Table of Content

30 October 2018, Volume 33 Issue 10

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Establishment of pediatric reference interval of cTnI in Shanghai based on rapid immunochromatography

ZHENG Jianxin, YANG Hui, FU Qihua

2018, 33(10):  875-878.  DOI: 10.3969/j.issn.1673-8640.2018.10.001

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Objective To establish the pediatric reference interval of cardiac troponin I（cTnI） in Shanghai based on rapid immunochromatography,and to provide a reference for the clinical diagnosis of myocardial injury. Methods A total of 240 children aged from 7 months to 12 years were enrolled,and peripheral blood cTnI was determined by rapid immunochromatography. A methodology evaluation（accuracy,precision,minimum determination limit,linear range verification and method comparison） was carried out,and the reference interval of cTnI was determined by percentile method. Results The results of high-level and low-level quality control products determined by rapid immunochromatography were 4.73 and 0.49 ng/mL,respectively,which were in the expected range of quality control specification. The inter-day and intra-day precisions [coefficient of variation（CV）] for the quality control products with low level were 5.97% and 5.36%,and those with high level were 6.35% and 7.14%,respectively. They all met the requirements（CV<10%）. The minimum determination limit was 0.02 ng/mL,and the linear range was 0.028-26.400 ng/mL. There was a good correlation with chemiluminescence（r=0.988）. The 99th percentile of cTnI determination were 0.1 ng/mL,and the imprecision of the 99th percentile was 18.5%. The upper limit value of 99% reference interval（0.5 ng/mL） which was calculated by percentile method and the lower reference interval（<0.3 ng/mL） which was referred from reagent specification were used to establish the pediatric reference interval of serum cTnI based on rapid immunochromatography. The value of cTnI <0.3 ng/mL was negative,and the value of cTnI >0.5 ng/mL was positive. When the value of cTnI level was 0.3-0.5 ng/mL,further determination was required to perform and determine whether there was myocardial injury or not. Conclusions A rapid immunochromatography is preliminarily established for determining the reference interval of peripheral blood cTnI among children in Shanghai.

Establishment of serum creatinine reference interval by indirect method

YANG Shusheng, LI Qiong, WANG Wei, FAN Junxiu, FANG Huanying

2018, 33(10):  879-883.  DOI: 10.3969/j.issn.1673-8640.2018.10.002

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Objective To establish an indirect model based on mathematical statistics method and laboratory information system（LIS） data,and to investigate the reference interval of serum creatinine（Cr） in Ji'an,Jiangxi. Methods By a retrospective analysis of LIS data,9 411 healthy subjects （5 924 males and 3 487 females） from 20 to 90 years old were enrolled. Serum Cr was determined,and the results were analyzed by SPSS 19.0 software to obtain an approximate normal distribution if they were non-normal distribution through datum normality test. The outliers were identified and omitted,while P_2.5-P_97.5 as a reference interval was calculated using non-parametric sorting method and was verified. Results A total of 127 outliers were removed after datum normality test and conversion,and the total number of cases was 9 284. There was statistical significance for serum Cr levels between different age and sex groups（P<0.05）. Therefore,age-specific and sex-specific reference intervals should be established. The reference intervals of serum Cr which had been verified were 65-110 μmol/L for males of 20-59 years old,62-124 μmol/L for males of 60-79 years old,46-79 μmol/L for females of 20-59 years old and 49-85 μmol/L for females of 60-79 years old,respectively. Conclusions The reference intervals of serum Cr based on LIS data are slightly higher than current recommended reference intervals,and they are consistent with the feedback from clinical clients and laboratories,so clinical laboratories should choose,verify or establish suitable reference intervals according to actual situation.

Reference ranges of biochemical determination items for children's kidney function in Shanghai

CHEN Shiwei, YE Zhicheng, FU Pan, LI Wei, YANG Dan, XU Jin

2018, 33(10):  884-887.  DOI: 10.3969/j.issn.1673-8640.2018.10.003

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Objective To analyze the biochemical determination items [urea,creatinine（Cr）,uric acid（UA）,total protein（TP） and albumin（Alb）] for kidney function of 3-17-year-old healthy children in Shanghai,and to establish the reference ranges. Methods A total of 1 038 healthy children aged from 3 to 17 years in Shanghai,including 543 boys and 495 girls,were enrolled. The subjects were classified into 3 groups,including 3-6-year-old group（345 cases）,7-12-year-old group（434 cases） and 13-17-year-old group（259 cases）. Serum urea,Cr,UA,TP and Alb were determined by Hitachi 7180 automatic biochemical analyzer,and the reference ranges were established by x±1.96s. Results Except serum urea,there was statistical significance for serum Cr,UA,TP and Alb in different age groups（P<0.05）,and there was increasing trend with age. There was statistical significance for serum UA and Cr between 7-12-year-old group and 13-17-year-old group（P<0.05）. The reference ranges were established after the analysis of age and sex factors. The reference range of urea was 3.36-5.41 mmol/L （3-17-year-old）. The reference ranges of Cr were 24.47-38.07 μmol/L（3-6-year-old）,33.45-49.27 μmol/L（7-12-year-old boys）,33.09-46.05 μmol/L（7-12-year-old girls）,46.00-70.00 μmol/L（13-17-year-old boys） and 42.67-60.63 μmol/L（13-17-year-old girls）. The reference ranges of UA were 210.00-312.42 μmol/L（3-6-year-old）,216.70-364.58 μmol/L（7-12-year-old boys）,217.27-336.53 μmol/L（7-12-year-old girls）,287.93-474.13 μmol/L（13-17-year-old boys） and 260.39-340.11 μmol/L（13-17-year-old girls）. The reference ranges of TP were 66.23-74.75 g/L（3-6-year-old）,69.12-77.64 g/L（7-12-year-old） and 70.08-78.24 g/L（13-17-year-old）. The reference ranges of Alb were 43.62-48.14 g/L（3-6-year-old）,44.62-48.86 g/L（7-12-year-old） and 45.28-50.28 g/L（13-17-year-old）. Conclusions The reference ranges of biochemical determination items for 3-17-year-old healthy children's kidney function in Shanghai have been preliminarily established.

Role of noninvasive diagnostic model for liver fibrosis in patients with chronic hepatitis B

HOU Li, YU Lu, NIU Yao, ZHANG Yuan, WANG Liang

2018, 33(10):  888-893.  DOI: 10.3969/j.issn.1673-8640.2018.10.004

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Objective To establish the noninvasive diagnostic model for liver fibrosis in patients with chronic hepatitis B（CHB）,and to investigate the role for diagnosis. Methods Serum liver fibrosis markers [platelet（PLT）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,gamma-glutamyltransferase（GGT）,alkaline phosphatase（ALP）,total bilirubin（TB）,albumin（Alb）,albumin to globulin（A/G） ratio,red blood cell distribution width（RDW）,prothrombin time activity（PTA）,fibrinogen（Fib） and hepatitis B e antigen（HBeAg）] were determined in 270 patients with CHB undergoing liver biopsy. The correlation between these indices and liver fibrosis stage of CHB patients was analyzed. Logistic regression analysis was performed to establish a diagnostic model,and the results were analyzed by receiver operating characteristic（ROC） curve and compared with established diagnostic models（APRI,FIB-4,AAR,GPR and RPR）. Results By Logistic regression analysis,the indices were analyzed,and the regression equation for new diagnostic model AFPPR,which was AFPPR =1/[1+EXP（-2.584-A/G ratio×1.426-PLT×0.013-PTA×0.016-Fib×0.605+RDW×0.364）],was set up. The area under curve（AUC） of AFPPR for the diagnosis of liver fibrosis was 0.80,which was bigger than those of the other 5 diagnostic models（P<0.01）. AAR had no diagnostic value for significant and severe liver fibrosio（P>0.05）. The AUC of AFPPR for severe liver fibrosis was 0.76,which was bigger than those of the other 5 diagnostic models. Compared with the AUC of the other 5 diagnostic models,there was no statistical significance,except for AAR（P=0.000）. Conclusions The established AFPPR diagnostic model for liver fibrosis can be used as clinical supplementary reference on the dynamic observation of liver fibrosis.

Expressions of leukocyte CD35 and CD11b in the diagnosis of bacterial infection

WANG Weiwei, HAO Jun, YUAN Xiangliang, ZHANG Lihua, ZHENG Peiming, FEI Qili, XI Di, SHEN Lisong

2018, 33(10):  894-898.  DOI: 10.3969/j.issn.1673-8640.2018.10.005

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Objective To evaluate the roles of leukocyte complement receptor （CR） 1 （CD35） and CR3（CD11b） expressions for the diagnosis of bacterial infection. Methods The mean fluorescence intensities （MFI） of CD35 and CD11b in leukocytes （lymphocytes,monocytes and neutrophils） in 39 patients with bacterial infection and 23 healthy subjects （healthy control group） were determined by flow cytometry. The neutrophil CD35 MFI/lymphocyte CD35 MFI ratio （hereinafter referred to as CD35 ratio） and neutrophil CD11b MFI/lymphocyte CD11b MFI ratio （hereinafter referred to as CD11b ratio） were calculated. CD35 infection index and CD11b infection index were calculated according to the formula： infection index = neutrophil MFI²/（lymphocyte MFI×monocyte MFI）. CD64 MFI was determined,and the CD64 ratio and CD64 infection index were calculated. The performance of each indicator in the diagnosis of bacterial infection was assessed using receiver operating characteristics （ROC） curve. Results The MFI of lymphocyte CD35,CD11b and CD64 in bacterial infection group were lower than those in healthy control group （P<0.000 1,P<0.01,P<0.000 1）. The MFI of neutrophil CD35,CD11b and CD64 in bacterial infection group were higher than those in healthy control group （P<0.000 1,P<0.000 1,P<0.01）. The MFI of monocyte CD11b and CD64 in bacterial infection group were higher than those in healthy control group （P<0.000 1,P<0.01）,and there was no statistical significance for monocyte CD35 MFI between the 2 groups （P>0.05）. In bacterial infection group,CD35 ratio,CD35 infection index,CD11b ratio,CD11b infection index,CD64 ratio and CD64 infection index were higher than those in healthy control group （P<0.000 1）. ROC curve analysis showed that the areas under curves （AUC） of CD35 ratio,CD11b ratio and CD64 ratio had no statistical significance （P>0.05）. The AUC of CD11b infection index was bigger than that of CD64 infection index （P<0.05）,and there was no statistical significance between CD35 infection index and CD64 infection index （P>0.05）. Conclusions CD35 and CD11b could be new markers for the diagnosis of bacterial infection.

Establishment and preliminary application of optimal cut-off value of anti-multi-epitope fusion antigen IgG antibody of Mycobacterium tuberculosis

QI Yingjie, SHI Yuru, LIU Ting, YUE Li, ZHAO Changcheng, WANG Yun, MA Xiaoling

2018, 33(10):  899-902.  DOI: 10.3969/j.issn.1673-8640.2018.10.006

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Objective To establish an optimal cut-off value of anti-multi-epitope fusion antigen IgG antibody of Mycobacterium tuberculosis（MTB-Ab）,and to evaluate the diagnostic efficiency for pulmonary tuberculosis. Methods MTB-Ab was determined by enzyme-linked immunosorbent assay （ELISA）in 62 patients with active pulmonary tuberculosis,58 patients with inactive pulmonary tuberculosis and 168 healthy subjects （healthy control group）. The optimal cut-off value was confirmed as cut-off index （COI） by receiver operating characteristic （ROC） curve. The diagnostic efficiency of the cut-off value recommended by kit and optimal COI on pulmonary tuberculosis and active pulmonary tuberculosis was evaluated. Results Using healthy control group as control,the optimal COI₁ of MTB-Ab for the diagnosis of pulmonary tuberculosis was 0.90,and the sensitivity was 92.5%,which was higher than the sensitivity for the cut-off value（0.18） recommended by kit （86.7%）（P<0.05）. There was no statistical significance for specificity,Youden index,positive likelihood ratio,negative likelihood ratio,positive predictive value and negative predictive value between the cut-off value recommended by kit and COI₁ for the diagnosis of pulmonary tuberculosis （P>0.05）. Using inactive pulmonary tuberculosis group as control,the optimal COI₂ was 3.65,the sensitivity,specificity,Youden index,positive likelihood ratio,positive predictive value and negative predictive value were lower than those of COI₁（P<0.05）,and negative likelihood ratio was higher（P<0.05）. Conclusions Using healthy control group as control,the COI₁ of MTB-Ab as the cut-off value could improve the diagnostic sensitivity of pulmonary tuberculosis. Using inactive pulmonary tuberculosis group as control,the diagnostic efficiency of COI₂ for active and inactive pulmonary tuberculosis decreases.

Serum TPOAb and TgAb levels in Hashimoto's thyroiditis patients and their correlations with disease severity

ZHU Xudong

2018, 33(10):  903-906.  DOI: 10.3969/j.issn.1673-8640.2018.10.007

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Objective To investigate the correlations of serum anti-thyroid peroxidase antibody（TPOAb） and thyroid-globulin antibody（TgAb） levels in Hashimoto's thyroiditis（HT） patients with disease severity. Methods A total of 80 HT patients were enrolled as HT group,and 50 healthy subjects were enrolled as healthy control group. The levels of serum TPOAb and TgAb were determined. They were further classified into high TPOAb group（40 cases）,low TPOAb group（40 cases）,high TgAb group（40 cases） and low TgAb group（40 cases） according to TPOAb and TgAb medians. Serum thyroid function indices [thyroid-stimulating hormone（TSH）,free triiodothyronine（FT₃） and free thyroxine（FT₄）],T helper cell（Th） 1 [interferon gamma（IFN-γ） and interleukin（IL）-2 and Th2（IL-4 and IL-13）] were determined in HT group. Results Serum TPOAb and TgAb levels in HT group were higher than those in healthy control group（P<0.05）. Serum TSH in high TPOAb group and high TgAb group were higher than those in low TPOAb group and low TgAb group,and FT₃ and FT₄ were lower than those in low TPOAb group and low TgAb group. Serum IFN-γ and IL-2 in high TPOAb group and high TgAb group were higher than those in low TPOAb group and low TgAb group. Serum IL-4 and IL-13 were lower than those in low TPOAb group and low TgAb group （P<0.05）. Conclusions TPOAb and TgAb have high expressions in HT patients,and there are relations of TPOAb and TgAb levels with thyroid damage degree and Th1/Th2 immune disorder degree,which can reflect the severity of disease.

Correlation of the kinds of gut bacteria with serum inflammatory cytokines in patients with chronic

HE LIU Jichuan

2018, 33(10):  907-912.  DOI: 10.3969/j.issn.1673-8640.2018.10.008

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Objective To investigate the correlation of the kinds of gut common bacteria and serum inflammatory cytokines [tumor necrosis factor alpha（TNF-α）,interleukin（IL）-12,IL-6,IL-10,IL-1β and IL-23] in chronic hepatic encephalopathy（HE） patients,and to evaluate the roles of intestinal microecology and serum inflammatory cytokines in chronic HE. Methods Among chronic hepatitis B liver cirrhosis patients with decompensation,120 cases with HE were enrolled as HE group,and 100 cases without HE were enrolled as control group. Liver function indices [albumin（Alb）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,total bilirubin（TB） and prothrombin time（PT）] and the Child classification of liver function were recorded. A total of 12 gut common bacteria were determined by fluorescence quantitative polymerase chain reaction（PCR）,and serum levels of 6 inflammatory cytokines were determined by enzyme-linked immunosorbent assay（ELISA）. Results Alb,ALT,AST,TB and the Child classification of liver function in HE group were higher than that in control group（P<0.05）,and there was no statistical significance for PT between the 2 groups（P>0.05）. Compared with control group,gut common bacteria with increased proliferation in HE group included pathogenic Escherichia coli,Pseudomonadaceae,Enterococcus,Prevotella,Staphylococcus,Fusobacterium and Candida albicans（P<0.05）,while gut common bacteria with decreased included Bifidobacterium,Lactobacillus and Ruminococcus（P<0.05）. Serum TNF-α,IL-12,IL-6,IL-10,IL-1β and IL-23 levels in HE group were higher than those in control group（P<0.001）. The correlations of gut common bacteria with liver function indices and with serum inflammatory cytokines in HE group were higher than those in control group. Conclusions Gut dysbacteriosis in intestinal microecology might collaboratively contribute to the development mechanism of chronic HE,through regulating the production and secretion of a variety of inflammatory cytokines.

Efficiency of red blood cell parameter formulas for the differential diagnosis of iron-deficiency anemia and beta-thalassemia trait in children

HE Hailin, CHEN Jianhong, ZHONG Zeyan, YANG Kunxiang, GUAN Zhiyang, ZHONG Guoxing, DONG Hui

2018, 33(10):  913-915.  DOI: 10.3969/j.issn.1673-8640.2018.10.009

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Objective To evaluate the efficiency of 8 red blood cell（RBC） parameter formulas for the differential diagnosis of iron-deficiency anemia（IDA） and beta-thalassemia trait（β-TT） in children. Methods A total of 149 patients with IDA and 146 patients with β-TT were enrolled. Their RBC parameters were determined. Totally,8 foreign common RBC parameter formulas（F1-F8） were used. Their sensitivities（SEN）,specificities（SPE）,positive predictive values（PPV）,negative predictive values（NPV）,Youden indices（YI）,positive likelihood ratios（+LR） and negative likelihood ratios（-LR） were evaluated. Receiver operating characteristic（ROC） curves were constructed,and the areas under curves（AUC） were calculated. Results The efficiencies of F5,F4 and F2 for the differential diagnosis of IDA and β-TT were high,and the AUC were 0.916,0.889 and 0.889,respectively,which were higher than those of the other 5 formulas. The efficiency of F5 was the highest,and the SEN and SPE were 87.14% and 88.41%,respectively. Conclusions F5,F4 and F2 show high efficiencies for the differential diagnosis of IDA and β-TT,especially for F5,which can be used for pediatric clinicians in Huizhou.

Influencing factors of the determination of urinary protein by dry chemical method

ZHANG Jun, ZHOU Fangfang, XU Wei, WANG Lei

2018, 33(10):  916-919.  DOI: 10.3969/j.issn.1673-8640.2018.10.010

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Objective To evaluate the commonly-used methods for quantitative determination of urinary protein,and to analyze the influencing factors of false positivity in the determination of urinary protein by dry chemical method. Methods A total of 2 500 cases of random urine specimens were collected,and urinary protein was determined by dry chemical method and sulfosalicylic acid precipitation test. For those specimens with different results from the 2 methods,quantitative determination was performed using Modular P800 automatic biochemical analyzer,focusing on the main influencing factors. Aiming at the main influencing factors of occult blood and urinary pH design simulation experiments,the reason of false negativity or false positivity in dry chemical method was evaluated. Results Totally,2 500 random urine specimens were determined by dry chemical method and sulfosalicylic acid precipitation test. The results of 2 391（95.64%） specimens were identical,including one-level difference,while the results of 109（4.36%） were not identical. There was statistical significance between dry chemical method and sulfosalicylic acid precipitation test（P<0.05）. Red blood cell ≥1×10⁵ in urine specimens would cause false positivity. Urinary pH 7.0-8.5 would cause false positivity,while urinary pH ≥8.5 would cause false negativity. Conclusions Red blood cell in urine and urinary pH would cause false positivity and false negativity in dry chemical method. Clinical laboratories should pay enough concern and attention.

Antithrombin and D-dimer in predicting pregnancy complications in the 3rd trimester of pregnancy

LI Qin, ZHANG Chi, FEI Yang, TANG Ning

2018, 33(10):  920-923.  DOI: 10.3969/j.issn.1673-8640.2018.10.011

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Objective To investigate the roles of antithrombin（AT） and D-dimer（DD） in predicting pregnancy complications in the 3rd trimester of pregnancy. Methods A total of 5 095 pregnant women were enrolled. Women in the 3rd trimester of pregnancy were included,while women with primary hypertension,diabetes mellitus,cardiac diseases,chronic nephrosis and chronic hepatopathy before pregnancy and women terminating pregnancy due to fetal chromosome abnormality were excluded. The levels of AT and DD in patients with and without pregnancy complications were compared,and Logistic regression analysis was used for evaluating the roles of AT and DD in predicting pregnancy complications. Results The maternal complications of 5 095 pregnant women during the 28th-40th gestational weeks in this study included 353 cases of preeclampsia,105 cases of intrahepatic cholestasis during pregnancy（ICP）,88 cases of gestational diabetes mellitus,45 cases of stillbirth and 15 cases of deep vein thrombosis（DVT）. There were 4 548 pregnant women without pregnancy complications. The level of DD in patients with pregnancy complications was higher than that without pregnancy complications（P<0.05）. The level of AT in patients with preeclampsia was lower than that without pregnancy complications（P<0.05）. The level of AT in patients with ICP was higher than that without pregnancy complications（P<0.05）. Compared with pregnant women without pregnancy complications,patients with ICP and stillbirth were younger,while those with gestational diabetes mellitus were elder（P<0.05）. The odds ratio （OR） of ICP for patients with AT>115% was 20.24 [95% confidence interval （CI）12.870-31.819]. The OR of preeclampsia for patients with AT<70% was 5.41（95%CI 3.72-7.87）. The OR of DVT for patients with DD>3.98 μg/mL was 5.74（95%CI 2.03-16.20）,that of stillbirth was 4.05（95%CI 2.16-7.52）,that of ICP was 2.95（95%CI 1.73-5.02）,and that of preeclampsia was 2.76（95%CI 2.01-3.81）. Conclusions AT and DD can predict pregnancy complications in the 3rd trimester of pregnancy.

Urinary miRNA143 and miRNA133a determinations in the diagnosis of bladder cancer

LU Yang, LIANG Wei, SONG Yongsheng

2018, 33(10):  924-927.  DOI: 10.3969/j.issn.1673-8640.2018.10.012

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Objective To investigate the roles of microRNA143（miRNA143） and microRNA133a（miRNA133a） in the diagnosis of bladder cancer. Methods There were 50 patients with bladder cancer （bladder cancer group）,60 patients with non-bladder tumor （disease control group） and 60 healthy subjects （healthy control group）. The levels of miRNA133a and miRNA143 in urine of bladder cancer group before and after surgery and control groups were determined by polymerase chain reaction （PCR）. Receiver operating characteristic（ROC） curve was used to evaluate the roles of miRNA143 and miRNA 133a in the diagnosis of bladder cancer. Results The preoperative levels of miRNA143 and miRNA133a in bladder cancer group were lower than those in control groups（P<0.05）, and there was no statistical significance between the 2 control groups （P>0.05）. In bladder cancer group, miRNA143 and miRNA133a levels increased after surgery（P<0.05）. There was no statistical significance for miRNA143 and miRNA133a with different TNM stages（P>0.05）. ROC curve showed that the optimal cut-off value of the preoperative level of miRNA143 for the diagnosis of bladder cancer was ≤0.165,the area under curve （AUC） was 0.827,the sensitivity was 72.7%,and the specificity was 80.8%. The optimal cut-off value of the level of miRNA133a for the diagnosis of bladder cancer was ≤0.165,the AUC was 0.846,the sensitivity was 75.0%,and the specificity was 85.4%. The diagnostic performance of the combined determination of miRNA143 and miRNA133a was not improved. Conclusions There are low levels of miRNA143 and miRNA133a in patients with bladder cancer. MiRNA143 and miRNA133a are potential for the diagnosis of bladder cancer.

Comparison on peripheral blood and venous blood for the determination results of MQ-6000 glycated hemoglobin analyzer

QIAN Cheng, MA Jing, XUE Mingyang, ZHAI Feng, LIU Tong

2018, 33(10):  928-929.  DOI: 10.3969/j.issn.1673-8640.2018.10.013

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Objective To investigate the comparability of glycated hemoglobin A_1c（HbA_1c） determination using finger peripheral blood and venous blood by MQ-6000 glycated hemoglobin analyzer（MQ-6000） and the clinical application value of peripheral blood for the determination of HbA_1c. Methods A total of 97 patients with diabetes mellitus were enrolled,and 39 healthy subjects were enrolled as control group. Finger peripheral blood and venous blood were used for HbA_1c determination by MQ-6000,and the results were compared with those using venous blood determined by VARIANT Ⅱ hemoglobin testing system（VARIANT Ⅱ）. Results There was no statistical significance for the results of HbA_1c determination between using peripheral blood and venous blood in control and diabetes mellitus groups（P>0.05）,and there was a good correlation between using peripheral blood and venous blood（r=0.996）. MQ-6000 had a good correlation with VARIANT Ⅱ（r=0.992）. Conclusions Finger peripheral blood can replace venous blood for the determination of HbA_1c and be used for the screening,diagnosis and monitoring of diabetes mellitus.

Inhibition of DC-CIK VISTA signal for improving the anti-tumor effect of malignant tumor cells

YANG Huikuan, YUAN Zhaohu, CHEN Xiaojie, WEI Yaming, CHEN Dandan

2018, 33(10):  933-937.  DOI: 10.3969/j.issn.1673-8640.2018.10.015

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Objective To inhibit the antigen of anti-V-domain Ig suppressor of T cell activation（VISTA） antibody on dendritic cell-cytokine-induced killer cell（DC-CIK） and the down regulation due to VISTA signal activation,and to evaluate the anti-tumor effect of malignant tumor cells. Methods Anti-VISTA antibody on DC-CIK was determined by flow cytometry. The killing activity of DC-CIK on human chronic myeloid leukemia cell line K562 was analyzed by 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide（MTT）. The effect of anti-VISTA antibody on the proliferation and differentiation of DC-CIK was analyzed by cell count analysis and flow cytometry,respectively. Results After the incubation of mature DC-CIK with anti-VISTA antibody,the percentage of anti-VISTA antibody positive cells was（10.26±0.57）%. With the increasing of effector cells（DC-CIK）-to-target cells（K562） ratio,the killing activities in experimental group（DC-CIK cell treated with anti-VISTA antibody） and control group（untreated DC-CIK cell） were increased. When effector cells-to-target cells ratios of 10∶1 and 20∶1,the killing activities in experimental group were（77.3±6.8）% and（92.8±5.9）%,respectively,which were higher than those in control group [（64.8±4.0）% and（81.8±5.4）%]（P<0.01）. After incubation for 54 h,the cell number of experimental group was 1.35-time higher than that of control group（P<0.01）. The percentage of CD3⁺CD56⁺ natural killer T cells（NKT） in experimental group [（35.12±2.13）%] was higher than that in control group [（21.35±1.32）%]（P<0.01）. Conclusions The inhibition of DC-CIK VISTA signal can improve the anti-tumor effect of malignant tumor cells through the proliferation and differentiation of DC-CIK.

Analysis on the test quality of clinical laboratories in Shanghai by unannounced inspection results

YANG Xue, ZHU Jun, YUAN Libin, QIN Fei, LOU Jiao, XU Chong

2018, 33(10):  938-942.  DOI: 10.3969/j.issn.1673-8640.2018.10.016

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Objective To evaluate the role of unannounced inspection for assessing the test quality of clinical laboratories in Shanghai organized by Shanghai Center for Clinical Laboratory（SCCL） in 2017,through analyzing the data of unannounced inspection,external quality assessment（EQA） and internal quality control（IQC）. Methods The coefficients of variation（CV） were calculated for the items from the 1st unannounced inspection in 2017 and the quantitative items of EQA. The CV between the 2 programs was evaluated. Results A total of 770 clinical laboratories participated in the programs of unannounced inspection and EQA organized by SCCL. There were 83.33%（85/102） clinical laboratories failed in the unannounced inspection [blood lipid,blood gas and acid-base analysis,blood coagulation,rapid C-reactive protein,rapid blood glucose,homocysteine（Hcy）and tumor markers],but they passed the EQA. The CV were from 0.11% [apolipoprotein B（apo B）] to 52.15% [carbohydrate antigen（CA）19-9],and the average CV was 6.10%,and the CV of unannounced inspection was higher than that of EQA（P=0.014）. Conclusions Clinical laboratories should reserve the primary data of EQA to ensure the truth of EQA,and unannounced inspection could be more useful for reflecting the test quality of clinical laboratories than EQA.

Function and clinical role of serum orosomucoid

WANG Zhixue, HOU Xiaodan, JIN Xinyuan, SONG Mingming, LIU Xia, YANG Yili

2018, 33(10):  943-948.  DOI: 10.3969/j.issn.1673-8640.2018.10.017

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Orosomucoid（ORM） is an acute phase reactive protein synthesized by many tissues and cells,but the liver is the main organ that synthesizes ORM. ORM can adjust various cells participating in innate and acquired immunity,balance energy metabolism,and fight fatigue. The levels of ORM in cells and blood have been shown to increase dramatically resulting from various tissue injuries. In the process of infection or trauma, blood ORM levels are continuously elevated in the multiple phases of inflammation. Therefore,monitoring the level of ORM in blood can be complemented with the current clinical index of emergency response C-reactive protein（CRP）. ORM can reflect the persistent,progress and fade status of inflammatory diseases and provide new clues to precise treatment. This review makes a comprehensive exposition of ORM from the aspects of structure,biological function and clinical significance of determining ORM.

Influence of hepatitis B virus Pre-S/S region gene mutation on hepatitis B surface antigen determination

HE Chengshan, MA Chenyun, LU Zhicheng

2018, 33(10):  949-953.  DOI: 10.3969/j.issn.1673-8640.2018.10.018

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Hepatitis B surface antigen（HBsAg） is the most commonly used marker for the diagnosis of hepatitis B virus（HBV） infection. In recent years,the mutations in Pre-S/S region of HBV genome and amino acid replacement have received widespread attentions. This review summarizes the reasons for the missed determination of HBsAg for Chinese epidemic HBV-mutant strains,which is crucial for the prevention and surveillance of HBV infection and the safety of blood transfusion.