Table of Content

25 July 2013, Volume 28 Issue 7

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The role of serum copeptin in the diagnosis and treatment of dilated cardiomyopathy patients with heart failure

YUAN Jinke

2013, 28(7):  563-566.  DOI: 10.3969/j.issn.1673-8640.2013.07.001

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Objective To investigate the relationship between serum copeptin level and the severity of dilated cardiomyopathy (DCM) with heart failure (HF). Methods A total of 40 DCM patients with HF (HF group) were classified into New York Heart Association (NYHA) class Ⅲ group (17 cases) and NYHA class Ⅳ group (23 cases) according to NYHA cardiac function classification. The left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) values were detected. A total of 40 healthy subjects were enrolled as control group. Simultaneously copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were determined. Results The levels of serum copeptin and NT-proBNP in HF group were significantly higher than those in control group (P<0.01), and they increased with the increasing of NYHA classification (P<0.01). There was a significantly positive correlation of copeptin with NT-proBNP and NYHA classification (r=0.71 and 0.62,P<0.01). There was a negative correlation of copeptin with LVEF(r=-0.36,P<0.05). Conclusions The level of copeptin can be used as a parameter for the clinical diagnosis and patient′s condition assessment in DCM patients with HF.

The significance of serum NT-proBNP for the future risk evaluation of major adverse cardiac events in elderly patients with stable coronary artery disease

WU Shuzhi

2013, 28(7):  567-572.  DOI: 10.3969/j.issn.1673-8640.2013.07.002

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Objective To investigate the significance of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP)for the future risk evaluation of major adverse cardiac events (MACE) in elderly patients with stable coronary artery disease (SCAD). Methods A total of 810 elderly patients with SCAD were classified into non-MACE group(468 cases) and MACE group [342 cases, including cardiogenic readmission group (200 cases), nonfatal acute myocardial infarction (AMI) group(61 cases) and death group(81 cases)] according to disease prognosis. The 342 cases of MACE group were classified into the short-term MACE group(180 cases)and the long-term MACE group(162 cases). The serum NT-proBNP levels of 40 healthy controls and 810 elderly patients with SCAD, which were followed up in the third month, in the sixth month and in the twelfth month, were determined by bi-directional lateral flow immunoassay. The results were analyzed statistically. The MACE were followed up and observed for an average of 24 months. Results The serum NT-proBNP levels at initial admission in the MACE group and non-MACE group were significantly higher than those in the control group(P<0.01),the serum NT-proBNP levels at initial admission in the MACE group were significantly higher than those in the non-MACE group (P<0.01), the serum NT-proBNP levels at initial admission in the short-term MACE group were significantly higher than those in the long-term MACE group (P<0.05), and the serum NT-proBNP level at initial admission in the death group and nonfatal AMI group were significantly higher than those in the cardiogenic readmission group (P<0.05). The serum NT-proBNP levels at initial admission were negatively correlated with the interval time of the patients with readmission and AMI [r=-0.359(P=0.000),r=-0.458(P=0.026)]. The serum NT-proBNP level was higher,and the incidence rates of MACE were higher. The incidence rates of MACE in different serum NT-proBNP level groups were significantly different (P<0.01), except the NT-proBNP>6 000 ng/L group. Before MACE, the top value of serum NT-proBNP in the MACE group was significantly higher than that in the non-MACE group, and the top value of serum NT-proBNP in the death group was significantly higher than that in the other groups (P<0.05, P<0.01). In the third, sixth and twelfth months of follow-up period, the serum NT-proBNP levels in the MACE group were significantly higher than those at initial admission(P<0.01). The serum NT-proBNP levels in the non-MACE group were significantly lower than those at initial admission(P<0.01), and were significantly lower than those in MACE group(P<0.01). Kaplan-Meier curve showed that the survival rate with different serum NT-proBNP levels had statistical significance (P<0.01). The death group with various diseases had no statistical significance for the serum NT-proBNP levels (P>0.05). Conclusions The incidence rate of MACE and the interval time of the MACE in elderly patients with SCAD are closely correlated with the serum NT-proBNP level at initial admission and with the changes of serum NT-proBNP levels and the top value of serum NT-proBNP in the follow-up period. The serum NT-proBNP determination for the MACE risk evaluation in elderly patients with SCAD has an important prognostic significance.

Investigation of the reference intervals of serum cardiac marker in healthy subjects

HU Xiaobin,LU Xinmin,YU Xiao, XIANG Xiaojie

2013, 28(7):  573-576.  DOI: 10.3969/j.issn.1673-8640.2013.07.003

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Objective To establish the reference intervals of serum cardiac marker high sensitivity cardiac troponin T (hs-cTnT) and creatine kinase isoenzyme (CK-MB) mass by age and sex in healthy subjects. Methods A total of 5 172 healthy subjects were enrolled and classified into 19 groups (＜28 d, 29 d-＜2 months, 2-＜3 months, 3-＜4 months, 4-＜5 months, 5-＜7 months, 7-＜10 months, 10 months-＜1 year old, 1-2 years old, 3-4 years old, 5-9 years old, 10-19 years old, 20-29 years old, 30-39 years old, 40-49 years old, 50-59 years old, 60-69 years old, 70-79 years old and ＞80 years old) according to age, and hs-cTnT and CK-MB mass were detected by Roche E411 electrochemiluminescence analyzer. The results were analyzed statistically. Results The hs-cTnT levels in the neonatal serum were high,the medians (males: 61.48 pg/mL and females: 68.27 pg/mL)decreased gradually with age and reached the lowest point in the 10-30 years old, and then gradually increased with age. There were statistical significance between males and females in the 20-28 years old (P<0.05). The CK-MB mass in the neonatal serum was the highest and decreased with age, and the lowest point appeared later than the hs-cTnT. Conclusions The hs-cTnT and CK-MB mass in healthy subjects of different age and sex are different. The levels of foreign healthy subjects provided by Roche are not applied. Laboratories should establish the reference intervals according to different age and sex.

The dynamic observation of vascular endothelial growth factor in type 2 diabetes mellitus patients during glucose tolerance test

ZHANG Li,GE Caibao,HUANG Zhongwei

2013, 28(7):  577-580.  DOI: 10.3969/j.issn.1673-8640.2013.07.004

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Objective To study the dynamic change of vascular endothelial growth factor (VEGF) in type 2 diabetes mellitus (T2DM) patients during oral glucose (GLU) tolerance test(OGTT). Methods OGTT was performed in T2DM patients and healthy controls. The GLU, insulin (INS), VEGF concentrations in different times were determined. The secretion regularity of VEGF and INS was analyzed. Results VEGF secretion did not change significantly in control group for OGTT(P>0.05). The VEGF in T2DM group at 30, 60 and 120 min decreased more significantly comparing to the VEGF at fasting (P<0.05 or 0.01). The VEGF at 180 min and fasting had no significant difference (P>0.05). The INS at 30, 60, 120 and 180 min in T2DM group had significant difference with that at fasting (P<0.05). The highest value of INS in control group was higher than that in T2DM group (P<0.05). Conclusions The cell disfunction of beta cells, VEGF-secreting cells and other cells exists in T2DM.

Research on the influence of rude rhubarb on serum IL-10 and IL-18 levels in patients with severe acute pancreatitis

YU Xiuwen,WU Sufen

2013, 28(7):  581-584.  DOI: 10.3969/j.issn.1673-8640.2013.07.005

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Objective To research the influence of rude rhubarb on serum interleukin 10 (IL-10) and interleukin 18 (IL-18) levels in patients with severe acute pancreatitis (SAP). Methods SAP patients were classified into group A(22 patients) and group B (36 patients) randomly.The patients in group A were given comprehensive treatment.On the basis of comprehensive treatment,the patients in group B were given rude rhubarb by nasojejunal feeding. The serum levels of IL-10 and IL-18 in the 2 groups were detected by enzyme-linked immunosorbert assay (ELISA) at different intervals (0 d, 7 d and 14 d). The sera of healthy subjects were as controls. Results On 0 d, the serum levels of IL-18 in A and B groups were higher than those in the control group (P<0.01), and the serum levels of IL-10 in A and B groups were also higher than those in the control group (P<0.05). However, the serum levels of IL-18 and IL-10 between A and B groups had no statistical significance (P>0.05). On 7 d,the serum levels of IL-18 in A and B groups decreased compared with those on 0 d, especially in group B, and there were statistical significances between A and B groups (P<0.01). On 7 d,the serum levels of IL-10 in A group didn′t change obviously compared with those on 0 d, but the serum levels of IL-10 in B group significantly increased compared with those on 0 d (P<0.01) .On 14 d, the serum levels of IL-18 in A and B groups decreased compared with those on 7 d with no statistical significance (P>0.05), but the levels of IL-18 between A and B groups showed significant differences(P<0.01). On 14 d, the serum levels of IL-10 in A and B groups increased compared with those on 7 d with no statistical significance (P>0.05), but the levels of IL-10 between A and B groups showed significant differences (P<0.05). The total effective rate in B group after administration of rude rhubarb was higher than that in A group (P<0.05). IL-18 and blood amylases were positively correlated (r_A=0.55,P<0.05;r_B=0.81,P<0.01), and IL-18 and urine amylases were positively correlated (r_A=0.51,P<0.05;r_B=0.79,P<0.01). There was negative correlation between IL-10 and blood amylases(r_A=-0.46,P<0.05;r_B=-0.72,P<0.01), and urine amylases(r_A=-0.44,P<0.05;r_B=-0.63,P<0.01)in A and B groups. Conclusions The administration of rude rhubarb can effectively reverse SAP by regulating the serum levels of IL-10 and IL-18.

The adjustment and validation of the Q-flags positive alarm threshold values in Sysmex XE-2100

WU Junlu, JIANG Hua, DAI Yan, LI Dong, WAN Haiying

2013, 28(7):  585-589.  DOI: 10.3969/j.issn.1673-8640.2013.07.006

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Objective To improve the work efficiency and ensure the accuracy of the blood test through establishing an appropriate standard of microscopic examination based on setting up reasonable threshold values to suspicious alarm informations (Q-flags) in Sysmex XE-2100 automatic hematology analyzer. Methods A total of 4 500 specimens from the out-patient and emergency departments and the in-patient department during March 2011 to March 2012 underwent the measurement by Sysmex XE-2100 with blood slide, subsequent staining and manual microscopic examination. The positive standard was set up as follows: blast cell ≥1%,promyelocyte and myelocyte ≥ 1%, metamyelocyte > 2%,stab granulocyte > 5%,atypical lymphocyte > 5% and nucleated erythrocyte ≥ 1%. According to these positive standards, the threshold valus of the main parameters in the Q-flags were redefined. Finally, 1 400 specimens were measured to verify the reliability of the newly established cut-off value. Results (1) Threshold values before/after amendment were: blast cell 100/130, immature granulocyte 100/150, left shift 100/160, atypical lymphocyte 100/180, nucleated erythrocyte 100/90 and abnormal/blast lymphocyte 100/200. (2) False positive rates (%) before/after amendment were: 61.05/50.15, 56.36/35.60, 44.34/14.10, 62.12/32.20, 36.18/40.61 and 62.96/26.30. Real negative rates (%) before/after amendment were: 38.95/49.85, 43.64/64.36, 55.66/85.90, 37.88/67.80, 63.82/59.39 and 37.04/73.70. Total coincidence rates(%) before/after amendment were : 47.75/56.42, 57.00/71.83, 73.44/89.67, 45.33/71.33, 80.17/79.17 and 43.33/76.00. The alarm rate decreased by 14.67%. (3) There were no initial leukemic cells omitted in the validation test. Conclusions (1) Amending reasonable threshold values of Q-flags in Sysmex XE-2100 can effectively filter out the truly abnormal samples and ensure the accuracy of blood test results. The selected and targeted microscopic examination of the smeared blood specimen can greatly improve work efficiency. (2) The threshold values of the Q-flags in automatic blood cell analysis system should be revised according to the practical situation for each laboratory. Original factory value cannot be directly used.

Correlation investigation of anti-sperm antibodies and sperm morphology

YANG Dagan,Li Junxia,YAO Dongying, SHEN Naixian

2013, 28(7):  590-594.  DOI: 10.3969/j.issn.1673-8640.2013.07.007

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Objective To investigate the influence of anti-sperm antibodies (AsAb) on sperm morphology. Methods A total of 51 AsAb positive patients,40 control patients and 47 healthy controls were enrolled. The sperm morphology was evaluated according to World Health Organization (WHO) sperm morphology classification standards by Diff-Quik staining method. The abnormal sperm index (TZI) and sperm deformity index (SDI) were calculated. Results In the AsAb positive patients, the percentages of abnormal morphology (%), cone-shaped head (%), amorphous head (%) and middle neck thickening sperms (%) were 80.2?7.7, 6.3?5.5, 11.0?7.4 and 21.9?9.0, respectively. In the control patients, these percentages were 71.6?5.8, 4.2?4.5, 11.1?4.8 and 16.0?6.9, respectively. In the healthy controls, these percentages were 70.1?6.4, 3.5?4.6, 8.4?4.3 and 16.2?6.9, respectively. There were statistical significances between the 3 groups as to the above mentioned parameters (F values were 28.732, 3.867, 3.282 and 4.893, P<0.05 or P<0.01).The TZI and SDI were 1.306?0.123 and 1.057?0.180 in the AsAb positive patients, 1.255?0.096 and 0.901?0.119 in the control patients, and 1.257?0.098 and 0.882?0.121 in the healthy controls, respectively. There were statistical significances between the 3 groups (F values were 3.088 and 19.115, P<0.05 or P<0.01). Conclusions The positivity of AsAb is one of the reasons for the increasing of abnormal sperm morphology. Abnormal sperm morphology has mainly cone-shaped head, amorphous head and middle neck thickening sperms.

Analysis of clinical and cell morphology features in 106 patients with metastatic carcinoma of bone marrow

CHEN Pu,WANG Beili, GUO Wei,PAN Baishen

2013, 28(7):  595-598.  DOI: 10.3969/j.issn.1673-8640.2013.07.008

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Objective To investigate the clinical and cell morphology features of metastatic carcinoma of bone marrow. Methods A total of 106 patients with metastatic carcinoma of bone marrow diagnosed were enrolled. The bone marrow and peripheral blood smear cytological characteristics, blood biochemical parameters and clinical manifestations were retrospectively analyzed. Results Osteodynia was the most common symptom. Hematological abnormalities included anemia and thrombocytopenia. The presences of immature erythrocyte and immature granulocyte in peripheral blood smear were demonstrated in 74% of the patients, and 46% of the patients had a dry pumping phenomenon undergoing bone marrow puncture. Metastatic carcinoma cells could be found as a single or formed group or cluster in the bone marrow smears in all 106 patients.Serum alkaline phosphatase and lactate dehydrogenase levels increased in 67% and 69% of the patients, respectively.Carcinomas of unknown origin accounted for 47%,followed by gastric cancer (14%),breast cancer (11%) and prostate cancer (9%). Conclusions The possibility of metastatic carcinoma of bone marrow should be considered, if the symptoms include unexplained anemia,fever,hemorrhage and osteodynia,with increasing alkaline phosphatase and lactate dehydrogenase,the presences of immature erythrocyte and immature granulocyte in peripheral blood smear. The bone marrow puncture is a simple and valuable method for the diagnosis of metastatic carcinoma of bone marrow.

An epidemiological study of pathogens in children with acute respiratory infection of Changzhou region

JI Yun, WANG Yuyue, SHI Weifeng,SHEN Li

2013, 28(7):  599-601.  DOI: 10.3969/j.issn.1673-8640.2013.07.009

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Objective To investigate the pathogens in children with acute respiratory infection (ARI) and epidemiological characteristics in Changzhou region. Methods The sera were collected from 2 259 children with ARI, and IgM antibodies against 9 kinds of pathogenic microorganisms, including Iegionella pneumophila type 1 (LP-1), mycoplasma pneumonia (MP), Q fever rickettsia (QFR), chlamydia pneumonia (CP), adenovirus (ADV), respiratory syncytial virus (RSV), influenza A virus (FluA), influenza B virus (FluB) and parainfluenza virus (PIV), were detected by indirect immuno-fluorescence assay. The results were analyzed statistically. Results Among 2 259 children with ARI , 856 cases were detected positively, which accounted for 37.9% . Of the 856 cases, there were 601 cases of infection with unique microorganism (70.2%). MP infection was predominant, and the positive rate was 43.6%. The positive rates of FluB, RSV and PIV were 11.4%, 6.3% and 5.3%, respectively. There were 29.8% (255/856) mixed infection, and the main mixed infection was MP+FluB (8.4%), followed by MP+PIV (5.8%), MP+RSV (2.9%), MP+LP-1 (2.4%) and MP+PIV+RSV (1.4%). Among the 856 positive cases, the percentages of MP were 34.4%, 64.0%, 51.5% and 54.6% respectively in <1 year old, 1- 4 years old, 5-8 years old and > 8 years old groups.The highest positive rate was noted in the 1-4 years old group (χ²=18.127, P<0.01). The positive rates of RSV, FluB and PIV had no significant difference in every age group (P>0.05). The rate of children infected with ARI was higher in autumn and winter, which accounted for 11.8% and 13.6%, respectively. Conclusions MP are major pathogens among children with ARI and complicated with virus infection in Changzhou region. The 1- 4 years old children as susceptible populations occur in the autumn and winter, and the therapy of macrolide antibiotics in combination with ribavirin is effective.

Analysis on the detection situation of 7 common viruses in 2 425 children with respiratory tract infection

ZHANG Xueqing,HU Jun,NING Xiaoxiao,GAO Shufang,WANG Lei

2013, 28(7):  602-605.  DOI: 10.3969/j.issn.1673-8640.2013.07.010

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Objective To analyze the infection situation of 7 common viruses [parainfluenza virus Ⅰ(PIVⅠ),parainfluenza virus Ⅱ(PIVⅡ),parainfluenza virus Ⅲ(PIVⅢ),respiratory syncytial virus (RSV),influenza virus A (IVA),influenza virus B (IVB) and adenovirus (ADV)] among children with acute lower respiratory tract infection. Methods Nasopharyngeal secretion was collected from 2 425 hospitalized children with acute respiratory tract infection,and 7 respiratory viruses were detected to analyze the clinical epidemiological characteristics by age group [1 526 cases of infants(≤3 years old),650 cases of preschools(4-7 years old) and 250 cases of children(≥8 years old)],virus distribution and seasons. Results Among 2 425 children,552 cases were shown to be positive for 7 viruses which included 360 cases of single virus infection (65.22%) and 192 cases of mixed infection(34.78%). The total positive rate was 22.76%. In different age groups,the number of infected infants were 377 cases (68.29%),including 242 cases of single virus infection (43.84%) and 135 cases of mixed infection (24.46%). Among the 7 viruses, the infections were mainly related to PIVⅢ infection with 196 cases (35.51%),followed by RSV infection [183 cases (33.15%)]. In 4 seasons, the positive rates were 17.79%(spring),19.73%(summer),22.37%(autumn) and 31.01%(winter), respectively. The positive rate in winter was the highest. Conclusions PIVⅢ is the major virus in children with respiratory tract infection. The respiratory tract viral infection rate in infants (≤3 years old) is the highest. The respiratory viruses are most prevalent in winter.

Evaluation on the influence factor on pathogen detection of bloodstream infection by BD BACTEC 9240 automated blood culture system

TANG Jin,WANG Jianqiang,CHEN Yu,GAO Feng

2013, 28(7):  606-610.  DOI: 10.3969/j.issn.1673-8640.2013.07.012

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Objective To evaluate the influence factor on pathogen detection of blood stream infection by BD BACTEC 9240 automated blood culture system. Methods The results of BD BACTEC 9240 automated blood culture system was studied retrospectively, and the pathogen detection rate in double sets of blood culture was analyzed. The influences of antibiotic therapeutic concentration and delivery time were evaluated in simulated blood cultures in vitro. Results Double sets of blood culture can increase the detection rate of bloodstream infection. Escherichia coli and Staphylococcus aureus could be detected in therapeutic concentrations of gentamicin, cefotaxime, vancomycin, piperacillin / tazobactam and levofloxacin in simulated blood cultures in vitro, but be not detected by imipenem therapeutic concentration. Streptococcus pneumoniae was inhibited by the selected antibiotic therapeutic concentration. Delivery time would not affect the pathogen detection, but decreased the time to detection(TTD) in blood cultures. Conclusions Double sets of blood culture can increase the detection rate of bloodstream infection. Antibiotics would inhibit some pathogen growth in blood cultures, leading false negative. Delivery time would not affect pathogen detection, but would change TTD. TTD is effected by many factors, could not be a surrogate for the initial bacterial concentration in bloodstream infection.

Evaluation on the analysis performance of high sensitive cardiac troponin I detected by PATHFAST

TANG Hongxia, JIA Kegang, HAN Xuejing, HE Cong, SHANG Ziyi, ZHEN Li

2013, 28(7):  611-617.  DOI: 10.3969/j.issn.1673-8640.2013.07.013

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Objective To establish and evaluate the analysis performance of high sensitive cardiac troponin I (hs-cTnI) detected by PATHFAST chemiluminescence enzyme-immunoassay system.The data included precision, the function sensitivity (FS), the limit of blank(LoB), the limit of detection(LoD), the limit of quantity(LoQ), the low-limit of detection(LLD), the biological limit of detection(BLD) and the linearity range, and the biology reference intervals offered by manufactures were verified. Methods PATHFAST was performed to detect blank samples and series low-concentration samples of hs-cTnI according to the document of Clinical and Laboratory Standards Institute (CLSI) EP17-A and EP5-A2.The corresponding statistical method was used to define the LoB,LoD, LoQ and the linearity range of hs-cTnI in plasma in accordance with the distribution of the data. Simultaneously, the LLD, BLD and FS of hs-cTnI were established by traditional method. According to National Committee for Clinical Laboratory Standards (NCCLS) C28-A2 recommendation method and the laboratory standard operation procedure (SOP), the biology reference interval was verified. Results By PATHFAST, the within-run and between-run coefficients of variation (CV) were 4.70％ and 5.05％ in high-concentration of hs-cTnI (2.65 ng/mL), were 5.16％ and 5.23％ in middle-concentration of hs-cTnI (0.65 ng/mL), and were 5.30％and 6.07％ in low-concentration of hs-cTnI (0.025 ng/mL). According to the document of CLSI EP17-A, the LoB was 0.001 ng/mL, LoD was 0.008 ng/mL, and LoQ was 0.008 ng/mL. The LLD was 0.001 ng/mL,BLD was 0.002-0.004 ng/mL, and FS was 0.019 8 ng/mL by traditional method. The equation of linearity range of the expectant value and detected value was Y＝1.015X＋0.152,r²＝0.993.The results of 95% samples were within the biology reference intervals offered by manufactures. Conclusions The imprecision is higher than the value offered by manufactures. FS is basically consistent with the value offered by manufactures. The LoB and LLD established by the 2 methods are same. The biology reference interval being used is suitable for the laboratories.

Improvement of G banding technique for chromosome of peripheral blood lymphocytes

MO Fengming,YANG Lihua,ZHANG Lu

2013, 28(7):  618-620.  DOI: 10.3969/j.issn.1673-8640.2013.07.014

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Objective To investigate the improvement of Giemsa banding technique (G banding technique) for chromosome of peripheral blood lymphocytes, and improve the effects of G banding, save time and further improve the efficiency in the diagnosis of chromosome. Methods For 250 suspected patients, cultivation and smear production of peripheral blood lymphocytes were carried out by routine method. Peripheral blood lymphocytes were digested in 0.05% trypsin working solution for 20s, and stained by Giemsa. The results were compared with the routine banding technique digested in 0.025% trypsin working solution for 5-6 min. Results Specimen by improved method presented clear band and repeated prominent shade band, with 98% of pass and 72.8% of optimal ratio, while the routine method achieved 98% of pass and 44.8% of optimal ratio. Two methods had statistical significance in optimal ratio (P<0.01). Conclusions The application of improved technique not only shortens time for smear production of chromosome and achieves optimal effects, but also saves time for staffs, and shows results as soon as possible, improving efficiency in clinical diagnosis of chromosome diseases. Therefore, this improved method is worthy of publicity.

Application evaluation of ERIC-PCR on genotyping of Acinetobacter baumannii

LI Yongli,YING Chunmei,CHEN Yisheng

2013, 28(7):  621-624.  DOI: 10.3969/j.issn.1673-8640.2013.07.015

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Objective To investigate the gene homology of Acinetobacter baumannii clinical isolates in Renji Hospital and to demonstrate the role of enterobacterial repetitive intergenic consensus (ERIC)-polymerase chain reaction (PCR) on genotyping of Acinetobacter baumannii. Methods The minimum inhibitory concentrations (MIC) of common clinical antibiotics against 81 isolates of Acinetobacter baumannii were determined by agar dilution method. ERIC-PCR was used to type 81 isolates of Acinetobacter baumannii. Pulsed-field gel electrophoresis (PFGE) as reference standard was used to further type 43 imipenem-resistant Acinetobacter baumannii. The practicability of ERIC-PCR was verified. Results The 81 isolates of Acinetobacter baumannii were commonly resistant to 13 antibiotics. The lowest resistant rate was 30.9% for polymyxin, the second was 53.1% for imipenem, and the others were all >60%. The 81 isolates of Acinetobacter baumannii were classified into 6 types by ERIC-PCR, named genotype A, B, C, D, E and F. There mainly were A, B and C genotypes. The 43 imipenem-resistant Acinetobacter baumannii belonged to 3 genotypes, including genotype A had 41 isolates (29 isolates of type A1 and 12 isolates of type A2), genotype B had 1 isolate, and genotype C had 1 isolate. There mainly were 5 PFGE pulsotypes for the 43 isolates, pulsotype A had 34 isolates (31 isolates of type A1 and 3 isolates of type A2), pulsotype B had 6 isolates, and C, D and E types had 1 isolate for each. Conclusions There has been clonal spread of Acinetobacter baumannii among patients in the hospital, which mainly were imipenem-resistant Acinetobacter baumannii. The ERIC-PCR is a useful and expeditious method for genotyping of Acinetobacter baumannii, and the results are correlated with those of PFGE.

The study on new statistical method for the data of external quality assessment in routine chemistry items

ZHAO Haijian,ZHANG Chuanbao, HE Falin, MA Rong, WANG Jing, ZHANG Jiangtao,WANG Zhiguo

2013, 28(7):  625-628.  DOI: 10.3969/j.issn.1673-8640.2013.07.016

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Objective To study a new statistical method for the data of external quality assessment in quantitative determination items. Methods The results of Ministry of Health National Center for Clinical Laboratory external quality assessment for routine chemistry items 2011 were collected. The data were analyzed by a new statistical method. The standard deviation, the traditional Z-score and robust Z-score were added, and the relative difference with the median was added and expressed as the percentage of the allowed difference. The multiple results were plotted on a standardized chart. Results The traditional and robust Z-scores can reflect the consistency of results. The percentage of relative difference D% was used to replace the existing deviation (D%) or bias (%). In addition, it is helpful to compare directly by plotting multiple results in one chart, demonstrating the comparability for each external quality assessment result in the standardization way. Conclusions It is more scientific and appropriate to use the new statistical method for the data of external quality assessment, as it is also helpful for the external quality assessment and continual quality improvement in participating laboratories.

Report on a case of panmyelosis

SONG Jun,YUAN Ye,SHI Min,HU Rui, YANG Hongle, GAO Zhanxi

2013, 28(7):  629-633.  DOI: 10.3969/j.issn.1673-8640.2013.07.017

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Objective To analyze the characteristic of laboratory examination and clinical diagnosis for improving the recognization of panmyelosis. Methods The clinical laboratory data including bone marrow cell morphology, cytochemistry, flow cytometry and bone marrow pathological biopsy in a patient with panmyelosis was reported, and the literatures were reviewed. Results Granular, erythroid and megakaryocytic hyperplasia proliferations, mainly archaeocytes, were showen in bone marrow cell morphology and pathological biopsy. Immunophenotyping of abnormal cells showed in the expressions of CD34, CD117, CD33, CD41, CD61 and GlyA by flow cytometry. Conclusions The diagnosis of panmyelosis is made according to all the results of determinations.