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【Objective】 To explore the correlation of DAT-positive hemolytic anemia(HA) with gender, age, and ABO serological indicators (anti-A, anti-B, anti-AB, anti-D; Ac, Bc, Oc), so as to provide references for clinical diagnosis. 【Methods】 2 832 HA patients who had underwent DAT tests in the Second Affiliated Hospital of Xi′an Jiaotong University in recent years were divided into the positive-DAT patients ( n=382 )and negative-DAT patients (n=2 450 ) according to the testing results. The correlation between the positive-DAT patients and the sex, age and ABO serological indicators was analyzed using SPSS 25.0 statistical software. 【Results】 DAT-positive HA risk in women were significantly higher than men (OR=1.712, CI95%= [1.365, 2.147], P<0.01), and it differed significantly by ages; it increased significantly with the presence of positive anti-A, negative Ac (OR=1.429, CI95%= [1.150, 1.775] ; P<0.01), and positive Oc(OR=21.369, CI95%= [13.813, 33.057] ; P<0.01). Men aged 31~40 were prone to develop mixed type(OR=19.304, CI95%= [2.208, 168.751] ; P<0.01), women aged 41~50 were prone to cold antibody(OR=3.981, CI95%= [1.545, 10.259] ; P<0.01); anti-AB positive patients were prone to mixed type (OR=1.852, CI95%= [1.027, 3.339] ; P<0.05), Oc positive was prone to warm antibody(OR=4.018, CI95%= [1.386, 1.646], P<0.01). 【Conclusion】 DAT-positive HA is significantly correlated with gender and age, and is positively correlated with anti-A, Oc positive and Ac negative.
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Objective To evaluate endoscopic ultrasound for preoperative staging of ampullar tumors.Methods A total of 31 patients with ampullar tumors who underwent surgery from 2010 to 2015 were retrospectively reviewed.B-US,CT,MRCP and EUS were performed in all patients.The diagnostic rates of EUS and other imaging technology,and the diagnostic accuracy of preoperative staging and postoperative pathological staging were compared.Results Diagoses of 31 patients of ampullar tumors patients undergoing preoperative endoscopic ultrasonography assessment T staging were as the following:uT1,4 cases; uT2,15 cases; uT3,10 cases; uT4,2 cases.Compared with the postoperative pathological diagnosis,the T staging accuracy was 90.3％ (28/31),anong which 1 case was overestimated,2 cases were underestimated.The accuracy of endoscopic ultrasound in preoperative diagnosis of ampullar lesions was superior to other detection technology.Conclusion EUS is a valuable diagnostic tool for patients with suspected ampullar tumors.
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Objective To investigate the diagnostic value of the immediate early antigen(IE) mRNA by nucleic acid sequence-based amplification(NASBA) in peripheral blood cytomegalovirus (CMV) infection,and to establish and promote the diagnosis method for CMV.Methods Five to seven ml blood was taken from 32 patients at 3 week and 7 week after renal transplantation to detect serum cytomegalovirus antigen and antibody expression by NASBA,Real time-PCR and enzyme-linked immunosorbent assay (ELISA) sensitivity and specificity were compared.Results The results of CMV detection in 32 renal transplanted patients respectively showed that the positive rate of peripheral blood IE-mRNA by NASBA was 45.8％ (15/32) ;The positive rate of HCMV-DNA in blood by Real time-PCR was 45.8％ (15/32).Using ELISA,the positive rate of HCMV-(IgG +IgM) was 37.5％ (14/32).IE-mRNA and HCMV-DNA had higher sensitivity and specificity and lower false positive rate than HCMV-(IgG +IgM).The positive rates of IE-mRNA by NASBA,Real time-PCR and ELISA were 92.8％,71.5％ and 42.8％ respectively in the 14 cases.Conclusion The nucleic acid amplification method (NASBA based sequence) and Real time-PCR are sensitive,rapid diagnosis methods of HCMV infection,with higher sensitivity and specificity and lower false positive rate than traditional ELISA.And NASBA detection of IE-mRNA has good value for auxiliary clinical diagnosis.
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ObjectiveTo investigate the relation of the human cytomegalovirus pp67-mRNA with the active infection in renal transplant recipients and the role in the direction for antiviral therapy.Methods Total 128 samples were collected from peripheral blood treated with EDTA of 32 recipients at the 3rd week or the 7th week after transplantation.IFA was used to detect CMV pp65 antigen,and NASBA was used to detect pp67 mRNA assay.Compared with CMV-Ag,the recipients were followed up to observe the change of pp67 in the cases of the active infection and the CMV disease.ResultsCompared with the proportion between two groups,44 samples out of 128 samples showed CMV-Ag pp65 positive,while pp67-mRNA were positive in 21 samples.8 patients had been found positive CMV-Ag pp65 and pp67-mRNA; 12 recipients were clinically diagnosed with HCMV disease.In the early stage of the HCMV infection,the sensitivity and specificity of the CMV-Ag pp65 ( 91.7％,50.0％ ) was higher than that of pp67-mRNA ( 66.7％,95.0％ ).During the periods of symptoms appeared and the late stage of clinical treatment,the specificity of pp67-mRNA was higher than that of CMV-Ag pp65,while the sensitivity sit on the contrary.And in the antiviral therapy course,the indicator of antiviral therapy pp67 turned negative more quickly than the CMVAg,the therapy course could be reduced.ConclusionsBoth of CMV-Ag pp65 and of pp67-mRNA have clinical significance.Testing for CMV-Ag pp65 is suitable for detecting HCMV active infection at the early stage,which was important for in time anti-virus treatment in the clinical settings.The test for pp67-mRNA is a quick method to accquire the accurate results; therefore,it can be used as the reference criteria for the clinical anti-virus treatment.