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Table of Content

    30 August 2014, Volume 29 Issue 8
    Talking about precision again
    FENG Renfeng
    2014, 29(8):  787-793.  DOI: 10.3969/j.issn.1673-8640.2014.08.001
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    Clinical laboratories around the world reporting determination results deeply depend on only once determining for each analyte for each specimen. This approach only occurs in clinical laboratories in the world, it is the main characteristic of clinical laboratory, however, there also are disadvantages. Relative determinations should be performed again when clinicians and patients have doubts about the reports. The re-determination results are consistent with previous reports, which is the best result. To ensure the quality of determination results and meet the requirements of clinic and patients, clinical laboratories must pay full attention to the precision performance of measurement system, as the primary analytical performance of quantitative analysis. Unfortunately, today's clinical laboratories and in vitro diagnostic manufacturers have not done well precision experiments. This paper calls for the careful study of the Clinical and Laboratory Standards Institute (CLSI) EP5 document, and establishes or verifies the precision performance of each analyte measurement system for determining patient specimen, and this is the key to ensure the quality of determination results for clinic and patients. This paper describes the use of chi-square test for standard deviation when verifying the precision performance from manufacturers as well.

    Clinical significance of 1,3-beta-D-glucan and anti-Candida albicans germ tube antibody for the diagnosis of invasive candidiasis
    HE Lizhi, SHI Guomin, HU Fangxing
    2014, 29(8):  794-797.  DOI: 10.3969/j.issn.1673-8640.2014.08.002
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    Objective To investigate the clinical significance to diagnose and monitor invasive candidiasis (IC) using 1,3-beta-D-glucan (BG) and anti-Candida albicans germ tube antibody (CAGTA). Methods The clinical specimens were collected from 26 patients infected IC and 100 patients colonized Candida.BG and CAGTA were detected and monitored dynamically. Sensitivity, specificity, positive and negative predictive values of the detection of BG or CAGTA and the combination detection of BG and CAGTA were analyzed. The relationship between the 2 markers and antifungal therapy was analyzed. Results The sensitivities, specificities, positive and negative predictive values of BG and CAGTA detections were 61.5%,90.0%,61.5%,90.0% and 57.7%,83.0%,46.9%,88.3%, respectively. As the combination detection of BG and CAGTA was performed, the specificity and positive predictive value, each up to 100.0%, were significantly higher than those of individual detections. The BG and CAGTA values in the effective group receiving antifungal therapy showed a gradual decline.The BG and CAGTA values varied with a upward trend in the ineffective group. Conclusions The combination detection of BG and CAGTA can improve specificity and positive predictive value for the diagnosis of IC, and it is very useful for the early diagnosis and therapeutic monitoring of IC.
    Laboratory investigation on the nosocomial infection outbreak of methicillin-resistant Staphylococcus aureus
    XU Weihong, XU Bin, FAN Lieying
    2014, 29(8):  798-801.  DOI: 10.3969/j.issn.1673-8640.2014.08.003
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    Objective Through detecting methicillin-resistant Staphylococcus aureus (MRSA)with mecA gene related hyper-variable region (HVR) genotyping to understand the nosocomial infection outbreak of MRSA. Methods By polymerase chain reaction (PCR), the HVR of MRSA mecA gene from 38 isolates of MRSA was amplified. According to size differences, the amplified fragments were genotyped. Results According to the PCR fragment size, 38 isolates of MRSA were classified into A, B, C and D genotypes respectively, in which C genotype was the most common type (23 isolates, 60.53% ), followed by A genotype (7 isolates, 18.42%), B genotype (3 isolates, 7.89%), D genotype (2 isolates, 5.26%) and no genotype (3 isolates, 7.89%). C genotype distributed in various departments, mainly in cadre department. MRSA showed serious multi-drug resistance. Therefore, the first choice of antibiotic therapy was vancomycin,teicoplanin/dalfopristin and tigecycline. Conclusions There was a spread of nosocomial MRSA cloning in hospital, and it should be paid attention to strengthen the detection and control of nosocomial infection outbreak.
    Research on the clinical significance of serum procalcitonin in predicting bacteremia
    HOU Weiwei, XIAO Qianru, JIANG Lian, WAN Haiying
    2014, 29(8):  802-805.  DOI: 10.3969/j.issn.1673-8640.2014.08.004
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    Objective To investigate the relationship of serum procalcitonin (PCT) and bacteremia,and to evaluate the diagnosis significance of serum PCT to predict bacteremia determined by blood cultures. Methods A total of 1 690 patients undergoing blood cultures and PCT were concurrently enrolled for detecting bacteremia by retrospective analysis. The patients were classified into blood culture positive group(129 cases), blood culture negative group(1 463 cases) and contaminated blood culture group(98 cases). According to the difference of PCT concentration, the blood culture positive group was subclassified into 3 groups, gram-negative bacterium group, gram-positive bacterium group and Candida mycoderma group. The difference of PCT concentration in the blood culture positive group was further analyzed comparatively. Results The concentration of PCT in blood culture positive group was higher than those of blood culture negative group and contaminated blood culture group [medians(quartiles) were 2.62(0.37-12.80), 0.17(0.07-0.62) and 0.20(0.09-0.72) ng/mL, P<0.000 1]. In gram-negative bacterium group, Candida mycoderma group and gram-positive bacterium group, the positive rates of serum PCT were 74.5%, 37.5% and 66.7%, respectively, while the PCT concentrations [medians (quartiles) were 6.24(0.43-16.09), 0.47(0.22-3.18) and 1.09(0.24-4.05) ng/mL. PCT concentration in gram-negative bacterium group was higher than those in gram-positive bacterium group and Candida mycoderma group (P<0.05). Conclusions In addition to other clinical parameters, PCT is a reliable parameter for ruling out blood culture contamination and non-bacterial conditions. PCT is effective as a parameter for predicting early bacteremia, and is able to improve the accuracy of diagnosis and avoid the unnecessary antimicrobial usage. PCT has great clinical significance for the clinical diagnosis and treatment.
    Distribution and drug resistance analysis on 962 cases of urinary culture pathogenic bacteria
    WU Fangfang, XU Wen, YANG Leyuan
    2014, 29(8):  806-808.  DOI: 10.3969/j.issn.1673-8640.2014.08.005
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    Objective To analyze bacterial distribution and drug resistance of urinary tract infection, and to provide the reference for clinical rational use of antimicrobial agents. Methods A retrospective investigation was performed. The isolates from urine specimens were analyzed. Results There were 962 isolates including 701 isolates of gram negative bacilli (72.9%) and 261 isolates of gram positive cocci (27.1%). There were Escherichia coli (429 isolates, 44.6%), following 228 isolates of Enterococcus (23.7%) and 83 isolates of Klebsiella pneumoniae (8.6%). The drug resistance rates of Escherichia coli and Klebsiella pneumoniae to quinolone were 77.9% and 47.0%. The drug resistance rates to cefotaxime were 62.9%and 57.8%. The drug resistance rate of Enterococcus faecium was higher than that of Enterococcus faecalis, and there was no isolate resistant to vancomycin. Conclusions The main pathogenic bacteria of urinary culture are Escherichia coli as the representative of gram negative bacilli. The drug resistances to quinolone and the 3rd and 4th generation cephalosporins are serious.
    The correlation of carotid intima-media thickness with homocysteine, lipoprotein(a)and high-sensitivity C-reactive protein
    WANG Guoqiang, GAO Lili, GUO Lijuan
    2014, 29(8):  809-812.  DOI: 10.3969/j.issn.1673-8640.2014.08.006
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    Objective To investigate the correlation of carotid intima-media thickness(CIMT)with homocysteine(Hcy), lipoprotein(a)[Lp(a)] and high-sensitivity C-reactive protein(hs-CRP). Methods A total of 177 healthy subjects were enrolled and classified into high Hcy group (108 subjects)and normal Hcy group(69 subjects) based on Hcy level. Their Lp(a), hs-CRP and CIMT were determined. The differences of Lp(a), hs-CRP and CIMT between the 2 groups were analyzed comparatively. The correlationship of CIMT with Hcy, Lp(a) and hs-CRP was analyzed. The significance of Hcy, Lp (a) and hs-CRP in the diagnosis of carotid artery intima-media thickness incrassation was evaluated by receiver operating characteristic (ROC) curve. Results The serum levels of hs-CRP and CIMT in high Hcy group were significantly higher than those in normal Hcy group(P=0.000), however there was no significant difference for serum level of Lp(a) between the 2 groups (P=0.217). There was a positive correlation of CIMT with Hcy and hs-CRP (r=0.660 and 0.624, P=0.000). There was no correlation between Lp(a) and CIMT(r=0.122, P=0.316). There was a positive correlation between Hcy and hs-CRP(r=0.597, P=0.000). There was no correlation of Lp(a) with Hcy and hs-CRP(r=0.063, P=0.65; r=0.01, P=0.994). As CIMT ≥1.0 mm as the carotid artery intima-media thickness incrassation upper limit, the areas under ROC curves(AUC) of Hcy, hs-CRP and Lp(a) were 0.869 (P=0.000), 0.872 (P=0.000) and 0.512 (P=0.857). Conclusions The correlation of CIMT with Hcy and hs-CRP is significant, and Hcy and hs-CRP play important roles for carotid artery intima-media thickness incrassation.
    ThestabilityofHbA1cmeasurementbythreedetectionsystemsunderdifferentstorageconditions
    SUOMinghuan, WENDongmei, ZHANGXiuming, ZHOUJiasi, CHENYaqiong, WUJianyang, XUQuanzhong, HUTing, KANLijuan
    2014, 29(8):  813-816.  DOI: 10.3969/j.issn.1673-8640.2014.08.007
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    Objective To investigate the stability differences of glycosylated hemoglobin A1c(HbA1c) measurement by 3 detection systems under different storage conditions. Methods Three whole blood samples anti-coagulated by ethylene diamine tetraacetic acid-K2(EDTA-K2) at 3 HbA1c levels were collected and stored at room temperature(20-25℃), 4℃,-30℃ and -70℃. One aliquot from each temperature was analyzed by each method on day 1, 3, 5, 7, 14, 21, 28, 35, 42, 56 and 84. The 3 detection systems were Bio-Rad variant Ⅱ Turbo HbA1c analyzer (positive ion exchange high performance liquid chromatography, Bio-Rad variant Ⅱ Turbo), Primus Ultra2 HbA1c analyzer (affinity high performance liquid chromatography, Primus Ultra2) and Roche Modular PPI automatic biochemistry analyzer and its reagents (inhibition immunoturbidimetry, Roche Modular PPI). Results The results of samples stored at -70℃ were similar at different days. The coefficient of variation (CV) for Bio-Rad variant ⅡTurbo was 2.12%-2.80%. The CV for Primus Ultra2 was 2.19%-2.71%. The CV for Roche Modular PPI was 2.28%-2.91%. The Bio-Rad variant Ⅱ Turbo showed having stabilities at room temperature for 7 d, 4 ℃ for 14 d and -30℃ for 35 d. The Primus Ultra2 showed having stabilities at room temperature for 14 d, 4℃ for 56 d and -30℃ for 84 d. The Roche Modular PPI showed having stabilities at room temperature for 14 d, 4℃ for 84 d and -30℃ for 84 d. Conclusions The HbA1c measurement is differently detected by different systems under different storage conditions.
    Correlationship research of ischemia modified albumin in patients with early acute myocardial infarction
    WANG Qijun, CHEN Pei, ZENG Qinfei, CHEN Pingping, YING Luman, CAO Jianming, CEN Dong
    2014, 29(8):  817-821.  DOI: 10.3969/j.issn.1673-8640.2014.08.008
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    Objective To investigate the clinical significance of ischemia modified albumin(IMA)in the early diagnosis of acute myocardial infarction(AMI). Methods A total of 126 patients with acute chest pain were enrolled. Through the final diagnosis, 67 cases were AMI(AMI group), while the other 59 cases were non-AMI (NAMI group). Their serum concentrations of IMA, cardiac troponin I(cTnI), myoglobin(MYO) and creatine kinase-MB(CK-MB) were determined respectively within or more than 6 h (7-24 h) after the onset of chest pain. A total of 50 healthy subjects without cardiac disorders were enrolled as control group. The sensitivity and diagnostic effectiveness of IMA in the early diagnosis of AMI were evaluated by receiver operating characteristic(ROC)curve. Results In AMI group, the serum levels of IMA, cTnI, MYO and CK-MB were higher than those in NAMI and control groups(P<0.001), and the serum levels in NAMI group were also higher than those in control group (P<0.001).The area under ROC curve(AUC)of IMA(<6 h) was 0.851[95% confidence interval (CI):0.775-0.926]. At the optimal cut-off of 82.1 U/mL, the sensitivity, specificity, positive predictive value and negative predictive value were 82.2%, 84.9%, 85.9% and 80.6%, respectively. The sensitivity of IMA was higher than that of cTnI(50.7%, P<0.001), MYO(67.1%, P<0.05)and CK-MB(20.9%, P<0.001).The positive detection rate for the combined determination of IMA, cTnI, MYO and CK-MB was 92.5% in the early diagnosis of AMI. Conclusions The determination of IMA among the suspected AMI patients has important significance in the early diagnosis of AMI. The combined determination of cardiac markers can improve the positive detection rate of AMI.
    Clinical research on the correlationship of different cytokines and proteins with pregnancy induced hypertension syndrome
    HAO Dianjin, LI Yazhuo, SUN Xin, LI Hongchen, ZHANG Xiujun
    2014, 29(8):  822-825.  DOI: 10.3969/j.issn.1673-8640.2014.08.009
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    Objective To investigate the clinical significance of serum tumor necrosis factor-alpha(TNF-α), interleukin 12(IL-12), interleukin 4(IL-4), immunoglobulin (Ig)G, IgA, IgM, complement (C)3, C4 and C-reactive protein(CRP)in the diagnosis of pregnancy induced hypertension syndrome and the change regularity in different degrees of pregnancy induced hypertension syndrome. Methods The serum samples were collected from 114 patients with pregnancy induced hypertension syndrome and 93 healthy pregnant women. The levels of TNF-α, IL-12 and IL-4 were determined by enzyme-linked immunosorbent assay(ELISA), the levels of IgG, IgA, IgM, C3, C4 and CRP were determined by immunonephelometry. Results The levels of serum TNF-α, IL-12 and CRP in pregnancy induced hypertension sydrome group were higher significantly than those in healthy pregnant group (P<0.001). The levels of serum IL-4, IgG, IgM, C3 and C4 in pregnancy induced hypertension syndrome group were lower than those in healthy pregnant group (P<0.001). The levels of serum TNF-α, IL-12 and CRP in prophase of heavy degree eclampsia were higher significantly than in prophase of light degree eclampsia (P<0.05, 0.001 and 0.001), and the levels of serum IL-4, IgG, C3 and C4 were lower (P<0.05). There was a positive correlation of serum CRP with IL-12 and TNF-α among pregnancy induced hypertension syndrome, prophase of light degree eclampsia, prophase of heavy degree eclampsia and healthy pregnant groups (P<0.05). There was a negative correlation of serum TNF-α with C3 and C4 among pregnancy induced hepertension sydrome, prophase of light degree eclampsia, prophase of heavy degree eclampsia and healthy pregnant groups, respectively (P<0.05). Conclusions The levels of serum TNF-α, IL-12, IL-4, IgG, IgM, C3, C4 and CRP are different-degree abnormal in pregnancy induced hypertension syndrome group, and the levels of serum IL-12, IL-4, IgG, C3, C4 and CRP reflect the severity degree of pregnancy induced hypertension syndrome, and can be effective markers for judging patient's conditions.
    Confirmation and analysis of the cut-off value in hepatitis C antibody determined by ELISA with receiver operating characteristic curve
    TANG Jing, BAO Jianling, MENG Cunren, ZHANG Zhaoxia
    2014, 29(8):  826-830.  DOI: 10.3969/j.issn.1673-8640.2014.08.010
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    Objective To confirm and analyze the cut-off value in anti-hepatitis C virus (HCV) antibody determined by 2 different kinds of enzyme-linked immunosorbent assay (ELISA) analysis systems with receiver operating characteristic (ROC) curve. Methods A total of 202 sera confirmed by recombinant immunoblot assay (RIBA) were determined by domestic addcare ELISA 1100 automatic analysis system and imported combined TECAN with FAME ELISA analysis system for anti-HCV antibody. ROC curve was drawn with absorbance (A) by SPSS 17.0 software, and the optimal cut-off value was obtained. Results According to the results of ROC curve, RIBA as the golden standard, the optimal cut-off values were 0.448 in addcare ELISA 1100 automatic analysis system and 0.406 in TECAN+FAME combined ELISA analysis system. Their sensitivities, specificities, Youden indices and areas under ROC curve were 99.3%, 99.3%; 96.7%, 96.7%; 0.960, 0.960 and 0.998, 0.998. Conclusions The cut-off values are 0.448 and 0.406 in the 2 analysis systems with by ROC curve, and the ambiguous regions are 0.140-0.448 and 0.140-0.406.The 2 ELISA analysis systems can optimize the performance of detection.
    Diagnostic significance on the detections of serum pepsinogens, CEA, CA19-9 and CA72-4 for gastric cancer
    ZHANG Jinfeng
    2014, 29(8):  831-834.  DOI: 10.3969/j.issn.1673-8640.2014.08.011
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    Objective To investigate the diagnostic significance on the detections of serum typeⅠpepsinogen(PGⅠ), typeⅡpepsinogen(PGⅡ),PGⅠ/PGⅡratio, carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 72-4(CA72-4) for gastric cancer. Methods A total of 40 cases diagnosed as gastric cancer by electronic gastroscope were enrolled for gastric cancer group, 40 cases with superficial gastritis or stomach ulcers were as benign gastric disease group, and 40 healthy subjects were as control group. Serum PGⅠ, PGⅡ, PGⅠ/PGⅡratio, CEA, CA19-9 and CA72-4 were determined quantitatively. The results were analyzed comparatively among the 3 groups. Results The serum levels of PGⅠ, PGⅡ, PGⅠ/PGⅡratio,CEA, CA19-9 and CA72-4 in gastric cancer group were significantly different from those in the other 2 groups (P<0.05) .According to the receiver operating characteristics (ROC) curve, the cut-off value of PGⅠwas 54 ng/mL (sensitivity 63.9%, specificity 79.7%, the area under ROC curve 0.851±0.047). The cut-off value of PGⅠ/PGⅡratio was 4.5(sensitivity 75%,specificity 80.6%, the area under ROC curve 0.788±0.056).The cut-off value of CEA was 3.20 ng/mL (sensitivity 56.4%, specificity 76.9%, the area under ROC curve 0.310±0.063). The cut-off value of CA19-9 was 34.05 U/mL (sensitivity 54.6%, specificity 69.2%, the area under ROC curve 0.352±0.065). The cut-off value of CA72-4 was 3.18 IU/mL (sensitivity 53.8%, specificity 79.5%, the area under ROC curve 0.344±0.065).The sensitivity of the combined detections of PGⅠ,PGⅠ/PGⅡratio,CEA, CA19-9 and CA72-4 (89.4%) was significantly higher than those of the individual detections (P<0.05). Conclusions The levels of serum PGⅠ, PGⅠ/PGⅡratio,CEA, CA19-9 and CA72-4 are very valuable in the diagnosis of gastric cancer. The combined detection helps with improving the positive detection rate of gastric cancer.
    Study on the significance of K562 cell ssDNA aptamer detection method for the clinical diagnosis of chronic myeloid leukemia
    ZHA Chengxi, XING Fujun, ZHANG Xueyan, GUO Peng, XI Jing, HAN Yuewu
    2014, 29(8):  835-837.  DOI: 10.3969/j.issn.1673-8640.2014.08.012
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    Objective To evaluate the significance of K562 cell ssDNA aptamer detection method for the clinical diagnosis of chronic myeloid leukemia(CML).Methods A total of 5 mL blood samples of 18 patients with CML, 22 patients with other leukemia and 20 healthy subjects were collected. The granulocytes were separated, and aptamer detection method was established for the determination of fluorescence intensity. The receiver operating characteristics (ROC) curve was drawn. Results The fluorescence intensities were 492.26±41.67 in CML group, 466.86±33.23 in other leukemia group and 469.33±37.13 in healthy control group, and the results showed no statistical significance (P=0.078 and P=0.243). There was no statistical significance between other leukemia group and healthy control group (P=0.835). The area under ROC curve was 0.702, the optimal positive threshold was 475.13, the sensitivity was 83.33%, the specificity was 54.76%, the positive predictive value was 44.11%, and the negative predictive value was 88.46%. Conclusions The aptamer detection method has a low accuracy in the clinical diagnosis of CML, and it has some limitations for clinical application.
    The expression and significance of extracellular ATP in murine acute liver injury model
    HU Meicong, ZOU Lingli, HUANG Baojun, WANG Lei
    2014, 29(8):  838-842.  DOI: 10.3969/j.issn.1673-8640.2014.08.013
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    Objective To observe the expression and significance of extracellular adenosine triphosphate (eATP) in concanavalin A (ConA)-induced murine acute liver injury model. Methods A total of 72 mice were randomly classified into control group (saline, 36 cases) and ConA group (20 mg/kg ConA, 36 cases). The blood specimens and liver tissues were collected at 2, 6, 12, 18, 24 and 48 h after injection. The activities of serum alanine aminotransferase (ALT) were measured by Reitman Frankel assay. Hematoxylin-eosin (HE) dyeing was carried out to assess the pathological change of liver tissue. The levels of eATP in serum were detected by chemiluminescence. Western-blot was employed to detect the expression of purinoceptor P2(P2X7). The contents of serum interleukin 1 beta (IL-1β) were assayed by enzyme-linked immunosorbent assay (ELISA). Results The ConA-induced murine acute liver injury model was constructed successfully. The level of eATP increased at 2 h after ConA injection, and reached peak at 18 h (700 nmol / L). Meanwhile, there expressed P2X7 in liver tissues. Compared with control group, the IL-1β levels in serum of ConA group increased significantly (P<0.01). Conclusions In ConA-induced murine acute liver injury model, eATP releases from the injury liver tissues, and might influence the synthesis and secretion of inflammatory cytokine IL-1β through the P2X7 pathway, eventually aggravating the process of acute liver injury.
    Multicenter comprehensive comparison analysis and assessment of bone marrow cell morphology in children with acute lymphocytic leukemia
    ZHANG Xue, LI Bei, CHEN Zhenping, WU Minyuan, LI Zhigang
    2014, 29(8):  843-847.  DOI: 10.3969/j.issn.1673-8640.2014.08.014
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    Objective Through the cooperation Chinese Children's Leukemia Group (CCLG) members, to compare the diagnosis comprehensive level of bone marrow cell morphology in child with acute lymphocytic leukemia (ALL) in these hospitals, in order to assess and standardize the cell morphology determination method, unify terminology, improve the identification ability of bone marrow cell morphology. Methods A total of 110 children with ALL were enrolled randomly from the hospitals of CCLG. These hospitals provided the bone marrow smear of every child with newly diagnosed, treatment for 15th d, 33rd d and 12 weeks, respectively. Totally, there were 440 samples. These smears were randomly issued to 2 inspectors to reexamine. The review reports and original reports were compared and analyzed by another hematologist. Results Out of these 440 bone marrow smears, the consistent judgment was described in both review reports and original reports in 427 cases(97.0%). Of the other 13 cases(3.0%), the review reports showed the dilution of bone marrow aspiration without the description of bone marrow hyperplasia grade, but the original reports showed good aspiration of bone marrow with bone marrow hypoplasia. Good staining of bone marrow smear was described in both review reports and original reports in 428 cases(97.3%). Light or deep staining was showed in the other 12 cases(2.7%), but in the original reports, they showed good staining. In the procedure of describing the character of bone marrow, both the review and original reports were showed no standard terms with Sino-English language mixing, without standard Chinese and English abbreviation. The conclusions of bone marrow smear in the review and original reports were consistent in 427 cases(97.0%), except for the other 13 cases with objection in the aspiration of bone marrow between the 2 reports. Conclusions The comparison analysis of bone marrow smear in children with ALL in multicenter is a very important attempt and exploration to improve the diagnosis level of bone marrow cell morphology, establishes a standardized cell morphology determination pattern, unify terminology, and improve the report recognition degree.
    Analysis of external quality assessment of Taiwan glucose-6-phosphate dehydrogenase being participated by Fujian Neonatal Screening Center
    CHEN Yao, ZHU Wenbin, ZHOU Jinfu, ZHAO Hong, SU Yueqing, WANG Jing
    2014, 29(8):  848-850.  DOI: 10.3969/j.issn.1673-8640.2014.08.015
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    Objective In order to understand the external quality assessment of Taiwan glucose-6-phosphate dehydrogenase (G6PD), to analyze the results from 2011 to 2012. Methods The results from other laboratories using the same experiment method to deal with the external quality assessment samples from the Preventive Medicine Foundation in Taiwan from 2011 to 2012 (2011: 14 laboratories, 2012: 18 laboratories). The quantitative and qualitative methods were used to describe and analyze the measurement results including 12 batches of 120 samples from 2011 to 2012. Results In the quantitative analysis, 2 statistical methods were used to analyze the results. The acceptable rate of 11 results was>80% by evaluation limit law, and the acceptable rate was>80% by Z-score method. In qualitative analysis, the acceptable rate was 100%. Conclusions In the quantitative analysis, Z-score method even in the measurement of low-density samples also can have a good evaluation ability, and it is a complement to the evaluation limit law.
    Laboratory diagnosis on three cases of imported plasmodium ovale malaria infection
    TIAN Bin, DUAN Jihui, XU Mingzhong, ZHANG Bing, LIAO Yu, SHEN Xiaojun, WEN Lan
    2014, 29(8):  851-855.  DOI: 10.3969/j.issn.1673-8640.2014.08.016
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    Objective To analyze 3 cases of imported malaria infection, in order to reduce the misdiagnosis and missed diagnosis of ovale malaria infection. Methods By morphological test, nested polymerase chain reaction (PCR) and sequence analysis were used to confirm the 3 cases of imported malaria infection. Results The morphological test results showed no plasmodium (laboratory initial inspection), plasmodium ovale mixed infection with plasmodium falciparum and plasmodium ovale. However, plasmodium ovale, plasmodium ovale mixed infection with plasmodium falciparum and plasmodium ovale mixed infection with plasmodium vivax were detected by nested PCR by follow. Conclusions The morphological technique training and the application of molecular biology techniques should be strengthen for imported plasmodium ovale malaria infection, and can reduce the misdiagnosis and missed diagnosis of imported plasmodium ovale malaria infection.
    A case of T cell prolymphocytic leukemia transforming to ALK-negative anaplastic large cell lymphoma
    WANG Cuiling, CHENG Panpan, LI Kaizhi, CHEN Xinke, DOU Cuiyun, LI Ying
    2014, 29(8):  856-859.  DOI: 10.3969/j.issn.1673-8640.2014.08.017
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    Objective To report a case of T cell prolymphocytic leukemia (T-PLL) transforming to anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL, ALK-), and to review the literatures. Methods The MIC criteria was adopted. Morphology included bone marrow smear (wright staining), pleural effusion smear and cell block, lymph node biopsy, cell chemical dyeing. R banding technique was used in cell genetics analysis, and the immuno-phenotype was analyzed by multicolor flow cytometry. Results The patient was onset as T-PLL, and the abnormal phenotypes in the bone marrow were CD2+, CD3+, cCD3+, CD4+, CD7+, CD8-, CD10-, HLA-DR+, cTDT-, TCRα/β+ and CD38, CD5 partly positive. Karyotype analysis showed 46, XX. After 6 months, abnormal phenotypes had been changed into ALCL, and karyotype analysis showed 94, XXX, -X, 1q-x2,+3mar. Conclusions T-PLL can transform into ALCL, ALK- .
    Study on the relationship between biofilm formation and drug resistance of Helicobacter pylori
    HU Binjie, ZHAO Fuju, ZHAO Hu
    2014, 29(8):  865-870.  DOI: 10.3969/j.issn.1673-8640.2014.08.020
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    Biofilm formation plays an important role in gastrointestinal tract recurrent refractory infections caused by Helicobacter pylori. This review discusses the formation and structure, formation kinetics and quorum sensing system of Helicobacter pylori biofilm, in order to describe the recent advances in the research direction of its drug resistance mechanism. There includes 4 theories, osmosis and nutrient limitation, fighting against immune system, horizontal gene transfer and the anomaly expression of efflux pump genes. This review also summarizes the research progress of prevention strategies to Helicobacter pylori biofilm.