Table of Content

30 May 2018, Volume 33 Issue 5

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Orginal Article

Relationship of routine examinations and treatment with the etiological diagnosis of acute infectious diarrhea

YANG Feng, ZHANG Jinghao, FANG Yi, GUO Mingquan, LIU Yue, ZHAO Hu, ZHANG Yanmei

2018, 33(5):  379-383.  DOI: 10.3969/j.issn.1673-8640.2018.05.001

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Objective To analyze the relationship of routine examinations and treatment with the etiological diagnosis of acute infectious diarrhea,and to provide a reference for the diagnosis and treatment of acute infectious diarrhea. Methods Totally,962 specimens of acute infectious diarrhea patients were collected,and the pathogens were identified. Blood routine examination and stool routine examination were performed. The relationship of the results of blood routine examination and stool routine examination and treatment with the etiological diagnosis was analyzed. Results A total of 295 pathogens,including 239 bacteria and 56 viruses,were determined from 962 specimens. There was statistical significance for the abnormal proportions of white blood cell （WBC） count,neutrophil percentage （NE%）,abnormal NE% and lymphocyte percentage （LYM%） between patients infected with bacteria and viruses（P<0.05）. The proportion of water stool was higher in patients infected with viruses than that in patients infected with bacteria （P=0.002）,and the proportion of mucous stool was higher in patients infected with bacteria （P=0.049）. The consistency rate was 72.2%（213/295） between empirical treatment and pathological diagnosis results. Conclusions The routine examinations could provide a reference for the diagnosis and treatment of acute infectious diarrhea,while accurate and comprehensive pathogenic determination is also needed for its precious clinical diagnosis and treatment.

Relationship between Corynebacterium urealyticum and the formation of ammonium magnesium phosphate crystals in urine

LI Caiqing, CAO Jing, ZHAN Minghua, HAN Xuying, LI Xiaofeng, LIU Jinlu

2018, 33(5):  384-387.  DOI: 10.3969/j.issn.1673-8640.2018.05.002

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Objective To study the role of Corynebacterium urealyticum in the formation of ammonium magnesium phosphate crystals in urine,and to provide a reference for the prevention of urinary calculi. Methods Urine samples with ammonium magnesium phosphate crystals were collected from the First Affiliated Hospital of Hebei North University from January 2015 to December 2016, Corynebacterium urealyticum was cultured in the fresh urine without bacteria and other urine formed elements. After culturing for 24 and 48 h,the formation of ammonium magnesium phosphate crystals was observed by ultrahigh sensitive microscope. Results Bacteria in urine samples of 17 males and 8 females were isolated in 46 cases of urine samples with ammonium magnesium phosphate crystals, and 12 cases had 2 pathogens. There were 8 isolates of Corynebacterium urealyticum,the positive rate was 32.0%（8/25）,and there were 7 isolates from males. There were 8 isolates of Enterococcus,6 isolates of Proteus mirabilis,5 isolates of Escherichia coli,3 isolates of Klebsiella pneumoniae,3 isolates of Candida albicans and 2 isolates of Pseudomonas aeruginosa. There were 4 of 8 isolates of Corynebacterium urealyticum mixed with other pathogens. Ammonium magnesium phosphate crystals were observed from urine culture fluid. Most of the crystals formed were unformed feather crystals, followed by cubic, square cylinder and envelope-like crystals. Conclusions Corynebacterium urealyticum is one of the main pathogens of urinary tract infection and urinary calculus formation for specific population.

Peripheral blood circulating CD34⁺ cell count in patients with MDS-RA/RARS/RCMD

DONG Haibo, ZENG Hui, ZHANG Qiguo, ZHOU Min, YUAN Cuiying, CHEN Bing

2018, 33(5):  388-392.  DOI: 10.3969/j.issn.1673-8640.2018.05.003

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Objective To evaluate peripheral blood circulating CD34⁺ cell count in patients with myelodysplastic syndrome（MDS）-refractory anemia（RA）/refractory anemia with ring siderblasts（RARS）/refractory cytopenia with multilineage dysplasia（RCMD）. Methods A total of 52 MDS-RA/RARS/RCMD patients and 19 hematopoietic stem cell donors （healthy controls） were enrolled,and their peripheral blood circulating CD34⁺ cell percentages and counts were determined by flow cytometry. They were classified into low risk, intermediate-Ⅰ risk,intermediate-Ⅱ risk,high risk subgroups and very low risk,low risk, intermediate risk,high risk, very high risk subgroups according to the International Prognostic Scoring System （IPSS） and World Health Organization （WHO）-Based Prognostic Scoring System （WPSS）,respectively. The correlation of peripheral blood circulating CD34⁺ cell count with the clinical characteristics of MDS-RA/RARS/RCMD patients was analyzed. Results MDS-RA/RARS/RCMD patients had higher percentage and count of peripheral blood circulating CD34⁺ cells compared with healthy controls（P<0.01）. There was no correlation between peripheral blood circulating CD34⁺ cell count in MDS-RA/RARS/RCMD patients and patients' sex,age,cytopenia degree,white blood cell count decreasing and abnormal localization of immature precursor （ALIP）（r<0.625,P>0.05）,and there was correlation between peripheral blood circulating CD34⁺ cell count and abnormal karyotype,IPSS score, WPSS score and myelofibrosis（r>0.995,P<0.01）. There were 16 MDS-RA/RARS/RCMD patients with peripheral blood circulating CD34⁺ cell count >10.00×10⁶/L. Among them, there were 12 patients with complex karyotype abnormalities （10 patients with chromosome 7 abnormalities）. A total of 12 and 13 patients belonged to IPSS intermediate-Ⅱ risk and WPSS high risk subgroups,respectively. There were 9 patients with myelofibrosis. Among 36 MDS-RA/RARS/RCMD patients with peripheral blood circulating CD34⁺ cell count <10.00×10⁶/L,no patient had complex karyotype abnormalities or chromosome 7 abnormalities. Except for 1 patient in WPSS high risk subgroup,other patients were in IPSS low,intermediate-Ⅰ risk subgroups and WPSS very low,low and intermediate risk subgroups. Only 1 patient had myelofibrosis. Conclusions The count of peripheral blood circulating CD34⁺ cells increases in MDS-RA/RARS/RCMD patients,which can be further used for the classification of MDS risk.

Reticulocyte parameters in the treatment of hemolytic disease of newborns

YANG Dan, LI Wei, YE Zhicheng, XU Jin

2018, 33(5):  393-395.  DOI: 10.3969/j.issn.1673-8640.2018.05.004

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Objective To investigate the role of reticulocyte（RET） parameters in the treatment of hemolytic disease of newborns（HDN）,and to provide a reference for evaluating treatment efficiency. Methods Peripheral blood samples of 44 patients with HDN were collected on the days of admission,treatment and discharging,respectively. All samples were determined for reticulocyte percentage（RET%）,immature reticulocyte fraction percentage （IRF%）,low fluorescence reticulocyte percentage （LFR%）,medium fluorescence reticulocyte percentage （MFR%） and high fluorescence reticulocyte percentage （HFR%）. The results on the day of admission were as baselines,and the change trend of the results on the days of treatment and discharging were evaluated. Results The RET%,IRF%,MFR% and HFR% decreased,and LFR% showed an increase with the treatment progressed. RET% was decreased,which accounted for 84.09%. In decreased group,RET%,IRF%,MFR% and HFR% on the day of discharging had statistical significance compared with those on the day of admission（P<0.05）. The decrease of RET% was positively correlated with those of IRF% and HFR% in decreased group（r=0.632 and 0.639,P<0.01）. There was no statistical significance for RET%,IRF%,MFR% and HFR% between the days of admission and discharging （P>0.05）. Conclusions RET% could be used as a sensitive indicator in monitoring the treatment of HDN. The decreasing of RET% indicates that the treatment is effective. IRF%,HFR% and LFR% could be used as auxiliary indicators for monitoring HDN treatment.

Influence of reanalysis time for polymorphonuclear neutrophil elastase on male genital tract infection patients

CHENG Zhaojun, ZHOU Wenjing, FENG Ying, WANG Chong

2018, 33(5):  396-398.  DOI: 10.3969/j.issn.1673-8640.2018.05.005

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Objective To investigate the influence of polymorphonuclear neutrophil elastase （PMNE） on the quality of semen,and to investigate optimal reanalysis time for PMNE. Methods The quality of semen of 763 patients were determined by SCA-H-01 computer-assisted sperm analysis,and PMNE level was determined by enzyme-linked immunosorbent assay （ELISA）. According to PMNE level,genital tract infection was identified. After treatment for inapparent and confirmed infection patients, different reanalysis times were chosen and evaluated. Results Sperm motility of PMNE confirmed infection patients was decreased（P<0.05）. The positive rate of PMNE in patients reanalyzed in <7 d had statistical significance compared with those in 7-14 d （χ²=7.601,P=0.006）and >14 d （χ²=18.530,P<0.001）. Conclusions The increasing of PMNE level may influence on semen quality,and it is important for choosing a proper time to reanalyze PMNE level and obtain exact results.

Risk factors of decompensated liver cirrhosis in primary biliary cirrhosis

LI Jinghua, ZHAO Wei, TONG Jingjing, ZHANG Tie, CAO Yongtong

2018, 33(5):  399-403.  DOI: 10.3969/j.issn.1673-8640.2018.05.006

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Objective To investigate the risk factors of decompensated liver cirrhosis in patients with primary biliary cirrhosis（PBC）,and to provide an evidence-based medicine reference for clinical diagnosis and treatment. Methods The clinical data of 115 PBC patients,including 72 compensated patients and 43 decompensated patients,were collected retrospectively. The correlations of decompensated liver cirrhosis with biochemical indices [albumin（Alb）,globulin（Glb）,total bilirubin （TB）,alkaline phosphatase （ALP）,gamma-glutamyltransferase（GGT）,total bile acid（TBA）,alanine aminotransferase（ALT） and aspartate aminotransferase（AST）],coagulation index [prothrombin time（PT）],immunological indices（IgM,IgG,IgA and γ-Glb）,autoantibodies [anti-soluble acidic nuclear protein 100（sp100） antibody,anti-nuclear pore glycoprotein 210（gp210） antibody and anti-centromere antibody] and Mayo risk score were analyzed. Multivariate Logistic regression analysis was used to identify independent risk factors for predicting decompensation in PBC patients. Results Compared with compensated patients,the decompensated patients had higher levels of TB,TBA,PT,γ-Glb,IgA,IgG and Mayo risk score,but they had lower levels of Alb and GGT （P<0.05）. There was no statistical significance for the levels of Glb,ALP,ALT,AST and IgM and the positive rates of anti-sp100 antibody,anti-gp210 antibody and anti-centromere antibody between the 2 groups（P>0.05）. Multivariate Logistic regression analysis showed that Alb<34.5 g/L [odds ratio （OR）=4.458,95% confidence interval （CI） 1.019-19.501],IgA>3.09 g/L（OR=15.41,95%CI 2.868-82.786）,Mayo risk score >5.04 （OR=15.7,95%CI 2.653-92.907）were independent risk factors for predicting decompensation. The areas under receiver operating characteristic（ROC）curves of Alb,IgA and Mayo risk score were 0.881,0.700 and 0.860,respectively. The area under ROC curve of the combined determination of Alb,IgA and Mayo risk score was 0.912. Conclusions Alb<34.5 g/L,IgA >3.09 g/L and Mayo risk score >5.04 and the probability of Alb,IgA and Mayo risk score combined determination >0.45 play roles for predicting decompensation in patients with PBC.

Influence of hemolysis on serum glucose determination according to CLSI EP7-A2

SHEN Jianjiang, FU Buqing, ZHAO Chun, XU Tian

2018, 33(5):  404-406.  DOI: 10.3969/j.issn.1673-8640.2018.05.007

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Objective To evaluate the influence of hemolysis on serum glucose （Glu） determination by hexokinase（HK）assay. Methods The hemoglobin （Hb） was identified as an interfering substance by paired-difference experiment according to the Clinical and Laboratory Standards Institute （CLSI） EP7-A2 document. The correlation between Hb level and interference was evaluated by dose-effect experiment. Results Paired-difference experiment showed that Hb at 5 g/L could influence high-level and middle-level Glu determinations. Dose-effect experiment with 5 levels of Hb showed that there existed non-linear interference in Glu determination. The non-linear equations were Y=6.496+0.160 5X-0.013 10X² for middle-level Glu determination （r²=0.983） and Y=10.13+0.211 0X-0.017 83X² for high-level Glu determination （r²=0.973）. Conclusions There exists interference for Glu determination from hemolytic samples by HK assay. It should avoid hemolytic samples if necessary. If another sample is not available,the hemolysis degree and potential interference should be attached to the laboratory report sheets for clinical reference.

Correlations of serum calcium and free fatty acid with metabolic syndrome among elders in community

ZHU Wenkui, XU Qi, CHEN Jin

2018, 33(5):  407-410.  DOI: 10.3969/j.issn.1673-8640.2018.05.008

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Objective To investigate the correlations of serum calcium （Ca） and free fatty acid（FFA） with metabolic syndrome（MS） among elders in community. Methods A total of 104 elderly patients with MS and 113 healthy subjects were enrolled. Clinical data（age,sex,waist circumference and blood pressure） were collected. Fasting plasma glucose（FPG）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,Ca and FFA levels were determined. The correlations of Ca and FFA with waist circumference,blood pressure,FPG,TG and HDL-C were analyzed. Results Waist circumference,TG,systolic blood pressure （SBP）,FPG,Ca and FFA in MS group were higher than those in healthy control group （P<0.01）, and HDL-C was lower （P<0.01）. There was no statistical significance for age and diastolic blood pressure （DBP）between MS and healthy control groups （P>0.05）. There were positive correlations of Ca with waist circumference,TG,SBP and FPG （r=0.182,0.367,0.173 and 0.361,P<0.01）,and there was a negative correlation with HDL-C （r=-0.358,P<0.01）. FFA had positive correlations with TG and FPG （r=0.324 and 0.215,P<0.01）. Conclusions Serum Ca and FFA are correlated with MS among elders in community.

Roles of 25-hydroxyvitamin D levels and related indicators for inflammatory myopathy

LI Yaju, CHEN Kun, GUAN Ming

2018, 33(5):  411-415.  DOI: 10.3969/j.issn.1673-8640.2018.05.009

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Objective To investigate the levels and roles of 25-hydroxyvitamin D [25（OH）D] levels and related indicators for idiopathic inflammatory myopathy （IIM）. Methods A total of 35 untreated patients with IIM were enrolled,and 44 patients with other autoimmune diseases were enrolled as control group. The levels of 25（OH）D,white blood cell （WBC）,neutrophil count （NEUT#）,hemoglobin （Hb）,platelet （PLT）,creatinine （Cr）,uric acid （UA）,blood urea nitrogen （BUN）,alanine aminotransferase （ALT）,aspartate aminotransferase （AST）,creatine kinase （CK）,creatine kinase MB isoenzyme （CK-MB）,lactate dehydrogenase （LDH）,myoglobin （MYO）,cardiac troponin T （cTnT）,complement （C） 3,C4,IgA,IgG,IgM,anti-Jo-1 antibody and anti-nuclear antibody were determined. The results were analyzed statistically. Results The levels of 25（OH）D,Cr,UA and BUN were lower in IIM group than those in control group （P<0.05）,and the levels of ALT,AST,CK,CK-MB,LDH,MYO and C4 and the positive rate of anti-Jo-1 antibody were higher in IIM group than those in control group （P<0.05）. There was no statistical significance for sex,age,Hb,WBC,NEUT#,PLT,cTnT,IgA,IgG,IgM,C3 and anti-nuclear antibody between IIM and control groups （P>0.05）. Conclusions The level of 25（OH）D in patients with IIM is lower than that in patients with other autoimmune diseases,which can be used as an auxiliary indicator for the differential diagnosis of IIM and other autoimmune diseases.

Relationship between the levels of anti-nuclear antibodies and Epstein-Barr virus antibodies

ZHANG Minjie, GAO Yufang

2018, 33(5):  416-420.  DOI: 10.3969/j.issn.1673-8640.2018.05.010

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Objective To evaluate the specific antibody immune response against Epstein-Barr virus （EBV） in patients with anti-nuclear antibody （ANA） positivity and negativity. Methods ANA was determined by indirect immunofluorescence. Anti-extractable nuclear antigen （ENA） antibodies were determined by immunoblotting. Serum EBV-virus capsid antigen（VCA） IgM,EBV-VCA IgG,EBV-early antigen（EA） IgG and EBV nuclear antigen（EBNA-1） IgG levels were determined by enzyme-linked immunosorbent assay（ELISA） in 80 patients with ANA positivity and 48 healthy subjects. The difference of EBV antibody positive rates and levels was evaluated in ANA-positive patients in comparison with those in ANA-negative healthy controls. The relationship between EBV antibody level and the types and numbers of ENA antibodies was analyzed. Results EBV-VCA IgG,EBV-EA IgG and EBNA-1 IgG levels were higher in ANA-positive patients than those in healthy controls （P<0.01）,and ANA-positive patients showed a higher EBV-EA IgG positive rate compared to healthy controls（χ²=5.747,P=0.017）. Furthermore,elevated EBNA-1 IgG was found in anti-SS-A/Ro antibody positive and anti-SS-B/La antibody positive groups compared to those in anti-SS-A/Ro antibody negative and anti-SS-B/La antibody negative groups（Z=-2.630,P=0.008;Z=-2.515,P=0.011）. EBV-VCA IgG and EBV-EA IgG levels had no statistical significance （P>0.05）. EBV-VCA IgG and EBV-EA IgG were higher in anti-nucleosome antibody positive group than those in anti-nucleosome antibody negative group （Z=-2.355,P=0.018;Z=-2.017,P=0.043）,while there was no statistical significance for EBNA-1 IgG （P>0.05）. There was difference in the number of anti-ENA antibodies and the distribution of EBV-EA IgG levels （χ²=11.380,P=0.023）. Conclusions EBV reactivation might be correlated with the presence of ANA.

Peripheral blood monocyte M2/M1 ratio for the diagnosis of breast cancer

DU Yan, LIU Hua, ZHANG Boke, LIU Yiwen, HE Yiqing, YANG Cuixia, ZHANG Guoliang, GAO Feng

2018, 33(5):  421-424.  DOI: 10.3969/j.issn.1673-8640.2018.05.011

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Objective To compare the difference of peripheral blood monocyte M2/M1 ratio between breast cancer patients and healthy subjects,and to investigate the role of peripheral blood monocyte M2/M1 ratio as a circulating tumor marker. Methods Flow cytometry was used to determine peripheral blood monocyte M2/M1 ratio in 89 patients with breast cancer and 53 healthy subjects. The results of carcinoembryonic antigen （CEA） and carbohydrate antigen15-3 （CA15-3） determinations were analyzed comparatively. Results The peripheral blood monocyte M2/M1 ratio in patients with breast cancer was higher than that in healthy subjects（P<0.001）. The area under receiver operating characteristic （ROC）curve of peripheral blood monocyte M2/M1 ratio determination was bigger than those of CEA and CA15-3 determinations. Conclusions The application of flow cytometry in determining peripheral blood monocyte M2/M1 ratio for breast cancer patients is of high diagnostic significance. Peripheral blood monocyte M2/M1 ratio may become a new circulating tumor marker for the diagnosis of breast cancer.

Performance of CellaVision DM96 automated image analysis system for determining red blood cell morphological abnormalities

SHEN Huiying, LIN Xiaoyi, YANG Hui, ZHENG Jianxin

2018, 33(5):  428-430.  DOI: 10.3969/j.issn.1673-8640.2018.05.013

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Objective To evaluate the performance of CellaVision DM96 automated image analysis system for determining red blood cell morphological abnormalities. Methods A total of 500 ethylenediaminetetraacetic acid-K₂anticoagulated peripheral blood samples were made into blood smears and stained,and they were determined by DM96 and manual microscopy. The results of manual microscopies were as standard. The sensitivity and specificity of DM96 were evaluated. Results By manual microscopy,there were 12 kinds of red blood cell morphological abnormalities. The overall accuracy of DM96 was 94.9%. The sensitivities ranged from 23.1% to 89.7% according to different kinds of red blood cell morphological abnormalities,while the specificity and consistency were >90% for all red blood cell morphological abnormalities. Conclusions CellaVision DM96 automated image analysis system plays a role in identifying red blood cell morphological abnormalities. However,positive samples should be verified by manual microscopy.

Performance verification and interference factors of SYSMEX XN-9000 hematology analyzer for the determinations of reticulocyte count and parameters according to CAP accreditation requirements

JIANG Haoqin, GU Jianfei, CHEN Jian, WANG Ji, WANG Kaijun, LÜ Yuan

2018, 33(5):  431-436.  DOI: 10.3969/j.issn.1673-8640.2018.05.014

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Objective To assess the performance of reticulocyte （RET） determination and its specific parameters by SYSMEX XN-9000 hematology analyzer,and to improve the diagnosis and treatment of anemia. Methods A total of 508 specimens were collected. New methylene blue （NMB） visual microscopy method and SYSMEX XN-9000 for the determination of RET count were compared,and the interference factors were analyzed. The precision,carry-over rate,comparability,accuracy and interference factors of RET determination by SYSMEX XN-9000 were evaluated according to the Clinical and Laboratory Standards Institute （CLSI）-the International Council for Standardization in Haematology （ICSH）document H44-A2. The correlation analysis was performed by linear regression analysis and paired t test. The consistency test was performed by Bland-Altman test,and the interference factors were assessed by t test or Wilcoxon rank sum test. Results The coefficient of determination （r²） between NMB visual microscopy method and SYSMEX XN-9000 was 0.97,and the consistency rate was 91.7%. The precision,carry-over rate,accuracy and stability were within allowable ranges. Linear range and normal reference interval met the requirements of verification. The main sources of spuriously high RET counts were erythrocytosis,thrombocytosis,erythrocyte fragments and nucleated erythrocytes,especially autofluorescence due to drugs and malaria. Conclusions SYSMEX XN-9000 for the determination of RET count has good performance. Potential interference may exist,which should be corrected in time.

Flow fluorescent dot matrix technique for hepatitis B virus genotyping

ZHU Jun, ZHU Yuqing, ZHU Lingfeng, JIANG Lingli, XU Chong

2018, 33(5):  437-441.  DOI: 10.3969/j.issn.1673-8640.2018.05.015

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Objective To establish a flow fluorescent dot matrix technique （liquid microarray） for the determinations of hepatitis B virus （HBV） genotype B and C. Methods Specific primers against genotype B and C of HBV were designed to have 5' terminal labeled by biotin. After amplification by multiple polymerase chain reaction （PCR）,the products were hybridized with different genotype specific oligonucleotide probes conjugated on the beads coded with different fluorescence. The beads were stained with streptavidin-phycoerythrin,and were determined by Luminex. A total of 67 samples were determined for genotyping by sequencing （24 cases of genotype B and 43 cases of genotype C）. The efficiency of liquid microarray was evaluated. Results The results of liquid microarray were compared with those of sequencing,and the consistency rate was 94% （63/67）. In 24 cases of genotype B determined by sequencing,only 1 case got double-positive signals from genotype B and C probes determined by liquid microarray. However,in 43 cases of genotype C,there were 3 cases getting double-positive signals. Conclusions Liquid microarray is accurate and effective for HBV genotyping,and it has the advance for the further determination of mixed infection of HBV with different genotypes.

Establishment of magnetic particle chemiluminescence for the determination of urinary type Ⅳ collagen and its clinical application in membranous nephropathy

WANG Lei, CHEN Weiqin, XU Minyi, CHEN Xudong

2018, 33(5):  442-446.  DOI: 10.3969/j.issn.1673-8640.2018.05.016

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Objective To establish a magnetic particle chemiluminescence for the determination of urinary type Ⅳ collagen（ⅣC）,and to investigate the role of urinary ⅣC in membranous nephropathy（MN）. Methods A magnetic particle chemiluminescence was established for the determination of urinary ⅣC. The performance （determination limit,linear range,accuracy,precision,recovery rate and sensitivity） was verified. The receiver operating characteristic （ROC）curve was used to evaluate the efficiency of urinary ⅣC in the diagnosis of MN. The urinary ⅣC levels of 274 patients with chronic kidney disease（CKD） was determined,and the changes of urinary ⅣC levels in different pathological types and different CKD stages were compared. Results Urinary ⅣC was determined by magnetic particle chemiluminescence,and the standard curve was drawn,with the equation of Y= 42.802X²+10 626X-10 856 （r²=0.999）. The lower determination limit was 1.48 ng/mL,the within-run coefficients of variation（CV） for low-level, middle-level and high-level samples were 4.22%,8.16% and 3.46%,and the between-run CV for low-level and middle-level samples were 18.23% and 17.61%. The average recovery rate was 97.0%. ROC curve showed that the area under curve （AUC） of urinary ⅣC in the diagnosis of MN was 0.875 [95% confidence interval （CI）0.837-0.913]. The optimal cut-off value of urinary ⅣC was 4.15 ng/mL. The sensitivity was 79.0%,and the specificity was 86.7%. Compared with healthy control group,the levels of urinary ⅣC in MN group,mesangial proliferative glomerulonephritis（MsPGN） group and non-membranous nephropathy （N-MN）group were increased（P<0.01）. Compared with N-MN group,the levels of urinary ⅣC in MN group and MsPGN group were increased （P<0.01）. For CDK staging,there was a statistical significance in urinary ⅣC level between CKD1 group and CKD2,CDK3,CDK4 groups（P<0.01）. There was no statistical significance between CKD1 and CKD5 groups （P>0.05）. Conclusions Magnetic particle chemiluminescence for the determination of urinary ⅣC is simple,reliable and inexpensive,and it plays a role for the diagnosis and prognosis of MN.

Establishment and validation of a time-resolved fluoroimmunoassay for transient receptor potential channel 5

LU Yangfan, HUANG Biao, MA Xin

2018, 33(5):  447-451.  DOI: 10.3969/j.issn.1673-8640.2018.05.017

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Objective Transient receptor potential channel 5（TRPC5） can be as a marker of breast cancer drug resistance. To establish a method for the diagnosis of breast cancer in vitro drug resistance. Methods Time-resolved fluoroimmunoassay（TRFIA）was established for TRPC5. Anti-TRPC5 antibody was prepared by immunizing New Zealand white rabbits with TRPC5-keyhole limpet hemocyanin （KLH） as an immunogen. Mucin 1 （MUC1） antibody coated immunomagnetic beads to process samples. TRPC5 peptides, coated with 96-well plates as solid-phase antigens, competed with free TRPC5 antigen. Eu³⁺-goat anti-rabbit antibody was used as a tracer. Results The sensitivity was 1 ng/mL for TRPC5 TRFIA. The range was 5-500 ng/mL. The coefficient of variation（CV）was 5.5%. The mean recovery rate was 94.6%. The ED80,ED50 and ED20 of TRFIA were（4.68±0.13）,（321.66±2.77） and （714.42±4.07）ng/mL,respectively. There was statistical significance for the results of chemotherapy-resistant patients and chemotherapy-tolerant patients（P<0.000 1）. Conclusions TRPC5 TRFIA has a certain degree of differentiation between breast cancer chemotherapy resistance or not. It has clinical significance and is worth further study.

Study of 23S rRNA gene mutation in 4 clinical isolates of linezolid non-sensitive Enterococcus faecalis

LIN He, XUE Miao, WANG Huaizhou, HUANG Xiaochun, QIN Yanghua

2018, 33(5):  452-456.  DOI: 10.3969/j.issn.1673-8640.2018.05.018

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Objective To study the drug resistance mechanism of 4 clinical isolates of linezolid non-sensitive Enterococcus faecalis. Methods Phenotype identification and in vitro antimicrobial susceptibility test of the 4 clinical isolates of linezolid non-sensitive Enterococcus faecalis were performed by Vitek 2 Compact microbial analysis system,and the minimum inhibitory concentration （MIC） of linezolid was rechecked by E-test strips. Chloramphenicol-florfenicol resistance （cfr） gene,23S rRNA V region and 4 copies of 23S rRNA were amplified and sequenced to find mutations. Results No cfr gene was found in the 4 clinical isolates of linezolid non-sensitive Enterococcus faecalis,and sequencing 23S rRNA V region did not find G2576U mutation. After further amplification and sequencing of 4 copies of 23S rRNA,only G2576U mutation was found in 1 isolate,and all 4 isolates contained U2826C mutation. G2389A,U2363C and A2881G mutations were also determined. Since U2826C was located at the edge of variable region of 23S rRNA,the sequcening results showed that linezolid non sensitive Enterococcus faecalis harbored U2826C mutation. Conclusions For the 4 clinical isolates of linezolid non-sensitive Enterococcus faecalis 23S rRNA,random mutation might be the main mechanism of drug resistance to linezolid.

Development and application of clinical laboratory equipment management system

LUO Jiajun, QIU Wenhui, YIN Xiaomao, WU Haixiong, ZENG Fangyin

2018, 33(5):  457-462.  DOI: 10.3969/j.issn.1673-8640.2018.05.019

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Objective To develop a clinical laboratory equipment management system for realizing information-based management. Methods A clinical laboratory equipment management system was developed by Visual Basic 6.0 and SQL Server 2005 softwares. Results The system consisted of 6 modules. Equipment management module mainly for file management and basic settings can quickly access equipment basic information and related information. Maintenance module included routine maintenance,planning maintenance and troubleshooting,which had the highest frequency for staff. Business management module included purchase,acceptance,allocation,lease,scrap and bad reports,which can achieve the whole life cycle management of equipment. Statistical analysis module included benefits,depreciation and use analysis. Using this module,managers can easily understand the benefit and use of equipment assets in the department. Appendix management module included 3 kinds of certificates and relevant documents,which can set different permissions. System setting module was for administrator background management,including parameter settings,personnel settings,operation logs and so on. After debugging,the system ran stably and replaced original manual and paper registration mode. After the system on-line running,the time of equipment archive management was shortened from 30 min to 2 min,and the time of record accessing and file searching reduced from 15 min to 30 s. The maintenance registration and fault record was decreased by 70%. Employee satisfaction increased from 62% to 90%. Conclusions The system helps us with improving work efficiency,reduce operation cost,realize information-based and paperless management of equipments.