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Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.
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Objective To observe the expression of leukocyte-associated immunoglobulin(Ig)-like receptor-1 (LAIR-1) on Treg cells in children with immune thrombocytopenia (ITP) and the level of soluble LAIR-1 (sLAIR-1),LAIR-2 in peripheral blood,and to discuss the possible role of LAIR in the pathogenesis of childhood ITP.Methods The levels of LAIR-1 on Treg cells of peripheral blood were measured in 36 children with ITP by using flow cytometry.Plasma levels of sLAIR-1 and LAIR-2 were measured by adopting enzyme-linked immunosorbent assay(ELISA).Real-time PCR was used to measure both LAIR-1 mRNA and LAIR-2 mRNA.Twenty-eight healthy children served as the healthy control group.Results The expression of Treg cells in children with ITP was significantly lower than that in the healthy control group [(2.05 ± 0.85) ％ vs (3.04 ± 1.03) ％,t =4.198,P ＜ 0.001].The expression rate of LAIR-1 on Treg cells and tyrosine phosphatase-2 (SHP-2) in children with ITP group had no statistically significant difference with the healthy control group [(71.18 ± 13.36) ％ vs (67.69 ± 13.07)％,t=1.045,P＞0.05;(1.20 ± 0.97) ％ vs (0.85 ±0.66)％;t=1.718,P＞0.05].The levels of sLAIR-1 and LAIR-2 in plasma in children with ITP group were increased significantly than those in the healthy control group [(20.53 ±4.32) μg/L vs (17.51 ± 5.15) μg/L,t =2.424,P ＜0.05;(5.83 ± 1.08) μg/L vs (5.19 ± 1.24) μg/L,t =2.267,P ＜ 0.05].The LAIR-1 mRNA expression level in children with ITP group was significantly increased compared with the healthy control group (t =2.851,P ＜ 0.05),but not the LAIR-2 mRNA expression level (t =1.715,P ＞ 0.05).Conclusions The expression of Treg cells in children with ITP is decreased,and it may be associated with the onset of ITP,and it may suggest that LAIR-1 does not play a leading role in Treg cells when ITP occurrs.And the levels of sLAIR-1,LAIR-2 in plasma are both increased,suggesting that LAIR-1,LAIR-2 may be one of the factors of immune disorders in children with ITP.
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Objective To investigate the effects of batroxobin on blood coagulation and fibrinolytic function of patients with sud-den deafness .Methods 87 patients with sudden deafness were enrolled .Their prothrombin time(PT ) ,activated partial thrombo-plastin time(APTT) ,thrombin time(TT) ,fibrinogen(Fib) ,D-dimer and fibrin/fibrinogen degradation products(FDP) were detec-ted before batroxobin treatment and 3 ,6 days after treatment .Results Compared with pre-treatment ,patients after treatment expe-rienced prolonged PT and TT (P0 .05) .Conclusion PT ,TT ,Fib ,FDP can be applied to monitor the coagulation and fibrinolytic function of patients with sudden deafness treated with batroxobin .
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Objective To compare low-dose dobutamine electrocardiography (ECG) stress test and echocardiography (ECHO) stress test in the diagnosis of coronary artery disease (CHD).Methods Fifty-six patients with CHD were chosen.They were given dobutamine before test in the speed of 1 μ g/(kg· min ),and gradually increased to 5 μ g/(kg·min).Low-dose dobutamine ECG stress test,ECHO stress test and coronary angiography (CAG) were performed,and the results were compared.The sensitivity,specificity and accuracy of low-dose dobutamine ECG stress test and ECHO stress test were calculated.Results CAG showed 37 cases of patients with coronary artery stenosis.The sensitivity,specificity and accuracy of low-dose dobutamine ECG stress test were 62.16％ (23/37),73.68％ (14/19) and 66.07％ (37/56).The sensitivity,specificity and accuracy of ECHO stress test were 86.49％ (32/37),52.63％ (10/19) and 75.00％ (42/56).There were significant differences in sensitivity and specificity between two test methods (P ＜0.05).Conclusions In the diagnosis of CHD, low-dose dobutamine ECG stress test has high specificity,and ECHO stress test has high sensitivity andaccuracy.Combination of them has high clinical value.
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Objective To study the value of color Doppler ultrasound-guided treatment in the interventional femoral artery pseudoaneurysm.Methods Fifty-two patients with interventional femoral artery pseudoaneurysm who treated from February 2009 to February 2011 were chosen,they were divided into two groups by random digits table with 26 cases each,the patients in the observation group underwent ultrasoundguided thrombin injection treatment,the patients in the control group underwent ultrasound-guided compression method.The operation time,lower limb braking time,used of sedative drugs and the effective rate were compared.Results The effective rate in the observation group and the control group were 92.31％ (24/26) and 69.23％ (18/26) respectively,there was significant difference between the two groups (P ＜ 0.05).The operation time and lower limb braking time in the observation group were (28.65 + 6.84) min and (2.54 ±0.45) h,siguificantly lower than those in the control group [(69.84 ± 13.63) min and (18.54 ±2.87) h],there were statistical differences between the two groups (P ＜ 0.05 ).The proportion of patients with sedation in the observation group (23.08％,6/26) was lower than that in the control group (53.85％,14/26),there was statistical difference between the two groups (P ＜ 0.05).Conclusion Color Doppler ultrasound-guided treatment is very effective in the treatment of interventional femoral artery pseudoaneurysm,it has higher clinical value.