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    20 December 2016, Volume 31 Issue 12
    Orginal Article
    Comparison of main biochemical indicators between healthy subjects and sub-healthy subjects with different sex
    MA Hongxia, ZHOU Yunheng, MA Liang, SHEN Jianfeng, LI Yang
    2016, 31(12):  1011-1016.  DOI: 10.3969/j.issn.1673-8640.2016.12.001
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    Objective To compare the difference of main biochemical indicators between healthy subjects and sub-healthy subjects with different sex.Methods A total of 3 000 healthy subjects and 1 000 sub-healthy subjects at the age of 30-55 were enrolled. Fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),creatinine(Cr)and uric acid(UA)were determined. The results were analyzed according to different subjects and different sex. Results Except TC and HDL-C,other biochemical indicators of healthy males were higher than those of healthy females(P<0.05). Except TC,HDL-C and LDL-C,other biochemical indicators of sub-healthy males were higher than those of sub-healthy females(P<0.05). Except Cr,HDL-C and BUN,other biochemical indicators of sub-healthy males were higher than those of healthy males(P<0.05). Except Cr and HDL-C, other biochemical indicators of sub-healthy females were higher than those of healthy females(P<0.05). Conclusions Most of main biochemical indicators are different between healthy subjects and sub-healthy subjects with different sex. Every laboratory should establish respective reference ranges according to different subjects and sex.

    Reference intervals of serum pepsinogen and gastrin-17 levels among healthy population in some areas of Shanghai
    YANG Jianhua, WANG Binghua, LIN Yong
    2016, 31(12):  1017-1020.  DOI: 10.3969/j.issn.1673-8640.2016.12.002
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    Objective To investigate the reference intervals of serum pepsinogen(PG) Ⅰ,PG Ⅱ and gastrin-17(G-17) levels among healthy population in some areas of Shanghai.Methods Serum PGⅠ,PGⅡ and G-17 levels were determined by enzyme-linked immunosorbent assay(ELISA) in 1 235 healthy subjects,and PGⅠ/PGⅡ ratio was calculated. Results In 1 235 healthy subjects,the levels of PGⅠ,PGⅡ and PGⅠ/PGⅡ ratio showed a skewed distribution,and the reference intervals were established by percentile method. The levels of G-17 showed a normal distribution,and the reference intervals were established by x±1.96s. Males had lower serum PGⅠ and PGⅡ levels than females(P<0.05),and there was statistical significance for different ages(P<0.05). It was necessary to establish age-specific and sex-specific reference intervals. There was no statistical significance for serum PGⅠ/PGⅡ ratio between males and females(P>0.05),and there was statistical significance for different ages(≥4.79 for 18-44 years old,≥5.40 for 45-59 years old and ≥4.35 for ≥60 years old). For serum G-17 levels,there was no statistical significance for different ages and sex(P>0.05),and the uniform reference intervals could be established(2.22-6.26 pmol/L). The reference intervals of PGⅠ were 57.31-159.42 μg/L for males and 60.07-169.68 μg/L for females at the age of 18-44,57.96-158.33 μg/L for males and 64.84-183.50 μg/L for females at the age of 45-59 and 65.28-200.04 μg/L for males and 67.15-188.35 μg/L for females at the age of ≥60. The reference intervals of PGⅡ were ≤12.59 μg/L for males and ≤20.72 μg/L for females at the age of 18-44,≤20.85 μg/L for males and ≤25.33 μg/L for females at the age fo 45-59 and ≤23.10 μg/L for males and ≤27.22 μg/L for females at the age of ≥60. Conclusions The reference intervals of serum PGⅠ,PGⅡ and G-17 levels and PGⅠ/PGⅡ ratio are established for healthy population in some areas of Shanghai.

    Plasma cell-free DNA as a biomarker for the diagnosis of acute coronary syndrome
    CONG Hui, JING Rongrong, WANG Huimin, WU Xiaohui, CHU Haidan, FAN Mengkang, JU Shaoqin
    2016, 31(12):  1021-1025.  DOI: 10.3969/j.issn.1673-8640.2016.12.003
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    Objective To investigate the significance of plasma cell-free DNA(cfDNA) as a biomarker for the diagnosis of acute coronary syndrome(ACS) by choosing Alu as a target gene.Methods Blood specimens of 140 patients with ACS(ACS group) and 60 healthy subjects(healthy control group) were collected. A branched DNA(bDNA) assay based on Alu gene was used to determine the concentration of cfDNA,and the serial changes of cfDNA concentrations were observed dynamically in some ACS patients before and after percutaneous coronary intervention(PCI). The concentrations of cardiac troponin I(cTnI),creatine kinase-MB(CK-MB) and myoglobin(MYO) were determined by chemiluminescence assay,and the correlations of cfDNA with cTnI,CK-MB and MYO were analyzed. Receiver operating characteristic (ROC) curve was performed for evaluating the significance of cfDNA in the diagnosis of ACS. Results The concentration of cfDNA was higher in ACS group [2 550.3(969.9-4 866.4) ng/mL] than that in healthy control group [118.3(81.1-221.1) ng/mL,P<0.001]. The concentration of cfDNA was decreased in 10 patients after PCI,and there was no statistical significance for cfDNA concentration before and after PCI(P>0.05). No correlation was found between cfDNA concentration and cTnI,CK-MB,MYO in patients with ACS (r2=0.031,0.152 and 0.217,P>0.05). ROC curves showed that the areas under the curves(0.95) and the sensitivities of cfDNA(82.76%) were better than those of cTnI(0.57 and 22.41%),CK-MB(0.81 and 20.69%) and MYO(0.64 and 10.34%). The specificities of the 4 parameters were all 100.00%. Conclusions Plasma concentration of cfDNA is increased in ACS patients,its diagnosis significance is better than those of commonly-used myocardial biomarkers,and cfDNA may be an important biomarker for the diagnosis of ACS.

    Status of vitamin D in women at the first and second trimesters of pregnancy
    CHEN Fangfang, WU Yingting, WANG Yi, ZHANG Jun, CHEN Huifen
    2016, 31(12):  1026-1030.  DOI: 10.3969/j.issn.1673-8640.2016.12.004
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    Objective To study the level of 25-hydroxyvitamin D [25(OH)D] in women at the first and second trimesters of pregnancy in Shanghai,and to provide a reference for the supplement of vitamin D(Vit D) for pregnant women.Methods A total of 13 440 pregnant women [10 400 cases at the first trimester(<12 weeks) and 3 040 cases at the second trimester(12-27 weeks)] and 205 healthy subjects(healthy control group) were enrolled. The level of serum 25(OH)D was determined by enzyme-linked immunosorbent assay(ELISA). Serum 25(OH)D levels <25,25-<50,50-<75,75-<250,250-375 and >375 nmol/L were as Vit D famine,deficiency,insufficiency,sufficiency overdose and poisoning. Results The level of serum 25(OH)D in healthy control group was(58.07±14.64) nmol/L,and the proportions of Vit D famine,deficiency,insufficiency and sufficiency were 1.95%(4 cases),47.32%(97 cases),41.95%(80 cases) and 8.78%(18 cases),respectively. The level of serum 25(OH)D in pregnancy group was(45.05±15.79) nmol/L,and the proportions of Vit D famine,deficiency,insufficiency and sufficiency were 7.66%(1 029 cases),55.69%(7 485 cases),33.81%(4 544 cases) and 2.84%(382 cases).The level of serum 25(OH)D in healthy control group was higher than that in pregnancy group(P<0.05). The serum 25(OH)D levels at the first and second trimesters of pregnancy were(44.66±15.36) and(46.40±17.05) nmol/L. In the 2 groups,the proportions of Vit D famine were 7.72% and 7.43%,the proportions of deficiency were 56.67% and 52.34%,the proportions of insufficiency were 33.17% and 36.02%,and the proportions of sufficiency were 2.44% and 4.21%. The differences of Vit D deficiency,insufficiency and sufficiency proportions were significant statistically between the 2 groups(P<0.05). The level of serum 25(OH)D in winter-spring [(44.27±15.98) nmol/L] was lower than that in summer-autumn [(45.76± 15.55) nmol/L](P<0.01). Conclusions The deficiency or insufficiency of Vit D is common in women at the first and second trimesters of pregnancy.The Vit D deficiency at the first trimester of pregnancy is more serious compared with that at the second trimester of pregnancy,which is more common in winter-spring. It would be good for pregnant women to have a determination of serum 25(OH)D at the first trimester of pregnancy,and the determination can provide a scientific and appropriate Vit D supplement.

    Establishment on the reference intervals of serum free κ light chain, free λ light chain and their ratio in the population over 60 years old
    LI Ping, WU Jiong, PAN Baishen
    2016, 31(12):  1031-1035.  DOI: 10.3969/j.issn.1673-8640.2016.12.005
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    Objective To establish the reference intervals of serum free kappa(κ) light chain,free lambda(λ) light chain and their ratio in the population over 60 years old.Methods Epidemiological data(the histories of cardiovascular,hepatic,renal and diabetes mellitus diseases and pharmacohistory) were collected from 342 elder healthy subjects(227 cases of derivation cohort and 115 cases of validation cohort) in communities. Serum free κ light chain,free λ light chain,total κ light chain and total λ light chain were determined,and the ratio of free κ light chain to free λ light chain(free κ/λ ratio) was calculated. The results were classified and analyzed according to sex and age. The bilateral 2.5th and 97.5th percentiles were used to establish reference intervals,and the validation cohort's distribution of free κ/λ ratio in reference intervals was evaluated. Results There was statistical significance for hemoglobin,creatinine and calcium between males and females(P<0.05). There was no statistical significance for total κ light chain,total λ light chain,the ratio of total κ light chain to total λ light chain(total κ/λ ratio),free κ light chain,free λ light chain and free κ/λ ratio between males and females with different ages(P>0.05). There was no correlation of free κ/λ ratio with hemoglobin,creatinine and calcium(r=0.046,-0.071 and 0.054,P>0.05). According to the bilateral 2.5th and 97.5th percentiles,the reference intervals of free κ light chain,free λ light chain and free κ/λ ratio were 7.17-14.07 mg/L,23.04-60.59 mg/L and 0.15-0.46. There were 95.65%,95.65% and 96.52% subjects' free κ light chain,free λ light chain and free κ/λ ratio in validation cohort within the above 3 reference intervals. Conclusions The reference intervals of free κ light chain,free λ light chain and free κ/λ ratio in the population over 60 years old have been established,which can be used in the population over 60 years old.

    Correlations of genotype and viral load with HCV antibody S/CO ratio,liver enzymes and peripheral blood T lymphocyte subsets among patients with chronic HCV infection in Xinjiang
    YU Lu, WU Jing, MU Chaodong, HOU Li, ZHANG Zhaoxia
    2016, 31(12):  1040-1043.  DOI: 10.3969/j.issn.1673-8640.2016.12.006
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    Objective To investigate the influence of genotype and viral load on hepatitis C virus(HCV) antibody S/CO ratio,liver enzymes and peripheral blood T lymphocyte subsets among patients with chronic HCV infection in Xinjiang.Methods A total of 106 outpatients and inpatients from the First Affiliated Hospital of Xinjiang Medical University were enrolled from January 2014 to September 2015,and 30 healthy subjects were enrolled as healthy control group. HCV antibody,liver enzymes [alanine aminotransferase(ALT) and aspartate aminotransferase(AST)],HCV RNA,HCV genotype and peripheral blood T lymphocyte subsets were determined by chemiluminescence,enzymatic analysis,fluorescence quantitation reverse transcription polymerase chain reaction(PCR),PCR-reverse dot blot hybridization and multi-color flow cytometry. Results There was statistical significance in HCV antibody S/CO ratio,ALT and the percentage of CD8+T lymphocyte among 1b,2a,3a and 3b genotypes(P<0.05). The percentages of CD4+ T lymphocyte and CD4/CD8 ratio in 1b and 2a genotypes were lower than those in healthy control group [CD4+T lymphocyte percentages were(39.05±9.42)%,(38.65±10.26)% and(42.45±4.61)%,and CD4/CD8 ratios were 1.60±0.64,1.53±0.66 and 2.31±0.25],and the percentages of CD8+ T lymphocyte [(26.79±7.58)% and(27.15±10.40)%] were higher than those in healthy control group [(18.36±3.88)%,P<0.05]. According to HCV RNA load for classification,there was statistical significance for HCV antibody S/CO ratio,liver enzymes and CD4/CD8 ratio(P<0.05). Conclusions HCV 1b and 2a genotypes are main genotypes for patients with chronic HCV infection in Xinjiang. Viral load and different genotypes may affect HCV antibody S/CO ratio,liver enzymes and peripheral blood T lymphocyte subsets.

    Correlations of genotype and viral load with HCV antibody S/CO ratio,liver enzymes and peripheral blood T lymphocyte subsets among patients with chronic HCV infection in Xinjiang
    YU Lu, WU Jing, MU Chaodong, HOU Li, ZHANG Zhaoxia
    2016, 31(12):  1040-1043.  DOI: 10.3969/j.issn.1673-8640.2016.12.006
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    Objective To investigate the influence of genotype and viral load on hepatitis C virus(HCV) antibody S/CO ratio,liver enzymes and peripheral blood T lymphocyte subsets among patients with chronic HCV infection in Xinjiang.Methods A total of 106 outpatients and inpatients from the First Affiliated Hospital of Xinjiang Medical University were enrolled from January 2014 to September 2015,and 30 healthy subjects were enrolled as healthy control group. HCV antibody,liver enzymes [alanine aminotransferase(ALT) and aspartate aminotransferase(AST)],HCV RNA,HCV genotype and peripheral blood T lymphocyte subsets were determined by chemiluminescence,enzymatic analysis,fluorescence quantitation reverse transcription polymerase chain reaction(PCR),PCR-reverse dot blot hybridization and multi-color flow cytometry. Results There was statistical significance in HCV antibody S/CO ratio,ALT and the percentage of CD8+T lymphocyte among 1b,2a,3a and 3b genotypes(P<0.05). The percentages of CD4+ T lymphocyte and CD4/CD8 ratio in 1b and 2a genotypes were lower than those in healthy control group [CD4+T lymphocyte percentages were(39.05±9.42)%,(38.65±10.26)% and(42.45±4.61)%,and CD4/CD8 ratios were 1.60±0.64,1.53±0.66 and 2.31±0.25],and the percentages of CD8+ T lymphocyte [(26.79±7.58)% and(27.15±10.40)%] were higher than those in healthy control group [(18.36±3.88)%,P<0.05]. According to HCV RNA load for classification,there was statistical significance for HCV antibody S/CO ratio,liver enzymes and CD4/CD8 ratio(P<0.05). Conclusions HCV 1b and 2a genotypes are main genotypes for patients with chronic HCV infection in Xinjiang. Viral load and different genotypes may affect HCV antibody S/CO ratio,liver enzymes and peripheral blood T lymphocyte subsets.

    Orginal Article
    Establishment of the reference intervals of thyroid function for children in Shanghai
    LI Huaiyuan, JIANG Limin, QIAN Yueping, FU Qihua, LI Dong
    2016, 31(12):  1045-1049.  DOI: 10.3969/j.issn.1673-8640.2016.12.008
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    Objective To establish the reference intervals of thyroid stimulating hormone(TSH),free triiodothyronine(FT3) and free thyroxine(FT4) for children in Shanghai.Methods A total of 720 healthy children of 4 d to 17 years old from 9 hospitals in Shanghai were enrolled from August 2014 to July 2015. These children were classified into 6 groups according to ages and 120 cases were in each group. After centrifugation,serum specimens were frozen at -20 ℃. The levels of TSH,FT3 and FT4were determined by Beckman Coulter DxI 800 automated immunoassay system. The reference intervals of TSH,FT3 and FT4 were established according to the Clinical and Laboratory Standards Institute(CLSI) C28-A3 and the International Federation of Clinical Chemistry and Laboratory Medicine(IFCC) guidelines. Nonparametric methods were used to establish the 2.5th and 97.5th percentiles for reference intervals and 90% confidence interval. Results The ages of Group A-F were 4 d -<1 month,1-<12 months,1-<5 years,5-<10 years,10-<14 years and 14-17 years,respectively. The reference intervals of Group A were TSH 0.53-18.91 μIU/mL,FT3 2.42-5.67 pmol/L and FT4 11.85-33.81 pmol/L. The reference intervals of Group B were TSH 0.75-5.75 μIU/mL,FT3 4.21-8.16 pmol/L and FT4 9.40-19.54 pmol/L. The reference intervals of Group C were TSH 0.63-6.20 μIU/mL,FT3 3.54-6.90 pmol/L and FT4 9.32-18.40 pmol/L. The reference intervals of Group D were TSH 0.58-5.39 μIU/mL,FT3 3.97-7.83 pmol/L and FT4 10.65-19.23 pmol/L. The reference intervals of Group E were TSH 0.39-5.36 μIU/mL,FT3 4.27-8.55 pmol/L and FT4 9.80-19.64 pmol/L. The reference intervals of Group F were TSH 0.48-5.06 μIU/mL,FT3 3.14-6.15 pmol/L and FT4 9.57-18.27 pmol/L. There was statistical significance for reference interval distribution between Group A and B(Z>3). The TSH,FT3 and FT4 reference intervals for sex in all age groups showed no statistical significance(P>0.05). Conclusions The reference intervals of TSH,FT3 and FT4 are established for healthy children of 4 d to 17 years old in Shanghai. The reference intervals above can explain the results of thyroid function,which can improve the diagnosis,treatment and monitoring of hypothyroidism,hyperthyroidism,thyroiditis,goiter and thyroid neoplasm for children.

    Dynamic analysis on the drug susceptibility of mycoplasma from urogenital tract
    YAO Rongfeng, LI Zhi, SHEN Juying, XU Long
    2016, 31(12):  1050-1054.  DOI: 10.3969/j.issn.1673-8640.2016.12.09
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    Objective To analyze the infection status and drug susceptibility of ureaplasma urealyticum(Uu) and mycoplasma hominis(Mh) among patients with urogenital tract infection,and to provide a reference for diagnosis and treatment.Methods Uu and Mh were cultured and identified from 1 638 outpatients with urogenital tract infection from January 2009 to December 2014,and drug susceptibility test was performed simultaneously. Results The positive rate of mycoplasma infection was 45.6%(747/1 638). The positive rates of Uu and Mh infections were 44.4% and 9.5%,respectively. There were 36.1% patients infected only with Uu,1.2% patients infected only with Mh and 8.4% patients infected with Uu and Mh. The positive rate of mycoplasma infection was higher in females(48.6%) than that in males(20.9%)(P<0.01). From 2009 to 2013,the positive rate of mycoplasma infection increased in turn from 19.3%,29.3%,41.4%,46.9% to 56.0%. The positive rate of mycoplasma infection in 2014 was 44.2%,which was lower than that in 2013(P<0.05),which the positive rate of Uu infection decreased,while that of Mh infection increased year by year. The drug susceptibility rates of Uu and Mh to quinolones were the lowest(<20%),but those to doxycycline,minocycline and josamycine were higher(>70%).The drug susceptibility rates of Mh to antibiotics were lower than those of Uu. The drug susceptibility rates of Uu and Mh to tetracycline and josamycine in females were higher than those in males.Conclusions The positive rate of Mh infection increases year by year,and patients with Mh infection are often infected with Uu simultaneously. The drug susceptibility of Mh to antibiotics is lower than that of Uu,which would bring challenges to treatment. Therefore,clinicians should pay more attention to it.

    Drug resistance of Pseudomonas aeruginosa in a teaching hospital from 2010 to 2014
    SHU Wen, QIAN Ying, LIU Qingzhong
    2016, 31(12):  1055-1060.  DOI: 10.3969/j.issn.1673-8640.2016.12.010
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    Objective To investigate the drug resistance of Pseudomonas aeruginosa(PAE) and the correlation between antibiotic usage and drug resistance,in order to provide a reference for clinical rational use of antibiotics.Methods A total of 790 isolates of PAE were collected from January 2010 to December 2014. Kirby-Bauer method was performed for determining the drug susceptibility of PAE to 12 commonly-used antibiotics,and the antibiotics use density(AUD) were counted. The correlation between drug resistance and AUD was analyzed by SPSS 16.0. Results In the past 5 years,the drug resistance rate of PAE to piperacillin-tazobactam decreased from 33.1% in 2010 to 16.5% in 2014(P<0.05),those to meropenem and imipenem decreased from 42.3% and 39.6% in 2010 to 17.2% and 19.0% in 2014(P<0.05),and those to amikacin and gentamicin decreased from 13.8% and 39.9% in 2010 to 6.8% and 17.1% in 2014(P<0.05). The determination rate of multi-drug resistance Pseudomonas aeruginosa(MDRP) was on the decline,and that in 2011(7.5%) was the highest. Carbapenem-resistant group was more frequently resistant to the other antibiotics than carbapenem-susceptible group,and the determination rate of MDRP was also higher(P< 0.05). There was no statistical significance in determination rates of MDRP between intensive care unit(ICU) and public wards. The drug resistance rate of MDRP to piperacillin-tazobactam(39.5%) was lower than those to imipenem(63.2%) and meropenem(68.4%)(P<0.05). A correlation was observed between AUD and PAE drug resistance rate(r=0.961,P<0.05). Conclusions The drug resistance rates of PAE to piperacillin-tazobactam,meropenem,imipenem,amikacin and gentamicin show a downside in the past 5 years,piperacillin-tazobactam could be used as a good choice for the treatment of MDRP. There is a correlation between PAE drug resistance and carbapenem consumption. The prevention and control measures for nosocomial infection and the rational use of antibiotics are effective means to reduce MDRP.

    Molecular epidemiological analysis of Streptococcus pyogenes isolated from children in Jiading,Shanghai
    QIAO Dan, CHEN Mingliang, ZHU Yongzhen, FAN Qishi, ZHOU Min
    2016, 31(12):  1061-1065.  DOI: 10.3969/j.issn.1673-8640.2016.12.011
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    Objective To study the emm genotype in Streptococcus pyogenes isolated from children in Jiading,Shanghai and its drug resistance,and to provide a reference for infection control and treatment.Methods Outpatient children diagnosed with acute respiratory infection,acute tonsillitis and acute pharyngitis or carriers in Ruijin Hospital(North) from November 2014 to July 2015 were enrolled,and 75 isolates of Streptococcus pyogenes were collected by pharyngeal swab culture. The isolates ofStreptococcus pyogenes were identified by API 20 Strep. Antimicrobial susceptibility test was done by Kirby-Bauer method for 8 kinds of commonly-used antibiotics. The emm gene encoding M protein was amplified by polymerase chain reaction(PCR),and the gene product of PCR was sequenced. Through comparison,the emm genotypes were obtained. The characteristics of different emm genotypes were analyzed by pulsed-field gel electrophoresis(PFGE). BioNumerics software was used to analyze PFGE results from 75 isolates of Streptococcus pyogenes for cluster analysis. Results The erythromycin and clindamycin resistance rates of Streptococcus pyogenes in Jiading,Shanghai were 94.7% and 97.3%,respectively. The double resistance rate to erythromycin and clindamycin was 93.3%. The isolates with the same emm genotype in PFGE band were in high cluster. There were major PFGE genotypes. Among 75 isolates of Streptococcus pyogenes,25 isolates(33.3%,25/75) contained emm1 genotype,49 isolates(65.3%,49/75) contained emm12 genotype,and only 1 isolate(1.3%,1/75) contained emm22 genotype. Conclusions There is a high erythromycin resistance rate of Streptococcus pyogenes isolated from children in Jiading,Shanghai. The cross resistance with clindamycin is high. Streptococcus pyogenes containing emm12 or emm1 genotype is the main epidemic pathogen among children in Jiading,Shanghai.

    Contamination bacteria in cord blood among pregnant women with different delivery modes
    GE Ping, LIU Xuejie, WANG Feng, CHEN Rong, XU Rong, WANG Jinghua
    2016, 31(12):  1066-1068.  DOI: 10.3969/j.issn.1673-8640.2016.12.012
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    Objective To analyze contamination bacterium spectra in cord blood among pregnant women with different delivery modes and the sources of contamination when collecting,in order to improve the collection quality for cord blood.Methods A total of 11 435 specimens of cord blood from Shanghai Cord Blood Bank were collected from August 2012 to July 2014. A total of 511 isolates and their sources were identified. Results The contamination rates of anaerobic bacteria by spontaneous deliver and cesarean were 65.2%(274 cases) and 64.9%(48 cases),and their contamination rates of aerobic bacteria were 34.8%(146 cases) and 35.1%(26 cases). The contamination rates of anaerobic bacteria by forceps delivery were 56.3%(9 cases) and 43.8%(7 cases). The main anaerobic bacteria were Bacteroides and Eubacterium,accounting for 69.3%. The main aerobic bacteria were Enterobacterium and Staphylococcus,accounting for 74.3%. Conclusions Anaerobic bacteria are main contamination bacteria in cord blood,and its contamination rate has no difference by different delivery modes. Colonization bacteria from genital tract are anaerobic bacteria(Bacteroides and Eubacterium) and aerobic bacteria(Enterobacterium and Staphylococcus),which are the main contamination sources for cord blood. It should strengthen aseptic processing when collecting cord blood in order to improve its quality.

    Platelet parameters for thrombocytopenia among children
    JIANG Linlin, WANG Huan, HUANG Jie, YANG Jianmin, GAO Yuan, ZHANG Hong
    2016, 31(12):  1069-1072.  DOI: 10.3969/j.issn.1673-8640.2016.12.013
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    Objective To investigate the significance of platelet(PLT) parameters [PLT count, plateletcrit(PCT),platelet distribution width(PDW),mean platelet volume(MPV) and platelet-large cell rate(P-LCR)] for the cause analysis of thrombocytopenia.Methods A total of 139 children with thrombocytopenia were enrolled. There were 48 cases of idiopathic thrombocytopenic purpura(ITP),19 cases of aplastic anemia(AA),9 cases of acute leukemia(AL),27 cases of extramedullary tumors [neuroblastoma (N) and hepatoblastoma(H)] and 36 cases of acute infections(INF). A total of 84 healthy children were enrolled as healthy control group. PLT parameters were analyzed statistically. Results There was consistency of PLT count and PCT,and MPV and P-LCR had consistency. MPV had independence. PLT count and PCT in thrombocytopenia group were lower than those in healthy control group(P<0.05). MPV and P-LCR in thrombocytopenia group were higher than those in healthy control group(P<0.05). Except for AL group,PDW in the other groups had statistical significance with that in healthy control group(P<0.05). PLT count and PCT in INF group were higher than those in the other groups(P<0.05). PDW,MPV and P-LCR in INF group were lower than those in ITP and AA groups(P<0.05). Conclusions There are different characteristics of PLT parameters in different groups. It has a certain significance of PLT count and PLT parameters for the cause analysis of thrombocytopenia.

    Screening dengue using hematology analyzer with multi-parameters
    ZHANG Limei, LIN Yongping, XU Yunjian, KUANG Meihua
    2016, 31(12):  1073-1077.  DOI: 10.3969/j.issn.1673-8640.2016.12.014
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    Objective To investigate white blood cell(WBC) cell population data(CPD) in the diagnosis of dengue by UniCel DxH 800 automatic hematology analyzer,and to establish the optimal cut-off value.Methods A total of 159 healthy subjects,278 dengue patients and 106 suspected dengue patients(they had similar clinical symptoms with dengue patients,but their serological markers were negative) were enrolled. Whole blood count and WBC differential count were determined by DxH 800. Monocyte and lymphocyte CPD were analyzed. Receiver operating characteristic(ROC) curve was used to evaluate diagnosis efficiency. Results WBC and platelet(PLT) counts in dengue group were lower than those in suspected dengue and healthy control groups(P<0.05),but the percentage of monocyte(MO%)was higher(P<0.05),there was marked anisocytosis of monocytes and increased monocyte volume standard deviation(s-V-MO)(P<0.05). Dengue indicator(MO%+s-V-MO) showed the optimal performance with an area under curve(AUC) of 0.99,when the cut-off value was 29.3,the sensitivity was 95.7%,and the specificity was 98.7%,for healthy control group. There was optimal performance with an AUC of 0.824,when the cut-off value was 34.8,the sensitivity was 78.3%,and the specificity was 75.2%,for suspected dengue group. Conclusions Dengue indicator is of significance in the diagnosis and differentiation of dengue.

    Introduction on protein value-transfer procedure using cystatin C as an example
    KANG Juan
    2016, 31(12):  1081-1086.  DOI: 10.3969/j.issn.1673-8640.2016.12.016
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    Objective To introduce protein value-transfer principle and procedure by immunoassay using cystatin C(Cys C) national standard as an example.Methods In open system of particle-enhanced turbidimetry immunoassay(PETIA),ERM-DA471 dilutions were used as calibrators,and candidate national standard dilutions were used as samples. Whereas,in closed system of particle-enhanced nephelometry immunoassay(PENIA),the manufacturer's calibrators must be used,and the dilutions of ERM-DA471 and candidate national standard were both determined as samples. All reconstitutions and dilutions were controlled by weighing. Based on mathematical principles,the national standard concentration was deduced from the slope of regression line passing through the zero obtained by plotting testing results against theory dilutions. Results The concentrations for Cys C in candidate national standards were 4.41 mg/L and 4.52 mg/L by PETIA and PENIA,and the coefficients of variation(CV) were 1.3% and 1.5%,correspondingly. Conclusions This procedure is expected to improve the protein value-transfer reliability by weighing dilutions and multipoint fitting.

    Uncertainty of serum electrolyte determinations based on ion chromatography as reference measurement procedures
    JIA Jianghua, TU Minmin, SHEN Min, ZOU Jihua, ZHANG Man
    2016, 31(12):  1087-1092.  DOI: 10.3969/j.issn.1673-8640.2016.12.017
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    Objective To establish a method for evaluating the uncertainty of serum electrolyte determinations based on ion chromatography as reference measurement procedures.Methods The uncertainties of sodium,potassium,magnesium and calcium determinations in the External Quality Assessment Scheme for Reference Laboratories in Laboratory Medicine(RELA)-A 2014 sample were evaluated from peak areas of samples,concentration correction factors of standard solution,correction factor of sample processing and measurement repeatability,according to JJF1059-1999 Evaluation and Expression of Uncertainty in Measurement,JJF1135-2005 Evaluation of Uncertainty in Chemical Analysis Measurement and CNAS-GL06 Guidance on Evaluating the Uncertainty in Chemical Analysis. Results The levels of RELA-A 2014 sample were 3 177.79 mg/L for sodium,228.84 mg/L for potassium,48.95 mg/L for magnesium and 127.01 mg/L for calcium. Standard uncertainties were 5.66,1.38,0.38 and 0.75 mg/L. The expanded uncertainties(k=2) were 11.33,2.76,0.75 and 1.50 mg/L,respectively. Conclusions The uncertainty evaluation reference measurement procedure method has been established for serum electrolyte determinations recommended by the Joint Committee for Traceability in Laboratory Medicine(JCTLM),which can meet the requirements of serum electrolyte determinations for clinical laboratories.

    Diagnosis of a case with type 2A of limb-girdle muscular dystrophy by high-throughput sequencing
    HU Juan, SHEN Chunmei, WANG Jian, LI Niu
    2016, 31(12):  1093-1096.  DOI: 10.3969/j.issn.1673-8640.2016.12.018
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    Objective To perform the clinical molecular diagnosis in a Chinese Han boy with muscular dystrophy.Methods This boy had been diagnosed to exclude Duchenne and Becker muscular dystrophy(DMD/BMD). The whole exome sequencing(WES) was performed for his peripheral blood genomic DNA,and the relevant mutations identified by WES were verified by Sanger sequencing. Results WES results revealed that calpin 3 gene(CAPN3) existed 2 compound heterozygous mutations. One is a heterozygous nonsense mutation c.439C>T,p.Arg147* in exon 3,while exon 13 had another heterozygous missense mutation c.1621C>T, p. Arg541Trp. Conclusions By high-throughput sequencing,the patient is eventually diagnosed as type 2A of limb-girdle muscular dystrophy(LGMD).