Table of Content

30 December 2019, Volume 34 Issue 12

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Role of tandem mass spectrometry for screening X-linked adrenoleukodystrophy

WANG Yanmin, TIAN Guoli, JI Wei

2019, 34(12):  1059-1065.  DOI: 10.3969/j.issn.1673-8640.2019.12.001

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Objective To establish a tandem mass spectrometry（MS/MS） for the determinations of very long chain acylcarnitine（VLCAC） and lysophosphatidylcholine（LPC）,and to evaluate the diagnostic efficiency of VLCAC and LPC in the diagnosis of X-linked adrenoleukodystrophy（X-ALD）. Methods A total of 3 530 samples of dried blood spots for screening genetic metabolic diseases and 10 samples of dried blood spots from children with X-ALD were collected. VLCAC and LPC were extracted from dried blood spots by solvent extraction with standard substances containing stable isotopic markers of ²H₃-hexacosanoylcarnitine（²H₃-C26） and ²H₄-C26：0 lysophosphatidylcholine（²H₄-C26：0-LPC） direct injection in tandem mass spectrometer. Eicosanoylcarnitine（C20）, docosanoylcarnitine（C22）, tetracosanoylcarnitine（C24）, hexacosanoylcarnitine（C26）, C20：0 lysophosphatidylcholine（C20：0-LPC）, C22：0 lysophosphatidylcholine（C22：0-LPC）, C24：0 lysophosphatidylcholine（C24：0-LPC） and C26：0 lysophosphatidylcholine（C26：0-LPC） were detected. Methodological evaluation （precision,accuracy and linearity） of the established MS/MS was performed. Partial least square method was used to analyze the contribution of each index to disease. Receiver operating characteristic（ROC）curve was used to evaluate the efficiency of each index for the diagnosis of X-ALD. Results The within-run coefficients of variation（CV） of low-concentration C26 and C26：0-LPC were 4.16% and 7.75%,and the between-run CV were 8.29% and 9.17%,respectively. The within-run CV of high-concentration C26 and C26：0-LPC were 5.57% and 8.68%,and the between-run CV were 7.45% and 8.11%,respectively. The accuracies were 93.25%-104.94%. The determination coefficients（r²） between the measured values of different dilution concentrations and the theoretical concentration were 0.996 and 0.994. Except for C20,C24：0-LPC/C20：0-LPC,C24：0-LPC/C22：0-LPC and C26：0-LPC/C20：0-LPC,the difference between control group and X-ALD group was statistically significant（P<0.05）. C26,C26/C22 ratio and C26：0-LPC had the highest contribution to disease（the partial regression coefficients were 0.175 3,0.130 0 and 0.079 2,respectively）. ROC curve analysis showed that the sensitivity and specificity of the ratios of C26 and C26/C22 in diagnosing X-ALD were all 100%,and the area under curve（AUC） was 1.0. The sensitivity,specificity and AUC of C26：0-LPC were 100%,72.9% and 0.972,respectively. Conclusions Non-derivatized MS/MS has high precision and accuracy in detecting VLCAC and LPC. C26 may be a diagnostic marker of X-ALD.

Monitoring lymphocyte subsets after β-mediterranean anemia allogeneic hematopoetic stem cell transplantation in children

CHEN Shiyang, FU Xiaoying, XU Gang, LIN Zhenhu, LUO Meizhu, MAI Huirong, CHEN Yunsheng, LIU Sixi

2019, 34(12):  1066-1071.  DOI: 10.3969/j.issn.1673-8640.2019.12.002

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Objective To monitor the development of lymphocyte subsets on the 1st,2nd,3rd,6th and 12th months dynamically after allogeneic hematopoetic stem cell transplantation（allo-HSCT） in children with β-mediterranean anemia,and to observe the immune reconstitution and characteristic of lymphocyte subsets. Methods A total of 27 patients with severe β-mediterranean anemia who underwent allo-HSCT were enrolled. Among them,20 cases received human leukocyte antigen（HLA） matched transplantation,and 7 cases received HLA mismatched transplantation. By flow cytometry,the percentage changes of CD3⁺T cells,CD3⁺CD4⁺T cells,CD3⁺CD8⁺T cells,CD4⁺/CD8⁺ratio,CD19⁺B cells and CD16⁺CD56⁺ natural killer（NK） cells were monitored dynamically in 1 year. Results CD16⁺CD56⁺ NK cells showed the fastest recovery,the percentages on the 1st,2nd,3rd and 6th months were higher than those of pre-operation（P<0.05）,and it returned to the percentages of pre-operation on the 12th month（P>0.05）. The percentage of CD3⁺T cells had no statistical significance on the 1st month compared to pre-operation（P>0.05）,but it started to decrease on the 2nd month（P<0.01）,and on the 12th month it was still lower than that of pre-operation（P<0.01）. The percentage of CD3⁺CD8⁺ T cells on the 1st month was higher than that of pre-operation（P<0.01）,and then it started to decrease but still high on the 12th month（P<0.05）. The percentage of CD3⁺CD4⁺T cells was lower than that of pre-operation（P<0.01）,showing a trend of slow recovery,and was still lower than that of pre-operation,even on the 12th month（P<0.01）. CD4⁺/CD8⁺ ratio inverted in the long term,but it was still lower than that of pre-operation although it continued to show increase（P<0.01）. CD19⁺ B cells decreased on the 1st month（P<0.01）then recovered after the 2nd month（P>0.05）,which were higher than those of pre-operation at the 6th and 12th months（P<0.01,P<0.05）. The immune reconstitution had no statistical significance at each time point between male and female patients（P>0.05）,and so did HLA matched transplantation and mismatched transplantation（P>0.05）. Conclusions The recovery of lymphocyte subsets after β-mediterranean anemia allo-HSCT in children following the regulation：CD16⁺CD56⁺ NK cells, CD3⁺CD8⁺ T cells,CD19⁺ B cells,CD3⁺ T cells and CD3⁺CD4⁺ T cells.

Establishment the reference interval of adult protein-induced vitamin K absence/antagonist Ⅱ by chemiluminescent microparticle immunoassay

TANG Jie, YANG Yuwei, WANG Kun, YU Jing

2019, 34(12):  1072-1076.  DOI: 10.3969/j.issn.1673-8640.2019.12.003

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Objective To establish the reference interval of adult protein-induced vitamin K absence/antagonist Ⅱ（PIVKA-Ⅱ） in Mianyang by chemiluminescent microparticle immunoassay（CMIA）,and to investigate the change of PIVKA-Ⅱ levels in patients with viral hepatitis,cirrhosis and hepatocellular carcinoma（HCC）. Methods Serum PIVKA-Ⅱ levels were determined by CMIA in 674 healthy subjects,147 viral hepatitis patients,90 cirrhosis patients and 98 HCC patients. The reference interval of PIVKA-Ⅱwas established by x±1.96s. The diagnostic efficiency of PIVKA-Ⅱto viral hepatitis,cirrhosis and HCC was evaluated by receiver operating characteristic（ROC） curve. Results The results of serum PIVKA-Ⅱ determination of 674 healthy subjects showed approximate normal distribution（z=1.428,P=0.034）,and there was no statistical significance between males and females（P>0.05）. The subjects were classified according to ages（18-30-year-old,31-44-year-old,45-59-year-old,60-69-year-old and ≥70-year-old groups）,and there was no statistical significance in these groups（P>0.05）. The data were merged,and the reference interval established by x±1.96s was 8.75-36.72 U/L. Compared to healthy control group,serum PIVKA-Ⅱ levels in viral hepatitis group,cirrhosis group and HCC group increased（P<0.001）. Serum PIVKA-Ⅱ levels in HCC group were higher than those in viral hepatitis group and cirrhosis group（P<0.001）,and there was no statistical significance between viral hepatitis group and cirrhosis group（P>0.05）. By ROC curve analysis,the areas under curve（AUC） of serum PIVKA-Ⅱ for viral hepatitis,cirrhosis and HCC were 0.656,0.663 and 0.900,and the optimal cut-off values were 27.27,29.86 and 40.36 U/L,the sensitivities were 49.7%,52.2% and 80.6%,and the specificities were 75.7%,80.8% and 94.5%,respectively. Conclusions The reference interval of serum adult PIVKA-Ⅱ by CMIA in Mianyang has preliminarily been established. PIVKA-Ⅱ increases in various degrees in patients with non-liver cancer,such as viral hepatitis and cirrhosis,and it should not be used alone as a marker of HCC.

Analysis of serum lipoprotein （a） and homocysteine levels in patients with acute coronary syndrome

DING Hui, LI Zhumeng, WANG Yin, WANG Dong, SHENG Huiming

2019, 34(12):  1082-1087.  DOI: 10.3969/j.issn.1673-8640.2019.12.005

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Objective To analyze the correlations of serum blood lipids and homocysteine（Hcy） with acute coronary syndrome（ACS）. Methods A total of 118 patients with ACS confirmed by coronary angiography,including 30 patients with ST-segment elevation myocardial infarction（STEMI）,28 patients with non-ST-segment elevation myocardial infarction（NSTEMI） and 60 patients with unstable angina（UA）,were enrolled. Totally,44 patients with chest pain confirmed by coronary angiography showing no significant stenosis of coronary arteries were enrolled as pathological control group,and 61 healthy subjects were enrolled as healthy control group. Serum blood lipids and Hcy levels were determined. The ACS patients were classified into New York Heart Association（NYHA） Ⅰ-Ⅳ according to NYHA cardiac function classification. Multi-variant Logistic regression analysis was used to evaluate the risk factors of ACS. Results The levels of serum lipoprotein（a）[Lp（a）] and Hcy in ACS group were higher than those in pathological control group and healthy control group（P<0.05）,while the levels of serum high-density lipoprotein cholesterol（HDL-C）and apolipoprotein（apo）A1 in ACS group were lower than those in pathological control group and healthy control group（P<0.05）. There was no statistical significance in serum triglyceride（TG）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C） and apoB levels among the 3 groups（P>0.05）. Serum Lp（a） and Hcy levels in STEMI group were higher than those in NSTEMI group and UA group（P<0.05）,and HDL-C and apo A1 levels were lower than those in NSTEMI and UA groups（P<0.05）. There was no statistical significance in serum Lp（a）,HDL-C,apo A1 and Hcy between NSTEMI group and UA group（P>0.05）. The levels of Lp（a）and Hcy were increased with the increasing of NYHA cardiac function classification（P<0.05）,and there was no statistical significance in serum HDL-C and apo A1 levels with NYHA cardiac function classification（P>0.05）. Multi-variant Logistic regression analysis showed that serum Lp（a） and Hcy were risk factors for ACS [odds ratios（OR） were 4.590 and 2.808,respectively],and the 95% confidence intervals（CI） were 1.375-15.322 and 1.026-7.685,respectively. Conclusions Lp（a）and Hcy may be involved in the process of coronary artery disease. Serum Lp（a）and Hcy levels may be serological indicators for screening high-risk ACS population.

Analysis on the microbial contamination of cord blood in Shanghai from 2014 to 2018

ZHANG Minmin, LIU Xuejie, JIN Weiming, WANG Jinghua, CHEN Rong, WANG Qingzhong, XU Rong, GE Ping, ZHOU Jing

2019, 34(12):  1088-1090.  DOI: 10.3969/j.issn.1673-8640.2019.12.006

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Objective To investigate the microbial contamination during cord blood collection and treatment,and to provide a reference for reducing cord blood microbial contamination rate. Mothods A total of 25 202 cord blood samples were collected from Shanghai Cord Blood Hematopoietic Stem Cell Bank from August 2014 to July 2018,and the culturing of aerobes（including facultative anaerobes） and anaerobes were carried out,and the identification was performed. Results A total of 458 isolates were determined,the total contamination rate was 1.82%. Among them,210 isolates were aerobes（45.85%）,and anaerobes（248 isolates） accounted for 54.15%. The proportion of cord blood samples from cesarean section was 5.02%（23 isolates）. The proportion of cord blood samples from eutocia was 94.98%（435 isolates）. There were 142 isolates of Escherichia coli（31.00%）,51 isolates of Bacteroides fragilis（11.14%）,36 isolates of Bacteroides thetaiotaomicron（7.86%）,22 isolates of Enterococcus faecalis（4.80%） and 18 isolates of Propionibacterium acnes（3.93%）. Among the anaerobes,Bifidobacterium,Peptostreptococcus and Clostridium had been found more in eutocia than those in cesarean section. Conclusions Anaerobes are more common than aerobes in cord blood. The contamination rate in eutocia is high,and the species of anaerobes in eutocia are more than those in cesarean section for cord blood microbial contamination.

Characteristics and whole-genome sequencing of 1 isolate of Campylobacter coil from blood

HUANG Chunlan, XU Qiuhong, YU Hongli, MA Limei, LIAO Zhihong

2019, 34(12):  1091-1096.  DOI: 10.3969/j.issn.1673-8640.2019.12.007

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Objective To investigate the characteristics and whole-genome sequencing of 1 isolate of Campylobacter coil from blood. Methods The isolate from an elder female blood was identified for type,drug susceptibility and gene sequence by routine biochemical method,mass spectrometry,genomic sequencing and so on. Results This Campylobacter coil was collected,which can survive for 3 months in blood culture bottle at room temperature,and it was sensitive to erythromycin,but it was resistant to ciprofloxacin and tetracycline. The data of whole-genome sequencing showed 1.86 Mb,the number of gene was 1 693. The sequence numbers of tRNA and rRNA were 3 and 40,respectively. A total of 21 groups of COG functions and 3 GO contents were obtained by comparing the annotations between COG database and GO database. The top 5 drug resistance genes were CmeB,TetO,CmeC,MacB and CmeA. The top 5 drug virulence genes were Cj1435c,fsrC,ECP_2806,lpg0769 and A1S-0053. Conclusions The isolate keeps high sensitive to erythromycin,but it is highly resistant to ciprofloxacin and tetracycline. There is a correlation between drug resistance and CmeB,TetO,CmeC,MacB,CmeA and so on. The virulence is related with Cj1435c,fsrC and so on.

Epidemiological characteristics of 7 common viruses among 0-12-year-old upper respiratory tract infection children in Songjiang district of Shanghai

GONG Ruhan, LIU Qingzhong, CHEN Shu, LIN Lihui, LUO Jialing, CUI Zelin

2019, 34(12):  1097-1100.  DOI: 10.3969/j.issn.1673-8640.2019.12.008

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Objective To investigate the epidemiological characteristics of common upper respiratory tract infectious viruses among children in Songjiang district of Shanghai,and to provide a reference for clinical treatment. Methods The nasopharyngeal secretion samples of 2 242 children with upper respiratory tract infection in Shanghai Jiaotong University Shanghai General Hospital（South Campus） from 2016 to 2018 were collected. Direct immunofluorescence assay（DFA） was used to determine influenza virus type A（IVA） and influenza virus type B（IVB）,adenovirus（ADV）,parainfluenza virus（PIV） 1,PIV2,PIV3 and respiratory syncytial virus（RSV）. Results Among the 2 242 children with upper respiratory tract infection,427 cases were positive for 7 kinds of respiratory tract infectious viruses,and the positive rate was 19.05%. The positive rates of <28 d,29 d-2 years and 3-5 years（top 3） were 28.57%,25.66% and 24.56%,respectively. The positive rate of RSV was the highest in inpatient children（16.26%） and outpatient children（10.19%）. RSV mostly occurred in autumn and winter,PIV3 mostly occurred in spring,summer and autumn,and ADV occurred all year round. IVA and IVB were more common in spring and winter. Conclusions RSV is the most common virus in 0-12-year-old children with upper respiratory tract infection in Songjiang district of Shanghai,and most viral upper respiratory tract infections have a characteristic of seasonal epidemic. Clinic should do prevention and control according to the epidemiological characteristics of viruses.

Association of TIM-3 rs1036199 polymorphisms with the onset risk of rheumatoid arthritis：a Meta analysis

WANG Xing, MA Yan, WANG Shengnan, ZHANG Heqian, LIU Rongzeng

2019, 34(12):  1101-1106.  DOI: 10.3969/j.issn.1673-8640.2019.12.009

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Objective To evaluate the association of TIM-3 rs1036199 polymorphisms with the susceptibility of rheumatoid arthritis（RA）. Methods A systematic search of published studies related to the association of TIM-3 rs1036199 polymorphisms with RA was conducted in PubMed,Embase,Web of Science,CNKI,Wanfang and VIP databases（last updated on August 28,2018）. A Meta analysis was performed using STATA software. A total of 7 studies including 1 267 RA cases and 1 360 healthy subjects were enrolled. Results TIM-3 rs1036199 polymorphism was not associated with RA in allele comparison [G to T：odds ratio（OR）=1.44,95% confidence interval（CI） 0.73-2.82] and heterozygous comparison（GT to TT：OR=1.46,95%CI 0.70-3.06）. Subgroup analysis based on ethnicity demonstrated that TIM-3 rs1036199 polymorphism was associated with RA in Korean（G to T：OR=1.61,95%CI 1.20-2.14;GT to TT：OR=1.71,95%CI 1.26-2.32）. Subgroup analysis based on the source of control showed that TIM-3 rs1036199 polymorphism contributed to RA susceptibility in population based on case-control studies（G to T：OR=3.66,95%CI 1.90-7.04;GT to TT：OR=3.85,95%CI 1.98-7.48）. Conclusions The present studies reveal that TIM-3 rs1036199 polymorphism is associated with RA in Korean,while the association of TIM-3 rs1036199 with RA in Chinese remains uncertain.

Relationship between P53 expression and the recurrence,metastasis and prognosis of breast cancer patients

YI Qingqing, YANG Rong, LIANG Dongyu, CHANG Qing

2019, 34(12):  1107-1110.  DOI: 10.3969/j.issn.1673-8640.2019.12.004

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Objective To investigate the change of P53 expression in paraffin biopsy specimens of breast cancer patients and its role in monitoring recurrence,metastasis and prognosis of breast cancer patients. Methods Immunohistochemical SP staining and in situ hybridization were used to determine the expression of P53 in paraffin biopsy specimens of 88 patients with breast cancer. The relationship between the expression of P53 and the prognosis of patients with breast cancer was analyzed according to clinical metastasis and recurrence. Results Immunohistochemical SP staining showed that P53 was overexpressed in 27 cases and underexpressed in 43 cases. In situ hybridization showed that P53 was overexpressed in 28 cases and underexpressed in 42 cases. The consistency rate of high P53 expression between the 2 methods was 100%. The sensitivity to chemotherapy and 5-year survival rate of patients with high P53 expression were lower than those of patients with low P53 expression（P<0.05）,while the recurrence and metastasis rates of patients with high P53 expression were higher than those of patients with low P53 expression（P<0.05）. Conclusions P53 may be an independent indicator for evaluating the recurrence,metastasis and 5-year survival of breast cancer patients.

Relationship between P53 expression and the recurrence,metastasis and prognosis of breast cancer patients

YI Qingqing, YANG Rong, LIANG Dongyu, CHANG Qing

2019, 34(12):  1107-1110.  DOI: 10.3969/j.issn.1673-8640.2019.12.004

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Objective To investigate the change of P53 expression in paraffin biopsy specimens of breast cancer patients and its role in monitoring recurrence,metastasis and prognosis of breast cancer patients. Methods Immunohistochemical SP staining and in situ hybridization were used to determine the expression of P53 in paraffin biopsy specimens of 88 patients with breast cancer. The relationship between the expression of P53 and the prognosis of patients with breast cancer was analyzed according to clinical metastasis and recurrence. Results Immunohistochemical SP staining showed that P53 was overexpressed in 27 cases and underexpressed in 43 cases. In situ hybridization showed that P53 was overexpressed in 28 cases and underexpressed in 42 cases. The consistency rate of high P53 expression between the 2 methods was 100%. The sensitivity to chemotherapy and 5-year survival rate of patients with high P53 expression were lower than those of patients with low P53 expression（P<0.05）,while the recurrence and metastasis rates of patients with high P53 expression were higher than those of patients with low P53 expression（P<0.05）. Conclusions P53 may be an independent indicator for evaluating the recurrence,metastasis and 5-year survival of breast cancer patients.

Role of serum carbohydrate antigen 153 determination in the disease course of megaloblastic anemia

YAN Kuanghua, ZHANG Tiansheng

2019, 34(12):  1111-1113.  DOI: 10.3969/j.issn.1673-8640.2019.12.011

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Objective To investigate the role of serum carbohydrate antigen 153（CA153） determination in the disease course of megaloblastic anemia（MA）. Methods A total of 48 MA patients without folic acid（FA） and vitamin B₁₂（VitB₁₂） supplement treatment were enrolled as research group,and 32 healthy subjects were enrolled as control group. The CA153 levels were determined in research group before and after treatment and control group. The correlations of CA153 with other determination indicators were evaluated. Results The level of CA153 in research group before treatment [（51.10±5.77）U/mL] was higher than that in control group [（20.22±4.69）U/mL]（P<0.001）. After FA and VitB₁₂ supplement treatment for 2-6 weeks,CA153 level in research group decreased [（21.92±4.52）U/mL]（P<0.001）,which had no statistical significance compared with that in control group（P=0.108）. CA153 was negatively correlated with hemoglobin（Hb）（r=-0.882,P<0.001）,and it was positively correlated with lactate dehydrogenase（LDH）（r=0.455,P=0.001）. Conclusions Serum CA153 levels increase in patients with MA. Serum CA153 determination can provide a reference for the early diagnosis of MA.

Roles of lymphocyte parameters in the diagnosis of diffuse large B-cell lymphoma

YUAN Qinwei, GUO Yongcan, CHEN Chen, YE Runfa

2019, 34(12):  1114-1117.  DOI: 10.3969/j.issn.1673-8640.2019.12.012

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Objective To investigate the roles of lymphocyte parameters in the diagnosis of diffuse large B-cell lymphoma（DLBCL）. Methods A total of 60 healthy subjects（healthy control group）,44 patients with DLBCL,24 patients with chronic lymphocytic leukaemia（CLL）,42 patients with other non-Hodgkin lymphomas（NHL） and 40 patients with infectious mononucleosis（IM） were enrolled,and their lymphocyte parameters were determined. The difference between DLBCL and the other groups was evaluated. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficiency of different lymphocyte parameters for DLBCL. Results Compared with healthy control group,DLBCL group had statistical significance in LY-X,LY-Y and LY-WZ,their areas under ROC curves（AUC） were 0.644,0.655 and 0.742,and the optimal cut-off values were 76.9,69.1 and 536,respectively. Compared with CLL group,the differences of LY-X,LY-WX,LY-WY and LY-WZ were statistically significant,the AUC were 0.772,0.608,0.863 and 0.827,and the optimal cut-off values were 79.4,612,1 020 and 533,respectively. Compared with other NHL group,LY-WZ had statistical significance,the AUC was 0.575,and the optimal cut-off value was 588. Compared with IM group,LY-Z,LY-WX,LY-WY and LY-WZ were statistically significant,the AUC were 0.772,0.561,0.777 and 0.887,and the optimal cut-off values were 60.9,612,1 022 and 633,respectively. Conclusions Lymphocyte parameters have a certain value for the diagnosis of DLBCL.

Role of machine learning in peripheral blood blast intelligent determination

WANG Shuang, CHEN Si, FU Yang, MAO Zhigang, JIANG Hong

2019, 34(12):  1118-1123.  DOI: 10.3969/j.issn.1673-8640.2019.12.013

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Objective Using computer learning software（SPSS 21.0）,to establish a peripheral blood blast intelligent determination model,and to lay a foundation for the intelligent review of blood routine reports and the intelligent diagnosis of laboratory determination results. Methods A total of 6 173 outpatients and inpatients were enrolled,and their data were collected through laboratory information system（LIS） and hospital information system（HIS） of West China Hospital of Sichuan University. A total of 64 blood cell determination indexes were enrolled,and the P value of blast was obtained by computer statistical software. The screening performance was evaluated. Results The indexes,including hemoglobin（Hb）,hematocrit（HCT）,lymphocyte absolute value（LYMP#）,nucleated red blood cell percentage（NRBC%）,lymphocyte corrected absolute value（LYMPH#）,forward scatter intensity distribution width of lymphocyte（LY-WZ）,immature granulocyte absolute value（IG#）,forward scatter intensity distribution width of neutrophil（NE-WZ）,white blood ecell count in WDF channel（WBC-D）,white blood cell（WBC） count,white blood cell in WNR channel（WBC-N）,nucleated cell count in WDF channel（TNC-D）,total nucleated cell（TNC） count,nucleated cell count in WNR channel（TNC-N）,side scatter intensity distribution width of neutrophil（NE-WX）,side fluorescence intensity distribution width of monocyte（MO-WY）,side fluorescence intensity distribution width of neutrophil（NE-WY）,side scatter intensity distribution width of monocyte（MO-WX）,nucleated red blood cell absolute value（NRBC#） count and monocyte absolute value（MONO#）,were included in the model. The P value of blast was 96.4%. In this model,989 cases of outpatients were verified by blind method,the predictive sensitivity was 100.0%,and the specificity was 53.2%. Furthermore,493 cases of inpatients were verified by blind method,the predictive sensitivity was 68.1%,and the specificity was 52.4%. Conclusions The model of peripheral blood blast intelligent determination based on machine learning plays a role in blood cell analysis,which provides experience for the application of artificial intelligence in intelligent diagnosis in the future. The model's ability for determining blood diseases under treatment needs to be improved,and the machine learning algorithm should be optimized for a better model for determining peripheral blood blast.

Role of red blood cell distribution width and monocyte to lymphocyte ratio in ankylosing spondylitis

CHEN Lijun, GAO Dandan, Lü Qianwen, XU Wei

2019, 34(12):  1124-1127.  DOI: 10.3969/j.issn.1673-8640.2019.12.014

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Objective To evaluate the diagnostic value of red blood cell distribution width（RDW） and monocyte to lymphocyte ratio（MLR） in ankylosing spondylitis（AS）. Methods A total of 131 AS patients,137 other rheumatic diseases and 135 healthy subjects were enrolled from the First Hospital of Jilin University. The correlations of RDW and MLR with the clinical indexes of AS were evaluated. Results RDW and MLR were higher than those in healthy subjects（P<0.05）. There was statistical significance between RDW and MLR in the positive and negative patients defined by high-sensitivity C-reactive protein（hs-CRP） and erythrocyte sedimentation rate（ESR）（P<0.05）. There was statistical significance in MLR between IgG, IgA,IgM abnormal and normal patients（P<0.05）. RDW was positively correlated with ESR and hs-CRP,and the correlation coefficients（r） were 0.277 and 0.225, respectively. MLR was positively correlated with ESR,hs-CRP,IgG,IgA and complement 3（C3）, and the r were 0.358,0.399,0.214,0.183 and 0.241,respectively. Conclusions Both RDW and MLR may play roles for AS diagnosis and disease observation.

Comparability of routine biochemical indexes between dry chemistry and wet chemistry analysis systems

GU Dongmei, SUN Ying, JIA Zichao, FAN Liming, REN YanNü, ZHANG Hua, YUAN Yuhua, LUO Wei

2019, 34(12):  1128-1132.  DOI: 10.3969/j.issn.1673-8640.2019.12.015

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Objective To investigate the comparability of routine biochemical indexes between dry chemistry and wet chemistry analysis systems. Methods The within-run precisions and intermediate precisions for middle and high values of quality control materials were determined by AU 5800 automatic biochemical analyzer and VITROS 5600 automatic biochemical immune analyzer. According to the Clinical and Laboratory Standards Institute（CLSI） document EP15-A2,AU 5800 automatic biochemical analyzer was used as comparative system,and VITROS 5600 automatic biochemical immune analyzer was used as experimental system. Totally,18 routine biochemical indexes were determined by the 2 systems. The correlation and bias between the comparative system and experimental system were evaluated and calculated by linear regression analysis. Linear regression equation and r were obtained,and the bias between the 2 systems was evaluated. Result The within-run precisions and intermediate precisions for the 18 routine biochemical indexes were all lower than precision requirement. Except for lactate dehydrogenase,the other indexes showed good correlations between the 2 systems（r²>0.95）. The biases for gamma glutamyltransferase,total bilirubin,uric acid,Cl,Ca,CO₂,glucose and total protein were acceptable. The biases for alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase and creatinine were unacceptable. The biases for alkaline phosphatase,urea,creatine kinase,K,Na and albumin were acceptable at certain concentrations. Conclusions AU 5800 automatic biochemical analyzer and VITROS 5600 automatic biochemical immune analyzer display good correlation. The biases for a part of indexes are acceptable. It is necessary to establish the different reference intervals aiming at different methods.

Research progress in the determination methods of urinary system infections

SUN Zhaoyang, LIU Wenjian, ZHANG Jinghao, FANG Yi, ZHAO Hu, ZHANG Yanmei

2019, 34(12):  1133-1138.  DOI: 10.3969/j.issn.1673-8640.2019.12.016

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Urinary system infection is one of the most common infectious diseases in clinic. Timely treatment of urinary system infections can avoid pathogens invading the important organs,such as kidney,and improve patients'prognosis and living quality. The key of efficient treatment of urinary system infections is timely determining the types of pathogens and their susceptibility to antibiotics. At present,the traditional clinical diagnosis of urinary system infections focuses on urinary culturing and routine urinary examination,which have some shortcomings in timeliness and accuracy. Many new technologies and methods,such as mass spectrometry,surface-enhanced Raman spectroscopy,sensors and molecular biology,provide new ideas for the timely and accurate diagnosis and treatment of urinary system infections,and display potential application prospects.

Research progress and diagnostic value of exosome microRNA

ZHANG Ping, YANG Bo, CAI Xiaoling, XIONG Wanyuan, WEI Xupan, TIE Baoxia

2019, 34(12):  1139-1144.  DOI: 10.3969/j.issn.1673-8640.2019.12.017

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Early diagnosis of cancer is significant for reducing the mortality of cancer patients. In recent years,exosome microRNA（miRNA） plays a role in the early diagnosis of cancer,and it is closely related to the occurrence and development of cancer. Exosome miRNA is secreted by cancer cells. It also can regulate other cancer cells and the growing environment of tumors and ultimately drive the development of cancer. This review describes exosome miRNA and its extraction methods,and further describes its mechanism in cancer,and finally analyzes the advantages and disadvantages of exosome miRNA in cancer diagnosis.