Table of Content

30 March 2020, Volume 35 Issue 3

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Pathogenic distribution and drug resistance analysis of secondary infection in malignant hematological diseases

LI Li, ZHOU Min, QIAO Dan, ZHU Yongzhen, HAN Lizhong

2020, 35(3):  189-194.  DOI: 10.3969/j.issn.1673-8640.2020.03.001

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Objective To investigate the distribution and drug resistance of pathogenic bacteria in hematological malignancy patients with secondary infection,and to provide a reference for clinical treatment,prevention and control of nosocomial infection. Methods Whonet 5.6 software was used to analyze the distribution,specimen source and drug resistance of pathogenic bacteria in hematological malignancy patients with secondary infection from April 2014 to March 2018. Results A total of 268 isolates of pathogenic bacteria were collected,of which 221 isolates （82.5%） were isolated from respiratory tract specimens,followed by 19 isolates （7.1%） from blood specimens. Gram-negative bacteria accounted for 41%,of which 7.8% were Stenotrophomonas maltophilia,6.7% were Escherichia coli,and 6.0% were Klebsiella pneumoniae,fungi accounted for 40%,and Gram-positive bacteria accounted for 19%. Gram-negative bacteria were highly resistant to ciprofloxacin,levofloxacin,ceftriaxone and aztreonam,and were sensitive to carbapenems and enzyme inhibitors. Staphylococcus and Enterococcus had high resistance to quinolones and macrolides,and were sensitive to glycopeptides and oxazolidinones. The isolation rate of Gram-negative bacteria was higher in patients with grain deficiency and fever,and the resistance rates of Klebsiella pneumoniae and Acinetobacter baumannii isolated from patients with grain deficiency and fever were higher than those without grain deficiency and fever. Conclusions The distribution and drug resistance of pathogenic bacteria in hematological malignancy patients with secondary infection have their own characteristics. Clinical laboratories should monitor pathogenic bacteria and drug resistance isolated from patients with hematological diseases,in order to provide a reference for using antibiotics rationally.

Risk factors and prognosis of bloodstream infection caused by carbapenem-resistant Klebsiella pneumoniae

WANG Junjie, YAO Zonghui, MA Bing, LI Yi, YAN Wenjuan, WANG Shanmei, MA Qiong, YUAN Youhua

2020, 35(3):  195-199.  DOI: 10.3969/j.issn.1673-8640.2020.03.002

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Objective To analyze the risk factors and prognosis of bloodstream infection caused by carbapenem-resistant Klebsiella pneumoniae（CRKP）,and to provide a reference for the control and prevention of nosocomial infection. Methods The clinical data of 281 patients with bloodstream infection caused by Klebsiella pneumoniae from July 2017 to July 2019 in Henan Provincial People's Hospital were analyzed retrospectively. The risk factors and prognosis of bloodstream infetction caused by CRKP was analyzed. Results There were 124 CRKP infection cases and 157 carbapenem-sensitive Klebsiella pneumoniae（CSKP） infection cases. The mortality rate and inpatient day in CRKP infection cases were higher than those in CSKP infection cases（P<0.05）. The risk factors of bloodstream infection caused by CRKP included using antibiotics（carbapenems and enzyme inhibitors） before infection and invasive treatment. The prognosis of CRKP infection was poor. Conclusions Bloodsteam infection caused by CRKP has low cure rate and poor prognosis. Using antibiotics before infection and invasive treatment are the risk factors of bloodstream infection caused by CRKP. The rational use of antibiotics after infection is a protective factor for good prognosis.

Identification and drug resistance of rapidly growing Mycobacterium soft tissue infection

ZHOU Jia, JIN Bo, XIAO Nan, HUANG Lei, SUN Liying

2020, 35(3):  200-204.  DOI: 10.3969/j.issn.1673-8640.2020.03.003

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Objective To analyze the drug resistance of rapidly growing Mycobacterium（RGM） and the clinical characteristic of RGM infection patients,and to provide a reference for the further research of RGM. Methods Three isolates of RGM from soft tissue infection patients in Peking University First Hospital for the last 10 years were collected. The 3 RGM isolates were determined by matrix-assisted laser desorption ionization time-of-flight mass spectrometry（MALDI-TOF MS） and sequencing. Drug susceptibility test was performed. The clinical characteristic of RGM infection patients were analyzed. Results The 3 RGM isolates were sensitive to amikacin,tobramycin,imipenem and linezolid,and were resistant to sulfamethoxazole. Levofloxacin,azithromycin and/or rifampicin were used to treat these patients. The patients infected with Mycobacterium fortuitum and Mycobacterium farcinogenes were cured and discharged. The patient with Mycobacterium abscessus was discharged without being completely cured since being in stable condition. Conclusions RGM is resistant to macrolides,which should be avoided in clinical experience.

Changes of inflammatory factors,CHE and Hcy levels in patients with Alzheimer's disease

CHEN Shuzi, LIN Ping, LI Ping, JIN Weifeng, LI Zhenhua, GAO Qiong, CHENG Xunjia

2020, 35(3):  205-208.  DOI: 10.3969/j.issn.1673-8640.2020.03.004

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Objective To observe the changes of inflammatory factors [C-reactive protein（CRP）,immunoglobulin G（IgG）,neutrophil/lymphocyte ratio（NLR）],cholinesterase（CHE） and homocysteine（Hcy） in peripheral blood of patients with Alzheimer's disease（AD）. Methods A total of 35 AD patients（AD group） and 35 patients with mild cognitive impairment（MCI）（MCI group,disease control group）were enrolled,and 35 healthy subjects were enrolled as healthy control group. CRP and IgG were determined by immunoturbidimetry,the determination of CHE was performed by thio-acetylcholine method,and the determination of Hcy was performed by circulatory enzyme method. The absolute values of neutrophils and lymphocytes were determined by flow cytometry,and the NLR was calculated. Results Hcy and CRP in MCI group were higher than those in healthy control group（P<0.05）,and CHE decreased（P<0.05）. There was no statistical significance of IgG and NLR（P>0.05）. IgG,Hcy,CRP and NLR increased in AD group（P<0.05）,and CHE decreased（P<0.05）. Compared with MCI group,IgG,Hcy and NLR increased in AD group（P<0.05）,and CHE decreased（P<0.05）. There was no statistical significance in CRP（P>0.05）. Hcy and NLR were negatively correlated（r=-0.344,P=0.043）. There was no correlation among the other indicators in AD group（P>0.05）. Conclusions CRP,IgG,CHE,Hcy,NLR may be of value in the diagnosis of AD and differential diagnosis of MCI.

Changes of CD3^bright T lymphocytes in patients with hepatocellular carcinoma before and after recurrence

JIN Fangfang, JIN Zizheng, LIU Ning, LOU Jinli

2020, 35(3):  209-213.  DOI: 10.3969/j.issn.1673-8640.2020.03.005

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Objective To investigate the changes of CD3^bright T lymphocytes in patients with hepatocellular carcinoma（HCC） before and after recurrence. Methods A total of 69 patients with HCC,including 52 cases of recurrence within 5 years and 17 cases without recurrence,were enrolled. By flow cytometry,the proportions of CD3⁺T cells,CD4⁺T cells,CD8⁺T cells and CD3^bright T cells in total T cells（CD3%,CD4%,CD8% and CD3^bright%） were determined,and the CD4/CD8 ratio was calculated. Alpha-fetoprotein（AFP） was determined as well. Pearson correlation analysis was used to evaluate the correlation of CD3^bright% with other indicators. Logistic regression analysis was used to evaluate the indicators for the prediction of HCC recurrence. By receiver operating characteristic（ROC） curve analysis,the roles of the indicators for the judgment of HCC recurrence were evaluated. Results The levels of AFP,CD4% and CD8% were higher（P<0.01）,and CD3^bright% was lower in patients with recurrence within 5 years than those without recurrence（P<0.01）. There was no statistical significance for CD3% and CD4/CD8 ratio between the 2 groups（P>0.05）. The level of AFP after recurrence was higher than that after operation（P<0.01）,CD3^bright% was decreased after recurrence（P=0.04）,and there was no statistical significance for the other indicators（P>0.05）. AFP and CD3^bright% were related with HCC recurrence independently [odds ratios（OR） were 1.012 and 0.841,95% confidence intervals（CI） were 1.001-1.023 and 0.783-0.902 ]. Conclusions Decreased CD3^bright T lymphocyte is related with poor prognosis and high recurrence rate.

Meta analysis on the positive detection rate of anti-Epstein-Barr virus antibodies in Chinese population with infectious mononucleosis

ZHANG Minjie, GAO Yufang, YANG Feifei, XU Xiaoli

2020, 35(3):  214-223.  DOI: 10.3969/j.issn.1673-8640.2020.03.006

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Objective To investigate the relation of anti-Epstein-Barr virus（EBV） antibodies with Chinese population with infectious mononucleosis（IM） by Meta analysis. Methods The databases,including China National Knowledge Infrastructure（CNKI）,WANFANG Database,Pubmed,EMbase,Chinese Biological Medicine Database（CBM） and Chinese Weipu Database（VIP）,were searched from inception to February 2018. The case-control studies of IM patients and control subjects for anti-EBV antibodies were collected for conducting a Meta analysis. The literatures were strictly screened according to the inclusion and exclusion criteria. Quality assessment was performed using a modified version of the Newcastle-Ottawa scale（NOS）. The odds ratios（OR） of seropositivity to anti-EBV antibodies were calculated using Rev Man 5.3. OR for each anti-EBV antibody was combined in a Meta analysis,and the stability was evaluated by sensitivity analysis. Egger test was used to evaluate the publication bias. Results Totally,16 studies were included,including 1 305 IM cases and 973 control cases. There was a higher seroprevalence of anti-EBV viral capsid antigen（EBV-VCA） IgM/IgG/IgA antibodies and anti-EBV early antigen（EBEA） IgM/IgG antibodies in IM cases compared to control cases. An overall OR for anti-EBV-VCA IgM was 81.67 [95% confidence interval（CI） 57.88-115.22],that for anti-EBV-VCA IgG was 7.86（95% CI 2.05-30.25）,that for anti-EBV-VCA IgA was 15.45（95% CI 1.13-211.81）,that for anti-EBEA IgM was 17.21（95%CI 7.76-38.15） ,and that for anti-EBEA IgG was 4.21（95% CI 1.08-16.40） in IM cases. The difference in seropositivity rates between IM cases and control cases for anti-EBV nuclear antigen（EBV-NA） IgG had no statistical significance（OR=0.50,95%CI 0.08-3.00,P=0.45）. A total of 11 studies determined anti-EBV-VCA IgG were various widely in their qualities,and there was considerable heterogeneity in the results of Meta analysis. Subgroup analysis failed to demonstrate a statistical significance in any of the subgroups considered（P>0.05）. Egger test showed that there was no publication bias. Conclusions There is a higher seroprevalence of anti-EBV-VCA and anti-EBEA antibodies but not anti-EBV-NA antibody in Chinese population with IM compared to control subjects.

Laboratory examination results and clinical characteristics of 28 cases of IgD multiple myeloma

ZHENG Wei, LU Jie, GUI Qingrong, WANG Dongyun

2020, 35(3):  224-228.  DOI: 10.3969/j.issn.1673-8640.2020.03.007

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Objective To investigate the clinical characteristic and laboratory examination results of IgD multiple myeloma（MM）. Methods The clinical manifestations and laboratory examination results of 28 patients with IgD MM were analyzed retrospectively,which were compared with those of IgG MM. Results Among the 28 cases of IgD MM,there were 3 cases of IgD-κ type and 25 cases of IgD-λ type. There was no statistical significance for blood routine test（hemoglobin,red blood cell,white blood cell and platelet） and serum calcium between IgD MM and IgG MM（P>0.05）. The levels of urea,creatinine and albumin in patients with IgD MM were higher than those in patients with IgG MM（P<0.05）,and the levels of total protein,IgA,IgG and IgM were lower than those in patients with IgG MM （P<0.05）. There was statistical significance in total light chain,free light chain,free light chain κ/λ ratio and urine total light chain,urine total light chain κ/λ ratio between IgD MM and IgG MM（P<0.05）. Among the 28 IgD MM patients,21（75%） cases were found to be Bence-Jones proteins positive in urine. The MM genotype of IgD type mostly showed 1q21 amplification. Conclusions The clinical manifestations of IgD MM are lack of specificity,which requires comprehensive laboratory examination,including the quantitative determination of immunoglobulin,immunofixation electrophoresis,morphological analysis of bone marrow cells,gene determination and so on,in order to improve the diagnosis rate.

Establishment of GA reference intervals in Huaihai

CUI Can, CHEN Yanhong, ZHANG Rui, NIU Guoping

2020, 35(3):  229-232.  DOI: 10.3969/j.issn.1673-8640.2020.03.008

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Objective To establish the reference intervals of glycated albumin（GA） in different age groups in Huaihai,which is evaluated by laboratory diagnosis. Methods A total of 1 784 healthy subjects in the Central Hospital of Xuzhou City from January 2017 to January 2018 were enrolled. All the subjects were classified according to different ages. There were 429 children（0-6 years old）,199 juniors（7-17 years old）,203 young people（18-40 years old）,618 middle-aged people（41-65 years old） and 315 elder people（≥66 years old）. The GA levels were determined by enzymatic method. The 95% confidence intervals of reference intervals were calculated. Totally,221 healthy subjects' samples were collected in the Central Hospital of Xuzhou City from May 2018 to June 2018. The results of GA were collected,and the value of R was calculated. The reference interval was verified. There were 1 367 samples which were collected from whom came to the Central Hospital of Xuzhou City from June 1th 2018 to June 5th 2018,which were contained 149 diabetes mellitus patients and 1 218 non-diabetes mellitus patients. The reference interval was evaluated by laboratory diagnosis. Results The reference interval of child group was 6.28%-13.54%,that of junior group was 7.25%-14.93%,that of young group was 8.32%-14.66%,that of middle-aged group was 9.52%-15.64%,and that of elder group was 10.09%-16.29%. The specificity of the reference intervals of GA was 95.00%,the sensitivity was 98.65%,the misdiagnosis rate was 6.89%,and the missed diagnosis rate was 1.34%. Conclusions The reference interval of GA in Huaihai is 7.61%-15.37%. The level of GA increases with ages. It is recommended to set GA reference interval according to different ages. GA has a diagnostic value for diabetes mellitus.

Determination of lecithin and sphingomyelin in amniotic fluid by ultra-performance liquid chromatography-tandem mass spectrometry

CAO Zheng, LIU Jingrui, XIE Xin, LIU Yilin, DONG Ying, TANG Guodong, ZHAI Yanhong

2020, 35(3):  233-237.  DOI: 10.3969/j.issn.1673-8640.2020.03.009

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Objective To establish a method based on ultra-performance liquid chromatography-tandem mass spectrometry（UPLC-MS/MS） to measure the ratio of lecithin/sphingomyelin（L/S） in amniotic fluid to accurately and efficiently predict fetal lung maturity. Methods According to the Apgar scoring standard for newborns,23 amniotic fluid specimens obtained at 32-39 gestational weeks were classified into 3 fetal lung immature cases and 20 fetal lung mature cases. Totally,7 amniotic fluid specimens obtained at 18 gestational week were used as baseline controls. UPLC-MS/MS for determining the ratio of L/S in amniotic fluid was established. Lamellar body （LB） was determined by lamellar body count （LBC） method. The roles of the 2 methods for predicting fetal lung maturity were evaluated. Results The UPLC-MS/MS for the determination of L/S had good precision. Both ion peak intensity and retention time were within the determinable range,and principal component analysis （PCA） showed good clustering of 6 quality control samples. When L/S=10 was used as the cut-off value to discriminate maturity and immaturity,the sensitivity and specificity reached 100%. When LB=50×10⁹ /L was used as the cut-off value,2 cases of positive specimens and 1 case of negative specimen were incorrectly identified,with a sensitivity of 80% and a specificity of 95%. Conclusions The measurement of L/S in amniotic fluid by UPLC-MS/MS is reliable and can predict fetal lung maturity accurately and efficiently.

Correlations of serum ferritin,hemoglobin and thyroid hormones in different trimester pregnant women

CHEN Hong, LI Jinying, FU Wei

2020, 35(3):  238-242.  DOI: 10.3969/j.issn.1673-8640.2020.03.010

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Objective To investigate the changes and the correlations of ferritin,hemoglobin（Hb） and thyroid hormones in different trimester pregnant women. Methods A total of 561 pregnant women at different trimesters receiving the first antenatal care were enrolled,and they were classified into 3 groups according to different trimesters,including the first trimester（200 cases）,the second trimester（180 cases） and the third trimester（181 cases）. Totally,180 healthy non-pregnant women were enrolled as control group. The levels of serum thyroid hormones,such as triiodothyronine（T₃）,thyroxine（T₄）,free triiodothyronine（FT₃）,free thyroxine（FT₄）,thyroid stimulating hormone（TSH）, were determined,and ferritin and Hb were determined as well. Statistical analysis was performed. Results Compared with control group,the levels of ferritin in the 3 groups were lower（P<0.05）. The levels of Hb in the second trimester and the third trimester groups were lower（P<0.05）,but there was no statistical significance between the first trimester and control groups（P>0.05）. The levels of ferritin and Hb were decreased with the progress of pregnancy,and there was statistical significance between the first trimester and the third trimester groups（P<0.05）. Pearson correlation analysis showed that Hb was positively correlated with FT₃ and FT₄ in the first trimester（r=0.265 and 0.180,P=0.000 and 0.004,respectively）,and it was positively correlated with FT₃ in the third trimester（r=0.556,P=0.005）. Serum level of ferritin was correlated with FT₃ and FT₄ in the third trimester（r=0.502 and 0.494,P=0.013 and 0.014,respectively）. Conclusions The decreasing of serum ferritin and Hb may lead to the low levels of FT₃ and FT₄. Thyroid dysfunction in pregnant women is closely related to iron deficiency.

Roles of serum NT-proBNP,CRP and MMP-9 in children with Kawasaki disease

CHEN Bin, LU Weiwei, XU Zhongyu

2020, 35(3):  243-246.  DOI: 10.3969/j.issn.1673-8640.2020.03.011

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Objective To investigate the changes and roles of N-terminal pro-B-type natriuretic peptide（NT-proBNP）,C-reactive protein（CRP） and matrix metalloproteinase 9（MMP-9） in children with Kawasaki disease（KD）. Methods A total of 107 children suspected with KD were enrolled. Among the 107 children,68 children,including 54 cases of complete Kawasaki disease（CKD） and 14 cases of incomplete Kawasaki disease（IKD）,were confirmed as KD group,and the other 39 children were enrolled as disease control group. The levels of serum NT-proBNP,CRP and MMP-9 were determined. Receiver operating characteristic（ROC） curve was used to assess the diagnostic efficiency of each index. Results Compared with disease control group,the age and sex of KD group had statistical significance（P<0.05）. The levels of serum NT-proBNP,CRP and MMP-9 had statistical significance between KD and disease control groups（P=0.000）. There was no statistical significance in NT-proBNP,CRP and MMP-9 between CKD and IKD groups（P>0.05）. ROC curve analysis showed that the areas under the curves（AUC） of NT-proBNP,CRP and MMP-9 and combined determination predictor L in the differential diagnosis of KD were 0.858,0.861,0.689 and 0.938,respectively. Conclusions The levels of serum NT-proBNP,CRP and MMP-9 are closely related with KD,which can be used in the differential diagnosis of KD.

Analysis on the results of Epstein-Barr virus antibody combined determination in healthy subjects of Beijing

ZHANG Han, ZHANG Chaoyan, XIE Qiuxia, TIAN Jianhui

2020, 35(3):  247-250.  DOI: 10.3969/j.issn.1673-8640.2020.03.012

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Objective To analyze the results of 3 Epstein-Barr virus（EBV） antibody combined determination,to evaluate the status of EBV infection among healthy subjects,and to provide a reference for the early screening of nasopharyngeal carcinoma. Methods A total of 4 251 healthy subjects from the Health Management Center of Beijing Aerospace General Hospital from January 1,2017 to June 30,2018 were enrolled. EBV Rta-IgG,viral capsid antigen（VCA）-IgA and early antigen（EA）-IgA antibodies were determined combinedly. The results were analyzed statistically by SPSS 16.0 software. Results Among the 4 251 healthy subjects,there was statistical significance in the single positive rates of 3 EBV antibodies（χ²=12.465,P=0.000）,and the positive rates were in the order of VCA-IgA,EA-IgA and Rta-IgG antibodies from high to low. The positive rate of VCA-IgA antibody in males was higher than that in females（P=0.000）. The overall positive rate of 3 EBV antibodies increased with ages. The positive rates of EA-IgA antibody（P=0.000） and Rta-IgG antibody（P=0.003 8） ad statistical significance in different age groups. The positive rates of EA-IgA and Rta-IgG antibodies were high in subjects ≥61 years old（6.3% and 3.7%,respectively）,and the positive rate of VCA-IgA antibody was the highest in subjects ≥51 years old. Among the subjects,92.9% were triple-negative,6.4% were single-positive,0.7% were double-positive,and no tirple-positive was found. The results of antibody positivity showed no difference in the aggregation of males and females,and the proportions of rhinitis,sinusitis and other abnormalities were higher in antibody positive group. Conclusions The positive rates of 3 EBV antibodies are related to sex and age. Subjects ≥50 years old should focus on EBV antibody screening. Nasopharyngoscopy should be recommended for patients with positive EBV antibodies,in order to provide a reference for the early screening of nasopharyngeal carcinoma.

Analysis on hemophagocytic phenomenon after allogeneic hematopoietic stem cell transplantation

DING Jing, LIU Weiling, WAN Liping, LI Li, BAI Ping

2020, 35(3):  251-255.  DOI: 10.3969/j.issn.1673-8640.2020.03.013

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Objective To analyze the characteristics of hemophagocytic phenomenon after allogeneic hematopoietic stem cell transplantation（allo-HSCT）. Methods Two patients with hemophagocytic lymphohistiocytosis（HLH） after allo-HSCT were enrolled from Shanghai General Hospital,and the possible causes were discussed. Results The admission diagnosis of case 1 was immunodeficiency disease,granulocyte implantation was found after allo-HSCT for 13 d,hemoglobin and platelet were low,and coagulation function was poor. Gastrointestinal bleeding,cytomegalovirus enteritis and lung infection appeared,and hemophagocytic cells were visible in bone marrow smear. The admission diagnosis of case 2 was acute monocytic leukemia,granulocyte implantation was found after allo-HSCT for 14 d,and peripheral blood cells continued to decrease after allo-HSCT for 42 d. Fever,high ferritin and hemophagocytic phenomenon were visible,and stem cell transplantation chimeric rate declined progressively. Conclusions The hemophagocytic phenomenon after allo-HSCT is very rare,the progress is rapid,the prognosis is poor,and the hemophagocytic phenomenon is often caused by infection. When hemophagocytic phenomenon occurs after hematopoietic stem cell transplantation,it should actively check infection,determine whether primary disease recurs,detect patient and parent related genes,and seek a early therapy and better prognosis as soon as possible.

Reference intervals of peripheral blood reticulocyte and related parameters of 0-3 d neonates in Wuhan

HU Weihong, ZHANG Hongbo, YUE Daoyuan, ZHANG Chi

2020, 35(3):  256-259.  DOI: 10.3969/j.issn.1673-8640.2020.03.014

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Objective To establish the reference intervals of 6 items of peripheral blood reticulocyte（RET） and related parameters of 0-3 d neonates in Wuhan. Methods From June 2018 to December 2018,406 0-3 d neonates in the Obstetrics Ward of Tongji Hospital of Huazhong Univerisity of Science and Technology Tongji Medical College were enrolled. A total of 6 items,including the percentage of reticulocyte（RET%）,the absolute value of reticulocyte（RET#）,high fluorescent ratio（HFR%）,middle fluorescent ratio（MFR%）,low fluorescent ratio（LFR%） and reticulocyte hemoglobin（RET-He）,were determined for establishing the reference intervals. $\bar{x}$±1.96s was used as biological reference interval. Results The 6 items showed statistical significance between different days（P<0.05）. Except for HFR%,the other 5 items showed no statistical significance between sex（P>0.05）. The reference intervals of RET and related parameters of 0-3 d neonates in Wuhan were as follows. RET%：2.63%-6.27% on the 1st day,2.55%-6.35% on the 2nd day,and 2.06%-6.06% on the 3rd day. RET#：（0.139-0.397）×10¹²/L on the 1st day,（0.150-0.400）×10¹²/L on the 2nd day,and （0.124-0.386）×10¹²/L on the 3rd day. HFR%（male）：12.16%-30.97% on the 1st day,7.64%-29.30% on the 2nd day,and 4.85%-20.64% on the 3rd day;HFR%（female）：10.64%-27.67% on the 1st day,6.78%-25.10% on the 2nd day,and 2.06%-19.26% on the 3rd day. MFR%：13.48%-25.73% on the 1st day,13.24%-26.61% on the 2nd day,and 11.45%-23.00% on the 3rd day. LFR%：48.67%-71.07% on the 1st day,48.24%-77.26% on the 2nd day,and 58.38%-83.56% on the 3rd day. RET-He：29.58-37.30 pg on the 1st day,29.25-36.23 pg on the 2nd day,and 27.49-34.85 pg on the 3rd day. Conclusions Due to different regions and ages,there are differences in the reference intervals of RET. The reference intervals of 6 items of RET and related parameters for 0-3 d neonates in Wuhan have established preliminarily,providing a reference for the diagnosis and treatment of anaemic diseases.

Diagnostic value of D-dimer level in different types of pancreatitis

MENG Hongbing, CAO Xingjian, FAN Yuping, GU Shuijing, LI Na

2020, 35(3):  260-263.  DOI: 10.3969/j.issn.1673-8640.2020.03.015

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Objective To investigate the diagnostic value of D-dimer（DD） level in different types of pancreatitis. MethodsTotally,60 patients with acute pancreatitis were enrolled,and there were 40 cases of mild pancreatitis（mild group） and 20 cases of severe pancreatitis（severe group）. A total of 60 healthy subjects were enrolled as control group. The levels of DD,prothrombin time（PT）,activated partial thromboplastin time（APTT） and thrombin time（TT） were determined. Results The DD,PT,APTT and TT in severe group at admission were higher than those in mild group and control group（P<0.05）. The DD,PT,APTT and TT in mild group at admission were higher than those in control group（P<0.05）. The levels of DD,PT,APTT and TT in mild and severe groups at 3 d after admission were higher than those at admission（P<0.05）,and those at 7 d after admission in mild group were decreased（P<0.05）,while those in severe group continued to increase（P<0.05）. In severe group,DD,PT,APTT and TT at admission and 3 d,7 d after admission were higher than those in mild group（P<0.05）. The areas under receiver operating characteristic（ROC） curves of DD,PT,APTT and TT at admission in judging the severity of acute pancreatitis were 0.866,0.801,0.776 and 0.835,respectively（P<0.05）. Conclusions DD,PT,APTT and TT determinations play roles in the early diagnosis of acute pancreatitis and the assessment of disease severity.

Application of dry blood spot from newborn screening in deafness gene detection

GAO Peng, QIN Shiqi, TANG Meifang

2020, 35(3):  264-269.  DOI: 10.3969/j.issn.1673-8640.2020.03.016

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Objective To reduce sampling frequency and shorten deafness gene detection period in detecting deafness gene by time-of-flight mass spectrometry with discarded dry blood spot generated from newborn screening. Methods The DNA extracting method of boiling discarded dry blood spot with alkaline water was optimized by adjusting the pH value and the dosage of alkaline water. Results When extracting DNA from discarded dry blood spot by alkaline water with the pH values of 9,10,11 and 12,all the 20 deafness gene were accurately detected,and the concentration of DNA was positively correlated with the pH value of alkaline water（r=0.906,P=0.094）,however,the DNA extracted from alkaline water with pH12 was difficult to be detected,as the peak value got sharply decreased. When extracting DNA from discarded dry blood spot by alkaline water with the pH value of 11 and the volumes of 60,70,80 and 90 μL,the concentration of DNA was negatively correlated with the volume of alkaline water（r=-0.988,P=0.012）,and the genetic locus of 547G>A in one samples extracted from 90 μL alkaline water with the pH value of 11 was failed to be detected,while the concentration of DNA extracted from discarded dry blood spot with 80 μL alkaline water with the pH value of 11 was close to those extracted from fresh dry blood spot（t=0.035,P=0.974）,and all the 20 genetic locuses related to deafness were accurately detected as well. Conclusions Good detection results could be obtained when extracting DNA from discarded dry blood spot through 80 μL alkaline water with the pH value of 11,and this study provides a reference on the construction of automatic detection platform for both newborn screening of genetic metabolic disease and deafness gene detection.

Establishment and application of loop-mediated isothermal amplification for EGFR gene L858R mutation determination in non-small cell lung cancer patients

NIU Jing, QUAN Wenqiang, LI Dong

2020, 35(3):  273-277.  DOI: 10.3969/j.issn.1673-8640.2020.03.018

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Objective To establish a rapid screening method for epidermal growth factor receptor（EGFR） gene L858R mutation in peripheral blood by loop-mediated isothermal amplification（LAMP） among non-small cell lung cancer（NSCLC） patients. Methods The DNA sequence of exon 21（L858R） of EGFR gene was searched in Genebank,and then the Primer Explorer V4 software was used to design specific primers. LAMP was established,and the specificity and sensitivity were evaluated. Peripheral plasma of 11 patients with NSCLC diagnosed by clinical pathology was collected,and the accuracy of LAMP was verified using the amplification results of digital polymerase chain reaction（PCR） as standard. Results EGFR gene L858R mutant DNA can be specifically amplified by LAMP primer and reaction system designed by ourselves. The detection sensitivity was 0.1 %,and the specificity reached 100%. LAMP detected 9 positive cases in 11 NSCLC specimens with EGFR gene L858R mutation positive results. Conclusions The LAMP has been established for detecting EGFR gene mutation in human peripheral plasma,which has high sensitivity,specificity and accuracy. It can be used to visually interpret the detection results by fluorescence. It is a simple and rapid screening method for EGFR gene mutation.

Etiology, laboratory testing and laboratory biological safety protection of SARS-CoV-2

Lai Yuanyuan, Wang Yuting, Chen Jiani, Qi Jun, He Zhenye

2020, 35(3):  278-281.  DOI: 10.3969/j.issn.1673-8640.2020.03.019

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On December, 2019, an outbreak of pneumonia caused by a novel coronavirus that was first detected in Wuhan City, Hubei Province, China and which has now been detected in other regions in China and abroad. The virus seems to be highly contagious and has a high fatality rate. The rapid and accurate laboratory test is very important for the diagnosis and treatment of the novel coronavirus pneumonia and the clinical specimenscollected from patients with COVID-19 for testing have potential pathogenicity and high infectivity. Therefore, the laboratory test of SARS-CoV-2 and the management of clinical laboratory have become the research topics in China.The related measures of prevention and control are summarized.

Research progress of the mechanism of Helicobacter pylori transmission and colonization

WANG Jiajing, SHAO Zhoujie, YE Hongyan

2020, 35(3):  282-286.  DOI: 10.3969/j.issn.1673-8640.2020.03.020

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Helicobacter pylori is a microaerobic,helical Gram-negative bacterium colonized in the host gastric epithelial cell layer. Its infection can last for decades,and it can cause a series of gastrointestinal disorders,even gastric cancer. Helicobacter pylori has been defined as a classⅠcarcinogen factor by World Health Organization. Helicobacter pylori has a high infection rate. The infection rate of Helicobacter pylori in China can reach over 80%,and the infection rate is increasing year by year. Helicobacter pylori infection depends on many factors,and transmission and colonization are the key influencing factors. This review mainly focuses on the transmission and colonization of Helicobacter pylori.