ABSTRACT
Objective To investigate the thawing modes on stability of coagulation control products after frozen,looking for a new theoretical basis for cost control and the quality and safety of laboratory.Methods Using ACL TOP 700 automated co-agulation analyzer and supporting the same batch of reagents and quality control materials conduct of the study:after daily QC,recycled the remaining control materials immediately and dispensed into two EP tubes and frozen at-40℃,respectively thawed by room-temperature and 37℃water bath after 24 hours,and examined together with the date of quality control ma-terial,got 20 pairs of data for analysis the financial impact of two alternate ways on coagulation QC parameters.Results For the room-temperature thawing group,FIB high value increasedby an average 0.23 g/L (t=4.026 9,P0.05).For the 37℃water bath group,both normal and high value of APTT,PT,FIB,TT and D-Dimer were no significant difference after tha-wing (P>0.05).Conclusion The commercialization of coagulation control materials can be for the second QC,just follow the principle of rapid after melting and timely detection,other laboratories can be used as a reference.
ABSTRACT
Objective To investigate the diagnostic value of D-dimer age-adjusted threshold in elderly patients with Pulmonary thromboembolism(PTE).Methods Collected patients older than 50 years of suspected PTE,who visited Yan′an People′s Hospital and the Hospital Affiliated to Yan′an University from June 2015 to September 2016,using the revised Geneva criteria for clinical probability assessment firstly.The low-risk group was excluded from the study;the patients with moderate-to-high risk were performed D-dimer detection and CTPA.All patients determined both by D-dimer age-adjusted thresholds and traditional thresholds,comparing the diagnostic efficacy of the two methods subsequently.Results 163 patients were diagnosed with PTE by CTPA among the 549 subjects,the positive rate was 29.69％.The diagnostic sensitivity of plasma D-dimer was 83.44％,78.53％,the specificity was 17.88％,31.61％ respectively,the missed diagnosis rate was 16.56％,21.47％,respectively.The misdiagnosis rates were 82.12％ and 68.39％,respectively,and the Younden index was 0.013 2 and 0.101 4 respectively.All subjects were divided into four groups according to age:50-60 years,60-70 years,70-80 years,and equal or greater than 80 years age group.Compared with the traditional threshold,the misdiagnosis rates of the four groups of age-adjusted thresholds decreased by 4.00％,15.70％,21.36％ and 17.39％,respectively and the specificity was increased by 1.23,1.65,2.56 and 3.00 times,respectively.Conclusion The diagnostic accuracy of the age-corrected threshold is higher than the traditional threshold;combined with clinical practice,the optimal threshold is determined by the ROC curve,the clinician can serve as a reference.