Table of Content

30 June 2016, Volume 31 Issue 6

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Orginal Article

Standardization of glycated hemoglobin A_1c determination and its accuracy （continued）

FENG Renfeng

2016, 31(6):  437-441.  DOI: 10.3969/j.issn.1673-8640.2016.06.001

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Glycated hemoglobin A_1c（HbA_1c） is an important parameter for the diagnosis of diabetes mellitus and monitoring treatment efficiency. After HbA_1c measurand being defined by the International Federation of Clinical Chemistry and Laboratory Medicine（IFCC）,with efforts,the differences are decreasing gradually among clinical laboratories in the world. Although HbA_1c manufacturers introduces their instruments' advantages and clinical significance mainly,instead of weaknesses,clinical laboratories should know instruments' characteristics and disadvantages. Instruments can be used into clinical determinations,only when the analysis performances have been verified and satisfy clinical application. Every laboratory should use 2 different methods,which can identify whether there is abnormal hemoglobin or not. Although HbA_1c can be determined by immunological methods without interference from abnormal hemoglobin,the influence of abnormal hemoglobin has not been defined. In short,clinical laboratories should learn as much information as possible for patients.

Correlation of the single nucleotide polymorphisms of ATM gene with occupational radiation-induced chromosome damage

ZHAO Junyan, NIU Yujie, QIAN Xuelian.

2016, 31(6):  442-448.  DOI: 10.3969/j.issn.1673-8640.2016.06.002

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Objective To study the correlation of the single nucleotide polymorphisms （SNP） of ataxia telangiectasia（AT）-mutated gene（ATM）with occupational radiation-induced chromosome damage,to investigate the molecular mechanism of occupational radiation-induced chromosome damage and the differences of individual radiation sensitivity,and to provide a reference for high-risk population screen. Methods A total of 87 workers being exposed to X-ray,γ-ray and β-ray and suffering from chromosome aberration were enrolled. Applying 1∶1 pair matching case-control design,87 workers with normal chromosome and hemogram as well as similar annual radiation exposure（annual radiation dose≤1 mSv）,same sex and similar age were enrolled as control group. Three SNP sites,rs373759,rs189037 and rs4988044,were selected. SNaPshot technique,which was on the basis of fluorescent labeling single-nucleotide extension（SNE） reaction,was applied to genotyping. Results In rs189037,G>A base transition variation was found. The frequency of GA/AA genotype in chromosome damage group was 81.6%,which was higher than that in control group{64.4%;χ²=5.297,P<0.05;odds ratio（OR）[95% confidence interval（CI）]=2.364（1.136-4.919）}. The frequency of rs189037 A allele in chromosome damage group（53.4%） was higher than that in control group[44.3%;χ²=2.944,P>0.05; OR（95%CI）=0.691（0.453-1.054）]. There was no statistical significance in genotype distribution and allele frequencies of rs373759 and rs4988044 between chromosome damage group and control group（P>0.05）. Conclusions GA/AA genotype in rs189037 increase individual radiation sensitivity. There is no correlation between the SNP of rs373759 and rs4988044 and radiation-induced chromosome damage. Radiation-induced chromosome damage is affected by the SNP of ATM gene.

Changes of serum β₂-MG and LDH in combination therapy of multiple myeloma with honokiol and arsenic trioxide

HE Yali, LIANG Shunrong, FAN Jiaxin

2016, 31(6):  449-452.  DOI: 10.3969/j.issn.1673-8640.2016.06.003

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Objective To investigate the changes of serum beta₂-microglobulin（β₂-MG）and lactate dehydrogenase（LDH） in multiple myeloma（MM） patients before and after the treatment with a combination of honokiol （HNK）and arsenic trioxide（As₂O₃）.Methods A total of 35 patients diagnosed as MM were enrolled. They were treated with As₂O₃ and HNK on the basis of VAD（vincristine+adriamycin+dexamethasone）treatment. The levels of hemoglobin,M protein,β₂-MG and LDH in venous blood and the proportions of plasma cells in bone marrow were determined before and after treatment for 4,8 and 12 weeks. Results Remission rate and control rate increased with treatment time. After treatment for 12 weeks,remission rate and control rate were higher than those after treatment for 4 and 8 weeks（P<0.05）. There was no statistical significance for remission and control rates between 4 and 8 weeks after treatment（P>0.05）. After treatment for 4,8 and 12 weeks,the levels of hemoglobin were higher than that before treatment（P<0.05）,but the levels of M protein,β₂-MG and LDH and the proportions of plasma cells were lower than those before treatment（P<0.05）,and there was statistical significance at different treatment time（P<0.05）. Conclusions The combined treatment with HNK and As₂O₃ on the basis of VAD treatment can decrease the levels of β₂-MG and LDH in MM patients.

The combined determination of procalcitonin,C-reactive protein and white blood cell count for the diagnosis of hospital-acquired bacterial pneumonia in ICU

JIANG Youzhen, LI Shuang, HOU Defeng, CAO Li, ZHANG Li, YANG Jun, HUANG Yuanchen

2016, 31(6):  453-457.  DOI: 10.3969/j.issn.1673-8640.2016.06.004

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Objective To investigate the combined determination of procalcitonin（PCT）,C-reactive protein（CRP） and white blood cell（WBC） count for the early diagnosis and treatment of hospital-acquired bacterial pneumonia （acquired pneumonia） in intensive care unit（ICU）. Methods A total of 69 patients with acquired pneumonia in ICU were enrolled,and 71 patients with non-bacterial pneumonia（pathogens including fungus,mycoplasma,parasite,rickettsia and so on）were enrolled as control group. Sputum PCT,serum PCT,serum CRP and WBC count were determined in admission,after treatment for 2 d,after treatment for 7 d and at the end of treatment,and sputum smear and culture etiology were performed simultaneously. Receiver operating characteristic（ROC） curve was used to evaluate the significance of each parameter for the diagnosis of acquired pneumonia. Results Compared with non-bacterial pneumonia group,serum PCT in acquired pneumonia group increased after treatment for 2 d,CRP increased after treatment for 7 d,WBC count reduced at the end of treatment. There was no statistical significance for the other parameters between 2 groups at different time points（P>0.05）. For acquired pneumonia group in admission and at the end of treatment,WBC count（neutrophil percentage >70% as positive） had statistical significance compared with non-bacterial pneumonia group（P<0.05）. Sputum PCT in acquired pneumonia group had no statistical significance for the 4 time points（P>0.05）,and serum PCT after treatment for 2 d was higher than those in the other time points（P<0.001）. Serum CRP in admission was the highest,with treatment,the concentration decreased,and the difference among the 4 time points were statistically significant（P<0.001）. WBC count was higher in admission than at the other time points（P<0.001）,there was no statistical significance between after treatment for 2 d and 7 d（P>0.05）,and WBC count returned to normal at the end of treatment. In non-bacterial pneumonia group,the difference of sputum and serum PCT at the 4 time points was not statistically significant（P>0.05）,and the changes of serum CRP and WBC count were consistent with those in acquired pneumonia group. The top 3 isolates in acquired pneumonia group were Pseudomonas aeruginosa,Acinetobacter baumannii and Escherichia coli. After treatment for 2 d,serum PCT in patients infected with Escherichia coli was higher than those in patients infected with Pseudomonas aeruginosa and Acinetobacter baumannii（P<0.05）,and WBC count in patients with Escherichia coli was higher than that in patients with Acinetobacter baumannii（P<0.05）. There was no statistical significance among the 3 kinds of isolates for sputum PCT and serum CRP（P>0.05）. The area under ROC curve of serum PCT was 0.921（P<0.05）,with a sensitivity of 87.5% and a specificity of 93.7%. Conclusions Serum PCT in the early diagnosis of acquired pneumonia in ICU has good sensitivity and specificity,and the combined determination of serum PCT,CRP and WBC count is of clinical significance in the diagnosis of acquired pneumonia.

Comparison of serological assay and polymerase chain reaction for the monitoring of acute and chronic cytomegalovirus infections

CHEN Yanwen, HU Yao

2016, 31(6):  458-461.  DOI: 10.3969/j.issn.1673-8640.2016.06.005

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Objective To compare serological assay（chemiluminescence immunoassay） in cytomegalovirus（CMV） antibody determination and real-time fluorescence polymerase chain reaction（PCR） in qualitative CMV DNA determination for the monitoring of acute and chronic CMV infections. Methods A total of 361 patients suspected with CMV infections were analyzed retrospectively. Patients suspected with CMV infections were determined on the bases of nonspecific symptoms,including fever,leukopenia,hyperbilirubinemia and alanine aminotransferase elevation,alone or in combination. All patients were screened for CMV IgM and IgG antibodies and CMV DNA. Results CMV IgM antibody and CMV DNA by the 2 methods were all positive in only 7 patients. A total of 13 patients were positive for CMV IgM antibody and negative for CMV DNA,23 patients were positive for CMV DNA and negative for CMV IgM antibody. There was no consistency between the 2 methods（Kappa=0.229,P<0.05）. Furthermore,327 patients with positive CMV IgG antibody were classified into CMV DNA negative group（300 cases） and CMV DNA positive group（27 cases） according to CMV DNA determination results,and there was no statistical significance for CMV IgG antibody level [medians（quartiles） were 195.24（73.80,250.00） and 221.90（129.60,250.00） AU/mL,P=0.137]. Conclusions Having poor consistency with CMV DNA determination results,serological assay for CMV antibodies is not sensitive enough to diagnose acute CMV infection and cannot be used for monitoring CMV infections during the chronic period. The clinical diagnosis of CMV infections should be evaluated by the combination determination of CMV DNA and CMV antibodies,including the quantitation of CMV IgG.

Correlations of type 2 diabetic nephropathy with FGF-21,adiponectin,islet beta-cell function among elderly patients

SHAO Xiaoqun, CHEN Jie, WANG Shijun, FENG Xuhui

2016, 31(6):  462-466.  DOI: 10.3969/j.issn.1673-8640.2016.06.006

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Objective To investigate the correlations of type 2 diabetic nephropathy with serum fibroblast growth factor 21（FGF-21）,adiponectin,islet beta-cell function（HOMA-β） among elderly patients. Methods A total of 98 elderly patients with type 2 diabetes mellitus were enrolled as research subjects. According to the quantitation results of 24 h urinary protein,they were classified into type 2 diabetic albuminuria group（H1 group,32 cases）,persistent micro-albuminuria group（H2 group,34 cases） and normal albuminuria group（H3 group,32 cases）. Healthy subjects with normal glucose tolerance were enrolled as control group（H0 group,35 cases）. The levels of serum FGF-21 and adiponectin were determined by enzyme-linked immunosorbent assay（ELISA）,and homeostasis model assessment was used to evaluate HOMA-β. The differences among groups were compared. Results In H0 group,low-density lipoprotein cholesterol（LDL-C）,triglyceride（TG） and fasting insulin（FINS） levels were lower than those in the other 3 groups,while high-density lipoprotein cholesterol（HDL-C） levels and HOMA-β were higher than those in the other 3 groups. The systolic blood pressure（SBP） of H1 group was higher than those in the other 3 groups. Fasting plasma glucose（FPG）,FGF-21 and adiponectin levels among 4 groups were compared pairwise,and the differences had statistical significance（P<0.05）. In H1,H2 and H3 groups' pairwise comparisons,there was statistical significance（P<0.05）. Related risk factor analysis showed that disease course,serum FGF-21,adiponectin and HOMA-β levels were independent risk factors for elderly patients with type 2 diabetic nephropathy. Conclusions The levels of FGF-21,adiponectin and HOMA-β are closely related to the degree of albuminuria in elderly patients with type 2 diabetic nephropathy. FGF-21 and adiponectin may play important roles in the occurrence and development of elderly type 2 diabetic nephropathy.

Comparison of minimal residual leukemia immuno-phenotypes at primary diagnosis and after chemotherapy in patients with B-lineage acute lymphoblastic leukemia

WANG Jiying, LIU Yan, SONG Zhen, SHANG Lei, CHEN Xuejing, ZHOU Chunlin, RU Kun, WANG Huijun

2016, 31(6):  467-473.  DOI: 10.3969/j.issn.1673-8640.2016.06.007

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Objective To study the change of leukemia immuno-phenotypes before and after chemotherapy in patients with B-lineage acute lymphoblastic leukemia（B-ALL）,and to provide a reference for determining B-ALL minimal residual disease （MRD）by flow cytometry（FCM）. Methods The antigen positive rate and intensity changes of CD45,CD19,CD10,CD20,CD34,CD38,CD13 and CD33 determined by FCM were analyzed before and after chemotherapy among 226 B-ALL patients. Results The intensity changes from high to low were CD10,CD34,CD38,CD19,CD20 and CD45. The intensity changes of CD10 were significantly higher than those of CD38,CD19,CD20 and CD45（P<0.01）,the intensity changes of CD34 were higher than those of CD19,CD20 and CD45（P<0.01）,and the intensity changes of CD38 were higher than those of CD20 and CD45（P<0.01）. In the 33rd day of chemotherapy,the enhanced proportions of CD34 and CD45 expression were higher than those in the 15th day（P<0.05）. The changes of antigen positive rate from high to low were CD20,CD38,CD34,CD45,CD10 and CD19,and those of CD20 and CD38 were significantly higher than those of CD34,CD45,CD10 and CD19（P<0.01）. In the 33rd day of chemotherapy,the loss proportion of CD38 was higher than that in the 15th day（P<0.01）,and the gain proportion of CD34 was significantly higher than that in the 15th day（P<0.01）. In the 15th day, the loss proportion of CD10 was lower than those in the 33rd day and 48th day（P<0.05）. Most patients after chemotherapy had 1-4 antigens' expression changes. Conclusions After chemotherapy,the proportions of antigen positive rate and intensity changes for immuno-phenotypes are high in B-ALL patients. In the determination of MRD,it should consider phenotypes at primary diagnosis and their changes during chemotherapy.

Expressions of Tim-3 and PD-1 on T cells in patients with recurrent spontaneous abortion

DUAN Zhongliang, SHI Youhao, LI Mingqing, LI Cui

2016, 31(6):  474-478.  DOI: 10.3969/j.issn.1673-8640.2016.06.008

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Objective To investigate the expressions of T cell immunoglobin mucin-3 （Tim-3） and programmed death-1 （PD-1） on T cells in patients with recurrent spontaneous abortion（RSA）,and provide a reference for target treatment. Method The expressions of Tim-3 and PD-1 on T cells were determined by flow cytometry in 22 healthy pregnant women （control group） and 21 patients with RSA. Result The proportion of Tim-3⁺ T cells in RSA group （1.01%±0.64%） was lower than that in control group （1.85%±0.96%）（P<0.01）,and the proportion of PD-1⁺ T cells in RSA group（40.76%±13.76%） was lower than that in control group （54.32%±26.65%）（P<0.05）. The proportion of Tim-3⁺ PD-1⁺ T cells in RSA group（0.59%±0.27%） was lower than that in control group（1.37%±0.85%）（P<0.001）,while the proportions of Tim-3^-PD-1⁺ and Tim-3⁺ PD-1^-T cells（40.17%±13.68% and 0.43%±0.41%） had no statistical significance with those in control group（52.95%±26.28% and 0.48%±0.31%）（P>0.05）. ConclusionsThe expressions of Tim-3⁺CD3⁺,PD-1⁺CD3⁺ and Tim-3⁺ PD-1⁺ T cells are correlated with RSA. They can be potential targets for RSA treatment.

Correlation of Helicobacter pylori virulence genotypes and clinical characteristics

HU Binjie, ZHAO Fuju, WANG Shiwen, XIANG Ping, YANG Changqing, FANG Yi, CHEN Fei, YANG Feng, ZHAO Hu, ZHANG Yanmei

2016, 31(6):  479-485.  DOI: 10.3969/j.issn.1673-8640.2016.06.009

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Objective To study the molecular characteristics of Helicobacter pylori virulence genotypes and the correlation with different Helicobacter pylori-infected gastroduodenal diseases. Methods A total of 514 gastric mucosa biopsy samples were collected.Helicobacter pylori was isolated. Ten kinds of specific probes for Helicobacter pylori virulence genotypes were designed and synthesized,and the specific virulence genes were detected. The correlation of Helicobacter pylori virulence genotypes and clinical characteristics [chronic superficial gastritis,chronic atrophic gastritis and peptic ulcer disease（PUD）] was analyzed. Results A total of 129 isolates of Helicobacter pylori were isolated from 514 gastric mucosa biopsy samples. Helicobacter pylori carried multiple kinds of virulence genotypes,such as cagA,vacA（m1,m2 and s1）,iceA1,iceA2,dupA,luxS and oipA. Genotype vacA s1m2 and the combined genotype iceA1⁺/iceA2⁺ had an increased risk for PUD. Genotype vacA s1m1 was a risk factor for chronic active gastritis,while dupA was closely associated with duodenal ulcer. Conclusions Helicobacter pylori isolated from Shanghai carrys many kinds of virulence genes,iceA1⁺/iceA2⁺ and vacA s1m2 maybe risk factors for PUD,and dupA could be considered as a duodenal ulcer-specific virulence marker.

Molecular epidemiological analysis for pregnant women with syphilis in Zhabei District of Shanghai

WU Qi, WANG Li, JI Lingting, L Yingying

2016, 31(6):  486-490.  DOI: 10.3969/j.issn.1673-8640.2016.06.010

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Objective To evaluate the incidence,maternal-neonatal transmission and genotype of syphilis in pregnant women from Zhabei District,and to investigate the influence of genotype change and specimen on determination results. Methods A total of 3 022 pregnant women were enrolled for syphilis screening. The specimens were collected from whole blood,plasma,ear lobe blood and skin of syphilis-positive patients for genotype determination. Clinical data were collected to evaluate incidence,maternal-neonatal transmission and social factors. Results A total of 41 pregnant women were positive in syphilis screening,and the positive rate was 1.32%. The proportion of maternal-neonatal transmission accounted for 43.9%（18/41）. The predominant type was 14d/f （80.9%,17/21）,followed by 15d/f（4.7%,1/21）,13a/f（4.7%,1/21）,13d/f（4.7%,1/21） and 9o/c（4.7%,1/21）. Genotyping efficiency of skin was the highest,and that of ear lobe blood was lower than that of skin,which were higher than those of whole blood and plasma. Conclusions The incidence of syphilis in pregnant women in Zhabei District is higher than that in Shanghai,and the kinds of genotypes are various. Ear lobe blood is a good choice of specimen for genotyping.

Class Ⅰ integron for diagnosing imipenem resistance of Pseudomonas aeruginosa：a Meta-analysis

HUANG Qiulan, FAN Deping, GAO Shouxia, LIU Hongchou, XUE Nali, NI Yuxing

2016, 31(6):  491-498.  DOI: 10.3969/j.issn.1673-8640.2016.06.011

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Objective To analyze the correlation between Class Ⅰ integron and imipenem resistance of Pseudomonas aeruginosa through Meta-analysis,and evaluate Class Ⅰ integron for diagnosing imipenem resistance of Pseudomonas aeruginosa. Methods The databases,including Chinese Biomedical Literature Database（CBM）,China National Knowledge Infrastructure（CNKI）,WANFANG,Chinese VIP Database（VIP）,PubMed and Embase,were searched from establishment to December 2015 for Class Ⅰ integron,imipenem resistance and Pseudomonas aeruginosa. Datum selection,extraction and assessment were conducted by 2 reviewers independently according to inclusion and exclusion criteria. Meta-analysis was performed by RevMan 5.2 and Meta-Disc 1.4. Results A total of 24 papers were in accordance with inclusion criteria,which included 2 101 isolates of Pseudomonas aeruginosa isolated from clinical specimens. Among them,1 134 isolates （54.0%） were positive for Class Ⅰ integron,while 929 isolates （44.2%） were resistant to imipenem. Meta-analysis showed that Class Ⅰ integron was more common in imipenem-resistant Pseudomonas aeruginosa than in imipenem-sensitive Pseudomonas aeruginosa [odds ratio（OR） was 4.82,95% confidence interval（CI） was 2.68-8.66]. In the determination of Class Ⅰ integron for diagnosing imipenem resistance of Pseudomonas aeruginosa,the sensitivity,specificity,positive likelihood ratio and negative likelihood ratio were 0.73（95%CI was 0.70-0.76）,0.64（95%CI was 0.61-0.66）,1.90（95%CIwas 1.47-2.45） and 0.47（95%CI was 0.35-0.64）,respectively,and the area under summary receiver operating characteristic（SROC） curve（AUC） was 0.749 5. Conclusions Class Ⅰ integron is related to imipenem resistance of Pseudomonas aeruginosa. The determination of Class Ⅰ integron has certain significance in diagnosing imipenem resistance of Pseudomonas aeruginosa. It is suggested to be combined with other clinical methods to improve efficiency.

Epidemiological analysis of respiratory tract viruses among adult patients in Beijing

XU Hongtao, LI Yi, CHEN Dongke, WANG He, AI Xiaoman, CHEN Xue, TAO Fengrong, LAI Huiying, HU Yunjian, ZHANG Xiuzhen

2016, 31(6):  499-502.  DOI: 10.3969/j.issn.1673-8640.2016.06.012

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Objective To investigate the epidemiological characteristics of respiratory tract viruses among adult patients in Beijing. Methods Nasopharyngeal swabs were collected from outpatients and inpatients with acute respiratory tract infections in Beijing Hospital from April 2014 to March 2015. Liquid chip （xTAG RVP） was applied to detect 9 types of respiratory tract viruses（18 subtypes）,and all results were statistically analyzed. Results A total of 191 samples were collected to monitor 9 types of viruses,86 samples were positive,and the positive rate was 45.0%. The positive rates from high to low were as follows：influenza A virus（FluA,26.7% ,51/191）, influenza B virus（FluB,6.8%,13/191）,enterovirus/rhinovirus（E/R,3.7%,7/191）,coronaviridae（Cor,2.6%,5/191）,respiratory syncytial virus（RSV,2.1%,4/191）,human metapneumovirus（hMPV,2.1%,4/191） and parainfluenza virus（PIV,1.0%,2/191）. Adenovirus（AdV） and human bocavirus（HBoV） were not detected. There was no statistical significance for positive rates between inpatient and outpatient groups, female and male groups（P>0.05）. The positive rate of respiratory tract viruses in patients ≤60 years old was significantly higher than that in patients >60 years old（χ²=12.264,P<0.05）. The positive rate of viruses had monthly variation,and it was the highest in January accounting for 45.3%. Conclusions In Beijing,the positive rate of respiratory tract viruses reaches the highest in patients ≤60 years old and in January. FluA and FluB are main pathogens.

Research on 12 traditional Chinese medicine pellets reversing the drug resistance of common bacteria in vitro

PAN Jie, MIAO Xia, LIU Qibo, DENG Limei, NIU Xinyi, LI Aiwen

2016, 31(6):  503-508.  DOI: 10.3969/j.issn.1673-8640.2016.06.013

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Objective To investigate the antimicrobial efficiency of 12 traditional Chinese medicine pellets on 6 drug-resistant bacteria,like penicillin-resistant Streptococcus pneumoniae,meticillin-resistant Staphylococcus aureus,extended-spectrum beta-lactamases（ESBLs）-producing Enterobacteriaceae and so on. Methods The antimicrobial efficiency of 12 traditional Chinese medicine pellets was evaluated by determining minimal inhibitory concentration（MIC）,the validity of reversal drug resistance and the optimal concentration of reversal drug resistance. Results Vancomycin-resistant Enterococcus,ESBLs-producing Enterobacteriaceae and multi-resistant Acinetobacter baumannii were sensitive to gallnut,and penicillin-resistant Streptococcus pneumoniae and erythromycin-resistant hemolytic Streptococcus were sensitive to scutellaria baicalensis. Meticillin-resistant Staphylococcus aureus was sensitive to coptis chinensis. The antimicrobial efficiency of traditional Chinese medicine pellets was consistent with Chinese herb tablets as well as antibiotics（P>0.05）. Conclusions The 12 traditional Chinese medicine pellets are effective to 6 drug-resistant bacteria in different degrees. Traditional Chinese medicine pellets have antimicrobial properties.

Changes of indices for lymphangioleiomyomatosis

ZHAO Xuhong, HUO Meng, YANG Miao, HOU Junlin

2016, 31(6):  509-512.  DOI: 10.3969/j.issn.1673-8640.2016.06.014

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Objective To analyze the indices for lymphangioleiomyomatosis （LAM）,and provide a reference for its diagnosis and treatment. Methods A retrospective analysis was performed for 38 LAM patients. Indices of routine blood tests [white blood cell（WBC）,hemoglobin（Hb） and platelet（PLT）],liver function [alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,total protein（TP） and albumin（Alb）], kidney function [creatinine（Cr）],serum glucose（Glu）,triglyceride（TG）,tumor marker [carbohydrate antigen（CA）125],total complement and blood gas [pH,partial pressure of oxygen（PO₂） and partial pressure of carbon dioxide （PCO₂）] were analyzed. Results In LAM patients,the results of routine blood tests,liver function and kidney function had no significant changes. The results of blood gas showed that LAM patients existed different degrees of acidosis. CA125 of 90.9% LAM patients increased and exceeded the upper limit of reference interval for 3 times to 30 times. Serum total complement of 75.84% LAM patients increased slightly and within 1 time of the upper limit of reference interval. Conclusions CA125 and blood gas results of LAM patients have significant changes.

Thrombelastograms of 398 patients treated with different antiplatelet agents

ZHAO Xuhong, XU Long, HAN Ping, HUA Li, CAI Yuchan, LI Zhi

2016, 31(6):  513-515.  DOI: 10.3969/j.issn.1673-8640.2016.06.015

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Objective To analyze thrombelastograms（TEG） of patients treated with different antiplatelet agents,in order to provide a reference for clinical anticoagulation therapy. Methods The processes of coagulation were determined by TEG@5000 coagulation analyzer among 398 patients treated with different antiplatelet agents,including 259 elderly patients（≥65 years old） and 139 general patients（<65 years old）. Result differences between elderly patients and general patients were analyzed . Three common types of coagulation were analyzed as well. Results The main data of TEG had statistical significance between elderly patients and general patients（P<0.05）. There were 38 patients with hypercoagulability determined by TEG,and they were all elderly patients,including 23 patients with enzymatic hypercoagulability（60.53%）,9 patients with platelet hypercoagulability（23.68％） and 6 patients with enzymatic and platelet hypercoagulability（15.79%）. Conclusions Elderly patients above 65 years old treated with different antiplatelet agents are more likely to have hypercoagulability than other patients. It is essential to analyze the etiology of hypercoagulability in order to optimize clinical anticoagulation therapy and minimize the frequency of thrombosis.

Establishment of ultra performance liquid chromatography-tandem mass spectrometry for the high-throughput determinations for Gaucher disease and Niemann-Pick disease type

A/B ZHAN Xia, GU Xuefan, LIN Na, YE Jun, QIU Wenjuan, HAN Lianshu, ZHANG Huiwen, LIANG Lili

2016, 31(6):  521-526.  DOI: 10.3969/j.issn.1673-8640.2016.06.017

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Objective To establish a method for the determination of the activities of acid-beta-glucocerebrosidase （ABG）and acid sphingomyelinase （ASM） in dried blood spot specimens by ultra performance liquid chromatography-tandem mass spectrometry（UPLC-MS/MS）. Methods The extraction of dried blood spot specimens was incubated with enzyme substrates and internal standards overnight,and the reaction solution was extracted,dried under nitrogen and reconstituted. The concentrations and internal standards were analyzed by UPLC-MS/MS,and the activities of enzymes were calculated. Linearity,precision and accuracy were analyzed. Results The within-run and between-run precisions for ABG and ASM activities were 3.6%-8.4%,and the within-run and between-run accuracies were 101%-115%. ABG and ASM activities of healthy newborns showed a skewed distribution（P<0.01）. The reference intervals for ABG and ASM activities were 5.52-49.50 and 2.02-15.44 μmol·L^-1·h^-1 according to 0.5th-99.5th percentiles. After judgement,the determination rate for Gaucher disease（GD）or Niemann-Pick disease type A/B （NPA/B）patient was 100%. Conclusions UPLC-MS/MS can determine ABG and ASM activities in dried blood spot specimens simultaneously,and it is rapid and specific,which could be applied in newborn screening of high-throughput determinations for GD and NPA/B.

Influence of AJUBA overexpression on T47D gene expression profile by RNA sequencing

XU Beihui, LI Qi, ZOU Xiuqun, XU Hong, HOU Zhaoyuan, WANG Jiamin, NI Peihua

2016, 31(6):  527-532.  DOI: 10.3969/j.issn.1673-8640.2016.06.018

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Objective To investigate the influence of AJUBA gene on estrogen receptor-positive breast cancer cell line T47D gene expression. Methods T47D cell line for stable expression of AJUBA was established. RNA-seq analysis was performed for RNA extracted from T47D-vector and T47D-AJUBA groups. After mapping and reading,transcriptome reconstruction,normalization and expression quantification,differentially expressed genes were identified with gene ontology（GO） analysis and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analysis. Differentially expressed genes were validated by real-time fluorescence quantitative polymerase chain reaction（RT-qPCR）. Results A total of 568 differentially expressed genes were identified,including 239 up-regulated genes and 329 down-regulated genes. In GO analysis,3,23 and 8 up-regulated genes were annotated to molecular function,biological process and cellular component,respectively,while 21,35 and 9 down-regulated genes were also annotated to molecular function,biological process and cellular component,respectively. In KEGG analysis,2 were up-regulated genes,and 4 were down-regulated genes. Conclusions The overexpression of AJUBA gene may have remarkable effects on a series of biological function-related multiple signal pathways,and AJUBA gene might play an important role in the tumorigenesis and development of breast cancer.

Investigation on prenatal screen for maternal serum during the 1st trimester in 45 laboratories in China

HE Falin, TAO Jiong, WANG Wei, ZHONG Kun, YUAN Shuai, WANG Zhiguo

2016, 31(6):  533-537.  DOI: 10.3969/j.issn.1673-8640.2016.06.019

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Objective To investigate the data of 45 prenatal screen laboratories for 6 months in China,to analyze the status of prenatal screen and provide a reference for quality control. Methods All the laboratories which participated in quality assurance program in 2014 were asked to submit their data,including risk assessment software,positive cut-off value,monthly sample throughput,monthly multiple of median （mMoM） of free beta-human chorionic gonadotropin （free β-HCG） and pregnancy-associated plasma protein A （PAPPA） and trisomy 21. The data were analyzed. Results （1）A total of 33 laboratories used lifecycle system,2 laboratories used 2T-risk system,and 6 laboratories used Aiboluo system.（2）A total of 86.67%（39/45） laboratories used 1/270 as positive cut-off value for trisomy 21. There were 69.76% （30/43） laboratories with monthly sample throughput < 500 . There were 48.78%（20/41）laboratories,which their monthly positive rates for trisomy 21 had standard deviation of 1.00-7.79.（3）All the medians of free β-HCG and PAPPA existed outlier data.（4）The percentages of all mMoM for 6 months were 15.38%（6/39） in 0.90-1.10 for free β-HCG and 7.69%（3/39）in 0.95-1.05 for PAPPA. Conclusions It is not optimistic for the quality control of prenatal screen in the 1st trimester. It is difficult to use single criterion to evaluate a laboratory. It would be effective and applicable to use multiple quality control criteria for laboratories to improve quality control.

Application and progress of next-generation sequencing technology in non-invasive prenatal testing

BAO Yun, XIAO Yanqun, WANG Hualiang

2016, 31(6):  541-545.  DOI: 10.3969/j.issn.1673-8640.2016.06.021

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This article briefly introduces cell-free fetal DNA（cff DNA） in maternal circulations,followed by polymerase chain reaction（PCR） application in prenatal diagnosis. The paper mainly includes the following aspects： sequencing approach,datum analysis and interpretation,current clinical application as well as quality control. Finally,the paper describes the future applications of next-generation sequencing technology in maternal malignacy determination during prenatal testing.

Progress on the molecular anti-tumor mechanisms of arctigenin

HUANG Dongdong, CAI Zhiyi

2016, 31(6):  546-548.  DOI: 10.3969/j.issn.1673-8640.2016.06.022

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Arctigenin is a main composition of traditional Chinese medicine Fructus arctii. The article focuses on the molecular anti-tumor mechanisms of arctigenin,which provides a reference for further development and utilization．