Table of Content

30 July 2018, Volume 33 Issue 7

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Orginal Article

Roles of SF,Vit B₁₂ and FA in 3 subtypes of myelodysplastic syndrome

JIANG Xianyong, CHEN Xiaoli, LIANG Zhuangyan, ZHANG Yan, YUAN Caijia, ZHOU Zhixiong, XIA Yong, SHU Yang, LI Dengjun

2018, 33(7):  581-585.  DOI: 10.3969/j.issn.1673-8640.2018.07.001

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Objective To investigate the roles of serum ferritin （SF）,vitamin B₁₂（Vit B₁₂）and folic acid（FA）in the auxiliary diagnosis and prognosis evaluation of 3 subtypes of myelodysplastic syndrome（MDS）[refractory anemia（RA）,refractory anemia with excess blasts（RAEB）-Ⅰ and RAEB-Ⅱ]. Methods A total of 55 MDS patients（13 cases of RA,18 cases of RAEB-Ⅰ and 24 cases of RAEB-Ⅱ） and 50 healthy subjects（healthy control group） were enrolled,and the levels of SF, Vit B₁₂ and FA were determined. The 55 MDS patients were classified into relatively low risk group（25 cases）and relatively high risk group （30 cases）according to the International Prognostic Scoring System （IPSS）. Receiver operating characteristic（ROC）curve was used to evaluate the roles of SF,Vit B₁₂ and FA in assessing the risk of MDS. The roles of SF,Vit B₁₂ and FA for prognosis was evaluated by Kaplan-Meier survival curve. Results The levels of SF,Vit B₁₂ and FA in the 3 subtypes of MDS group were higher than those in healthy control group （P<0.01）,especially for RAEB- Ⅱ patients. The levels of SF,Vit B₁₂ and FA in relatively high risk group were higher than those in relatively low risk group （P<0.01）. ROC curve analysis showed that the areas under curve（AUC） of single determinations of SF,Vit B₁₂ and FA for distinguishing MDS patients with low risk from high risk were 0.749,0.791 and 0.811,respectively. The optimal cut-off values of SF,Vit B₁₂ and FA were 425.77 ng/mL,940.77 pg/mL and 18.28 ng/mL,respectively. The AUC of the combined determination was 0.907. The median survival time of good prognosis group was longer than that of poor prognosis group （P<0.01）,when FA+Vit B₁₂+SF （SF>425.77 ng/mL,Vit B₁₂>940.77 pg/mL and FA>18.28 ng/mL） was used to predict prognosis. Conclusions The single determinations of SF,Vit B₁₂ and FA have auxiliary diagnostic value for the 3 subtypes of MDS. The combined determination of SF,Vit B₁₂ and FA plays a role in the prognosis evaluation of MDS.

Combined determination of SAA,CRP and ESR in the diagnosis of AECOPD

FU Haiwei, KONG Yiming, LI Xiaobo, ZHANG Tianwei, DAI Yuanrong

2018, 33(7):  586-589.  DOI: 10.3969/j.issn.1673-8640.2018.07.002

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Objective To study the role of serum amyloid A（SAA）,C-reactive protein（CRP） and erythrocyte sedimentation rate（ESR） combined determination in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods A total of 100 AECOPD patients were enrolled and classified into AECOPDⅠ group （44 cases） and AECOPDⅡ/Ⅲ group （56 cases） according to the severity of AECOPD. Totally,50 healthy subjects were enrolled as control group. The levels of SAA,CRP and ESR were determined. Logistic regression and receiver operating characteristic（ROC） curve were used to analyze the diagnosis efficiency of SAA,CRP and ESR single determinations and combined determination. Results The levels of SAA,CRP and ESR in control,AECOPDⅠ and AECOPD Ⅱ/Ⅲ groups increased in turn （P<0.05）. ROC curve analysis showed that the area under curve （AUC） of SAA,CRP and ESR single determinations were 0.835,0.906 and 0.873,the sensitivities were 79.98%,80.54% and 83.54%,the specificities were 85.65%,87.78% and 78.76%,the accuracies were 86.76%,79.76% and 82.13%,and the Youden indices were 0.66,0.68 and 0.62, respectively. The AUC of SAA,CRP and ESR combined determination for the diagnosis of AECOPD was 0.949,the sensitivity was 96.65%,the specificity was 92.35%,the accuracy was 90.34%,and the Youden index was 0.89. Conclusions SAA,CRP and ESR combined determination has high sensitivity and specificity for the diagnosis of AECOPD.

Combined determination of multiple tumor markers for the diagnosis of primary lung cancer

ZHANG Haichen, WANG Hao, SONG Yunxiao, MA Jin

2018, 33(7):  590-596.  DOI: 10.3969/j.issn.1673-8640.2018.07.003

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Objective To investigate the role of combined determination of multiple tumor markers in the diagnosis of lung cancer,and to establish appropriate strategies of tumor marker determinations. Methods A total of 280 patients with primary lung cancer（PLC） and 455 patients with benign pulmonary disease（BPD） were enrolled. Serum alpha-fetoprotein（AFP）,carcinoembryonic antigen（CEA）,carbohydrate antigen（CA）50,CA242,CA125,CA15-3,CA19-9,cytokeratin 19 fragment（CYFRA 21-1）,CA72-4,squamous cell carcinoma antigen （SCC-Ag）,neuron-specific enolase（NSE） and tumor specific growth factor（TSGF） were determined. Receiver operating characteristic（ROC） curve was used to evaluate diagnosis performance. Exploratory factor analysis（EFA） and Logistic regression model were used to evaluate the role of combined determination. Results The levels of CEA,CA15-3,CA72-4,CA242,CYFRA 21-1,CA125,CA19-9,CA50,SCC-Ag,NSE and AFP in PLC group were higher than those in BPD group （P<0.01）,except for TSGF. ROC curve analysis showed that the areas under curves （AUC）of CA15-3,NSE,CA125,CEA,CYFRA 21-1 and CA72-4 in PLC group were ≥0.7,while the AUC of TSGF,CA19-9,CA242,AFP,CA50 and SCC-Ag were <0.7. After excluding TSGF,EFA showed that there were 4 independent potential factors in PLC group. The independent potential factors were evaluated by comprehensive evaluation in order to give PLC predictive model,which was made up of CA125,CA19-9,CYFRA 21-1,NSE,SCC-Ag,CEA and CA15-3. The diagnosis performance of PLC predictive model and the combined determination of 11 tumor markers had no difference （Z=1.744,P=0.081）. The PLC predictive model had better diagnosis performance comparing to that of any single tumor marker determination,having the AUC of 0.831,the sensitivity of 70.7% and the specificity of 83.7%,and the positive likelihood ratio （+LR） and negative likelihood ratio （-LR） were 4.35 and 0.35,respectively. The optimal cut-off value was -0.958 8. Conclusions Comparing to single tumor marker determinations,the PLC predictive model reached a balance between sensitivity and specificity. The diagnosis performance of PLC predictive model is not decreased with the reduction of tumor marker number.

PCT and hs-CRP determinations and the combined determination for the diagnosis of neonatal septicemia

GU Lei, YANG Yuqin, WANG Xia

2018, 33(7):  597-600.  DOI: 10.3969/j.issn.1673-8640.2018.07.004

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Objective To investigate the role of serum procalcitonin （PCT） and high-sensitivity C-reactive protein（hs-CRP） combined determination in the diagnosis and treatment of neonatal septicemia. Methods A total of 156 patients with neonatal septicemia and 245 control neonates were enrolled. There were 88 cases of ≤3 d and 68 cases of 4-28 d in septicemia group. There were 162 cases of ≤3 d and 83 cases of 4-28 d in control group,and the cases in control group had respiratory distress syndrome and neonatal asphyxia. According to preset periods,the blood samples were collected for PCT and hs-CRP determinations,blood culturing and blood routine test,and the data were analyzed statistically. Results The results of blood culturing were as gold standard. The sensitivities, specificities, positive predictive values, negative predictive values and Youden indices of PCT determination were 94.3%,39.5%,45.9%,92.7%,0.34 for ≤3 d group and 85.3%,86.7%,84.1%,87.8%,0.72 for 4-28 d group, respectively. The sensitivities, specificities, positive predictive values, negative predictive values and Youden indices of hs-CRP determination were 85.2%,83.3%,73.5%,91.2%,0.69 for ≤3 d group and 83.8%,83.1%,80.3%,86.2%,0.67 for 4-28 d group, respectively. The sensitivities, specificities, positive predictive values, negative predictive values and Youden indices of PCT and hs-CRP combined determination were 80.7%,90.1%,81.6%,89.6%,0.71 for ≤3 d group and 77.9%,90.4%,86.9%,83.3%,0.72 for 4-28 d group, respectively. Conclusions The combined determination of PCT and hs-CRP can improve the diagnosis of neonatal septicemia.

Role of serum IL-17A level in patients with polycystic ovary syndrome

WANG Jing, CHEN Li, LIU Chunhua, LI Lichun

2018, 33(7):  601-603.  DOI: 10.3969/j.issn.1673-8640.2018.07.005

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Objective To investigate the role of serum interleukin（IL）-17A level in patients with polycystic ovary syndrome （PCOS）. Methods A total of 45 PCOS patients were enrolled,45 healthy women were enrolled as healthy control group,and 38 non-PCOS patients were enrolled as disease control group. Serum levels of dehydroepiandrosterone sulphate （DHEAS） and total testosterone （TT） were determined. The levels of serum IL-17A, IL-6 and transforming growth factor beta₁（TGF-β₁） were determined by enzyme-linked immunosorbent assay （ELISA）. Results Serum TT, DHEAS,IL-17A,IL-6 and TGF-β₁ levels were higher in PCOS group than those in healthy and disease control groups （P<0.05）. Serum level of TT was positively related to IL-17A,IL-6 and TGF-β₁（r=0.632,P<0.01;r=0.650,P<0.05;r=0.708,P<0.05）. After treatment,serum levels of IL-17A,IL-6 and TGF-β₁ in PCOS group were lower than those before treatment. Conclusions PCOS patients have increased serum IL-17A level,and serum IL-17A could be a biomarker for PCOS.

Cluster analysis of serum anti-nuclear antibody profile in 164 subjects with nuclear speckled pattern

LUO Wenbin, WANG Yekai, YU Qian, LIN Qilong

2018, 33(7):  604-607.  DOI: 10.3969/j.issn.1673-8640.2018.07.006

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Objective To analyze the difference of anti-nuclear antibody （ANA） in subjects with nuclear speckled pattern by cluster analysis. Methods Serum samples were collected from 164 subjects with nuclear speckled pattern. Indirect immunofluorescence （IIF） and immunoblotting were used to determine ANA and ANA profile. Anti-cyclic citrullinated peptide （CCP）antibody,liver function,renal function,rheumatoid factor （RF）,immunoglobulin,complement and routine blood test indicators were determined. Results The 164 subjects with nuclear speckled pattern were classified,and 3 clusters were identified by cluster analysis. Cluster A （120 cases） was characterized by high positive rates of antibodies against SS-A,Ro-52 and SS-B. Cluster B （21 cases） was characterized by a high positive rate of antibody against U1-RNP. Cluster C （23 cases） was characterized by high positive rates of antibodies against Sm,ribosome P protein, double-stranded DNA（ds-DNA）, nucleosome and histone. The positive rate of anti-CCP antibody of Cluster B was higher than those of Cluster A and Cluster C （P<0.01）. Cluster C had higher levels of creatinine（Cr）,immunoglobulin G （IgG） and globulin （GLB）,and Cluster C had lower level of white blood cell （WBC） than those of Cluster A and Cluster B （P<0.01）. Conclusions The study on cluster patterns of serum ANA profile in nuclear speckled pattern positive subjects is helpful for improving the determination rate of autoimmune diseases（AID） and timely-symptomatic treatment.

Procalcitonin and C-reactive protein in the diagnosis of neonatal bloodstream infection

WANG Zhaorong, SHAO Xuefeng

2018, 33(7):  608-611.  DOI: 10.3969/j.issn.1673-8640.2018.07.007

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Objective To investigate the roles of procalcitonin （PCT） and C-reactive protein （CRP） in the diagnosis of neonatal bloodstream infection,and to provide a reference for the early diagnosis and antibiotic treatment of bloodstream infection. Methods A total of 55 patients with blood culturing positive were enrolled as experimental group,and they were determined for PCT and CRP. Totally,55 cases with blood culturing negative confirmed by clinical diagnosis in the same period were enrolled as control group. The experimental group were sub-classified according to Gram-positive and Gram-negative bacteria,and the difference of PCT and CRP levels among these groups was compared. The efficiencies of PCT and CRP for the diagnosis of neonatal bloodstream infection were analyzed and compared according to receiver operating characteristic （ROC）curve. Results In the experimental group,PCT was 0.65（0.25-7.00） ng/mL,which was higher than that in control group [0.17（0.12-0.24） ng/mL]（P=0.000）. CRP in the experimental group was 10.97（1.04-23.82） mg/L,and that in control group was 2.49（0.62-9.62） mg/L （P=0.002）. The PCT in Gram-negative bacteria was higher than that in Gram-positive bacteria （P<0.05）,and CRP level had no statistical significance between the 2 subgroups （P>0.05）. ROC curve analysis showed that when PCT was 0.245 ng/mL as the cut-off value of neonatal bloodstream infection,the sensitivity,specificity,positive predictive value, negative predictive value and accuracy were 76.4%,78.2%,77.8%,76.8% and 77.3%. The area under curve （AUC） was 0.830. The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 56.4%,72.7%,67.4%,62.5% and 64.5%,respectively,when CRP was 9.185 mg/L as the cut-off value of neonatal bloodstream infection. The AUC was 0.669. Conclusions The determinations of PCT and CRP play roles in diagnosing neonatal bloodstream infection. The sensitivity and specificity of PCT determination are superior to those of CRP determination. PCT level is high in bloodstream infection patients infected with Gram-negative bacteria than that with Gram-positive bacteria.

Several indicators for the early diagnosis of neonatal severe infection

LU Wenfeng, ZHANG Jie, FANG Chengzhi

2018, 33(7):  612-615.  DOI: 10.3969/j.issn.1673-8640.2018.07.008

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Objective To evaluate the roles of several indicators,including white blood cell （WBC）,neutrophil ratio （NEUT%）,platelet （PLT）,C-reactive protein （CRP）,procalcitonin （PCT）and serum amyloid A （SAA） in the early diagnosis of neonatal severe infection and the assessment of neonatal infection severity. Methods A total of 158 newborns were enrolled. They were classified into severe infection group（53 cases）,local infection group（46 cases）and non-infection group（59 cases）according to clinical diagnosis. WBC,NEUT%,PLT,CRP,PCT and SAA were determined. Receiver operating charateristic （ROC）curve was used to evaluate their roles in the diagnosis of neonatal severe infection. Results The positive rates of WBC,PCT,hs-CRP and SAA had statistical significance in severe infection group,local infection group and non-infection group （P<0.05）. The positive rates of NEUT% and PLT had statistical significance in severe infection group,local infection group and non-infection group （P<0.05）. The positive rate of CRP was higher in severe infection group than those in the other 2 groups （P<0.05）. The levels of PCT and SAA had statistical significance in severe infection,local infection and non-infection groups （P<0.05）. The levels of PLT and CRP had statistical significance between severe infection group and the other 2 groups （P<0.05）. The level of WBC had statistical significance between local infection group and the other 2 groups （P<0.05）. There was no statistical significance for NEUT% among the 3 groups （P>0.05）. ROC curve analysis showed that PCT and CRP had high accuracies in the diagnosis of neonatal severe infection. The areas under curves （AUC） were 0.92 and 0.91. Conclusions WBC,NEUT%,PCT,CRP and SAA play roles in the early diagnosis of neonatal severe infection. The determinations of PCT,hs-CRP,CRP and SAA have clinical significance in the assessment of neonatal infection severity.

Drug resistance characteristics and epidemiological analysis of 8 isolates of NDM-1-producing Enterobacteriaceae

ZHANG Pan, SHEN Zhenhua, ZHANG Yanhua, LIU Xinghui, LI Xiangyang

2018, 33(7):  616-621.  DOI: 10.3969/j.issn.1673-8640.2018.07.009

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Objective To investigate the drug resistance and epidemiological characteristics of 8 isolates of New Delhi metallo-β-lactamase 1（NDM-1）-producing Enterobacteriaceae isolated from the Second Affiliated Hospital of Wenzhou Medical University. Methods Vitek 2 Compact automatic microbiological system was used for bacterial identification and antimicrobial susceptibility test. β-lactamase genes were determined by polymerase chain reaction （PCR）,which were performed sequencing and BLAST comparison analysis. The transferability of NDM-1 gene was determined by conjugational transfer experiment. The homology was analyzed by pulsed-field gel electrophoresis （PFGE）. Results The 8 isolates showed high drug resistance to β-lactam antibiotics and β-lactamase inhibitor combinations,and they had relatively better susceptibility to aminoglycosides and fluoroquinolones. Most isolates carried multiple drug resistance genes,including 5 isolates harboured SHV gene,2 isolates harboured CTX-M-1 gene,and 1 isolate harboured DHA-1 gene. Transconjugants were successfully obtained from all NDM-1-producing isolates except 2 isolates of Escherichia coli. All transconjugants showed high drug resistance to β-lactam antibiotics. PFGE showed that 2 isolates of Escherichia coli belonged to different clone isolates,and 2 from 3 isolates of Enterobacter cloacae had homology,which was seen as the same clone. Conclusions Most NDM-1-producing isolates carry multiple drug resistance genes at the same time,which show high drug resistance to β-lactam antibiotics and β-lactamase inhibitor combinations. NDM-1 gene has horizontal transferability in different isolates.

Roles of PCT,DD and MPV determinations in severe acute pancreatitis

LIU Shouzhu, ZHAO Haiming

2018, 33(7):  622-625.  DOI: 10.3969/j.issn.1673-8640.2018.07.010

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Objective To assess the roles of procalcitonin （PCT）,D-dimer （DD） and mean platelet volume （MPV） for the early diagnosis and curative effect monitoring of severe acute pancreatitis （SAP）. Methods A total of 75 patients with acute pancreatitis（AP） were enrolled,including 45 cases of mild acute pancreatitis（MAP） and 30 cases of SAP. The levels of PCT,DD and MPV were determined before treatment and after treatment for 24 h,48 h and 7 d. Receiver operating characteristic （ROC） curve was used for evaluating diagnostic effects. The sensitivities,specificities,positive predictive values and negative predictive values of PCT,DD and MPV for the diagnosis of SAP were evaluated before treatment. After treatment for 24 h,48 h and 7 d,the curative effects and the changes of PCT,DD and MPV in patients with SAP were evaluated and compared. Results The levels of PCT,DD and MPV were higher in SAP group than those in MAP group （P=0.000）. ROC curves showed that the areas under curves were 0.929,0.856 and 0.936. The sensitivity and specificity of PCT determination were 93.3% and 80.0%,the sensitivity and specificity of DD determination were 73.3% and 80.0%,the sensitivity and specificity of MPV determination were 70.0% and 86.7%,respectively. The sensitivity of the combined determination of PCT, DD and MPV was 96.7%,and the specificity was 97.8%. After treatment for 24 h, 48 h and 7 d,the levels of PCT,DD and MPV were decreased in patients with SAP （P<0.05）. Conclusions The combined determination of PCT,DD and MPV plays a role in the diagnosis and curative effect monitoring of SAP.

Roles of reticulated platelet and related parameters in children with immunological thrombocytopenia and sepsis

SONG Hui, KONG Feifei, LIU Xuan, SHI Cuiming, CHANG Min, WANYAN Xinrui

2018, 33(7):  626-628.  DOI: 10.3969/j.issn.1673-8640.2018.07.011

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Objective To investigate the roles of reticulated platelet （RP） and related parameters in children with immunological thrombocytopenia （ITP） and sepsis. Methods A total of 30 newly diagnosed children with ITP,30 children with sepsis, 20 children with aplastic anemia （AA）（disease control group） and 30 healthy children （healthy control group） were enrolled. Their blood specimens were collected. Reticulated platelet ratio （RP%）,RP absolute value,mean platelet volume （MPV）,platelet distribution width （PDW） were determined. Results RP%, MPV and PDW in ITP and sepsis groups were higher than those in disease control and healthy control groups （P<0.05）, and those in ITP group were higher than those in sepsis group （P<0.05）. The RP absolute values in ITP and sepsis groups were lower than that in healthy control group （P<0.05）. There was no statistical significance for RP%, MPV and PDW between disease control and healthy control groups （P>0.05）. Conclusions The determinations of RP and platelet（PLT）related parameters can be used for the differential diagnosis of child diseases caused by ITP and sepsis. The determinations of RP and related parameters play roles in the assessment of bone marrow hematopoietic function.

Clinical application of human papillomavirus E6/E7 mRNA determination

XUAN Qiankun, GUO Jian, WU Wenjuan, LI Guangbo

2018, 33(7):  640-643.  DOI: 10.3969/j.issn.1673-8640.2018.07.015

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Objective To evaluate the applicability of human papillomavirus（HPV） E6/E7 mRNA determination for screening HPV infection. Methods A total of 5 308 women were enrolled. Thinprep cytologic test（TCT）was performed. HPV DNA determination was performed in 4 062 cases,and HPV E6/E7 mRNA determination was performed in 1 246 cases. According to the results of TCT,the women were classified into normal group,atypical squamous cell of undetermined significance （ASCUS）group,low-grade squamous intraepithelial lesion （LSIL）group and high-grade squamous intraepithelial lesion （HSIL）group. Results The positive rate of HPV DNA determination [17.67%（718/4 062）] was higher than that of HPV E6/E7 mRNA determination [12.12%（151/1 246）] （P<0.05）. The positive rates of HPV DNA determination and HPV E6/ E7 mRNA determination had no statistical significance among HSIL,LSIL and ASCUS groups （P>0.05）. The positive rate of HPV DNA determination in normal group was 15.07%,which was higher than that of HPV E6/E7 mRNA determination （8.90%）（P<0.05）. The positive proportions of HPV DNA and HPV E6/E7 determinations in these groups had no statistical significance （P<0.05）. LSIL and HSIL were determined as cytopathological positive,and normal group and ASCUS group were determined as cytopathological negative. The proportions of LSIL and HSIL in the positive cases of HPV E6/E7 mRNA determination [15.23%（23/151）] were higher than those in HPV DNA determination positive cases [8.64%（62/718）]（P<0.05）. There was no statistical significance for sensitivities of LSIL+HSIL screening between HPV DNA determination （83.78%）and HPV E6/E7 mRNA determination （85.19%）（P>0.05）. The specificities were 83.55% and 89.50%,respectively （P<0.05）. Conclusions HPV E6/E7 mRNA determiantion is suitable for screening HPV infection. It is more specific than HPV DNA determination for screening LSIL and HSIL. It is suitable for clinical cervical cancer screening.

Evaluation of Diascie ProBact automated microbial inoculation system

ZHENG Tian, XU Xiuli, BAI Lu, ZHOU Ke, CHEN Xiao, HAO Xiaoke

2018, 33(7):  644-648.  DOI: 10.3969/j.issn.1673-8640.2018.07.016

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Objective To compare the bacterial separation effects of Diascie ProBact automated microbial inoculation system,Copan Wasp automated microbial pretreatment system and manual method,and to evaluate the clinical application significance of Diascie ProBact automated microbial inoculation system. Methods A total of 50 clinical specimens of sputum and 50 clinical specimens of mid-stream urine were inoculated by Diascie ProBact,Copan Wasp and manual method. The sputum specimens were inoculated with a quadrant streaking and incubated at 35 ℃ in 5% CO₂ incubator. Mid-stream urine specimens were inoculated with a continuous streaking and incubated at 35 ℃ in common incubator. The bacterial growth of the 2 types of specimens was observed after 24 h. The number of isolate species and single colony isolates and the growth of bacterial colony were analyzed and compared. Results Of 0,1,2 and ≥3 isolate species in the sputum specimens,1,16,8 and 25 cases were isolated by Diascie ProBact,1,14,10 and 25 cases by Copan Wasp,and 2,14,9 and 25 cases by manual method,respectively. Of 0,1,2 and ≥3 isolate species inthe mid-stream urine specimens,20,16,8 and 6 cases were isolated by Diascie ProBact,18,17,9 and 6 cases by Copan Wasp,and 19,18,7 and 6 cases by manual method,respectively. There was no statistical significance among the 3 methods （P>0.05）. Of ≤10×10³,100×10³,1 000×10³ and ≥10 000×10³ cfu/mL bacterial quantities in the sputum specimens,4,5,8 and 33 cases were isolated by Diascie ProBact,5,5,9 and 31 cases by Copan Wasp,and 6,7,10 and 27 cases by manual method,respectively. Of 0,10³-10⁴,10⁴-10⁵ and >10⁵ cfu/mL bacterial quantities in the mid-stream urine specimens,20,8,5 and 17 cases were isolated by Diascie ProBact,18,9,6 and 17 cases by Copan Wasp,and 19,7,6 and 18 cases by manual method,respectively. There was no statistical significance among the 3 methods（P>0.05）. In the sputum specimens,the single colony of Diascie ProBact was 9.78±5.37,that of Copan Wasp was 10.48±5.59,and that of manual method was 8.82±5.31. In the mid-stream urine specimens,the single colony of Diascie ProBact was 8.78±4.38,that of Copan Wasp was 9.74±4.49,and that of manual method was 7.33±5.03. There was no statistical significance among the 3 methods for sputum and mid-stream urine specimens （P=0.310 for sputum specimens and P=0.131 for mid-stream urine specimens）. Conclusions The performance of Diascie ProBact is not different from those of Copan Wasp and manual method. It could be used to clinical practice for improving the efficiency of colony separation,reducing the frequency of re-separation and shortening the time of report.

Design of information management system and application of two-dimension barcode in clinical microbiology laboratories

SUN Qing, YE Fangmin, SHENG Huiming, XU Weihong

2018, 33(7):  649-652.  DOI: 10.3969/j.issn.1673-8640.2018.07.017

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Objective To realize information management in clinical microbiology laboratories. Methods A development tool,Microsoft Visual Studio 2010,was adopted to establish information management procedures of clinical microbiology laboratories. The application of two-dimension barcode and turn around time statistics realized the information management of operation process. Results The paperless of microbiological tests, the controllability of information and the traceability of test results were realized and improved,which met the needs of clinicians for the timely diagnosis and treatment of infectious diseases,the management of antimicrobial drugs and the management of drug-resistant bacterium infection. Conclusions Two-dimension barcode for information management procedures of clinical microbiology laboratories changes original manual operation processes of microbiological tests,reduce error rates,enhance test quality effectively and realize the information management in clinical microbiology laboratories.

Internal audit result analysis of proficiency testing provider quality management system and strategies for improvement

GUO Xiaojun, FAN Jinong, XU Chong, ZHU Jun, YANG Xue, LOU Jiao, HUANG Yanjun

2018, 33(7):  653-656.  DOI: 10.3969/j.issn.1673-8640.2018.07.018

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Objective Through comparing and analyzing the nonconformity items in the internal audit of quality management system of Shanghai Center for Clinical Laboratory,to improve proficiency testing provider quality management system. Methods The characteristics,data and changes of nonconformity items in the internal audit of Shanghai Center for Clinical Laboratory from 2012 to 2017 were analyzed statistically. Results The top 3 items from the 25 factors of criteria were equipments,facilities and environment （17.80%）,personnel （16.10%） and proficiency testing scheme design （13.56%）. The top 3 items accounted for 47.46% totally. Conclusions Quality management system needs a continuous improvement process．The improvement key points are strengthening personnel training and supervision and improving personnel motivation sufficiently.

Targeting inhibition on the overexpressed HRR proteins in cancer cells to enhance chemoradio-sensitivity

ZHU Jiabei, HUANG Nan, CUI Zhongqi, YANG Qingyuan, PAN Qiuhui

2018, 33(7):  657-662.  DOI: 10.3969/j.issn.1673-8640.2018.07.019

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Homologous recombination repair （HRR） is a prominent approach for repairing exogenous and endogenous DNA double-stranded breaks in mammalian cells,which can preserve genome integrity and stability to ensure the function and viability of mammalian cells. It has been widely recognized as a tumor suppressor. Recent studies have found that cancer cells with increased expression of HRR proteins hold powerful repair vitality,causing resistance to chemotherapies and radiotherapies by repairing DNA damage triggered by these curing methods,impeding cell apoptosis pathway and activating cell survival pathway,thus greatly promoting cancer cell survival. These overexpressed proteins play an oncogenic role in cancer cells,as indicate by maintaining genome stability of these cells and promoting tumorigenesis and tumor development,thereby providing potential targets of precision cancer therapy. Targeting inhibition through drugs on the overexpressed HRR proteins in cancer cells will not only stimulate cell apoptosis,but also remarkably enhance the cellular sensitivity to ionizing radiation and cytotoxic chemotherapies.