass means and combination means. The other parameters had no statistical significance (P>0.05). After the combination of the above parameters， the interval of white blood cell was 4.8-11.6(7.7) ×10⁹/L， the interval of red blood cell was 3.75-5.18(4.47)×10¹²/L， the interval of hemoglobin was 110-145(126)g/L， the interval of hematocrit was 31.2-41.5(36.3)%， the interval of mean corpuscular volume was 76-88(81)fL， the interval of mean corpuscular hemoglobin was 25-31(28)pg， the interval of mean corpuscular hemoglobin concentration was 329368(349)g/L，and the interval of platelet was 175-460(310)×10⁹/L. The reference intervals of hemoglobin, red blood cell and hematocrit in Shanghai were similar to those in Changsha，and were lower than those in Kunming. The low and high limits of platelet in Shanghai were higher than those in Changsha and Kunming. Conclusions　Different detection system should be established for the reference intervals in the different regions and different laboratories.

Clinical application value evaluation of routine cytomorphology examination in bronchoalveolar lavage fluid

XU Jian;ZHOU Daoyin;YU Jinglong;TANG Gusheng

2012, 27(3):  221-224. 

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Objective　To evaluate the clinical application value of routine cytomorphology examination in 860 bronchoalveolar lavage fluid samples collected from January 2005 to December 2010 in Changhai Hospital by retrospective analysis. Methods　The 510 mL bronchoalveolar lavage fluid was collected in 10 mL plastic centrifuge tube and was centrifuged (500 g，5 min). The sediment was then loaded on microscopic slides, and ordinarily 6 smears were produced， including 2 thick slides without tails， 2 thick slides with tails and 2 thin slides with tails. WrightGiemsa was performed, and the monocytes/macrophages， lymphocytes， neutrophils， eosinophils， et al, cytomorphology and abnormal constituents were further counted and differentiated by experienced technicians under light microscopy. Periodic acidSchiff (PAS) stain and hemosiderin staining were also performed if necessary. Results　Neutrophil ratio >2% or 20% accounted for 88.8% (764 cases) or 47.2 % (406 cases) of the total 860 patients， respectively. Lymphocyte ratio >12% or 20% accounted for 27.2% (234 cases) or 15.7% (135 cases)， respectively. Eosinophil ratio>1% or 10% accounted for 7.4% (64 cases) or 3.2% (32 cases). A total of 117 cases accounted for 13.6% were found to have abnormal constituents， including cancer cells in 16 cases， heterogeneous nuclear or suspected cancer cells in 43 cases， fungus in 14 cases， Pneumocystis carinii in 3 cases and phagocytes in 2 cases. PAS stain positive had 33 cases, and hemosiderin staining positive had 6 cases. There were only 46 samples in which no abnormality was identified， accounting for 5.3% of total cases. Conclusions　High detection rates of abnormality in bronchoalveolar lavage fluid are identified, the high detection rates can provid helpful clinical reference for the diagnosis， treatment and prognosis of various diseases.