Table of Content

30 September 2019, Volume 34 Issue 9

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Expression and clinical significance of long noncoding RNA CCAT2 in serum of patients with gastric cancer

CAO Jijun, WANG Jinhu, SHEN Xianjuan, JU Shaoqing

2019, 34(9):  775-779.  DOI: 10.3969/j.issn.1673-8640.2019.09.001

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Objective To investigate the relative expression of serum long noncoding RNA（lncRNA） colon cancer-associated transcript 2（CCAT2） in patients with gastric cancer（GC） and its role in the early diagnosis and prognosis monitoring of GC. Methods A total of 40 GC patients diagnosed by pathology department were enrolled from the Affiliated Hospital of Nantong University,and their preoperative and postoperative serum samples were collected. Totally,30 patients with gastric benign lesions（gastric ulcers and gastric polyps） and 43 age-matched healthy subjects（healthy control group） were enrolled. The relative expression of CCAT2 was determined by real-time fluorescence quantitation polymerase chain reaction（PCR）,and chemiluminescence immunoassay was used to determine carcinoembryonic antigen（CEA）and carbohydrate antigen 19-9（CA19-9）. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficiency of CCAT2. Results Comparing with gastric benign lesion and healthy control groups,the relative expression of CCAT2 were higher in GC group（P<0.01）,and there was no statistical significance between gastric benign lesion and healthy control groups（P>0.05）. The preoperative relative expression of CCAT2 was higher than postoperative one with statistical significance（P<0.01）. High expression levels of CCAT2 were correlated with tumor size（P=0.028）,TNM stage（P=0.012） and lymph node metastasis（P=0.034）,and there was no correlation with age and sex（P>0.05）. The area under ROC curve（AUC） of CCAT2 was 0.851 [95% confidence interval（CI） 0.772-0.930,P<0.05] for the differential diagnosis of GC patients from healthy subjects. For the differential diagnosis of GC from gastric benign lesions,the AUC was 0.808（95% CI 0.701-0.916,P<0.05） as the cut-off value of 1.125. The combined determination of CCAT2 with CEA and CA19-9 can improve the sensitivity（98%）. There was no correlation between relative expression of CCAT2 and CEA,CA19-9 in GC group. Conclusions As a new biological marker,CCAT2 plays a role in the diagnosis and prognosis monitoring of GC,and it can improve the diagnostic efficiency combined with CEA and CA19-9 in GC patients.

Role of serum hepcidin in the diagnosis of myocardial damage among coronary heart disease patients

SHU Ming, JIN Lu, CHEN Qiuying

2019, 34(9):  783-786.  DOI: 10.3969/j.issn.1673-8640.2019.09.003

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Objective To investigate the roles of serum hepcidin（Hepc）,cardiac troponin I（cTnI） and homocysteine（Hcy） in patients with coronary heart disease. Methods A total of 120 patients with coronary heart disease were enrolled. There were 40 cases of stable angina pectoris（SAP）,40 cases of unstable angina pectoris（UAP） and 40 cases of acute myocardial infarction（AMI）. A total of 40 healthy subjects were enrolled as healthy control group. The level of Hepc was determined by enzyme-linked immunosorbent assay（ELISA）,cTnI was determined by chemiluminescence,and Hcy was determined by enzymatic cycling assay. Results The level of Hepc in coronary heart disease group was 94.3（36.3-134.6）μg/L,cTnI was 0.180（0.017-0.490）μg/L,and Hcy was （19.3±7.7）μmol/L,which were higher than those in healthy control group（P<0.05）. The levels of Hepc,cTnI and Hcy in SAP group,UAP group and AMI group were increased in turn,respectively（P<0.05）. The level of Hepc was 67.9（33.7-74.5）μg/L in SAP group,which was higher than that in healthy control group [31.6（26.8-39.7）μg/L]（P<0.05）. The areas under receiver operating characteristic（ROC） curves（AUC） of Hepc,cTnI and Hcy in the diagnosis of coronary heart disease were 0.932,0.841 and 0.812,and the optimal cut-off value of Hepc was 36.8 μg/L. The diagnostic sensitivity was 85.3%,and the diagnostic specificity was 98.3%. Conclusions Hepc,cTnI and Hcy can be used as indicators in the diagnosis of coronary heart disease,and Hepc is the indicator with good performance.

Change of granulocyte CD33 index in common myeloproliferative neoplasms

YIN Renbin, DING Lixia, REN Weidan, LIU Yuxia, ZHANG Peng, CHEN Huishu, YUE Baohong

2019, 34(9):  787-791.  DOI: 10.3969/j.issn.1673-8640.2019.09.004

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Objective To investigate the change of granulocyte CD33 index in common myeloproliferative neoplasms（MPN） by flow cytometry. Mehods A total of 95 MPN patients,including 42 cases of chronic myeloid leukaemia（CML）,29 cases of essential thrombocytosis（ET）,13 cases of polycythemia vera（PV） and 11 cases of primary myelofibrosis（PMF）,were determined for granulocyte CD33 index by flow cytometry. A total of 30 patients with iron deficiency anemia were enrolled as control group. Results Granulocyte CD33 indexes of CML,ET,PV and PMF groups were 26.35±13.40,5.44±3.72,5.44±2.83 and 1.54±1.25,respectively,which had statistical significance compared to that of control group（9.62±5.07）（P<0.01）. Conclusions Granulocyte CD33 index of CML group is the highest,followed by ET+PV and PMF groups. Granulocyte CD33 index can be a new abnormal immunophenotype for the diagnosis of MPN.

Study on the genotyping of gH gene among children with human cytomegalovirus infection in Zhejiang

LI Wei, LIU Lifang, SHANG Shiqiang

2019, 34(9):  792-794.  DOI: 10.3969/j.issn.1673-8640.2019.09.005

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Objective To investigate the distribution characteristics of human cytomegalovirus（HCMV） glycoprotein H（gH） genotyping among children in Zhejiang. Methods Urine,throat swab or mothers' milk sample was collected from children with positive HCMV DNA of Children's Hospital of Zhejiang University School of Medicine from January 2015 to December 2017. The genotyping of gH gene was performed using fluorescence quantitation polymerase chain reaction（PCR）. Children with positive HCMV DNA were classified according to ages,sample types and diseases. The genotype distribution of gH gene was compared. Results The gH genotyping was performed in 1 232 positive HCMV samples. There were 766 （62.2%） cases of gH1,373（30.3%） cases of gH2 and 93（7.5%） cases of gH1+gH2. The distribution trend of gH genotyping in positive HCMV children with different ages,different sample types and different diseases was consistent,without statistical significance （P>0.05）. Conclusions HCMV infection is mainly caused by gH1 in Zhejiang,and the distribution of HCMV gH genotypes shows no statistical significance in different ages,different sample types and different diseases.

Characteristic and mechanism of drug resistance of Neisseria gonorrhoeae in a teaching hospital of Shanghai

WANG Hui, ZHOU Aiping, WU Wenjuan

2019, 34(9):  795-799.  DOI: 10.3969/j.issn.1673-8640.2019.09.006

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Objective To investigate the characteristic,plasmid type and mechanism of drug resistance of Neisseria gonorrhoeae in Tongji University Shanghai East Hospital South Campus,and to provide a reference for the prevention of Neisseria gonorrhoeae. Methods A total of 142 isolates of Neisseria gonorrhoeae from Tongji University Shanghai East Hospital South Campus were collected from September 2016 to September 2017. Drug susceptibility test in vitro of 7 kinds of common antibiotics was performed by disc diffusion method. The β-lactamase was determined by nitrocephin. The plasmids from all β-lactamase-positive isolates were typed and analyzed for epidemic characteristics. Gene penA of non-sensitive isolates to cephalosporin was amplified and sequenced,which were compared with that of reference isolates for analyzing their drug resistance characteristics. Results The non-susceptibility rates to penicillin,ceftriaxone,cefixime,tetracycline,ciprofloxacin,spectinomycin and azithromycin were 100%,1.4%,17.6%,99.3%,99.3%,0% and 8.5%,respectively. Totally,54（38%） isolates produced β-lactamase,and the plasmid types were Asian plasmid（26 isolates,48%）,African plasmid（27 isolates,50%） and Toronto/Rio plasmid（1 isolate,2%）. Target protein for drug action [penicillin-binding protein 2（PBP2）] in all non-sensitive isolates to cephalosporin were mutated. The mutation points were mainly concentrated in 311-582 amino acid sites. There were 12 isolates with fewer mutation sites（≤10）. There existed A501T/V,A516G,G542S and P551S/T key mutations,and the other 13 isolates had more mutation sites（50-60）,but there was no above key mutation site. Conclusions Ceftriaxone and spectinomycin are the first experience medication for Neisseria gonorrhoeae therapy,azithromycin and cefixime could be candidates,and penicillin,tetracycline and ciprofloxacin have not been suitable for therapy. For β-lactamase resistance,there are mainly Neisseria gonorrhoeae isolates carrying Asian plasmid and African plasmid in Shanghai. The mechanism of Neisseria gonorrhoeae resistance to cephalosporin is complex,and drug action target protein mutagenesis is various.

Drug resistance of CRE and clinical application of eCIM combined with mCIM

TANG Kewen, LI Congrong, GUO Jing

2019, 34(9):  800-803.  DOI: 10.3969/j.issn.1673-8640.2019.09.007

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Objective To study the clinical infection and drug resistance of carbapenem-resistant Enterobacteriaceae（CRE） in Wuhan University Renmin Hospital,and to investigate the clinical application of ethylenediaminetetraacetic acid-modified carbapenem inactivation method（eCIM） combined with modified carbapenem inactivation method（mCIM） so as to effectively prevent and control infection and provide a reference for reasonable clinical use of antibiotics. Methods The drug susceptibility data of clinical isolates of non-repeatable CRE were analyzed. The mCIM and eCIM were combined to determine whether the 80 isolates produced metallo-beta-lactamase or serine carbapenemase [minimum inhibitory concentration（MIC）≥2 μg/mL]. Results A total of 329 CRE isolates were determined,and they are mainly Klebsiella pneumoniae,accounting for 59.0%. The departments were widely distributed,especially in intensive care unit（ICU） and neurosurgery,accounting for 16.4% and 16.1%,respectively. The infected sites were more common in the respiratory tract,accounting for 39.2%. The drug resistance rates of CRE isolates to the most antibiotics were more than 50.0%,except for minocycline and tigecycline,which were 25.1% and 2.9%,respectively. Totally,57 isolates of producing carbapenemase were determined among the randomly-chosen 80 CRE isolates,of which 28 isolates of metallo-beta-lactamase CRE were produced. Conclusions The drug resistance of CRE is severe in Wuhan University Renmin Hospital,which should be monitored at any time. It should use antibiotics based on drug susceptibility results rationally. The eCIM combined with mCIM is an economical and effective phenotypic detection method.

Analysis of the characteristics of sexually transmitted disease infection in Songjiang District of Shanghai

CAO Hui, XIA Wanbao, DING Xiali, LIU Jun, PENG Jinghong

2019, 34(9):  804-807.  DOI: 10.3969/j.issn.1673-8640.2019.09.008

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Objective To analyze the infection and drug resistance of Chlamydia trachomatis（CT）,Neisseria gonorrhoeae（NG） and Ureaplasma urealyticum（UU） in Songjiang District of Shanghai,and to provide a reference for the prevention and treatment of sexually transmitted disease. Methods The data of CT,NG and UU determinations from 15 768 patients were collected and analyzed statistically. Results The positive determination rates of CT,NG and UU were 5.07%,8.62% and 41.48%,respectively. There was no statistical significance in CT infection between different age groups（P=0.107 5）. The NG positive determination rate was the highest in patients with ≥51 years old（19.19%,P<0.000 1）,and the UU positive determination rate was the highest in patients with 41-50 years old（48.97%,P<0.000 1）. The positive determination rates of CT and UU in female patients were higher than those in male patients（P<0.000 1）. The NG positive determination rate in male patients was higher than that in female patients（P<0.000 1）. The drug susceptibility test for UU showed that the antibiotics with higher drug susceptibility were josamycin（98.64%）,minocycline（97.83%）,doxycycline（97.58%） and ofloxacin（81.92%）. Conclusions In Songjiang District of Shanghai,UU has the highest infection rate. The treatment of UU infection should be based on antibiotics with high drug susceptibility.

Clinical evaluation of 3 methods for the determination of Mycoplasma pneumoniae infection in children

FENG Zhishan, LI Guixia, LIU Jianhua, GUO Weiwei, ZHANG Wenchao, ZHANG Lixia, HUANG Hui, WANG Le

2019, 34(9):  808-811.  DOI: 10.3969/j.issn.1673-8640.2019.09.009

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Objective To compare the differences among 3 methods [passive agglutination,multiplex polymerase chain reaction（PCR） and real-time quantitation PCR] for the determination of Mycoplasma pneumoniae（MP） infection,and to investigate their roles in different ages and disease stages of children with pneumonia. Methods A total of 213 children with MP pneumonia treated with fiberoptic bronchoscopy were enrolled. The passive agglutination,multiplex PCR and real-time quantitation PCR were used to determine serum MP antibodies,MP DNA in sputum and MP DNA in the bronchoalveolar lavage fluid（BALF）,respectively. The results of real-time quantitation PCR for MP DNA in BALF were regarded as gold standard. The consistency of the 3 methods was compared. All the children were classified into <1-year-old group（8 cases）,1-3-year-old group（29 cases）,4-6-year-old group（97 cases） and >6-year-old group（79 cases）. According to disease courses,they were classified into ≤7 d and >7 d groups. The positive determination rates of the 3 methods were compared. Results Among the 213 children with MP pneumonia,the positive determination rates of passive agglutination,multiplex PCR and real-time quantitation PCR were 98.12%,76.06% and 89.20%,respectively. The results of real-time quantitation PCR for MP DNA in BALF were regarded as gold standard. The Kappa value of multiplex PCR with real-time quantitation PCR（0.301） was higher than that of passive agglutination with real-time quantitation PCR（0.043）. The positive determination rates of the 3 methods were related to ages（P<0.05）. The positive determination rate of real-time quantitation PCR in >7 d group was higher than that in ≤7 d group（P=0.003）,while the positive determination rates of passive agglutination and multiplex PCR had no statistical significance（P>0.05）. Conclusions Among MP pneumonia patients treated with fiberoptic bronchoscopy,the consistency of real-time quantitation PCR and multiplex PCR is superior to passive agglutination,and the positive determination rate of real-time quantitation PCR is related with disease courses.

Application of resazurin reduction-based assay for the rapid detection of polymyxin B drug susceptibility in vitro in Acinetobacter baumannii and Pseudomonas aeruginosa

WU Xinglong, ZHAO Xiangwen, ZHAO Qingling

2019, 34(9):  812-814.  DOI: 10.3969/j.issn.1673-8640.2019.09.010

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Objective To evaluate the feasibility of resazurin reduction-based assay for the rapid detection of polymyxin B drug susceptibility in vitro in Acinetobacter baumannii and Pseudomonas aeruginosa. Methods A total of 112 isolates of Acinetobacter baumannii and Pseudomonas aeruginosa were collected,and the polymyxin B drug susceptibility in vitro was performed by resazurin reduction-based assay and standard broth microdilution method. The performance of resazurin reduction-based assay was evaluated. Results Using broth microdilution method as standard,the accuracy and the positive detection rate of resazurin reduction-based assay were 98.2%（110/112） and 100%（33/33）,respectively. All drug resistance results can be obtained within 60 min after adding resazurin. Conclusions Polymyxin B drug susceptibility in vitro in Acinetobacter baumannii and Pseudomonas aeruginosa is rapid,highly sensitive,specific,easy-to-perform and inexpensive,which could be applied in clinic widely.

Role of aANCA in the evaluation of ulcerative colitis

ZENG Junxiang, HUANG Yilei, GE Wensong, PAN Xiujun, SHEN Lisong

2019, 34(9):  815-820.  DOI: 10.3969/j.issn.1673-8640.2019.09.011

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Objective To investigate the role of atypical anti-neutrophil cytoplasmic antibodies（aANCA） in the activity evaluation and disease monitoring of ulcerative colitis（UC）. Methods A total of 103 UC patients,64 non-UC patients（acute enteritis,intestinal polyps,intestinal tuberculosis and irritable bowel syndrome） and 40 healthy subjects were enrolled. Among the 103 UC patients,37 cases were in remission phase,and 66 cases were in active phase（7 cases of mild,45 cases of moderate and 14 cases of severe）. Serum level of aANCA was determined by enzyme-linked immunosorbent assay（ELISA）. Erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,platelet（PLT） count,hemoglobin（Hb）,mean corpuscular volume（MCV）,red blood cell distribution width（RDW） and albumin（Alb） were determined. The correlation between these parameters and Baron endoscopic score was analyzed by Spearman analysis. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficacy of UC activity. Results The serum levels of aANCA and ESR in UC patients in active phase were higher than those in remission phase,while the serum level of Hb in active UC group was lower than that in remission UC group（P<0.05）. There was no statistical significance between active and remission UC groups in MCV,RDW,PLT count,CRP and Alb（P>0.05）. In remission UC group,aANCA level was higher than those in non-UC group and healthy control group（P<0.05）,but there was no statistical significance in the serum levels of the other indicators among the 3 groups（P>0.05）. In active UC group,the levels of aANCA were in an order of severe>moderate>mild patients（P<0.05）. A positive correlation was demonstrated between serum aANCA level and Baron endoscopic score（r_s=0.649,P<0.001）,but there was no correlation of ESR and Hb level with Baron endoscopic score（r_s=0.303 and 0.155,P>0.05）. The area under ROC curve（AUC） of aANCA was 0.895 for the diagnosis of active UC. The specificity of aANCA was 93.3%,the sensitivity was 71.7%,and the optimal cut-off value was 6.27 IU/mL. Conclusions The aANCA may be used as a useful indicator in the evaluation of UC disease activity,and it is correlated with Baron endoscopic score.

Changes of IL-6 and other 7 indexes in patients with acute cerebral infarction in Qinghai

MA Xiuqing, JIA Haiju, QIN Huiping, MA Huiying, YANG Xingtang, QI Yanxia, LI Shengmei, WANG Chunwei, HE Yujuan

2019, 34(9):  821-825.  DOI: 10.3969/j.issn.1673-8640.2019.09.012

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Objective To study the role of the combined determination of interleukin（IL）-6,IL-8,IL-10,tumor necrosis factor-alpha（TNF-α）,homocysteine（Hcy）,high-sensitivity C-reactive protein（hs-CRP）,D-dimer（DD） and lipoprotein（a）[Lp（a）] in patients with acute cerebral infarction（ACI） in Qinghai. Methods A total of 300 patients with ACI were enrolled as ACI group,and 78 healthy subjects were enrolled as healthy control group. The levels of IL-6,IL-8,IL-10,TNF-α,Hcy,hs-CRP,DD and Lp（a） were determined. The relationship between the changes of above-mentioned indexes and cerebral infarction area was analyzed. Result The levels of IL-6,IL-8,IL-10,TNF-α,Hcy,hs-CRP,DD and Lp（a）in ACI group before treatment were higher than those in healthy control group（P<0.05）. Compared with those before treatment, all the indexes in ACI group were decreased after treatment（P<0.05）, and showed a downward trend with the extension of treatment time. The levels of IL-6,IL-8,IL-10,TNF-α,Hcy,hs-CRP,DD and Lp（a） with different cerebral infarction areas were higher than those in healthy control group（P<0.05）. All the indexes of large infarction area group were higher than those of middle infarction area group and small infarction area group（P<0.05）, and those of middle infarction area group were higher than those of small infarction area group（P<0.05）. Receiver operating characteristic（ROC） curve analysis showed that the areas under curves of IL-6,IL-8,IL-10,TNF-α,Hcy,hs-CRP,DD and Lp（a） for the diagnosis of ACI were 0.874,0.808,0.860,0.731,0.710, 0.813,0.658 and 0.705,respectively. Logistic regression analysis showed that the combined detection prediction probability was >0.49,the area under curve was 0.904,the opitmal cut-off value was 0.51,and the sensitivity and specificity were 86.4% and 85.6%,respectively. Conclusions The combined detection of IL-6,IL-8,IL-10,TNF-α,Hcy,hs-CRP,DD and Lp（a）is of significance for the judgment and efficacy evaluation of ACI in Qinghai.

Correlation of insulin resistance index and chronic inflammation index in type 2 diabetes mellitus patients with metabolic syndrome

LIU Xiaoni, WANG Ying, LI Taotao, MA Xiaomin, ZHAO Huanlao

2019, 34(9):  826-830.  DOI: 10.3969/j.issn.1673-8640.2019.09.013

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Objective To investigate the correlation of homeostasis model assessment for insulin resistance（HOMA-IR） and chronic inflammation index in type 2 diabetes mellitus（T2DM） patients with metabolic syndrome（MS）. Methods A total of 90 patients with T2DM were enrolled and classified into T2DM patients without MS（T2DM group,40 cases） and T2DM patients with MS（T2DM with MS group,50 cases）. Totally,40 healthy subjects with normal blood glucose were enrolled as healthy control group. The clinical data of 3 groups and biochemical indexes were collected and compared. Pearson correlation analysis was used. Results In T2DM with MS group,waist to hip ratio（WHR）,body mass index（BMI）,waist circumference and hip circumference,systolic blood pressure,diastolic blood pressure,triglyceride（TG）,atherogenic index of plasma（AIP）,fasting blood glucose,fasting insulin,high-sensitivity C-reactive protein（hs-CRP） and non-high-density lipoprotein cholesterol（non-HDL-C） were higher than those in healthy control group and T2DM group（P<0.05）,while there was no statistical significance between T2DM group and healthy control group（P>0.05）. The ratios of HOMA-IR and TG/high-density lipoprotein cholesterol（HDL-C） increased in turn from healthy control group,T2DM group to T2DM with MS group（P=0.000）,HDL-C levels decreased in turn（P=0.000）,and there was no statistical significance in age,total cholesterol（TC） and low-density lipoprotein cholesterol（LDL-C） levels among the 3 groups（P>0.05）. For T2DM with MS group,HOMA-IR,fasting blood glucose,TG and waist circumference were positively correlated（r=0.589,0.315 and 0.332,P=0.000）,and HOMA-IR was negatively correlated with HDL-C（r=-0.188,P=0.000）. Hs-CRP was positively correlated with fasting blood glucose,TG and waist circumference（r=0.168,0.172 and 0.338,P<0.05）. HOMA-IR was positively correlated with hs-CRP（r=0.353,P=0.019）. Conclusions HOMA-IR in patients with T2DM combined with MS is correlated with atherosclerosis,chronic systemic inflammation and TG/HDL-C ratio.

Predictive value of body mass index and triglyceride level changes in early pregnancy on gestational diabetes mellitus

YOU Xiuzhen

2019, 34(9):  831-834.  DOI: 10.3969/j.issn.1673-8640.2019.09.014

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Objective To study the predictive value of body mass index（BMI）,triglyceride（TG） level changes in early pregnancy on gestational diabetes mellitus（GDM）. Methods The antenatal examination data of 250 cases of pregnant women diagnosed GDM（GDM group） and 250 cases of non-GDM pregnant women（control group） were analyzed retrospectively. The results of TG and BMI in the gestation of 12 weeks were collected. Oral glucose tolerance test（OGTT） results in the gestation of 24 weeks were as diagnostic gold standard of GDM,the sensitivity,specificity,positive predictive value（PPV）,negative predictive value（NPV） and accuracy of BMI and TG levels in predicting GDM were calculated. The predictive values of BMI and TG during early pregnancy on GDM were analyzed by receiver operating characteristic（ROC） curve. The relationship between BMI,TG and GDM were evaluated by Pearson correlation analysis and Logistic regression analysis. Results BMI and TG levels of GDM group were higher than those of control group（P=0.000）. Pearson correlation analysis showed that the incidence of GDM was positively correlated with BMI and TG in early pregnancy（r=0.625 and 0.641,P<0.01）. ROC curve showed that the areas under curves of BMI,TG,BMI combined with TG were 0.712,0.651 and 0.889,respectively. The sensitivity,specificity,PPV,NPV and accuracy in predicting GDM of BMI combined with TG in early pregnancy were higher than those of BMI and TG. Logistic regression analysis showed that with the increasing of BMI and TG,the incidence rate of GDM showed a trend of increasing（r²=0.995 5 and 0.957 3,P<0.05）. Conclusions BMI and TG levels in early pregnancy have predictive values for GDM.

Construction of a 16 channel label-free electrochemical immunosensor for glycated hemoglobin A_1c detection

WANG Xiao, MI Xianqiang

2019, 34(9):  835-840.  DOI: 10.3969/j.issn.1673-8640.2019.09.015

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Objective To construct a label-free electrochemical immunosensor for the specific detection of glycated hemoglobin A_1c（HbA_1c）. Methods A 16 channel screen-printed carbon electrode（16-SPCE） was modified by HbA_1c antibody to prepare a label-free electrochemical immunosensor for the specific detection of HbA_1c. Cyclic voltammetry was used to detect the electrical signal of HbA_1c by 16-SPCE electrochemical immunosensor,and the detection conditions（the optimal coating concentration of HbA_1c antibody,the optimal incubation time of HbA_1c antigen,the electrochemical characteristics of the electrode and the performance of different modified electrodes） were optimized. A preliminary methodological evaluation was conducted. Results The optimal HbA_1c antibody coating concentration was 50 μg/mL,and the optimal HbA_1c antigen incubation time was 60 min. The linear range of HbA_1c was 1-50 μg/mL,and the linear equation was Y=0.199X+10.468（r=0.955）. The detection limit was 0.88 μg/mL,and 50 μg/mL bovine serum albumin（BSA）,50 μg/mL prostate-specific antigen（PSA） and 50 μg/mL glucose did not interfere with the detection of HbA_1c by 16-SPCE electrochemical immunosensor. The prepared immunoelectrode was stably placed at 4 °C for 5 d. The 16-SPCE electrochemical immunosensor was used to detect HbA_1c in the simulated serum samples. The current response values of each concentration were clearly distinguished,and the repeatability was good. Conclusions The constructed 16-SPCE electrochemical immunosensor has good electrochemical response,linear range and anti-interference ability.

Establishment of reference interval of serum SOD in Meizhou healthy adults

LI Lingfeng, LIU Guirong, WEI Huiping, HU Shijie

2019, 34(9):  848-850.  DOI: 10.3969/j.issn.1673-8640.2019.09.018

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Objective To investigate serum level of superoxide dismutase（SOD） in healthy adults in Meizhou,and to establish the reference interval for serum SOD. Methods A total of 1 598 healthy adults,including 792 males（49.59%） and 806 females（50.41%）,were enrolled. Serum SOD was determined,and the reference interval was determined by percentile method（P_2.5-P_97.5）. Results Serum SOD levels varied between ages and sex（P<0.05）. The reference intervals were determined according to ages and sex,respectively,144-313 U/mL for 18-54-year-old males,144-290 U/mL for 18-54-year-old females,120-261 U/mL for ≥ 55-year-old males and 131-231 U/mL for ≥ 55-year-old females. Conclusions The reference intervals of serum SOD have been preliminarily established in Meizhou healthy adults.

Application of proficiency testing/external quality assessment samples in trueness verification of electrochemiluminescence procedure

GUO Xuxiao, BAI Shumei, LING Xin, GAO Jie, LI Jinxing

2019, 34(9):  851-854.  DOI: 10.3969/j.issn.1673-8640.2019.09.019

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Objective To investigate the role of proficiency testing（PT）/external quality assessment（EQA） samples in trueness verification of electrochemiluminescence procedure. Methods The trueness of electrochemiluminescence procedure,such as free triiodothyronine（FT₃）and estradiol（E₂）,was verified according to the Clinical and Laboratory Standards Institute（CLIS） EP15-A3 document 5×5 experimental design,using the samples of PT/EQA of the National Center for Clinical Laboratories. The experimental procedure,1 run per day for 5 d and 5 replicates per run,was performed. The outliers were calculated by Grubbs' test,and one way ANOVA test was used to calculate the repeatability variance（S_R）of users,the within-laboratory variance （S_WL）,the overall standard error（SE_x ）,the standard error of target value（SE_RM）and the combined standard error（SE_C）. The m value was obtained from the T distribution table according to the degree of freedom（df_C）. Finally,the verification interval was calculated. If the overall mean was within the verification interval,the trueness verification passed,and if out,the bias was calculated and compared with the laboratory-specified target bias. Results The overall mean values of FT₃ and E₂were within the correctness verification interval,and the trueness was verified. Conclusions The samples from PT/EQA can be used as a reference material for trueness verification of laboratory determination procedure.

Preliminary study on external quality assessment method of thromboelastography

WANG Qing, QIAO Zhenglei, SONG Ying

2019, 34(9):  855-858.  DOI: 10.3969/j.issn.1673-8640.2019.09.020

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Objective To investigate an appropriate external quality assessment（EQA） method for thromboelastography（TEG）. Methods The response time（R）,clot kinetics（K）,angle（ANG） and maximum amplitude（MA） of 16 samples in 5 EQA plans from 2016 to 2018 in Shanghai were analyzed and evaluated by medium（M）±1.96 inter quartile range（IQR）,M±2.58 IQR,synthetic coefficient of variation（SCV） and allowable total error（TEa） based on current technical level. The qualified rates of assessment results were compared. Results The qualified rates of R,K,ANG and MA obtained from traditional statistical methods such as M±1.96 IQR,M±2.58 IQR,3SCV and TEa₈₀ were listed as R：86.36%-98.39%,86.36%-98.44%,56.45%-97.62% and 80.65%-100.00%;K：86.36%-98.39%,86.36%-100.00%,50.00%-98.39% and 75.81%-100.00%;ANG：86.36%-98.39%,86.36%-100.00%,29.03%-100.00% and 80.65%~100.00%;MA：81.82%-97.62%,86.36%-100.00%,51.56%-90.48% and 81.82%-100.00%. Conclusions TEa₈₀（R：M±33.28%,K：M±38.24%,ANG：M±30.77% and MA：M±26.45%） is suitable for the evaluation of TEG EQA quality in Shanghai,which could satisfy the current analysis level of TEG determination in Shanghai.

Research progress of G-test in the diagnosis of invasive fungal diseases

LI Zhanjia, ZHAI Hongyan, CHEN Shuiping

2019, 34(9):  859-863.  DOI: 10.3969/j.issn.1673-8640.2019.09.021

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In the past 30 years,the morbidity and mortality of invasive fungal diseases（IFD） are increasing. Considering the non-specific manifestations,limited treatment and high mortality,sensitive and specific laboratory diagnostic methods are of significance to prevent and treat IFD. As a fast and non-invasive method,G-test plays a role in the diagnosis of IFD. The main progresses of G-test in the last 5 years are focused in this review.

Research progress of pseudouridine as a biomarker of kidney disease and cancer

CHEN Xu, FENG Juan, HU Xiaobo, WANG Changfu

2019, 34(9):  864-867.  DOI: 10.3969/j.issn.1673-8640.2019.09.022

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Pseudouridine（PU） is the isomeride of uracil nucleoside,which is mainly produced by the metabolism of transfer RNA（tRNA）. PU can not be reused and is eliminated through urine directly. With further study,PU is getting more and more attention as a biomarker. This review describes the metabolic characteristics and determination methods of PU,evaluates the role of PU in the diagnosis and treatment of kidney diseases and cancers,and looks forward to the significance of PU on metabonomics.