Table of Content

19 February 2012, Volume 27 Issue 2

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Investigation on the application of trapezoid microplate method in determining ABO bloodgroup in blood donors

WANG Lin;ZHANG Guoping

2012, 27(2):  81-82. 

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Objective　To investigate the application value of trapezoid microplate method in determining ABO bloodgroup in blood donors. Methods　The known bloodgroup samples were collected. The samples and their forward and reverse test parameters of ABO bloodgroup were detected by orthogonal design and trapezoid microplate method. These test methods were routinely used for blood sample testing among blood donors. Results　A total of 24 922 blood donor samples were determined by trapezoid microplate method， which showed that the correct interpretation at one time was 99.6%. However, 5 cases of ABO bloodgroup detected in moving vehicle for donation were wrong， and 2 cases of A2 group，1 case of B3 group and 1 case of irregular antibody were also found. Conclusions　The correct interpretation at one time of trapezoid microplate method to detect ABO bloodgroup is high， and the ability of trapezoid microplate method to detect ABO subgroup and irregular antibody is great. Trapezoid microplate method brings about the standardization，automation of ABO bloodgroup test and digitization of test results， and the test results are issued automatically on net. It is simple， rapid and accurate for trapezoid microplate method to detect a large number of blood donor samples，and it is worth that trapezoid microplate method is used to the determination of ABO bloodgroup extensively.

Report of 2 cases with thrombotic thrombocytopenic purpura

YANG Xuemin;DONG Chenming;WANG Aihua

2012, 27(2):  83-87. 

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Objective　To summarize the examination data of 2 cases with thrombotic thrombocytopenic purpura (TTP) in Lanzhou University Second Hospital. Methods　The closely related diagnostic features of TTP were reviewed retrospectively：hemoglobin (Hb)，platelet (PLT)，reticulocyte (RET)，fragments of red blood cell（FRC），urinary protein (PRO)，urinary occult blood (BLD)，lactate dehydrogenase (LDH)，total bilirubin (TBil)，direct bilirubin (DBil)，indirect bilirubin (IBil)，urea nitrogen (BUN)，creatinine (Cr)，D-dimer (D-D) and bone marrow analysis. Results　Intravenous infusing plasma, PLT and immunoglobulin could not improve the severe reducing of PLT. Intravenously infusing red blood cells (RBC), Hb declined progressively. PRO and BLD were persistently positive. RET，TBil，IBil and LDH of hemolysis test continued to rise. D-D of coagulation test continued not to reduce. Bone marrow analysis showed that 2 patients were proliferative anemia and hemolytic anemia with Evans syndrome respectively. Conclusions　Shallow understanding of TTP diagnosis leads to delay the clinical diagnosis and treatment. By retrospectively reviewing the tests and clinical features of TTP， the classic "five signs" are found, including thrombocytopenia，microangiopathic hemolytic anemia,neurologic symptoms，renal damage and fever.

The correlation analysis the thromboelastogram and conventional coagulation tests in patients with acute cerebral infarction

XIE Yiwei;ZHU Bingwei

2012, 27(2):  88-90. 

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Objective　To investigate the correlations between the thromboelastogram (TEG) and conventional coagulation tests in patients with acute cerebral infarction， and evaluate the 2 methods′ commonness and differences in determining the blood coagulation of acute cerebral infarction. Methods　A total of 107 patients with acute cerebral infarction were enrolled，and all patients were determined by TEG and conventional coagulation tests simultaneously. Results　The reaction time (R) and prothrombin formation time (K) in the dead patients with acute cerebral infarction were significantly shorter than those in the controls，and the results of prothrombin time (PT) and activated partial thromboplastin time (APTT) were low. There were correlations between the TEG and conventional coagulation tests. The R and K times of TEG parameters were positively correlated with the prothrombin timeinternational normalized ratio (PTINR)， and were negatively correlated with fibrinogen （FIB）. α angle and maximal amplitude (MA) were negatively correlated with the PTINR，and were positively correlated with FIB. Conclusions　TEG parameters not only can reflect more fully in the body′s blood clotting process， but also have correlations with conventional coagulation tests in patients with acute cerebral infarction. TEG and conventional coagulation tests can be conducted simultaneously and have mutual complementary effect.

Expressions of FHIT and TSLC1 genes in cervical tissues and relationship with HPV infection

TANG Zhenhua;LI Zhunan;HUANG Yong;WANG Jinjin;HU Weiping;WAN Xiaoping

2012, 27(2):  91-94. 

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Objective　To study the expressions of fragile histidine triad (FHIT) gene and tumor suppressor in lung cancer 1 (TSLC1) gene in cervical tissues and the relationship with the occurrence of cervical cancer and human papillomavirus (HPV) infection. Methods　The FHIT and TSLC1 gene expressions and highrisk HPV were detected in normal cervical tissues (20 cases)， lowgrade squamous intraepithelial lesion (LSIL) tissues (20 cases)， highgrade squamous intraepithelial lesion (HSIL) tissues (45 cases) and cervical cancer tissues (33 cases) by realtime polymerase chain reaction (PCR). Results　The rates of HPV infection and FHIT and TSLC1 expressions in normal cervical tissues， LSIL tissues， HSIL tissues and cervical cancer tissues were 0%， 30%， 71% and 100%; 100%， 80%， 36% and 18%; 100%， 75%， 33% and 24%, respectively. Each of the 3 rates was significantly different between the different cervical tissues (P<0.01). Highrisk HPV infection was detected in all the patients with FHIT and TSLC1 gene expression loss. The receiver operating characteristic (ROC) curve analysis showed that detection of FHIT and TSLC1 gene expression loss had diagnostic values for cervical cancer and HSIL. Conclusions　The losses of FHIT and TSLC1 gene expressions may occur at the early stage of cervical cancer after HPV infection. The detections of FHIT and TSLC1 gene expressions in patients with highrisk HPV infection may provide important markers for cervical cancer diagnosis.

Study on the efflux pump mechanism of imipenemresistant Acinetobacter baumannii

HOU Panfei;DU Kun;YING Chunmei;HU Fupin;XU Xiaogang

2012, 27(2):  95-98. 

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Objective　To study the relationship between resistance and active efflux pump in imipenemresistant Acinetobacter baumannii (IRAB)， and guide the rational use of antibiotics and the control of nosocomial infections. Methods　A total of 50 IRAB and 30 imipenemsensitive Acinetobacter baumannii(ISAB) were collected from clinical specimens. The minimum inhibitory concentrations (MIC) to 13 antibiotics were determined by agar dilution method, and the changes of MIC in imipenem by adding PheArgbetaNaphthylamide（PAβN， a kind of pump inhibitor） were observed. Homology was analyzed by pulsefield gel electrophoresis (PFGE）. The adeB， adeR， adeS， adeJ and abeM genes were amplified by polymerase chain reaction (PCR). Results　In 50 IRAB， the antibiotics of MIC50>128 μg/mL included amikacin， ciprofloxacin， piperacillintazobactam， cefoperazone， cefoxitin， tetracycline and sulfamethoxazole. The antibiotics of MIC50 from 32 to 128 μg/mL included meropenem， cefoperazonesulbactam， cefepime， ceftazidime， ceftriaxone and cefotaxime. The antibiotics of MIC50<8 μg/mL included levofloxacin and polymyxin B. In 30 ISAB， the antibiotics of MIC50<8 μg/mL included meropenem， amikacin， ceftazidime， cefepime， cefoperazonesulbactam and polymyxin B. The MIC of 33(66%) IRAB in imipenem decreased 4 to 32 times after adding PAβN， while ISAB had no obvious changes. According to PFGE，80 isolates could be classified into 7 types， and type A was the major clone. By PCR amplification， the detection rates of adeB， adeR， adeS， adeJ and abeM genes were >80% in IRAB. There were significant differences in all genes compared with those of ISAB(P<0.01). Conclusions　There is an endemic of IRAB in Renji Hospital, and AdeABC， AdeIJK and AbeM efflux pump widely exist.

Research on the method of internal quality control for calculated laboratory tests

HU Litao;WANG Zhiguo

2012, 27(2):  99-102. 

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Objective　To investigate the method of internal quality control for calculated laboratory tests. Methods　A method was developed using a Taylor series expansion and alternative equations to obtain the mean value and standard deviation of calculated laboratory tests as low density lipoprotein cholesterol(LDL-C) for example, and then LeveyJennings charts were printed. The results were analyzed by Westgard multirules. Results　The preparation of Levey-Jennings charts for LDL-C (and other calculated laboratory tests) and the application of Westgard multirules to calculate LDL-C (and other calculated laboratory tests) could increase the reliability of the results of the calculated laboratory tests. Conclusions　Checking the reliability of only the measured tests by internal quality control before reporting patient results may be inadequate. Applying the quality control charts and Westgard multirules to calculate tests as a part of total quality management will increase the reliability of test results.

The study on Acinetobacter baumannii beta-lactamases in four hospitals of Shanghai

DU Kun;YING Chunmei;WANG Yaping;YANG Haihui;SUN Jingyong;ZHANG Wenyan;HUA Ling;YU Jiaping

2012, 27(2):  103-109. 

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Objective　To understand the resistance to 13 antibiotics and beta-lactamase genes in Acinetobacter baumannii in Shanghai 4 hospitals in 2010, and investigate the epidemic types, so as to provide the reference for rational use of antibiotics and control of nosocomial infections. Methods　The 204 isolates of Acinetobacter baumannii were collected from clinical specimens of 4 hospitals. Agar dilution was performed to determine the minimum inhibitory concentrations (MIC) to 13 antibiotics. Three dimensional extract test and ethylene diamine tetraacetic acid (EDTA) disc were carried out to screen AmpC enzyme and metal enzyme， respectively. OXA-23，OXA-24，OXA-51，OXA-58，ampC，IMP-1，IMP-4 and VIM-2 coding genes were amplified by polymerase chain reaction (PCR). Results　The resistance rates of these strains to ciprofloxacin，piperacillintazobactam，cefoxitin，sulfamethoxazole and cefoperazone were higher than 90%. The resistance rates of strains to levofloxacin and polymyxin B were relatively low. The resistance rates of the hospitals in Pudong to meropenem， levofloxacin and polymyxin B were higher than those of the hospitals in Puxi. The results of the three dimensional extract test showed that the positive rate of Gongli Hospital was the highest (84.6%)， and the positive rate of Ruijin Hospital was the lowest (42.3%). The results of metal enzyme phenotype testing showed that Gongli Hospital and Renji Hospital(West) did not detect the positive strains of metal enzyme phenotype， in the other 3 hospitals, the highest positive rate (27.3%) was detected in East Hospital，and the positive rate of Ruijin Hospital was the lowest (7.7%). The results of PCR amplification showed that the positive rate of Pudong hospitals was higher than that of Puxi hospitals for OXA-23 and ampC. OXA-51 were all positive in all strains，and OXA-24，OXA-58 and IMP-1 were all negative. IMP-4 and VIM-2 were detected at Renji Hospital(East) and East Hospital，while they were not detected in Gongli Hospital， Ruijin Hospital and Renji Hospital(West). Conclusions　OXA-51 is detected in the isolates of Acinetobacter baumannii， and there is slight difference between different hospitals in the mechanism of Acinetobacter baumannii beta-lactamases.

Detection and analysis of the penicillinbinding protein 4 in the AmpC beta-lactamase producing Escherichia coli isolates

WANG Xinhui;JIANG Yanqun

2012, 27(2):  110-113. 

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Objective　To detect the mRNA expression level of the nonessential penicillinbinding protein 4 (PBP4)dacB gene in AmpC beta-lactamase producing Escherichia coli isolates，and investigate the effect of PBP4 in the resistant mechanism of AmpC betalactamase producing gramnegative isolates. Methods　A total of 34 AmpC betalactamase producing Escherichia coli isolates were collected in Shanghai Sixth People′s Hospital from 2003 to 2010.The polymerase chain reaction(PCR) was used for the amplification of dacB gene and ampC gene, and the realtime quantitation PCR was used for the detection of the mRNA expression level of dacB. The isolates were classified into 2 groups: the high expression level group and the low expression level group. Real-time quantitation PCR was used for the detection of the mRNA expression level of ampC. The broth microdilution method was used for the detection of sensitivity. Results　Among the 34 Escherichia coli，26 (76.47%) of 34 isolates had mRNA overexpression level of dacB，and the mRNA of ampC in the high expression level group was higher than that in the low expression level group(P<0.05). Conclusions　The overexpression of PBP4 may be helpful to introduce highlevel resistance by triggering the overexpression of AmpC beta-lactamase among clinical isolates of Escherichia coli.

Analysis of clindamycininduced resistance by erythromycin among 146 strains of Staphylococcus aureus

QIAO Yun;CHEN Junhao;LUO Yuntao;ZHAO Yingmei;ZHANG Jue

2012, 27(2):  114-117. 

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Objective　To investigate the resistance of Staphylococcus aureus(SA) to erythromycin and clindamycin， and to detect the incidence of clindamycininduced resistance by erythromycin and the induction of resistance genes. Methods　The disk diffusion method recommended by the standards of Clinical and Laboratory Standards Institute (CLSI) was used，and cefoxitin disk diffusion test was used for the detection of meticillinresistant Staphylococcus aureus (MRSA). The inducible resistance phenotype of erythromycin to clindamycin was analyzed by clindamycin and erythromycin doubledisk diffusion method (D test)， and the resistant gene was detected by polymerase chain reaction(PCR). Results　In 146 strains of SA， MRSA accounted for 57.5%. SA resistant to both erythromycin and clindamycin were 82 strains， accounted for 56.2%.　The erythromycin resistant and clindamycin susceptible or intermediate strains were 34 strains， which D test positive were 26 strains ，the percentage for inducible resistance of erythromycin to clindamycin was 76.5%.The positive rates of D test were 80.0% and 71.4% in erythromycin resistant and clindamycin susceptible or intermediate MRSA and methicillinsensitive Staphylococcus aureus(MSSA). The predominant gene for clindamycin resistance was erm. The predominant gene for constitutive resistance to clindamycin was ermA. The predominant gene for inducible resistance to clindamycin was ermC. Conclusions　The detection of inducible clindamycin resistance in SA should be paid attention in clinical microbiology laboratories in order to guide physicians to select antimicrobial agents correctly such as macrolides and lincosamides.

The change of serum cystatin C level in patients with liver cirrhosis and primary liver carcinoma and its significance

WANG Kun;FANG Meng;ZHAO Lin;CAI Meilin;GAO Chunfang

2012, 27(2):  118-121. 

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Objective　To investigate the change and clinical significance of serum cystatin C (Cys C) level in patients with liver cirrhosis and primary liver carcinoma (PLC). Methods　Serum Cys C levels were detected in 90 cases of liver cirrhosis， 153 cases of PLC and 95 cases of benign liver disease(liver hemangioma and hepatic cyst) as controls by latex particle enhanced immunoturbidimetry， while serum creatinine (SCr) and urea were detected by enzymic method. The differences of serum Cys C， SCr and urea levels and their relationship were analyzed between the groups. The Cys C, SCr and urea levels were analyzed according to the liver function ChildPugh grade. Results　Serum Cys C level was significantly higher in liver cirrhosis group ［(1.04±0.24) mg/L］ and PLC group ［(0.98±0.28) mg/L］ than that in control group ［(0.78±0.18) mg/L］， (P<0.001)， and the Cys C level in liver cirrhosis group was higher than that in PLC group (P<0.05). Serum SCr and urea levels in liver cirrhosis and PLC groups were also significantly higher than that in control group (P<0.05)， but there was no significant difference between liver cirrhosis and PLC groups. There was significant positive correlation between serum Cys C and SCr levels (liver cirrhosis group: r=0.407, PLC group: r=0.673 and control group: r=0.511, P<0.001). The abnormal rates of Cys C were significantly elevated in both liver cirrhosis and PLC groups than those of SCr and urea (P<0.001). Serum Cys C level was significantly higher in ChildPugh B+C group ［(1.12±0.21) mg/L］ than that in ChildPugh A group ［(0.99±0.25) mg/L］ among the liver cirrhosis group(P<0.05). Conclusions　Serum Cys C increases with the progression of liver disease and severity of liver failure， and it indicates early renal disfunction better than SCr and urea in patients with chronic liver disease.

The observation of imprecision and linearity on detection of pepsinogen Ⅱby latexenhanced immunoturbidimetry assay

GAO Ling;FENG Pinning;YU Xiongwen;YAO Zhenrong;LI Songlin

2012, 27(2):  122-125. 

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Objective　To evaluate primarily the detection of pepsinogen Ⅱ （PGⅡ） by latexenhanced immunoturbidimetry assay, and provide the reference for clinical application. Methods　According to the National Committee for Clinical Laboratory Standards (NCCLS) EP5A and EP10A2 documents, the detection of PGⅡ by latexenhanced immunoturbidimetry assay was evaluated primarily. Results　The withinrun, betweenrun，betweenday and total coefficients of variation （CV） of samples with low concentration of PGⅡ were 2.05%，1.60%，3.92% and 4.70% respectively. The withinrun, betweenrun，betweenday and total CV of samples with high concentration of PGⅡ were 1.70%，1.21%，3.79% and 4.32% respectively.When PGⅡ concentrations were 9.6， 24.7 and 39.8 μg/L，the relative biases were -0.18，-0.47 and -0.39 μg/L respectively. The total imprecisions were 4.98%， 2.39% and 2.71% respectively. There was no statistical significance in total carryover （P>0.05）. The equation of linear regression of PGⅡ was Y =0.975 7X －0.016 8，and the coefficient of determination(R2)= 0.998 7. Conclusions　The latexenhanced immunoturbidimetry assay for the PGⅡ detection with good repeatability meets the clinical application requirements of EP5A document for precision and the requirements of EP10A2 document for the linearity， bias， total imprecision and carryover. It is suitable for the clinical application.

The clinical application of hs-cTnT，cardiac enzyme and electrocardiogram in HFMD of children

2012, 27(2):  126-128. 

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Objective　To investigate the relationship of highsensitivity cardiac troponin T(hs-cTnT)， cardiac enzyme and electrocardiogram with myocardial injury in handfootmouth disease(HFMD) of children. Methods　The levels of hs-cTnT, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), lactate dehydrogenase isoenzyme 1(LD1), creatine kinase (CK) and creatine kinase MB isoenzyme (CK-MB) were determined in 241 children with HFMD and 203 healthy children. Their electrocardiogram was examined. The levels of hscTnT, the levels of cardiac enzymes, the abnormal rates and electrocardiogram abnormal rates were analyzed between the 2 groups. Results　The levels of hs-cTnT and cardiac enzyme, the abnormal rates and the abnormal rates of ST-T， conduction blockade，bearing premature and pyknocardia in HFMD group were significantly higher than those of control group(P<0.01). The abnormal rate of hs-cTnT was significantly higher than those of cardiac enzymes. Conclusions　The levels of hs-cTnT and cardiac enzymes and electrocardiogram may be indicators for the diagnosis of myocardial injury and heart function in children with HFMD. The level of hs-cTnT has better diagnostic value.

The influence of homocysteine on the expressions of ABCA1 and ACAT1 in the formation of THP-1 monocytederived foam cells

MA Linna;LIANG Yu;YU Haijiao;XU Zhifang;WANG Yanhua;JIANG Yideng

2012, 27(2):  129-134. 

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Objective　To investigate the influence of homocysteine(Hcy) on the expressions of ATP-binding cassette transporter A1(ABCA1) and acylcoenzyme A: cholesterol acyltransferase-1 (ACAT1) in the formation of THP-1 monocytederived foam cells. Methods　THP-1 monocytes were cultured with phorbol myristate acetate(PMA) and oxidized low density lipoprotein(ox-LDL) so as to copy foam cell model， and then intervened by 50，100，200 and 500 μmol/L Hcy and 100 μmol/L Hcy+folic acid+vitamin B₁₂(Vit B₁₂) for 72 h. The control group(not intervened by Hcy) was set. The formation of foam cells was analyzed by the oil red O staining. The intracellular total cholesterol(TC)，free cholesterol(FC) and cholesterol ester(CE) of foam cells were measured by enzymatic end point determination in order to observe the effects of Hcy on foam cell CE efflux. Fluorescence quantitative reverse transcription polymerase chain reaction(RT-PCR) detected the expressions of ABCA1 mRNA and ACAT1 mRNA. Western blotting tested the expressions of ABCA1 protein and ACAT1 protein. Results　After the intervention of Hcy， oil red O staining showed that the formation of foam cells was increased significantly， but not in doseeffect relationship. The positive percentage of experimental group (50, 100, 200 and 500 μmol/L Hcy and 100 μmol/L Hcy+folic acid+Vit B₁₂) was higher than that of control group (P<0.05,P<0.01). The 100 μmol/L Hcy group was the most significant one(P<0.01). The outflow of foam intracellular TC，FC and CE was reduced significantly compared with control group(P<0.05), and the 100 μmol/L Hcy group was the most significant one (P<0.01). The 100 μmol/L Hcy+folic acid+Vit B₁₂ group showed that the formation of foam cells was decreased， whereas the cholesterol efflux was increased compared with 100 μmol/L Hcy group. RT-PCR showed that the expression of ABCA1 mRNA was decreased, but ACAT1 mRNA was increased，and the 100 μmol/L Hcy group was the most significant effect one(P<0.01). Western blotting showed that the expressions of ABCA1 protein and ACAT1 protein were consistent with mRNA expression. Conclusions　Hcy reduces the expression of ABCA1，in the contrast，the expression of ACAT1 is increased. Both of them promote the formation of foam cells.

The research of myocardial damage in children with congenital heart diseases before and after paediatric cardiovascular intervention

YAN Guochao;SHAO Yun;WU Yan;QI Guoqing

2012, 27(2):  135-137. 

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Objective　To investigate the myocardial damage in congenital heart diseases after paediatric cardiovascular intervention by the madeinChina occluder through monitoring the changes of heart fatty acidbinding protein (H-FABP) and cardiac troponin I (cTnI) dynamically. Methods　A total of 24 patent ductus arteriosus (PDA) patients, 20 atrial septal defect (ASD) patients and 16 ventricular septal defect (VSD) patients were enrolled, and their serum levels of cTnI and H-FABP were monitored dynamically. Results　The results of serum H-FABP and cTnI concentrations were (1.28±0.57)μg/L and (0.02±0.01)μg /L at preoperative time, respectively. After the operation, they were (8.51±5.47)μg/L and (0.46±0.49)μg/L after (10±5) min， and (2.31±1.73)μg/L and (0.66±0.45)μg/L after 4 h， respectively, and then they were decreased obviously after 24 h with statistical significance (P<0.01). Conclusions　After paediatric cardiovascular intervention, it exists myocardial damage which is related to the kinds of congenital heart diseases. Compared with cTnI, the serum H-FABP is an early and sensitive marker for predicting myocardial damage.It is useful to prevent postoperative complications by monitoring H-FABP and cTnI.

Change and significance of CD3⁺CD(16, 56)⁺ natural killer T cells in peripheral blood of patients with rheumatoid arthritis

YOU Haiyan;RUI Jinbing;JIAO Zhijun;LI Jing;WU Ling;QIU Yingying

2012, 27(2):  138-140. 

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Objective　To investigate the change and significance of CD3⁺CD(16, 56)⁺ natural killer(NK) T cells in peripheral blood of patients with rheumatoid arthritis(RA). Methods　The percentage 　of CD3⁺CD(16, 56)⁺ T cells and the expression of activation marker CD69 on CD3⁺CD(16,56)⁺ T cells in peripheral blood lymphocyte from active and inactive RA patients and healthy subjects as controls were determined by flow cytometry. Results　Compared with healthy controls and inactive RA patients, the active RA patients had a lower percentage of CD3⁺CD(16,56)⁺ NK T cells and downregulated expression of CD69 on CD3⁺CD(16, 56)⁺ NK T cells (P<0.01). The percentage of NK T cells and CD69 expression on CD3⁺CD(16,56)⁺ T cells　had no statistical significance between healthy controls and inactive RA patients (P>0.05). Conclusions　Low percentage of CD3⁺CD(16,56)⁺ NK T cells with downregulated expression of CD69 in peripheral blood may play a potential role in the pathogenesy of RA and be relevant to the activity of RA.

Investigation of HCV co-infection among HIV-1 infected patients in Dali city

ZHANG Haiyan;WANG Wanhai;XIA Xueshan;WANG Yongheng;FENG Yue;SU Tianrong;ZHANG Xiaoyan

2012, 27(2):  141-144. 

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Objective　To investigate the ratio of hepatitis C virus (HCV) coinfection and the impact of HCV co-infection on CD4⁺T cell counts in human immunodeficiency virus 1 (HIV-1)-infected patients. Methods　A crosssectional study was performed among HIV-1infected patients for assessment of HCV co-infection determination with serology and nucleic acid test in Dali Yunnan. Results　Among 526 HIV-1infected patients， the injecting drug users accounted for 94.3%, and the others were infected through sex. The percentage of anti HCVIgG positive was 86.9％(457/526)， and the positive accordant rate of HCV RNA and anti HCV-IgG was 78.3%. However，HCV RNA >1 000 IU/mL was detected in 24 patients out of 69 anti HCV-IgG negative patients. As for HCV nucleic acid test, the detection rate of HCV coinfection increased 4.6% (24/526). The ratio of HCV co-infection was 91.4%. The CD4⁺T cell counts among single HIV-1 infection were significantly higher than those among HCV co-infection. Conclusions　The ratio of HIV-1/HCV infection is high in highrisk areas or population， and the determination of HCV during screening HIV-1 infection may help for the early diagnosis and treatment of HCV and decrease the effect of HIV-1 infection patients.

Clinical significance of hepatitis B virus large envelope protein detection for judging HBV replication

FAN Gongren;LI Juan;WANG Shuai;HU Xueling

2012, 27(2):  145-147. 

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Objective　To investigate the correlation of serum hepatitis B virus (HBV) large envelope protein (LHBs) with HBV infection and replication. Methods　Serum HBV DNA load， LHBs and hepatitis B e antigen (HBeAg) of 282 patients with hepatitis B and 30 healthy controls were detected. LHBs was compared with HBeAg basing on HBV DNA load. Results　Among 107 patients whose serum HBV DNA loads were <10³ copies/mL， 9(8.41%) patients were LHBs positive, and 8(7.48%) patients were HBeAg positive. The linear correlation coefficients of LHBs and HBeAg with the scale of HBV DNA load were 0.972 1 and 0.837 0 respectively(P<0.01, P<0.05). To diagnose HBV infection， the sensitivities， specificities， positive predictive values， negative predictive values and accuracies of LHBs were 92.57%， 82.52%， 77.43%， 59.18% and 97.05%， respectively, and the values of HBeAg were 62.35%， 77.17%， 64.08%， 51.22% and 89.16%， respectively. Conclusions　LHBs is a good index to reflect the situation of HBV replication. The combined determination of LHBs， HBV DNA and HBeAg of hepatitis B patients contributes to the clinical diagnosis， therapeutic effect monitoring and prognosis evaluation.