Table of Content

30 December 2017, Volume 32 Issue 12

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Orginal Article

Role of Streptococcus pneumoniae pneumolysin in the diagnosis of infective pneumonia

WU Yanli, CHEN Yuxian, GU Hanfu

2017, 32(12):  1075-1079.  DOI: 10.3969/j.issn.1673-8640.2017.12.001

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Objective To obtain Streptococcus pneumoniae pneumolysin（PLY） through prokaryotic expression system,and to investigate its serological diagnosis role for infective pneumonia with Streptococcus pneumoniae. Methods The specific primers with cutting 33 nucleotides of carboxyl end were designed according to ply gene sequence of Streptococcus pneumoniae in GenBank. The ply gene was amplified by using the genome DNA of Streptococcus pneumoniae as template. The recombinant plasmid PET32a-ply was constructed,and it was expressed after transformation in Escherichia coli DH5aBL21（DE3）. Overexpression of recombinant protein without hemolysis activity in gene labeled with 6 infused amino acids was induced by isopropyl phosphorothioate（IPTG）. The immunocompetence of recombinant protein PLY was determined by western blotting after it was purified with Ni-NTA resin and identified with sodium dodecyl sulfate-polyacrylamide gel electrophoresis（SDS-PAGE）. Enzyme-linked immunosorbent assay（ELISA） reactive mode was established by setting PLY as IgM antigen so as to determine community acquired pneumonia（CAP）,and the role of PLY in the diagnosis of infective pneumonia with Streptococcus pneumoniae was evaluated. Results The prokaryotic expression vector PET32a-ply was successfully constructed. The recombinant protein PLY without hemolysis activity had soluble expression,with good immunogenicity. The positive rate of anti-PLY IgM antibody in CAP patients was higher than that in healthy subjects（P<0.05）,and the sensitivities were higher than those of conventional sputum culturing and blood culturing（P<0.05）. Conclusions ELISA reactive mode based on the recombinant protein PLY could be used for the serological diagnosis of infective pneumonia with Streptococcus pneumoniae.

Mechanism of carbapenems-resistant Enterobacteriaceae

WANG Jianqiang, WU Qiong, ZHUANG Yihui, CHEN Min, TANG Jin

2017, 32(12):  1080-1084.  DOI: 10.3969/j.issn.1673-8640.2017.12.002

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Objective To study the mechanism of carbapenems-resistant Enterobacteriaceae. Methods A total of 80 isolates of Enterobacteriaceae being resistant to carbapenems were isolated from patients in Shanghai Sixth People's Hospital from January 2011 to December 2013. The isolates were identified by Vitek Compao60 automatic system,and antimicrobial susceptibility was determined as well. The susceptibilities to imipenem and meropenem were determined Kirby-Bauer disc diffusion method. The modified Hodge test and inhibitor-potentiated double-disc diffusion test were performed for determining carbapenemase phenotype. Polymerase chain reaction（PCR） was performed for determining bla_KPC,bla_IMP,bla_OXA23,bla_OXA51,bla_OXA48,bla_VIM and bla_NMD. Results The isolates were resistant to many antibiotics. The consistencies of modified Hodge test and aminophenylboronic acid inhibition test to KPC were 47.5% and 97.5%. The determination rates of bla_KPC,bla_IMP,bla_OXA23,bla_OXA51,bla_OXA48,bla_VIM and bla_NMD were 88.75%,5.00%,3.75%,3.75%,0.00%,0.00% and 0.00%. The determination rate of isolates being negative for all the tested genes was 5.00%. Conclusions KPC-2 carbapenemase is the main mechanism of carbapenems-resistant Enterobacteriaceae in Shanghai Sixth People's Hospital. The inhibitor-potentiated double-disc diffusion test can determine KPC easily and correctly.

Peripheral blood PLT,Fib,FDP and DD in the prognosis of nasopharyngeal carcinoma

XIA Huan, WU Cuiyun, HE Jinlong

2017, 32(12):  1085-1088.  DOI: 10.3969/j.issn.1673-8640.2017.12.003

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Objective To investigate the relationships of platelet（PLT）,fibrinogen（Fib）,fibrinogen degradation product（FDP）,D-dimer（DD） with the prognosis of nasopharyngeal carcinoma（NPC）,and to provide a reference on the prognosis of NPC. Methods Blood samples were collected from 113 patients with NPC,30 patients with nasopharynx benign tumor,30 patients with nasopharyngitis and 30 healthy subjects. The levels of Fib,FDP and DD were determined by SYSMEX CA7000 automatic coagulation analyzer,and the count of PLT was determined by BECKMAN-COULTER LH750. Results The levels of Fib,FDP and DD in NPC group were higher than those in nasopharynx benign tumor,nasopharyngitis and healthy control groups（P<0.05）,and the count of PLT was higher than those in nasopharynx benign tumor and healthy control groups（P<0.05）. In NPC group without recurrence within 3 years,the count of PLT and the level of FDP were decreased when they left hospital compared with those being hospitalized（P<0.05）. In NPC group with recurrence within 3 years,the count of PLT and the levels of Fib and FDP were decreased when they left hospital compared with those being hospitalized（P<0.05）. When they were hospitalized again,the count of PLT and the levels of FDP and DD were increased significantly. Compared with those being hospitalized firstly,the levels of FDP and DD were increased as well. Conclusions The determinations of PLT count,Fib,FDP and DD play roles in the prognosis identification of NPC.

Correlation of ApoH gene single nucleotide polymorphisms and carotid plaques in patients with ischemic cerebral stroke

SHU Ming, WANG Yan, CHEN Ning, WU Jiemin, NI Peihua

2017, 32(12):  1089-1094.  DOI: 10.3969/j.issn.1673-8640.2017.12.004

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Objective To study the correlation of apopoprotein H（ApoH） gene single nucleotide polymorphisms（SNP）and carotid plaques in patients with ischemic cerebral stroke（ICS）. Methods A total of 737 patients with ICS were enrolled from Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine and Department of Neurology of Central Hospital of Shanghai Minhang District. They were classified into carotid plaque group（431 cases） and non-carotid plaque group（306 cases）（control group）. By multiple polymerase chain reaction（PCR） and sequence analysis,the genotype and allele frequencies of ApoH gene SNP loci（rs8178842,rs6933,rs4791079,rs2873966 and rs1801690） between the 2 groups were compared,and the relative risk was evaluated. Results In carotid plaque group,triglyceride（TG）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）,non-high-density lipoprotein cholesterol（non-HDL-C）,systolic blood pressure and blood glucose were higher than those in control group（P<0.05）. In carotid plaque group,rs4791079 locus CA and CA/AA genotype frequencies were 15.3% and 16.5%,which were higher than those in control group（8.8% and 8.8%）（P=0.008,P=0.022）. In carotid plaque group,rs1801690 locus GC/CC genotype frequency was 8.8%,which was lower than that in control group（13.4%）（P=0.049）. In carotid plaque group,rs4791079 locus A allele frequency（8.8%） was higher than that in control group（4.4%）（P=0.001）. The relative risk analysis found that carrying A allele increased the risk of carotid plaque [odds ratio（OR）=2.095,95% confidence interval（CI）1.333-3.292]. In carotid plaque group,rs1801690 locus C allele frequency（4.4%）was lower than that in control group（7.0%）（P=0.030）. The relative risk analysis found that carrying C allele decreased the risk of carotid plaque（OR=0.610,95%CI 0.389-0.956）. Conclusions ApoH gene rs4791079 and rs1801690 loci have correlations with carotid plaques in patients with ICS.

Combined determination of serum pepsinogen and gastrin 17 in healthy examination

LU Xun, ZHENG Weiling, SONG Miaoli, YANG Chen

2017, 32(12):  1095-1098.  DOI: 10.3969/j.issn.1673-8640.2017.12.005

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Objective To investigate the roles of serum pepsinogen（PG）Ⅰ,PGⅡ,pepsinogenⅠ/pepsinogenⅡ ratio（PGR） and gastrin 17（G-17） in healthy examination. Methods The levels of serum PGⅠ,PGⅡ and G-17 were determined by enzyme-linked immunosorbent assay（ELISA） in 1 872 healthy subjects. PGR was calculated. The relations of serum PGⅠ,PGⅡ,PGR and G-17 with sex and age were evaluated. The results of the combined determination of serum PG and G-17 were compared those of gastroscopy. Results The levels of serum PGⅠand PGR had statistical significance between males and females（P<0.001）,while the levels of PGⅡand G-17 had no statistical significance（P>0.05）. The levels of serum PGⅠ and PGⅡ were increased with the increasing of ages,while PGR was decreased. Serum G-17 reached a plateau in 21-50 years old,while it was gradually increased after 50 years old. There was no statistical significance in the positive rates of serum PG and G-17 and the double positive rate of serum PG and G-17 between males and females（P>0.05）,and the positive rate of serum G-17 was higher than that of serum PG（P<0.001）. Compared with the results of gastroscopy,the positive coincidence rate of the combined determination of serum PG and G-17 was 12.5%. Conclusions The combined determination of serum PG and G-17 is important in the screening of gastric-related diseases,which can be applied in healthy examination.

Serum vitamin D nutritional status of children and adolescents in Heilongjiang

CUI Mengzhu, WEN Ying, JIANG Xiaofeng, LIANG Hongyan

2017, 32(12):  1099-1104.  DOI: 10.3969/j.issn.1673-8640.2017.12.006

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Objective To study vitamin D nutritional status of children and adolescents in Heilongjiang,and to investigate its correlation with sex,age,season and region,so as to provide a reference for vitamin D supplement. Methods A total of 9 502 children and adolescents（1 month old-20 years old） were enrolled. Liquid chromatography tandem mass spectrometry（LC-MS/MS） was used to determine serum 25-hydroxyvitamin D₂[25 （OH）D₂] and 25-hydroxyvitamin D₃[25（OH）D₃]. Their sum was the level of serum 25-hydroxyvitamin D [25 （OH）D]. Its correlation with sex,age,season and region was evaluated. Results The level of serum 25（OH） D among 9 502 children and adolescents was 25.12（17.50~33.00）ng/mL,in which 3 122 cases（32.85%）were normal,3 268 cases（34.39%） were subclinically deficient,2 934 cases（30.88%）were deficient,144 cases（1.52%）were seriously deficient,24 cases（0.25%）were overdose,10 cases（0.11%）were toxic,and the overall level was subclinically deficienct. The 25（OH）D₂/25（OH）D₃ ratios were 0.02（0.01-0.05）for males and 0.02（0.01-0.06）for females（P=0.099）. Serum 25（OH）D levels decreased with age,in which that of school-age group was the lowest [19.80（13.25-26.69）ng/mL],and that of baby group was the highest [30.28（29.48-30.92）ng/ mL]（P<0.000 1）. With the changes of seasons,temperature and sunshine time exist difference,the level of serum 25（OH）D in spring [19.43（12.07-27.68）ng/mL] was the lowest,that in autumn [29.49（23.45-36.43）ng/mL] was the highest,and there was statistical significance among the 4 seasons（P<0.05）. Serum 25（OH）D had no statistical significance in different regions of Heilongjiang（P=0.275）. Conclusions The level of serum 25（OH）D is low among children and adolescents in Heilongjiang. Children and adolescents over 3 years old should receive reasonable supplement of vitamin D,especially in spring and winter.

Correlation between peripheral blood lipid level and age-related macular degeneration

SHAO Mingxi, LI Shengjie, CAO Wenjun

2017, 32(12):  1105-1108.  DOI: 10.3969/j.issn.1673-8640.2017.12.007

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Objective To investigate the correlation between peripheral blood lipid level and age-related macular degeneration（AMD）. Methods A total of 84 AMD patients and 40 healthy subjects were enrolled,and their data of age,sex and disease history were collected. Serum total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,apolipoprotein A（apo A） and apolipoprotein B（apo B） were determined. The results were analyzed by univariate analysis and multivariate Logistic regression analysis. Results The levels of TC,TG,HDL-C and apo A in AMD group were higher than those in healthy control group（P<0.05）. Multivariate Logistic regression analysis showed that TC [odds ratio （OR）=2.095,95% confidence interval（CI）1.277-3.434],HDL-C（OR=3.106,95%CI 1.133-8.513） and apo A（OR=3.588,95%CI 0.768-16.752）were risk factors for AMD. Conclusions The increasing levels of peripheral blood TC,HDL-C and apo A may be correlated with the incidence of AMD.

Homocysteine,blood lipid,renal function and carotid ultrasound in H-type hypertension

WANG Lei, XIONG Shenghe, ZHANG Jun, CHEN Weiqin, DENG Bing, ZHANG Yifan

2017, 32(12):  1109-1113.  DOI: 10.3969/j.issn.1673-8640.2017.12.008

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Objective To evaluate the roles of homocysteine（Hcy）,blood lipid,renal function and carotid ultrasound in the diagnosis and treatment of H-type hypertension. Methods A total of 346 patients with hypertension and 50 healthy subjects（healthy control group） were enrolled. The levels of blood pressure,total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,apolipoprotein（apo） A1,apo B100,apo E,lipoprotein（a）[Lp（a）],free fatty acid（FFA）,urea,creatinine（Cr）,uric acid（UA） and cystatin C（Cys C） were determined,and carotid ultrasound was performed. According to Hcy levels,the patients were classified into H-type hypertension group（Hcy≥10 μmol/L,168 cases） and non-H-type hypertension group（Hcy<10 μmol/L,178 cases）. Results Compared with healthy control group,the levels of Hcy,TG,apo B100,Lp（a）,UA and Cys C were higher in hypertension group（P<0.01）,while the level of apo A1 was lower（P<0.01）. The levels of Cr and urea in H-type hypertension group were higher than those in healthy control group（P<0.01）. Compared with non-H-type hypertension group,the levels of age,male proportion,Hcy,apo B100,FFA,Cr,UA,urea and Cys C were higher in H-type hypertension group（P<0.01）,and the level of apo A1 was lower（P<0.01）. There was no statistical significance for the other parameters among the 3 groups（P>0.05）. In H-type hypertension group,the level of Hcy was negatively correlated with the levels of HDL-C and apo A1（r=-0.127 and -0.214,P<0.05）,and it was positively correlated with urea,Cr,UA and Cys C（r=0.337,0.446,0.240 and 0.438,P<0.05）. Hcy level was positively correlated with carotid ultrasound grading and blood pressure classification in H-type hypertension group（r=0.383,P<0.05）. Conclusions H-type hypertension patients have a high risk of renal function impairment and atherosclerosis,and the periodic monitoring of Hcy levels is important for the diagnosis,treatment and prognosis of H-type hypertension.

Serum soluble triggering receptor expressed on myeloid cell-1 in the diagnosis of sepsis

XIN Na, JING Fahong, LI Jingmei, MU Yudong

2017, 32(12):  1114-1117.  DOI: 10.3969/j.issn.1673-8640.2017.12.009

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Objective To investigate the role of serum soluble triggering receptor expressed on myeloid cell-1（sTREM-1） in the diagnosis of sepsis. Methods A total of 50 patients with sepsis were enrolled as sepsis group,and 50 patients with non-sepsis were enrolled as control group. Serum samples were collected at the 1st day of admission. The level of sTREM-1 was determined by quantitative enzyme-linked immunosorbent assay（ELISA）. The level of procalcitonin（PCT） was determined by electro-chemiluminescence. The level of C-reactive protein（CRP） was determined by immunoturbidimetry. Meanwhile,anti-coagulated blood was collected for determining white blood cell（WBC） count．The efficiency of sTREM-1,PCT,CRP and WBC count for the diagnosis of sepsis was evaluated by receiver operating characteristic（ROC） curve. Results The levels of sTREM-1 and PCT in sepsis group were higher than those in control group（P<0.01）. The areas under ROC curves（AUC） of sTREM-1,PCT,CRP and WBC count in the diagnosis of sepsis were 0.922,0.775,0.728 and 0.685,respectively. The optimal point of sTREM-1 for the diagnosis of sepsis was 212.25 ng/L,and the sensitivity and specificity were 0.84 and 0.90,respectively. The optimal point of PCT was 0.475 ng/mL,and the sensitivity and specificity were 0.78 and 0.68,respectively. Conclusions Serum sTREM-1 with high diagnosis efficiency can be used as an early indicator for the diagnosis of sepsis.

HbA determined by capillary electrophoresis with dried filter blood paper in screening neonatal β-thalassemia

WAN Zhidan, HUANG Xiang, ZHONG Yuheng, WU Xuewei, LI Dongxiu

2017, 32(12):  1128-1131.  DOI: 10.3969/j.issn.1673-8640.2017.12.013

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Objective To investigate capillary electrophoresis with dried filter blood paper in screening neonatal β-thalassemia. Methods The level of glycated hemoglobin（Hb）A was determined by capillary electrophoresis with dried filter blood paper for screening neonatal β-thalassemia in 2 987 cases of neonatal heel blood,and the genotypes were analyzed. Its role was evaluated by fourfold table analysis. A total of 180 106 cases of neonatal heel blood were collected from July,2012 to December,2012 in Zhongshan. The cases of β-thalassemia positive phenotype（HbA<8.6%） were determined for genotypes. Results Among 2 987 cases of neonatal heel blood,94 cases carried β-thalassemia gene. After fourfold table analysis,as HbA<8.6%,the sensitivity of HbA determination in diagnosing β-thalassemia was 26.60%（25/94）, the false positive rate was 1.18%（34/2 893）,the specificity was 98.82%（2 859/2 893）, the false negative rate was 73.40%（69/94）,the positive predictive value was 42.37%（25/59）,and the negative predictive value was 97.64%（2 859/2 928）. Among 180 106 cases of neonatal heel blood,4 539 cases carried β-thalassemia gene（HbA<8.6%）,and the screening positive rate was 2.52% （4 539/180 106）. A total of 1 149 suspicious cases were called back,and 510 cases were diagnosed as β-thalassemia gene carriers,including 16 cases of serious β-thalassemia. The coincidence rate of HbA screening and gene diagnosis was 45.78%（526/1 149）. Furthermore,the HbA level of serious β-thalassemia cases was lower than that of β-thalassemia gene carriers（P<0.05）. Conclusions HbA determination has high specificity（98.82%） and high negative predictive value（97.64%） in screening neonatal β-thalassemia by capillary electrophoresis with dried filter blood paper. HbA level can be used for judging the status of β-thalassemia primarily,screening and diagnosing serious β-thalassemia cases.

Comparison on 3 methods of venous blood collection

LI Weifang, WANG Guiling, YU Xiaoling, HU Suqin

2017, 32(12):  1132-1133.  DOI: 10.3969/j.issn.1673-8640.2017.12.014

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Objective To compare 3 methods of venous blood collection,and to investigate the optimal method of venous blood collection. Methods A total of 600 outpatients were enrolled and randomly classified into 3 groups,Group A,B and C. Group A used traditional tourniquet for venous blood collection. For Group B,using traditional tourniquet,when seeing blood back,tourniquet was undone. Group C did not wear a tourniquet,and used infrared vein visual instrument. Results One-time puncture rate in venous blood collection,the incidence of skin congestion and pain index had statistical significance among the 3 groups （P<0.05）. Group C had the highest one-time puncture rate and the lowest incidence of skin congestion and pain index. Hemolysis rates had no statistical significance among the 3 groups （P>0.05）.Conclusions No tourniquet venous blood collection using infrared vein visual instrument can improve the success rate of puncture,improve specimen quality and relieve pain.

BD Affirm VPⅢ chip technology in determining vaginal secretions

WEI Bing, LU Tingyan, SHEN Li, TANG Zhenhua

2017, 32(12):  1134-1136.  DOI: 10.3969/j.issn.1673-8640.2017.12.015

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Objective To study the role of BD Affirm VPⅢ chip technology in determining vaginal secretions. Methods A total of 182 samples of vaginal secretions were determined by Nugent,trichomonad culturing,fungal culturing and BD Affirm VPⅢ,and the results of Nugent,trichomonad culturing,fungal culturing were used as gold standard. The results were analyzed statistically by SPSS 19. 0 software. Results Compared with Nugent,for bacterial vaginitis（BV）,the sensitivity of BD Affirm VPⅢ was 95.1%,the specificity was 83.8%,and Kappa value was 0.80. When the results of fungal culturing were used as gold standard,for determining Candida,the sensitivity of BD Affirm VPⅢ was 75.8%,the specificity was 99.0%,and Kappa value was 0.85. When the results of trichomonad culturing were used as gold standard,for determining trichomonad,the sensitivity of BD Affirm VPⅢ was 92.9%,the specificity was 100.0%,and Kappavalue was 0.96. Conclusions BD Affirm VPⅢ chip technology is convenient and can be simultaneously determine 3 kinds of pathogenic microorganisms for vaginitis,and it has high sensitivity and specificity. It overcomes the limitation of traditional determination methods with clinical application significance.

Performance of Mindray automatic H50 glycohemoglobin analyzer

ZHAO Zhiyun, YUAN Wenhua, SONG Yunxiao

2017, 32(12):  1137-1142.  DOI: 10.3969/j.issn.1673-8640.2017.12.016

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Objective To evaluate the performance of Mindray automatic H50 glycohemoglobin analyzer,and to confirm whether it meets clinical requirements. Methods According to guidelines published by the People's Republic of China health industry standard YY/T1246—2014 Glycohemoglobin Analyzer,WS/T 461—2015 Measurement of Hemoglobin A1 and the Clinical and Laboratory Standards Institute（CLSI） EP5-A2,EP6-A and EP9-A3,the carryover rate,repeatability,within-run precision,between-run precision,within-laboratory precision,linearity,comparability with BIO-RAD VariantⅡ glycohemoglobin analyzer,trueness,sample stability,interference and glycated hemoglobin E（HbE） identification were evaluated. Results The carryover rate of H50 for the determination of glycated hemoglobin A_1c（HbA_1c） was low（-0.56%）,and high-value samples were not carried to low-value samples. The results of repeatability showed that the coefficient of variation（CV） was <1%. The within-run precision,between-run precision and within-laboratory precision（CV） were <1%,which met the requirements of WS/T 461—2015. There was a wide linear range（4.2%-16.6%）,which can cover the majority of samples. The samples after storing in cold environment（4 ℃） and room temperature（18-24 ℃） were stable for 6 d. According to the requirements of the International Federation of Clinical Chemistry and Laboratory Medicine（IFCC）,the absolute bias was within ±0.3% HbA_1c. There was a positive relation with VariantⅡ（r=0.996）. The expected bias at medical decision level was <1% below the requirements of the College of American Pathologists（CAP）（6%）. Triglyceride（TG）,bilirubin and glucose（Glu） had no interference to HbA_1c. The extended model can effectively prompt for HbE. Conclusions H50 glycohemoglobin analyzer has good performance,which can meet clinical requirements.

EUROPattern auto-reading system for the determination of anti-nuclear antibody

JIA Rulin, LI Yun, ZHAO Jing, ZHU Lei, YANG Dongyue, HE Jing, LI Zhanguo

2017, 32(12):  1143-1147.  DOI: 10.3969/j.issn.1673-8640.2017.12.017

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Objective To evaluate EUROPattern auto-reading system（EPA） for the determination of anti-nuclear antibody（ANA） by indirect immunofluorescence（IIF）. Methods Biochips coated with HEp-2 cells and monkey liver cells by IIF were used to determine serum ANA in 836 cases of suspected autoimmune diseases（AID）. The fluorescence patterns were recognized by EPA and manual visual interpretation in parallel. The consistency was evaluated. Results The consistency rate was 96.29%（K=0.92,P<0.05） between EPA and manual visual interpretation regarding positive/negative classification. The results of manual visual interpretation were as standard,and the sensitivity and specificity of EPA were 99.70% and 94.02%. Through Spearman correlation analysis,there was a positive correlation between the 2 methods（r=0.93,P<0.05）. The consistency rates of single-pattern recognition and mixed-pattern recognition between the 2 methods were 93.46% and 91.78%,respectively. The consistency rates of the 2 methods for antibody titer evaluation were 90.95% and 94.03%. The coefficient of variation of negative control was 0.00%,that of weak positive control was 2.44%,and that of positive control was 1.78%. Conclusions EPA agrees well with manual visual interpretation,and it takes the advantages of automation,standardization and saving labor,as well as obtains practical significance for improving the diagnosis of AID.

Determinations of infant ToRCH specific antibodies by multiplex flow immunoassay

CHEN Li, HAN Biyun, MA Zhan, WANG Jie, ZHANG Hong

2017, 32(12):  1148-1151.  DOI: 10.3969/j.issn.1673-8640.2017.12.018

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Objective To evaluate the consistency of multiplex flow immunoassay and traditional methods in the determinations of infant ToRCH specific antibodies [toxoplasma（TOX）,rubella（RUB）,cytomegalovirus（CMV） and herpes simplex virus（HSV）]. Methods ToRCH-IgM and ToRCH-IgG antibodies were determined by multiplex flow immunoassay in 130 infants,and the results were compared with those of chemiluminescence. The samples with inconsistent results were further determined by enzyme-linked immunosorbent assay（ELISA）. Results Except for CMV IgG antibody,multiplex flow immunoassay and chemiluminescence had good consistency,and the consistency rate was >80.00%（K>0.4）. However,for CMV IgG antibody,the consistency rates of multiplex flow immunoassay with chemiluminescence and ELISA were 45.37% and 47.22%（K=0.10 and 0.11）. Conclusions There is a good consistency for TOX antibodies（IgM and IgG）,RUB antibodies（IgM and IgG）,CMV antibody（IgM）and HSV antibodies（IgM and IgG） between multiplex flow immunoassay and traditional methods（chemiluminescence and ELISA）,while there is difference for CMV antibody （IgG）between chemiluminescence and ELISA.

Performance of C. DIFF QUICK CHEK COMPLETE

QIN Juanxiu, ZHANG Haomin, LIU Qian, XIA Qiang, LI Min

2017, 32(12):  1152-1155.  DOI: 10.3969/j.issn.1673-8640.2017.12.019

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Objective To evaluate the performance of C. DIFF QUICK CHEK COMPLETE,which can be used to determine Clostridium difficile glutamate dehydrogenase antigen and toxin. Methods A total of 130 clinical diarrheal stools were collected. C. DIFF QUICK CHEK COMPLETE,VIDAS Clostridium difficile Toxin A/B and Clostridium difficile toxin culture were performed according to the manufacturers' instructions. The sensitivities,specificities,positive predictive values and negative predictive values were evaluated. The performance was evaluated,and the results of toxin culture were as standard. Results There were 18 positive cases（13.8%） by toxin culture,and the sensitivity,specificity and positive and negative predictive values were 55.6%,98.2%,83.3% and 93.2%,respectively. For C. DIFF QUICK CHEK COMPLETE,the sensitivity,specificity and positive and negative predictive values were 50.0%,95.6%,64.3% and 92.1%,respectively. Conclusions C. DIFF QUICK CHEK COMPLETE has high specificity and positive predictive value,with short turn-around time,which can be used for screening Clostridium difficile infection.

Bacteriological information of SYSMEX UF-1000i urinalysis analyzer in screening urinary tract infections

GAO Shufang, HU Jun, HU Xiaobo

2017, 32(12):  1156-1158.  DOI: 10.3969/j.issn.1673-8640.2017.12.020

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Objective To evaluate the bacteriological information of SYSMEX UF-1000i urinalysis analyzer in screening urinary tract infections（UTI）. Methods A total of 314 specimens of midstream urine were collected from outpatients and inpatients in Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine from April 27 to September 14,2016. These specimens of midstream urine were determined by microbiological culturing and UF-1000i. The results of Rods and Cocci/Mixed information of UF-1000i were compared with those of microbiological culturing. Results The sensitivity and positive predictive value of Rods in predicting negative bacillus were 76.8% and 70.0%,respectively. The sensitivity and positive predictive value of Cocci/Mixed in predicting positive coccus or mixed infection were 38.1% and 16.3%,respectively. Conclusions When UF-1000i indicates Rods,it can distinguish the types of bacteria preliminarily,guide the rational use of antibiotics in clinic and shorten the duration of treatment. When UF-1000i indicates Cocci/ Mixed,the results are diverse and are needed to be improved.

Survey on the comparability and consistency of whole blood cell count determination in Shanghai

WANG Qing, SONG Ying, XU Lei, ZHU Peichao, MIAO Yingbo

2017, 32(12):  1159-1164.  DOI: 10.3969/j.issn.1673-8640.2017.12.021

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Objective To know the comparability and consistency of whole blood cell count determination in Shanghai. Methods Various clinical laboratories in Shanghai were enrolled. For the comparability and consistency of whole blood cell count determination,their coefficients of variation（CV）and the difference among different instruments were evaluated. Results A total of 612 clinical laboratories finished the determinations and uploaded their results,and there involves 12 brands and 56 types of hematology analyzers. For 2 batches of investigation products,the CV of white blood cell（WBC） count were 3.34% and 3.56%,those of red blood cell（RBC） count were 1.46% and 1.50%,those of hemoglobin（Hb） were 1.42% and 1.31%,those of hematocrit（HCT） were 2.89% and 2.79%,and those of platelet（PLT） count were 3.96% and 3.65%. The difference between the means （$\overline{x}$） of different instruments and total mean were 0.38%--2.25% and 0.00%--2.87% for WBC count,0.13%--3.47% and 0.05%-3.04% for RBC count,0.16%--1.48% and 0.16%--1.11% for Hb,0.16%--4.65% and 0.05%-4.10% for HCT,and 0.15%--5.43% and -0.27%-3.21% for PLT count. Conclusions The results of whole blood cell count determination has comparability and consistency. However,the difference still exists among different instruments.

Research progress in the relationship between gut microbiome and human diseases

GUO Han, ZHANG Jie, YANG Shuo, QIAO Rui

2017, 32(12):  1165-1172.  DOI: 10.3969/j.issn.1673-8640.2017.12.022

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Human intestine harbors a large amount of microorganisms（gut microbiome）,which works like an organ providing metabolic,immunologic and enter-endocrinal physiological functions and develops commensal relationships with human organism. Under the influence of genetic factors,dietary habits and so on,if the dysbiosis of gut microflora occurs,or the balance with human organism is broken, it would lead to many kinds of diseases. This review mainly shows the relationships between gut microbiome and metabolic syndrome,cardiovascular disease,cancer,rheumatoid arthritis and central nerve system diseases.