Table of Content

30 September 2014, Volume 29 Issue 9

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The research progress of carbohydrate antigens and their relative molecules in tumor diagnosis

GAO Feng

2014, 29(9):  873-876.  DOI: 10.3969/j.issn.1673-8640.2014.09.001

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Glycosylation changes are the common characteristics of cancer cells. Some types of glycan structures are recognized as the markers of tumor development, but the current molecules cannot regularly meet the pressing needs of tumor early diagnosis, prognosis and metastasis judgment. In recent years, a remarkable progress has been made in the yield of carbohydrate antigens(CA) and their relative molecules in tumor diagnosis. In order to serve the clinical needs better, new tumor markers of CA and their relative molecules, together with multi-parameter analysis, should be established.

Carcinoembryonic antigen-related cell adhesion molecule 1 and tumor

YANG Changcheng, WANG Wenjuan, GAO Feng

2014, 29(9):  877-883.  DOI: 10.3969/j.issn.1673-8640.2014.09.002

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Application of the combination detection of serum AFP, GP73 and GPC3 on the diagnosis of primary hepatic carcinoma

FAN Gongren, WANG Weifang, HAN Juqiang, JIANG Shengying, CAO Jianbiao

2014, 29(9):  884-888.  DOI: 10.3969/j.issn.1673-8640.2014.09.003

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Objective To investigate the application significance of the combination detection of alpha-fetoprotein (AFP), Golgi protein 73(GP73) and glypican 3(GPC3) on the diagnosis of primary hepatic carcinoma (PHC). Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of GP73 and GPC3 in 148 patients with PHC, 73 patients with liver cirrhosis (LC), 57 patients with chronic hepatitis B (CHB) and 85 healthy subjects(healthy control group). Serum AFP was detected by chemiluminescence immunoassay. The levels of GP73 and GPC3 were compared with that of AFP. Results Serum levels of GP73, GPC3 and AFP in PHC group were 346.9±208.7, 143.1±66.9 and (690.3±402.5) μg/L, which were significant statistically compared with those inLC, CHB and healthy control groups (P<0.01). In the combination detection, the sensitivity was 95.9%, and the accuracy was 89.2%. Conclusions The combination detection of serum AFP, GP73 and GPC3 could cover the shortage of individual detections, increase the diagnosis rate of PHC and differentiate PHC with clinical significance.

The clinical significance of GAG and MDA detections in the diagnosis and treatment of non-Hodgkin's lymphoma

ZHANG Yu, JIANG Minglei, LU Renquan, GUO Lin

2014, 29(9):  889-892.  DOI: 10.3969/j.issn.1673-8640.2014.09.005

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Objective To investigate the significance of glycosaminoglycan (GAG) and malondialdehyde (MDA) in the diagnosis and treatment of non-Hodgkin's lymphoma(NHL). Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum GAG and MDA in 99 NHL patients and 58 healthy controls. The chemotherapy efficiency in 20 follicular lymphoma (FL) patients were followed and monitored, and the results were analyzed and compared by nonparametric rank sum test. Results The levels of serum GAG and MDA in 99 NHL patients were significantly higher than those in healthy controls (P<0.01), especially in FL patients(P<0.01).The progress of GAG level in 20 followed-up FL patients was consistent with disease progression (consistency rate>75%), while the progress of MDA level was not entirely consistent with disease progression. Conclusions GAG and MDA have a useful clinical application significance in the diagnosis and treatment monitoring of NHL.

Investigation on the application significance of serum tumor biomarker HE4 detection in the diagnosis of lung cancer

XIAO Ran, HU Haoyun, WANG Rui, LU Renquan, GUO Lin

2014, 29(9):  893-896.  DOI: 10.3969/j.issn.1673-8640.2014.09.006

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Objective To investigate the expression level of tumor biomarker human epididymis protein 4 (HE4) in tissue and serum of patients with lung cancer and its role in differential diagnosis of lung cancer. Methods HE4 expressions in lung adenocarcinoma, lung squamous cell carcinoma and cancer-adjacent tissues were detected by immunohistochemistry, and serum HE4 levels were determined in 214 patients with lung cancer and 76 healthy subjects by enzyme-linked immunobsorbent assay (ELISA). Simultaneously, the serum levels of squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), cytokeratin 19 fragment(CYFRA21-1) and neuron-specific enolase (NSE) were determined. The results were compared and analyzed among the groups. Results Lung adenocarcinoma tissues showed stronger positive staining than lung squamous cell carcinoma tissues, and the negative staining was shown in cancer-adjacent tissues. The level of serum HE4 in lung cancer patients[85.04(64.91,118.40) pmol/L] was significantly higher than that of healthy controls [48.48(43.12,58.81) pmol/L, P<0.01]. HE4 had a better diagnosis efficiency than CYFRA21-1 and CEA in non-small cell lung cancer through receiver operating characteristic (ROC) curve analysis. The positive rate of combined detection of SCC, CEA, CYFRA21-1 and NSE was 79.44% for lung cancer. However, HE4 improved the positive rate to 89.72% when combined with this biomarker panel. In the diagnosis of lung adenocarcinoma, the positive rate of combined detection of CEA and CYFRA21-1 was 68.46%. Moreover, HE4 improved the positive rate to 82.31% when combined with this biomarker panel. Conclusions HE4, as a biomarker of lung cancer, is a useful indicator for the early diagnosis of lung cancer.

The experimental study of establishing tumor-associated macrophage model

ZHANG Guoliang, LIU Yiwen, HE Yiqing, YANG Cuixia, WANG Wenjuan, DU Yan, GAO Feng

2014, 29(9):  897-802.  DOI: 10.3969/j.issn.1673-8640.2014.09.007

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Objective To establish the differentiation model of tumor-associated macrophages (TAM) in vitro. Methods Monocytes were isolated from the peripheral blood of healthy subjects and cultured in vitro. After stimulation by interleukin 4(IL-4) and interleukin 13(IL-13), the expression changes of molecule markers on monocytes were determined by flow cytometry, including CD14, CD204 and CD206. The levels of interleukin 10 (IL-10) secreted by monocytes weredetermined by enzyme-linked iummunosorbent assay (ELISA). After coculturing with monocytes, the apoptosis of tumor cells was investigated by Hoechst staining. Results After stimulation by IL-4 and IL-13, monocytes exhibited a markedly altered phenotype with retained CD14, the increasing expressions of CD204 and CD206 and the increasing amount of secreted IL-10. Moreover, when coculturing with tumor cells, the cytotoxity of monocytes on tumor cells was inhibited by IL-4/IL-13. Conclusions IL-4/IL-13 could induce monocytes to exhibit TAM phenotype and function, indicating IL-4/IL-13 could be applied to the establishment of TAM differentiation model, which can be used inthe research of TAM.

Investigation on the determination of tumor-associated macrophages inducing the drug resistance of human breast cancer

HE Linyan, YANG Cuixia, WANG Wenjuan, DU Yan, LIU Yiwen, HE Yiqing, GAO Feng

2014, 29(9):  903-908.  DOI: 10.3969/j.issn.1673-8640.2014.09.008

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Objective To investigate the role and drug resistance mechanism of tumor-associated macrophages (TAM) in human breast cancer cells. Methods Human monocytic cell line THP-1 was stimulated by phorbol myristate acetate (PMA), interleukin 4 (IL-4) and interleukin 13 (IL-13) to build a model of TAM which was cocultured with breast cancer cells in vitro. Flow cytometry (FCM) was used to determine CD14 and CD204. The effective concentration and time of paclitaxel for inhibiting the proliferation of breast cancer cell line T47D and BT-549, and the inhibitory rates of breast cancer cell cultured alone and cocultured with TAM/TAM conditioned medium were detected by 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) colorimetric signal. The signal pathway change of phosphorylated signal transducers and activators of transduction 3 (p-STAT3) and phosphorylated c-Jun N-terminal kinase (p-JNK) were analyzed by Western Blot. Results THP-1 differentiated to TAM by PMA, IL-4 and IL-13 and showed the expressions of CD14 (31.52%±9.39%) and CD204 (48.21%±8.76%). Breast cancer cell lines which had been cocultured with TAM/TAM conditioned medium showed a significant increase in the number of survival cells compared to breast cancer cell lines cultured alone (T47D cultured alone:43.52%±9.40%, T47D cocultured: 92.68%±2.32%/92.20%±2.10%, BT-549 cultured alone: 63.08%±2.71%, BT-549 cocultured: 77.96%±2.64%/79.55%±2.35%, P<0.05). The apoptosis signal p-JNK was significantly down-regulated (P<0.05), and the p-STAT3 was up-regulated (P<0.05). Conclusions The model for TAM is established successfully. TAM protects breast cancer cells from the effect of paclitaxel through the secretion of cytokines which may caused by the activation of STAT3 and down regulation of p-JNK in tumor cells.

Investigation on drug resistance variation and homology of Acinetobacter baumannii isolated from patients in neurosurgery department at Renji Hospital from 2011 to 2013

CHEN Yisheng, YING Chunmei, LI Yongli

2014, 29(9):  909-912.  DOI: 10.3969/j.issn.1673-8640.2014.09.009

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Objective To investigate the drug resistance variation and molecular epidemiology of Acinetobacter baumannii isolated from patients in neurosurgery department at Renji Hospitaland analyze the homology, in order to provide the reference for clinical treatment and nosocomial infection control. Methods A total of 87 clinical isolates of Acinetobacter baumannii were collected from July 2011 to June 3013 in neurosurgery department of Renji Hospital. The minimal inhibitory concentrations (MIC) of 12 antimicrobial agents against 87 Acinetobacter baumannii isolates were determined by agar dilution method. The genotype was identified by multilocus sequence typing technique, and the epidemiology characteristic was analyzed further. Results The 87 Acinetobacter baumannii isolates were commonly resistant to cephalosporin, fluoroquinolone, aminoglycoside and carbopenem, and the drug resistance rates increased year by year. A total of 6 genotypes were identified among 87 Acinetobacter baumannii isolates:ST-208(45 isolates), ST-191(15 isolates), ST-540(8 isolates), ST-195(2 isolates), ST-381(2 isolates) and ST-368(1 isolate). ST-208 was the main epidemiology type. The ST types had the homologous relevance belonging to CC92 except for ST-381. Conclusions The drug resistance rate of Acinetobacter baumannii to antimicrobial agents increases year by year, and there is dissemination characteristic, which should be paid more attention. Infection monitoring should be enhanced to reduce the spread of drug-resistant bacteria.

Research on the relationship between the emergence of constitutive high expression AmpC beta-lactamase and antibiotics therapy used in the infection caused by Enterobacter aerogenes

ZHAO Fuju, FANG Yi, ZHANG Jinghao, LIU Wenjian, ZHOU Lifang, PANG Lifeng, ZHAO Hu

2014, 29(9):  913-917.  DOI: 10.3969/j.issn.1673-8640.2014.09.010

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Objective To investigate the relationship between antibiotics therapy and producing constitutive high expression AmpC beta-lactamase (AmpC) infected by Enterobacter aerogenes, in order to provide the reference for rational antibiotics. Methods Enterobacter aerogenes were isolated from September 2011 to March 2012 from elderly nosocomial patients in the elderly ward of Huadong Hospital. The modified three dimensional test was used to detect AmpC. The homology of Enterobacter aerogenes was detected by pulsed-field gel electrophoresis(PFGE). Prospective and retrospective investigations were performed on the clinical data of the patientswith wild-type and constitutive high expession AmpC infected by Enterobacter aerogenes. Results A total of 19 isolates of Enterobacter aerogenes were isolated. The positive rates of constitutive high expression and wild-type AmpC were 31.58%(6/19) and 26.32%(5/19). The positive rate of constitutive high expression AmpC from sputum samples was 83.33%, and the positive rate from urine samples was 33.33%. The total amount of antibiotics used to treat Enterobacter aerogenes infection producing constitutive high expression AmpC was higher than that of wild-type Enterobacter aerogenes. The wild-type Enterobacter aerogenes may be changed to the constitutive high expression when cephamycin was used to inhibit for more than2 weeks. Conclusions The positive rate of producing constitutive high expression AmpC by Enterobacter aerogenes in Huadong Hospital is high, especially for isolates form respiratory tract.The 1st, 2nd and 3rd generation cephalosporins and cephamycin should be used with caution or not be used in the course of anti-infection therapy. It is necessary to strengthen the surveillance of antimicrobial resistance and reasonably use antibiotics.

Influence of Helicobacter pylori infection on carotid atherosclerosis in elderly patients with hypertension

HU Dong, WU Qian, CHEN Gang, ZHU Huaqiang, XIANG Lixian, ZHANG Wei

2014, 29(9):  918-921.  DOI: 10.3969/j.issn.1673-8640.2014.09.011

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Objective To investigate the status of Helicobacter pylori (Hp) infection and atherosclerosis risk factors in elderly patients with hypertension, and to investigate the role of Hp infection on the occurrence and development of carotid atherosclerosis in elderly patients with hypertension. Methods The status of Hp infection and the serum levels of low-density lipoprotein cholesterol(LDL-C), lipoprotein(a)[Lp(a)], homocysteine(Hcy) and high-sensitivity C reactive protein (hs-CRP) were determined in 83 elderly patients with hypertension. Ultrasonic inspection was performed, and the subjects were classified according to the status of Hp infection. The results were analyzed statistically. Results Hp infection occurred in 37 cases, and the Hp infection rate was 44.6%. Carotid intima media thickness (CIMT) in Hp positive group was significantly higher than that in Hp negative group (P<0.05). The serologic indices, LDL-C, Lp(a), Hcy and hs-CRP, in Hp positive group were significantly higher than those in Hp negative group(P<0.05). The serum levels of LDL-C, Hcy and hs-CRP in Hp current infection were significantly higher than those in Hp previous infection (P<0.05). Conclusions The Hp infection could be closely related with atherosclerosis, and Hp infection could increase the risk of carotid atherosclerosis in patients with hypertension.

The relationships between the serum levels of resistin and insulin resistance among pregnant women with gestational diabetes mellitus in mid-pregnancy

KE Huihui, GUO Limei, DING Haiying, XU Yiqun, GU Jiashi, YAN Yuzhong, YANG Xiaoning

2014, 29(9):  921-924.  DOI: 10.3969/j.issn.1673-8640.2014.09.012

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Objective To investigate the relationships between the serum levels of resistin and insulin resistance(IR) among pregnant women with gestational diabetes mellitus (GDM) in mid-pregnancy and its role in the progress of GDM. Methods A total of 98 GDM pregnant women (24-28 weeks) were enrolled as GDM group, and 95 healthy pregnant women (24-28 weeks) at the same period were enrolled as control group. The serum levels of resistin, fasting blood glucose(FBG) and fasting insulin(FINS) of all pregnant women were determined by enzyme-linked immunosorbent assay (ELISA), glucose oxidase method and electrochemiluminescence immunoassay, respectively. The home model insulin resistance index(HOMA-IR) was calculated. The difference of serum resistin and IR levels in the 2 groups were compared. The correlations between serum resistin and IR levels were analyzed. Results The serum levels of resistin, FBG, FINS and HOMA-IR in GDM group were (19.74±6.89)μg/mL, (5.35±1.23)mmol/L, (21.77±7.83)mU/L and 5.24±2.65, and those in control group were (15.62±4.19)μg/mL, (4.34±0.43)mmol/L, (17.81±4.92)mU/L and 3.43±1.00 (P<0.05). The serum levels of resistin were positively correlated with HOMA-IR(r=0.459, P<0.05). Conclusions The serum levels of resistin are closely correlated with HOMA-IR. Resistin probably plays its role in the progress of GDM.

The study of immune reconstitution after human leukocyte antigen-matched allogenetic hematopoietic stem cell transplantation

WEI Beiwen, TANG Wei, PENG Yibing, HU Jiong

2014, 29(9):  925-930.  DOI: 10.3969/j.issn.1673-8640.2014.09.013

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Objective To investigate the immune reconstitution after human leukocyte antigen (HLA)-matched allogenetic hematopoietic stem cell transplantation (allo-HSCT). Methods A total of 42 patients undergoing allo-HSCT from 2009 to 2013 in the Blood and Marrow Transplantation Center, Department of Hematology, Ruijin Hospital were enrolled in this study. The immunoglobulin levels of IgG, IgA, IgM and IgE prior to preconditioning and at 1, 3, 6, 12 and 24 months after transplantation were determined by rate nephelometry. T lymphocytes (CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺), B cell (CD19⁺) and natural killer (NK) cell (CD56⁺CD16⁺) levels were determined by flow cytometry(FCM) prior to preconditioning, at the day of transplantation, 14 and 21 d, 1, 3, 6, 12, 18 and 24 months after transplantation. The recovery of immunoglobulin and lymphocyte subsets was analyzed, and the impacts of pre-and post-transplantation variables were evaluated. Results The levels of CD3⁺ and CD3⁺CD8⁺ returned to be normal at 14 d after transplantation, while the recovery of CD3⁺CD4⁺ was slow, and its level remained lower than or closer to be normal in 2 years after transplantation. CD56⁺CD16⁺ recovered rapidly and returned to be normal at approximately 21 d after transplantation. CD19⁺ were back to be normal at 6 months after transplantation, and the recovery times of IgM, IgG and IgA were 1, 3 and 6 months, respectively. No significant differences were found in the immune reconstitution between male and female patients. The immune reconstitution of sibling donor transplantation was faster than that of unrelated donor transplantation. The levels of CD3⁺CD8⁺ at early stage of post-transplantation were significantly higher in patients with severe infection and Ⅲ-Ⅳ graft-versus-host disease (GVHD) than those in patients without infection and GVHD. For patients with Ⅲ-Ⅳ GVHD, CD3⁺ was significantly higher than that for patients without GVHD at early stage of post-transplantation, while the recovery of CD3⁺CD4⁺ tended to be slow. Conclusions The lymphocyte subsets recover after allo-HSCT in the following order: CD56⁺CD16⁺, CD3⁺CD8⁺, CD19⁺ and CD3⁺CD4⁺. HLA matching benefits the immune reconstitution. The application of anti-thymocyte globulin and GVHD occurrence after transplantation are the most important factors influencing the immune reconstitution.

The influence factors of S100A12 and its correlation with carotid artery atherosclerosis in hemodialysis patients

GUO Huan, LU Bin

2014, 29(9):  930-934.  DOI: 10.3969/j.issn.1673-8640.2014.09.014

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Objective To investigate the influence factors of plasma S100 calcium binding protein A12 (S100A12) level in hemodialysis patients and the correlation between S100A12 and carotid artery atherosclerosis. Methods A total of 150 hemodialysis patients and 100 healthy subjects were enrolled. The white blood cell counts, alanine transaminase(ALT), aspartate aminotransferase (AST), albumin(Alb), creatinine(Cr), urea, triglyceride (TG), total cholesterol(TC), blood glucose, glycosylated hemoglobin and S100A12 concentrations of hemodialysis patients were determined and compared with those of healthy subjects. Carotid intima-media thickness (CIMT) was measured by high-resolution B-mode ultrasonography in hemodialysis patients and also compared with that in healthy subjects. The correlation between S100A12 and CIMT was analyzed by Person correlation analysis. The multivariate regression analysis was used to analyze the influence factors of S100A12 concentration. Results The plasma S100A12 concentration was higher in hemodialysis patients than in healthy subjects (P<0.05). Significant positive correlation was recorded between S100A12 and CIMT (r=0.4, P<0.01). Multivariate regression analysis identified high white blood cell counts as a positive plasma independent determinant and low TC and low Alb as negative independent determinants of plasma S100A12 concentration. Conclusions S100A12 is related to carotid artery atherosclerosis. The white blood cell counts, TC and Alb are associated with S100A12 concentration.

Predictive research on the adverse outcome of persistently high level of heart-type fatty acid-binding protein in chronic heart failure patients

ZHONG Ling, HUANG Wenfang

2014, 29(9):  935-940.  DOI: 10.3969/j.issn.1673-8640.2014.09.015

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Objective To study the variation regularity of heart-type fatty acid-binding protein (H-FABP) at different stages in patients with chronic heart failure (CHF), and to investigate the predictive significance of persistently high level of H-FABP for early adverse outcome. Methods Serum H-FABP and B-type natriuretic peptide (BNP) levels were determined among 184 CHF patients at both admission and discharge and 100 healthy controls (healthy control group). According to the determination results, they were classified into 2 groups, low H-FABP level group (82 cases, Group 1) and high H-FABP level group (102 cases, Group 2). Follow-up study was made for the 2 groups, respectively, and their adverse outcomes were observed. Results The H-FABP level of healthy control group was ≤0.6 ng/mL. The H-FABP levels of Group 1 were low at both admission and discharge[3.042±0.914, (2.891±0.890) ng/mL]. The H-FABP levels of Group 2 were high at both admission and discharge[12.276±3.991, (9.374±3.116) ng/mL]. During the follow-up period, 54 cases had cardiovascular events (29.35%, 54/184, 24 died cases and 30 readmitted cases). There were 10 cases(12.20%) in Group 1 and 44 cases(43.14%) in Group 2 with cardiovascular events with statistical significance between the 2 groups (P<0.01). Kaplan-Meier curve showed Group 2 had evidently worse event-free rate than Group 1 (P<0.001). H-FABP increased significantly before cardiovascular events with an average of 27 d, while BNP increased earlier than cardiovascular event occurrence with an average of10 d. That of H-FABP was 17 d earlier than that of BNP. Univariate Cox proportional hazard analysis demonstrated that age, New York Heart Academy (NYHA) classification,BNP and H-FABP were all related to cardiovascular events. Multivariate Cox proportional hazard analysis showed that the persistently high level of H-FABP was an independent factor for cardiovascular events (OR=5.462,P<0.000 1). Conclusions Monitoring the level of H-FABP is a new tool that provides clinical information to predict prognosis and guide the therapy efficacy for CHF patients.

The influence of metabolic syndrome and its risk components on serum prostate-specific antigen level

ZHANG Benhong, ZHANG Fei, CHEN Baode, XU Songxiao, CHENG Haien

2014, 29(9):  940-944.  DOI: 10.3969/j.issn.1673-8640.2014.09.016

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Objective To investigate the influence of metabolic syndrome and its risk components on serum prostate-specific antigen(PSA) level. Methods A total of 5 717 male healthy subjects over 40 years old without the history of prostate cancer, who met the requirements and had integrated data, were enrolled from 3 hospitals.Physical examination and laboratory tests [triglyceride (TG), high-density lipoprotein cholesterol(HDL-C), fasting blood glucose(FBG)and PSA]were performed. According to Chinese Diabetes Society criteria for metabolic syndrome and its risk components, the influence of metabolic syndrome and its risk components on serum PSA level was analyzed statistically. Results The mean age of 5 717 healthy subjects was (53.49±10.64)years old, the prevalence of metabolic syndrome was 27.1%, and the PSA was (1.04±0.72) ng/mL. The PSA levels between metabolic syndrome group and healthy control group were not significantly statistical (P>0.05). After adjusting for age, the partial correlation among body mass index (BMI), FBG and PSA levels was negative, and the correlation coefficients(r) were -0.05 and -0.03, respectively(P<0.05). There was no correlation between metabolic syndrome and its risk components with serum PSA (P>0.05).For analysis of covariance, the age-adjusted means of serum PSA levels by BMI and FBG were cmputed, and they decreased with the increase of BMI and FBG. Conclusions The correlation of serum PSA level with BMI and FBG is negative. The influence of BMI and FBG on PSA level should be considered.

Gene identification of a patient with B(A) blood group

LI Huimin, LIN Junfeng, ZHANG Fan, GU Yuwei, GU Ping, FU Qihua, WANG Jing

2014, 29(9):  945-951.  DOI: 10.3969/j.issn.1673-8640.2014.09.017

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Objective To investigate the gene identification of a patient with serologic blood group discrepancy, and analyze the reason and variations. Methods Microcolumn agglutination and routine tube method were used for serologic blood group identification, and Coombs' and antibody screening were performed. Exon 6,7 and their adjacent intron region of ABO gene were amplified by polymerase chain reaction (PCR), and the PCR products were directly sequenced to identify the gene mutation. Results The forward and reverse tests of serologic blood group identification were not consistent. The red blood cells of the patient showed weak positive(++) with monoclonal anti-A and positive(++++) with monoclonal anti-B and anti-H. The patient's serum showed weak agglutination with type A1 red blood cells and no agglutination with type B and type O red blood cells. The direct and indirect Coombs and antibody screening were all negative. There were 2 heterozygous variations in exon 6 (261del and c.297A>G) and 11 heterozygous variations in exon 7 (c.526C>G, c.640A>G, c.646T>A, c.657C>T, c.681G>A, c.703G>A, c.771C>T, c.796C>T, c.803G>C, c.829G>A and c.930G>A) of ABO gene in the patient compared with the reference sequence of A101 allele. Based on the Blood Group Antigen Gene Mutation Database, B(A)04/O06 subgroup alleles were identified. Conclusions The variation of B allele and the weak AB phenotype are the main reasons of the discrepancy in blood group identification for the patient. DNA genotyping could help us with solving the blood group identification for complicated serologic discrepancy samples.

Significance of serum vitamin D3 and soluble myeloid cell trigger receptor 1 level for the diagnosis of senile pneumonia

DONG Yiyu, TAO Zhihua, SHEN Lili, CHEN Qun

2014, 29(9):  952-954.  DOI: 10.3969/j.issn.1673-8640.2014.09.018

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Objective Through the detections of serum soluble myeloid cell trigger receptor 1 (sTREM-1) and vitamin D3 (VitD3) levels in senile pneumonia patients, to investigate the relations of sTREM-1 and VitD3 with senile pneumonia, and to provide the reference for clinical diagnosis and treatment. Methods A total of 63 patients with senile pneumonia were enrolled, and 30 healthy subjects were enrolled as control group.sTREM-1 was determined by enzyme-linked immunosorbent assay (ELISA), and electrochemiluminescence was used to determine serum level of VitD3. The results were analyzed comparatively between the 2 groups. Results The sTREM-1 in senile pneumonia group [(234.80±68.90)pg/mL] was significantly higher than that in control group[(74.20±41.20)pg/mL] with statistical significance (P<0.01).VitD3 level in senile pneumonia group [(18.92±7.27)pg/mL] wassignificantly lower than that in control group[(33.75±9.28)pg/mL] with statistical significance (P<0.05). The areas under receiver operating characteristic (ROC) curve were 0.916 for sTREM-1 and 0.897 for VitD3. Conclusions VitD3 and sTREM-1 are good indicators for the diagnosis of senile pneumonia.

The discussion of applying precipitation to eliminate the state of chyle for HLAP patients' specimens

ZHANG Huiliang, HUANG Shuhua, LIU Jianling, XIA Houcai

2014, 29(9):  955-960.  DOI: 10.3969/j.issn.1673-8640.2014.09.019

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Objective To investigate phosphotungstic acid magnesium precipitation eliminating effects on hyperlipidemic acute pancreatitis(HLAP) patient's specimens in severe state of chyle before biochemical tests. Methods The normal appearance specimens undergoing phosphotungstic acid magnesium treatment were collected to do biochemical tests, and the correlation data before and after tests were analyzed. The 3 different, mild, moderate and severe, groups of chylous sera with intralipid were performed to do recovery test, and the recovery rates of all biochemical projects were calculated. HLAP patients' specimens were collected to do empirical test, and the chyle eliminating effect and biochemical test effect were observed. Results Except for CO₂ combining ability(CO₂CP), total bilirubin(TBil), direct bilirubin(DBil), creatine kinase-MB(CK-MB), lactate dehydrogenase 1(LD-1), cystatin C(Cys C), high-sensitivity C-reactive protein(hs-CRP), K^＋, Na^＋, Cl^－, Ca^2＋, glucose(Glu), urea, uric acid(UA), creatinine(Cr), amylase(AMY), alanine aminotransferase(ALT), aspartate aminotransferase(AST), gamma-glutamyl transpeptidase(GGT), alkaline phosphatase(ALP), cholinesterase(CHE), total protein(TP), albumin(Alb), total bile acid(TBA), creatine kinase(CK), lactate dehydrogenase(LD) and alpha-hydroxybutyrate dehydrogenase(α-HBDH) can be correctly detected after phosphotungstic acid magnesium treatment, and it showed obvious linear correlation before the treatment.Fitted curve showed that the P was <0.01. In the 3 groups of chylous sera, the lowest recovery rate was 98.03%, the highest recovery rate was 103.44%, and it showed a good recovery effect. The correctly detected biochemical projects of HLAP patients' specimens by phosphotungstic acid magnesium were consistent with the correlation tests of the normal appearance specimens. The specimens of triglyceride (TG)＜10 mmol/L or TG＞40 mmol/L had obvious chyle eliminating effects, and the specimens with TG 10-40 mmol/L needed to be diluted to TG<10 mmol/L before processing. Conclusions Phosphotungstic acid magnesium precipitation has an obvious effect on eliminating blood lipid. It won't interfere most of the biochemical tests. The treatment can be applied before the biochemical tests for HLAP patients' specimens in severe state of chyle.

Comparison analysis on the results of SYSMEX CA1500 and SYSMEX CA7000 coagulation analyzers

SHI Mei, SHEN Yuhua, SHI Weifeng

2014, 29(9):  961-963.  DOI: 10.3969/j.issn.1673-8640.2014.09.020

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Objective To study the comparability of the results between SYSMEX automatic coagulation analyzer CA1500 (CA1500) and SYSMEX automatic coagulation analyzer CA7000(CA7000) coagulation analyzers. Methods Activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrinogen(FIB) were detected by CA7000 (comparison method, X) and CA1500 (experimental method, Y) in 60 serum samples. The results were analyzed by t test and regression analysis. Clinical acceptability was evaluated by systematic error at medical determining level. Results There was no statistical significance between the results of PT and FIB by CA1500 and CA7000(P>0.05), and there was statistical significance between the results of APTT by CA7000 and CA1500(P<0.05). The results of APTT, PT and FIB by CA1500 were consistent with those by CA7000 according to the results of regression analysis. The systematic errors were within the 1/2 allowable error of the Clinical Laboratory Improvement Amendment 88 (CLIA'88). Conclusions The different coagulation analyzers in the same laboratory should be conducted periodically comparative experiments to ensure the comparability between test results.

Performance evaluation and reference range adjustment for 6 coagulation indicators of SYSMEX CS5100 coagulation analyzer

YAN Hongbin, ZHENG Shanluan, HAO Xiaoke

2014, 29(9):  964-968.  DOI: 10.3969/j.issn.1673-8640.2014.09.004

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Objective To evaluate the performance of SYSMEX CS5100 automatic coagulation analyzer(CS5100), verify the reference ranges of coagulation indicators recommended by manufacturers, and establish our own laboratory reference ranges. Methods The prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), fibrinogen(FIB), D-dimer (DD) and fibrinogen degradation product(FDP) were determined in mixed plasma, quality control plasma and plasma from 222 healthy subjects by CS5100. Results According to the technical program by the International Council for Standardization in Haematology (ICSH), the analyzer had high precision, accuracy, good linear range and low carryover rate. The recommended reference ranges of TT, DD and FDP were appropriate for our laboratory. The reference ranges of PT, APTT and FIB (10.4-13.0 s, 19.5-30.3 s and 1.6-3.6 g/L) were established statistically. There was no statistical significance between male and female groups on the coagulation indicators(P>0.05). Conclusions In the basis of ensuring a good condition of CS5100, the reference ranges of coagulation indicators for our own laboratory are established and verified, which may provide accurate results for clinic.

Use and effect of a semiautomatic blood slide maker in the teaching of high vocational college

ZHANG Shihua, MA Shaohua, WANG Donggang, XU Jianqiang, WUANG Wenjuan, CHEN Jing

2014, 29(9):  969-973.  DOI: 10.3969/j.issn.1673-8640.2014.09.022

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Objective To eliminate the interference of man-made ingredient in making peripheral blood smears, and improve the quality stability and standardization of blood smears and promote high vocational college students to better study and grasp cellular morphology. Methods A new type of semiautomatic blood slide maker was designed and manufactured. When conducting the preparation and staining of a blood smear, every blood smear made by student majoring in medical laboratory technology and health inspection and quarantine technology respectively by hand and by slide maker is evaluated by experts and teachers according to the criteria of a good blood smear, and the results were analyzed statistically. In addition, the times for blood collection and its preparation, staining and microscopic examination were recorded, and the advantages and disadvantages of the 3 groups of slide making by hand, by hand allied with by slide maker and just by slide maker were compared. Results The percentage of qualified blood smears made by slide maker was much higher than that by hand in the medical laboratory technology speciality (P<0.01), whichwas the same as that in the health inspection and quarantine technology speciality (P<0.01). The percentage of qualified blood smears made by hand in these 2 specialities did not take on remarkable change (P>0.05). Besides, making blood smears by hand allied with by slide maker can not only enable all students to practise slide making, but also helped the students who had difficulty in getting a qualified blood smear, which increased their time to observe microscope and further enhanced teaching effectiveness. Conclusions The use effect of the semiautomatic blood slide maker designed and manufactured by our research group is satisfactory, which can be used as an assistant teaching equipment in the teaching of our school.

Research advances on the mechanisms for Candida albicans resistance to antifungal azole

WEI Bing, LIU Jinyan, SHI Ce, XIANG Mingjie

2014, 29(9):  978-981.  DOI: 10.3969/j.issn.1673-8640.2014.09.025

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Candida albicans is the most important opportunistic pathogenic yeast in clinic. With the widespread use of antifungal agents, the chance of antifungal resistance in Candida albicans is increasing. The emergence of resistance is an difficult point for drug treatment. Mutation or overexpression in drug target enzymes, overexpression of multidrug transporters, cellular stress responses, formation of biofilm and so on, compose the major molecular mechanisms which contribute to the development of antifungal azole resistance in Candida albicans. This paper gives a general review of the azole resistance mechanisms in Candida albians.

Harmonization of quality indicators in clinical laboratory

KANG Fengfeng, WANG Wei, WANG Zhiguo

2014, 29(9):  982-986.  DOI: 10.3969/j.issn.1673-8640.2014.09.026

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The identification of reliable quality indicators in total testing process enables users to ensure the quality of laboratory testing. A large number of national and international study data show that most errors occur in the pre- and post-examination phases, but winning little attention. The study of quality indicators is on the beginning in our country, and the programs on the quality indicators of extra-examinational phases have been developed in some countries, as well. However, there is no consensus on the common terminology in total testing process and the recommendations for the adoption of universal quality indicators, which impedes the establishment and implement of quality indicators, so it is urgent to harmonize proposed quality indicators.