Table of Content

30 September 2018, Volume 33 Issue 9

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Role of monocytic HLA-DR and CD16 determinations in inflammatory diseases

ZHANG Lihua, WANG Weiwei, ZHANG Liang, SHEN Lisong

2018, 33(9):  775-780.  DOI: 10.3969/j.issn.1673-8640.2018.09.001

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Objective To evaluate the role of monocytic human leukocyte antigen-DR （HLA-DR） and CD16 determinations in inflammatory diseases. Methods A total of 56 patients with inflammatory diseases and 40 healthy subjects （healthy control group） were enrolled for the determinations of HLA-DR and CD16 expression levels [HLA-DR mean fluorescence intensity （MFI） and CD16 MFI],the percentages of positive HLA-DR and CD16 （HLA-DR⁺% and CD16⁺%） and MFI （HLA-DR⁺ MFI and CD16⁺ MFI） by flow cytometry. The correlations of HLA-DR and CD16 expression levels with neutrophil absolute value（NEUT#）,neutrophil percentage（NEUT%）,lymphocyte absolute value（LYMPH#）,lymphocyte percentage（LYMPH%）,monocyte absolute value（MO#）,monocyte percentage（MO%）and neutrophil/lymphocyte ratio（NLR） were evaluated. The diagnostic roles of HLA-DR and CD16 in inflammatory diseases were evaluated by receiver operating characteristic （ROC） curve. Results Compared with healthy control group,NEUT#,NEUT%,MO# and NLR in inflammatory disease group were higher（P<0.01）,and LYMPH# and LYMPH% were lower （P<0.01）. HLA-DR⁺%,HLA-DR MFI and HLA-DR⁺ MFI in inflammatory group were lower than those in healthy control group（P<0.01）,while CD16 MFI,CD16⁺% and CD16⁺ MFI were higher（P<0.01）. HLA-DR⁺%,HLA-DR MFI,HLA-DR⁺ MFI,CD16 MFI and CD16⁺ MFI were correlated with NEUT#,NEUT%,LYMPH#,LYMPH%,NLR and MO# （P<0.01）,and there was no correlation with MO% （P>0.05）. CD16⁺% was correlated with NEUT#,LYMPH#,LYMPH%,NLR,MO# and MO% （P<0.05）,and there was no correlation with NEUT%（P>0.05）. ROC curve analysis showed that the areas under ROC curves （AUC） of HLA-DR⁺%,HLA-DR MFI,HLA-DR⁺ MFI,CD16⁺%,CD16 MFI and CD16⁺ MFI for the diagnosis of inflammatory disease were 0.944,0.944,0.924,0.722,0.911 and 0.979,respectively. Conclusions The determinations of monocytic HLA-DR and CD16 can be used for the diagnosis of inflammatory diseases,and monocytic HLA-DR and CD16 can be used to assess the severity of inflammation and monitor immune status.

Relationship between peripheral blood lymphocyte subset and prognosis in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization

MENG Zhimin, ZHU Jie, ZHANG Chunyan, GUO Wei, PAN Baishen, WANG Beili

2018, 33(9):  781-785.  DOI: 10.3969/j.issn.1673-8640.2018.09.002

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Objective To investigate the relationship between peripheral blood lymphocyte subset and prognosis in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization （TACE）. Methods A total of 214 hepatocellular carcinoma patients undergoing TACE were enrolled. The preoperative ethylenediamine- tetraacetic acid whole blood samples were collected,and peripheral blood lymphocyte subset was determined by flow cytometry. The basic clinical data were collected. The data of magnetic resonance imaging （MRI） after TACE for 6 months and prognosis were evaluated. The patients were classified into 2 groups,including stable disease group （134 cases） and progressive disease group（80 cases）,according to MRI data. The difference of lymphocyte subset between the 2 groups and the independent risk factor of prognosis after TACE were analyzed. Results The cell percentages of CD4⁺ and CD4⁺CD8⁺ and the ratio of CD4⁺/CD8⁺ in stable disease group were lower than those in progressive disease group （P<0.05）. The cell percentages of CD19⁺,CD3⁺,CD8⁺ and CD56⁺ had no statistical significance （P>0.05）. Logistic regression analysis showed that the number of tumors,the cell percentage of CD4⁺and the cell percentage of CD4⁺CD8⁺ were independent risk factors for the prognosis of hepatocellular carcinoma after TACE [odds ratio （OR）=1.931,3.096 and 2.105,95% confidence interval （CI） 1.058-3.526,1.584-6.052 and 1.079-4.108]. Conclusions The increasing of preoperative CD4⁺ and CD4⁺CD8⁺ cell percentages may predict high possibility of poor prognosis in hepatocellular carcinoma patients after TACE.

Allergen spectrum analysis for 2 437 children with food intolerance in Shanghai

ZHENG Lan, YANG Lin, WANG Xing

2018, 33(9):  786-789.  DOI: 10.3969/j.issn.1673-8640.2018.09.003

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Objective To investigate the distribution characteristics of allergen spectrum for food intolerance children in Shanghai,and to provide a reference for the prevention and treatment of food intolerance disease. Methods A total of 2 437 children with food intolerance received allergen test. Enzyme-linked immunosorbent assay（ELISA） was used for determining serum food specific IgG antibody,and the results were analyzed statistically. Results Among the 2 437 patients,serum food specific IgG antibody was positive in 1 928 cases（79.1%）. The main allergen was egg white/yolk,whose positive rate was 54.7%,followed by wheat （44.3%）,tomato（31.3%） and milk （30.5%）. Pork and beef were allergens with low positive rates（<1%）. The positive rate of egg white/yolk in boys was higher than that in girls,while the positive rate of mushroom in girls was higher than that in boys（P<0.05）. There was statistical significance in milk,egg white/yolk,wheat,corn,cod,rice,tomato,crab,shrimp and chicken among children with different ages（P<0.05）. With the increasing of age,the positive rates of serum food specific IgG antibody for some allergens were decreased. Conclusions Egg white/yolk,wheat,tomato and milk are main allergens for child food intolerance disease in Shanghai. The allergen test can determine allergens,and it plays a role in individualized treatment and health education for children with food intolerance disease.

Changes of serum thyroid peroxidase antibody and thyroglobulin antibody in patients with hyperthyroidism heart disease

WANG Yao

2018, 33(9):  790-793.  DOI: 10.3969/j.issn.1673-8640.2018.09.004

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Objective To investigate the changes of serum thyroid peroxidase antibody（TPOAb） and thyroglobulin antibody（TgAb） in patients with hyperthyroidism heart disease（HHD）. Methods A total of 100 patients with HHD and 100 patients with hyperthyroidism were enrolled,and their general data [sex,age,body mass index（BMI）,hyperthyroidism course and mean arterial pressure（MAP）] were collected. Serum TPOAb and TgAb levels were determined. Results There was no statistical significance for sex,age,BMI,hyperthyroidism course and MAP between HHD and hyperthyroidism groups （P>0.05）. Serum TPOAb and TgAb levels in HHD group were higher than those in hyperthyroidism group before and after treatment（P<0.001）. In HHD group,serum TPOAb and TgAb after treatment were lower than those before treatment（P<0.001）. There were 76 effective cases （76.00%） and 24 invalid cases（24.00%）in HHD group. After treatment,serum TPOAb and TgAb levels in effective cases were lower than those before treatment and in invalid cases（P<0.001）. For invalid cases,serum TPOAb and TgAb levels had no statistical significance before and after treatment （P>0.05）. Serum TPOAb and TgAb levels in effective cases after treatment had no statistical significance compared with hyperthyroidism group （P>0.05）. Conclusions Serum TPOAb and TgAb levels may be related to the occurrence and transfer of HHD,and they can be used as reference indices for evaluating curative effects.

Serum procalcitonin level for guiding the discontinuation of antibiotics in patients with urinary sepsis

CHEN Xiaoyan

2018, 33(9):  794-797.  DOI: 10.3969/j.issn.1673-8640.2018.09.005

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Objective To investigate the role of serum procalcitonin （PCT） level for guiding the discontinuation of antibiotics in patients with urinary sepsis. Methods A total of 62 patients with urinary sepsis were enrolled and classified into experimental group and control group according to random number table （31 patients for each group）. All patients received antibiotics according to the principle of antimicrobial usage for sepsis. The control group was treated according to the principle of rational antimicrobial usage. The experimental group discontinued antibiotics according to the dynamic changes of serum PCT level. The discontinuation indication was that serum PCT level was ≤0.25 μg/L or serum PCT level had decreased by ≥90% of its peak value. Baseline data,antimicrobial drug use time,intensive care unit （ICU） stay time,total hospitalization time,the recurrence incidence of infection and the infection-related death rate in 28 d were compared between the 2 groups. Results There was no statistical significance in age,sex,complication diseases,acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score and the distribution of infectious bacteria between the 2 groups（P>0.05） with comparability. Antibiotic use time in experimental group was lower than that in control group （P<0.05）. There was no statistical significance for ICU stay time,total hospitalization time,the recurrence incidence of infection and the infection-related death rate in 28 d between the 2 groups （P>0.05）. Conclusions For patients with urinary sepsis,serum PCT level can guide the discontinuation of antibiotics. It could shorten antibiotic use time and could not affect short-term prognosis,which is safe and reliable.

Identification and antimicrobial susceptibility of Salmonella typhimurium monophasic variant in Shanghai

WU Wen, TU Lihong, ZHANG Wenxia, ZHANG Xi, CHEN Min

2018, 33(9):  798-802.  DOI: 10.3969/j.issn.1673-8640.2018.09.006

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Objective To investigate the genotypes and antimicrobial susceptibility of monophasic variant of Salmonella typhimurium （monophasic Salmonella typhimurium） in Shanghai from 2013 to 2015. Methods A total of 1 179 isolates of Salmonella isolated from diarrheal patients from 2013 to 2015 and stored by bacter testing laboratory in Shanghai Municipal Center for Disease Control and Prevention were collected. Serotyping and polymerase chain reaction （PCR） were used to screen and identify monophasic Salmonella typhimurium. The genotype was analyzed by PCR. Antimicrobial susceptibility was evaluated by Kirby-Bauer disk diffusion method with 14 antimicrobial agents for monophasic and diphasic Salmonella typhimurium,in accordance with the Clinical and Laboratory Standards Institute （CLSI） guidelines. Results A total of 52 isolates were identified as monophasic Salmonella typhimurium from 1 179 isolates of Salmonella. The percentages of monophasic Salmonella typhimurium in all isolates of Salmonella and Salmonella typhimurium were 4.4% and 23.3%,respectively. The determination rate of monophasic Salmonella typhimurium was high in young- and middle-aged groups. Most of them were from the suburbs of Shanghai. In the 52 isolates of monophasic Salmonella typhimurium,44 isolates （84.6%） were confirmed as fljB gene positive,and the remaining 8 isolates were fljB⁺ fljA^- hin^-（2 isolates,3.8%） and fljB⁺ fljA⁺ hin⁺ （6 isolates,11.6%）. There were 40 isolates （76.9%） of monophasic Salmonella typhimurium resistant to 3 or more antimicrobials. There were 36 isolates （69.2%） resistant to more than 4 antimicrobials. The drug resistance rates to ampicillin-streptomycin-sulfonamide-tetracycline（ASSuT） and ampicillin-chloramphenicol-streptomycin-sulfonamide-tetracycline（ACSSuT） were 61.54% and 19.23%,respectively,which were higher than those of diphasic Salmonella typhimurium （P<0.05）. Conclusions The determination rate of monophasic Salmonella typhimurium is high in Shanghai with multi-drug resistance and uneven population distribution. It should be paid attention to the reasonable distribution of resources and the rational use of antimicrobials.

Genotype distribution and HbA₂ parameter characteristic in thalassemia carriers or patients

LUO Mingyue, XIAO Kelin, LAN Huijuan, MAI Guangxing, XIONG Likuan

2018, 33(9):  803-806.  DOI: 10.3969/j.issn.1673-8640.2018.09.007

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Objective To analyze the genotype distribution and hemoglobin（Hb）A₂ parameter characteristic in thalassemia carriers or patients. Methods The genotype distribution of 2 194 α-thalassemia and 970 β-thalassemia female carriers or patients was analyzed retrospectively,and the HbA₂ levels of 1 438 α-thalassemia and 646 β-thalassemia carriers or patients were also analyzed. A total of 1 629 healthy females without thalassemia were enrolled as control group. Results The α-thalassemia group included silent group（740 cases）,trait group（1 400 cases） and HbH disease group（54 cases）. There were 5 genotypes in silent group,and -α^3.7/αα and -α^4.2/αα were common. There were 9 genotypes in trait group,and --^SEA/αα was common. There were 5 genotypes in HbH disease group,and -α^3.7/--^SEA was common. There was no statistical significance for HbA₂ levels between control and silent groups（P>0.05）,and the levels of HbA₂ were decreased in turn in control,silent,trait and HbH disease groups（P<0.05）. The β-thalassemia group included β^E-thalassemia group（26 cases）,β⁺-thalassemia group（400 cases） and β⁰-thalassemia group（544 cases）. Just 1 genotype was identified in β^E-thalassemia group,which was β^CD26/β^N. Four genotypes were identified in β⁺-thalassemia group,of which β^IVS-Ⅱ-654/β^N and β^-28/β^N were common. Eight genotypes were identified in β⁰-thalassemia group,of which β^CD41-42/β^N and β^CD17/β^N were common. HbA₂ levels were increased in the order of control,β⁺-thalassemia,β⁰-thalassemia and β^E-thalassemia groups（P<0.05）. Conclusions HbA₂ is important for β-thalassemia and HbH disease screening,and the results of blood routine test should be also considered in genetic counseling in case of silent and trait α-thalassemia being ignored.

Expressions of CD123 and CD66c in childhood B-cell acute lymphoblastic leukemia and their roles in monitoring minimal residual disease

ZHONG Jiaying, WU Yingying, LAO Mengxiao, ZHANG Xiaoyan, WANG Chunli, PAN Jianhua

2018, 33(9):  807-810.  DOI: 10.3969/j.issn.1673-8640.2018.09.008

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Objective To investigate the expressions of CD123 and CD66c in childhood B-cell acute lymphoblastic leukemia （B-ALL） and their roles in monitoring minimal residual disease （MRD）. Methods Multiparameter flow cytometry （MFC） was used to determine the expressions of CD123 and CD66c in bone marrow samples of 141 children with newly diagnosed B-ALL. A total of 25 children with acute myeloid leukemia （AML） with complete remission after chemotherapy were enrolled as control group,and their bone marrow samples had a proportion of normal B-progenitor cells. The antigens being different from those of control group were selected as MRD monitoring markers,and they were combined with CD10/CD34/CD19/CD45 antibodies for MRD monitoring. Results The expressions of CD123 and CD66c in normal B-progenitor cells and mature B-lymphocytes were negative. In the 141 cases of childhood B-ALL,there were 88 cases （62.41%） with the positive expression of CD123 and 70 cases （49.65%） with the positive expression of CD66c,respectively. The number of CD123 used for MRD monitoring was 45,and that of CD66c was 52. There were 35 cases with both CD123 and CD66c used for MRD monitoring,and there were 62 cases with CD123 or CD66c used for MRD monitoring,which the coverage rate was 43.97%. CD123 and CD66c showed good stabilities in MRD monitoring,with no decay or decline of antigen expression. Conclusions CD123 and CD66c can be used for MRD monitoring of childhood B-ALL,which should be combined with other markers so as to improve the coverage of MRD monitoring.

Application of dry chemical test for vaginal secretion determination in the diagnosis of common vaginal diseases

JIAO Ruibao, CHEN Ran, ZHOU Jiali, LIU Na, ZHANG Wen, TANG Jibin

2018, 33(9):  811-814.  DOI: 10.3969/j.issn.1673-8640.2018.09.009

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Objective To investigate the role of dry chemical test for vaginal secretion determination in the diagnosis of common vaginal diseases. Methods A total of 1 800 patients diagnosed as vaginitis were enrolled. Using dry chemical test,vaginal secretions were determined for 5 kinds of enzymes,including proline iminopeptidase（PIP）,saliva neuraminidase（SNA）,coagulase（COA）,N-acetylglucosaminidase（NAG） and glucosidase（GUS）. Vaginal secretion smear Gram staining microscopy was performed simultaneously. Results The results of vaginal secretion smear Gram staining microscopy were used as standard. The sensitivities of dry chemical test for bacterial vaginosis （BV）,vulvovaginal candidiasis and trichomonas vaginitis were 45.39%,44.68% and 92.31%,and the specificities were 97.14%,85.70% and 96.20%,respectively. The positive predictive values were 88.18%,36.73% and 34.95%,and the negative predictive values were 79.12%,89.29% and 99.82%,respectively. The consistency rates were 80.61%,79.28% and 96.11%,and the inconsistency rates were 19.39%,20.72% and 3.89%,respectively. The positive rate of BV for 1 800 cases of vaginal secretions by dry chemical test was lower than that by vaginal secretion smear Gram staining microscopy （χ²=515.24,P<0.001）. The positive rates of vulvovaginal candidiasis and trichomonas vaginitis by dry chemical test were higher than those by vaginal secretion smear Gram staining microscopy （χ²=142.36 and 537.70,P<0.001）. Conclusions Dry chemical test can not replace vaginal secretion smear Gram staining microscopy. It should make full use of 2 methods' advantages to improve the accuaracy of determination results.

Expression levels of microRNA-132 and high-mobility group box-1 protein in peripheral blood mononuclear cells of children with sepsis

ZHANG Cui

2018, 33(9):  815-818.  DOI: 10.3969/j.issn.1673-8640.2018.09.010

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Objective To investigate the expression levels of microRNA-132（miR-132） and high-mobility group box-1 protein（HMGB1） in peripheral blood mononuclear cells of children with sepsis. Methods A total of 87 children with sepsis were enrolled. According to prognosis,the children were classified into death group （25 cases） and non-death group （62 cases）. A total of 50 healthy children were enrolled as control group. Sepsis group was determined within 12 h after diagnosis,and control group was determined at physical examination day. Real-time fluorescence quantitation polymerase chain reaction （PCR）was used to determine the expression levels of miR-132 and HMGB1 in peripheral blood mononuclear cells. The roles of miR-132 and HMGB1 in the prognosis of children were analyzed using receiver operating characteristic （ROC） curve. Results The relative expression levels of miR-132 and HMGB1 mRNA in peripheral blood mononuclear cells in sepsis group were higher than those in control group （P<0.05）. The relative expression levels of miR-132 and HMGB1 mRNA in peripheral blood mononuclear cells in death group were higher than those in non-death group （P<0.05）. Pearson correlation analysis showed that the relative expression level of miR-132 in peripheral blood mononuclear cells of sepsis group was positively correlated with that of HMGB1 mRNA （r=0.521,P<0.001）. ROC curve analysis showed that using the relative expression levels of miR-132 and HMGB1 mRNA in predicting the prognosis of children,the areas under ROC curves （AUC） were 0.921 [95% confidence interval（CI） 0.853-0.989] and 0.858 （95%CI 0.769-0.947）,the sensitivities were 84.0% and 68.0%,and the specificities were 87.1% and 90.3%,respectively. The AUC of the combined determination of miR-132 and HMGB1 mRNA was 0.941 （95%CI 0.878-1.000）,the sensitivity was 88.0%,and the specificity was 91.9%. Conclusions The expression levels of miR-132 and HMGB1 in peripheral blood mononuclear cells of children with sepsis are increased,and they are related to the prognosis of children. They could be used as early assessment indices for the prognosis of children.

High-specific serum biomarkers for interstitial lung disease

XU Xiaoping, XU Lei, QIN Hui, ZHAO Xuqi, LI Min

2018, 33(9):  819-822.  DOI: 10.3969/j.issn.1673-8640.2018.09.011

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Objective To find high-specific serum biomarkers for the diagnosis and prognosis monitoring of interstitial lung disease（ILD）. Methods A total of 134 ILD patients,including 124 patients with connective tissue disease interstitial lung disease （CTD-ILD）,were enrolled,and 48 patients with ordinary pneumonia, 22 patients with chronic obstructive pulmonary disease（COPD）,38 patients with lung cancer and 9 patients with other pulmonary diseases were enrolled as well. Totally,30 healthy subjects were enrolled as healthy control group. Krebs Von den Lungen-6 （KL-6）,matrix metalloproteinase-3 （MMP-3）,fibronectin （FN） and C-reactive protein（CRP） were determined. Receiver operating characteristic （ROC） curve was used to evaluate the diagnostic efficiency of KL-6 for ILD. Results Compared with healthy control group,the KL-6 levels of ILD,lung cancer and ordinary pneumonia groups were higher （P<0.01,P<0.05）,and the KL-6 level of ILD group was the highest. The FN levels of ILD,ordinary pneumonia and COPD groups decreased （P<0.01）. CRP increased in all pulmonary disease groups（P<0.01）. ROC curve analysis showed that the area under curve of KL-6 for the diagnosis of ILD was 0.814. The optimal cut-off value for the diagnosis of ILD was 430 U/mL,the sensitivity was 59.4%,and the specificity was 89.8%. The MMP-3 level of ILD group was 155（84.5-290.5） ng/mL,which was 2-15 times higher than normal reference range provided by manufactories. The positive rate of MMP-3 in CTD-ILD group was 84.7%. Conclusions High-specific serum biomarkers,KL-6 and MMP-3,can improve the diagnostic efficiency for ILD and CTD-ILD.

Role of urinary kidney injury molecule-1 determination in the prediction of pre-eclampsia kidney injury during mid-gestation

CAI Leiming, LONG Anxiong, JIANG Liansheng, HOU Jian, TAN Longyi, LI Qian

2018, 33(9):  823-826.  DOI: 10.3969/j.issn.1673-8640.2018.09.012

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Objective To study the role of urinary kidney injury molecule-1（KIM-1） determination in the prediction of pre-eclampsia kidney injury during mid-gestation. Methods A total of 45 pre-eclampsia patients and 45 healthy subjects were enrolled. Urine and serum samples and clinical data during mid-gestation （the 26th to 32nd gestational weeks） were collected. Urinary KIM-1 and neutrophil gelatinase-associated lipocalin（NGAL） were determined by enzyme-linked immunosorbent assay. Urinary microalbumin （mAlb） was determined by immune transmission turbidimetric assay. Creatine （Cr） was determined by Jaffe method,and serum uric acid （UA） and urea were determined by enzymic method. Logistic regression analysis was used to assess risk factors. Results No statistical significance was found in maternal age,gestational week at sampling,primipara ratio,urinary mAlb,urinary NGAL,serum Cr and serum urea between the 2 groups （P>0.05）. The body mass index（BMI） of pre-eclampsia patients before pregnancy,urinary KIM-1 and serum UA were higher than those in healthy control group（P<0.05）. After the standardization of urinary KIM-1,mAlb and NGAL according to urinary Cr,urinary KIM-1/Cr in pre-eclampsia group was higher than that in healthy control group （P<0.01）,and urinary mAlb/Cr and NGAL/Cr had no statistical significance between the 2 groups （P>0.05）. Logistic regression analysis showed that KIM-1/Cr and BMI before pregnancy were independent risk factors for pre-eclampsia [odds ratio （OR）=1.38 and 8.48,95% confidence interval （CI） 1.04-1.83 and 1.41-50.82]. Conclusions Urinary KIM-1 might be a potential biomarker in predicting pre-eclampsia kidney injury during mid-gestation.

Analysis of the results of urinary protein determination in 307 cases with drug addicts

WANG Wei, WANG Lei, ZHOU Fangfang, GUAN Jing, LI Yongting, XU Haodong

2018, 33(9):  827-829.  DOI: 10.3969/j.issn.1673-8640.2018.09.013

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Objective To assess the status of renal function of cases with drug addicts by determining urinary total protein（TP）,microalbumin（mAlb） and alpha 1-microglobulin（α₁-MG） levels. Methods Urinary TP,mAlb and α₁-MG levels were determined in 307 cases with drug addicts and 201 healthy subjects （healthy control group）. According to the types of drugs taken by the cases with drug addicts,they were classified into methamphetamine group（213 cases）,morphine group（30 cases）,mixed group（36 cases） and the other group（28 cases）. Their results were compared. Results The TP,mAlb and α₁-MG levels in drug addict group were higher than those in healthy control group （P<0.000 1）. The mAlb level in methamphetamine group was higher than that in morphine group （P<0.05）,but the TP and α₁-MG levels were lower （P<0.05）. The mAlb level in morphine group was lower than that in mixed group （P<0.05）. The α₁-MG level in mixed group was higher than that in the other group （P<0.05）. The urinary TP and α₁-MG levels of male drug addicts were higher than those of female drug addicts（P<0.05,P<0.001）,and mAlb had no statistical significance （P>0.05）. Conclusions Methamphetamine tends to cause serious damage to glomerulus,while morphine tends to cause serious damage to renal tubule . It should pay attention to strength the health intervention for drug addicts and control the harm of drugs.

Consistency of electrochemiluminescence and 2 domestic chemiluminescence determination systems in CA72-4 determination

WEI Yancai, ZHENG Weiling, SHI Yan, SONG Miaoli, YE Kexue, LU Xun, YANG Chen

2018, 33(9):  830-834.  DOI: 10.3969/j.issn.1673-8640.2018.09.014

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Objective To evaluate the consistency of electrochemiluminescence and 2 domestic chemiluminescence determination systems in carbohydrate antigen 72-4（CA72-4）determination. Methods According to the Clinical and Laboratory Standards Institute（CLSI）EP09-A3 document,42 clinical serum specimens in linear range were determined by cobas e601 electrochemiluminescence immunoassay system（reference method,X）,MAGLUMI 4000 chemiluminescence immunoassay system（experimental method 1,Y₁）,CL-2000i chemiluminescence immunoassay system（experimental method 2,Y₂）. The results of outliers were determined by generalized extreme studentized deviate（ESD）method. The optimal regression model was fitted to the regression equation. The biases were calculated at the medical decision level,and the comparability were judged by 1/2 external quality assessment bias（±7.65%） as acceptance standard. Results The correlations between e601（X） and MAGLUMI 4000（Y₁） and between e601（X） and CL-2000i（Y₂）were good by plotting scatter plot. One outlier was visually found in each group. No outlier of CA72-4 was found using generalized ESD method. Deming（X and Y₁）and Passing-Bablok（X and Y₂）were used. The regression equations were Y₁ = 5.020 6+1.149 8X and Y₂= 0.726 3+0.830 0X,respectively. Assuming CA72-4 medical decision level of 6.9 U/mL to regression equation,the proportional bias was 60.96% at e601（X） and MAGLUMI 4000（Y₁）,which was higher than acceptable value（1/2 bias）. The proportional bias was -6.74% at e601（X） and CL-2000i（Y₂）,which was lower than acceptable value（1/2 bias）. Conclusions The results of CA72-4 determination by e601 and MAGLUMI 4000 are not comparable,while results of CA72-4 determination by e601 and CL-2000i are comparable. CLSI EP09-A3 document can be used for comparison between different labeled immunoassay determination systems.

Research progress in the virulence factors of Klebsiella pneumoniae liver abscess

GUAN Hongyan, LIU Ying

2018, 33(9):  839-843.  DOI: 10.3969/j.issn.1673-8640.2018.09.016

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Liver abscess is a pyogenic infection of the liver which is usually caused by amoeba histolytica or bacteria. It is a common digestive system disease and has a high fatality rate. Nowadays,Klebsiella pneumoniae has emerged as the main pathogen of bacterial liver abscess. Virulence factors,which contribute to the pathogenicity of Klebsiella pneumoniae, are identified,such as capsular polysaccharides,lipopolysaccharides,iron uptake system and fimbriae. Klebsiella pneumoniae liver abscess（KLA） is usually caused by hypervirulent strains. Here,the main virulence factors of KLA are summarized.

Research progress in RDW for the diagnosis and treatment of malignant tumors

YANG Dianyu, QUAN Wenqiang, SUN Zujun, LI Dong

2018, 33(9):  844-549.  DOI: 10.3969/j.issn.1673-8640.2018.09.017

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Red cell distribution width （RDW） is a parameter that reflects the size variability of erythrocytes,mainly used in the diagnosis of anemia. In recent studies,RDW has been associated with cardiovascular diseases,hypertension,inflammatory bowel diseases and autoimmune diseases. In recent years,more and more studies have begun to report the diagnostic role of RDW in malignant tumors. This review focuses on the research progress of RDW in the clinical diagnosis of tumors.

Research progress in new biomarkers of pediatric acute kidney injury

TIAN Xiaoyi, SHEN Ying, SONG Wenqi

2018, 33(9):  850-856.  DOI: 10.3969/j.issn.1673-8640.2018.09.018

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Acute kidney injury （AKI） is a common critical disease with high morbidity and mortality in hospitalized children. AKI has fast progress,and early diagnosis and risk prediction can assist clinical physicians in starting timely therapy and could effectively improve patients' prognosis. Traditional biomarker,serum creatinine,is related with renal function,but it can not timely reflect kidney injury. Recently,many new potential biomarkers have been widely investigated,such as neutrophil gelatinase-associated lipocalin（NGAL）,kidney injury molecule-1（KIM-1）,insulin-like growth factor-binding protein 7（IGFBP7） and tissue inhibitor of metalloproteinase-2（TIMP-2）. Children have their own unique growth and development rules. These biomarkers are at different baseline levels in different ages. This review summarizes the pathophysiological basis of these new AKI biomarkers,the application in the early diagnosis,risk stratification and prognostic evaluation of pediatric AKI and the difference for clinical performance compared with adult patients.