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Reflex tests are ordered when a particular test result indicates that additional testing should be performed according to the guidelines or the feedback process formulated by clinical consultation. The application scope of the reflex tests involves various subspecialties of laboratory medicine. The clinical application needs the support of qualified laboratory doctors, comprehensive information and financial system, clinical guidelines, and so on. Active application of reflex tests can promote the standardization of evidence-based medicine in clinical practice, save medical resources, and shorten the diagnosis and treatment time of patients.
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Objective To establish the MALDI-TOF-MS technique platform for detecting Cytochrome P450 gene polymor-phismfrom of patients.Methods Collected 53 EDTA anticoagulation peripheral blood samples from October 2013 to June 2014 in Peking Union Medical College Hospital.The whole genomic DNA was extracted from patients’peripheral blood. Used MALDI-TOF-MS to identify the SNP polymorphism of CYP2C9*2(rs1799853),CYP2C9*3(rs1057910),CYP2C19*2(rs4244285),CYP2C19*3(rs4986893),CYP2C19*4(rs28399504),CYP2C19*5(rs56337013)and CYP2C19*17 (rs12248560).To verify the above SNP polymorphism by Sanger sequencing method.Results The MALDI-TOF-MS could perform 53 samples on two cytochrome gene and 7 SNP locus simultaneously.In all the 53 patients,25 AG,6 AA and 22 GG genotypes were identified in CYP2C19*2(rs4244285),the allele frequency of A genotype was 34.9%.4 AG and 49 GG genotypes were identified in CYP2C19*3 (rs4986893),the allele frequency of A genotype was 3.8%.5 CA and 48 AA gen-otypes were identified in CYP2C9*3 (rs1057910),the allele frequency of C genotype was 4.7%.No mutation loci were i-dentified in CYP2C9*2 (rs1799853),CYP2C19*4 (rs28399504),CYP2C19*5 (rs56337013)and CYP2C19*17 (rs12248560).All the identification data were confirmed by Sanger sequencing.The coincidence rate was 100%.Conclusion The MALDI-TOF-MS technique platform for the cytochrome enzyme SNP was established.This platform has high throughput and accurate characteristics.It has important clinical application value for the treatment of personalized medicate.
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Objective To compare the detecting results of rotavirus (RV)and adenovirus (AdV)antigens using auto stool pretreatment system (machine method)and manual method.Methods A total of 100 stools collectecd from diarrear patients admitted in gastroenterology outpatient department from September 2014 to Octorber 2014 in Peking University Medical College Hospital were detected to identify RV and AdV antigens using machine method and manual method respectively,and the nucletic acids of positive samples were detected by liquid chip method to verify the results.Results The RV,AdV and co-infection antigen positive detection rate using machine method were 17.0% (17/100),25.0% (25/100)and 12.0% (12/100)respectively,whereas those using the manual method were 4.0% (4/100),13.0% (13/100)and 2.0% (2/100),re-spectively.Taking the nucletic acids detection as the golden method,the false positive detection rate of RV,AdV and co-in-fection antigen using machine method were 23.5% (4/17),20.0% (5/25)and 33.3% (4/12)respectively,whereas those u-sing the manual method were 75.0% (3/4),69.2% (9/13)and 50.0% (1/2),respectively.χ2 test for paired data for RV and AdV positive detection rate,false positive detection rate of RV and false positive detection rate of AdV using two meth-ods were statistically significant (χ2 =15.0,52.8 and 47.5,P values <0.05).Two methods for detecting RV and AdV had poor consistency (Kappa value was 0.25,Kappa values <0.4).Conclusion Machine method has much more advantage on RV and AdV positive detection rate and false positive detection rate than manual method,which is good for clinical applica-tion.
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Objective To analysis the related factors and the morbidity of patients with Chlamydia trachomatis(CT),Neisse-ria gonorrhea(NG),Ureaplasma urealyticum (UU)in Beijing Union Medical College Hospital.Methods Simultaneous Am-plification and Testing (SAT)was used to detect CT-RNA,NG-RNA,UU-RNA of patients from January of 2013 to Decem-ber of 2014.Results There were 6 262 cases in all and 2 412 cases in 2013,and 3 850 cases in 2014.The positive rate of CT-RNA,NG-RNA and UU-RNA were 7.29%,3.44% and 38.21% in 2013.The positive rate of CT-RNA,NG-RNA and UU-RNA were 8.17%,4.15% and 45.71% in 2014 respectively,which were higher than those of in 2013.There was a signifi-cant difference in UU-RNA positive rate between the two years (χ2 =12.66,P <0.01).The positive rate of CT-RNA,NG-RNA and UU-RNA were 8.15%,3.89% and 42.77% respectively in two years.The positive rate of UU-RNA in women’s (61.05%)was significantly higher than the men’s (24.50%)(χ2 =316.13,P <0.01).Most of the people with CT-RNA, NG-RNA and UU-RNA-positive were between 21 to 30 years old.The highest detection positive rate was in cervical swabs samples of UU-RNA.Conclusion There was a significantly increasing trend of the infection with UU.Male were more sus-ceptible to CT and NG.However,female were more susceptible to UU.There was the highest infection rate in youth (21~30 years)with CT,NG and UU.
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ObjectiveTo analyze the seroepidemiologic of Mycoplasma pneumoniae infection and evaluate antibiotics medication of some positive patients by follow-up. Methods Serodia-MycolⅡ particle agglutination assay was used to detect serum antibodies against Mycoplasma pneumoniae in 3 134 clinically suspected infections. Mycoplasma pneumoniae infection was determined and seroepidemiologic was analyzed by results of the test, including positive antibody rates in whole subjects, in male or female groups, in different seasons or age groups as well as in different sources. Evaluate antibiotics medication of some positive patients by follow-up. The average days of medication were counted, different antibiotics medication and medication effect were analyzed. Results In 3 134 serum samples from clinically suspected Mycoplasma pneumoniae infections, 350 ( 11.2％ ) were tested with positive antibodies. The positive antibody rate in female patients was 12. 3％ ( 198/1 604), which was higher than 9. 9％ ( 152/1 530) in males (X2 =4. 58,P ＜0. 05). The peak season was found in the fourth quarter (October-December) with 13.2％ of positive antibody and the highest positive rate (32. 8％, 45/137 ) was found in school aged (5 -9 years old )children. Samples from pediatrics clinic and ward were tested to have highest positive rates ( 27. 9％ and 26. 5％, respectively ), comparing that from other sources. Infection due to Mycoplasma pneumoniae was identified in 28％ (7/25) of community-acquired pneumonia (CAP) patients, which is higher than other diseases. Based on the follow-up of 91 antibody positive patients, between 5 to 120 days ( mean 24. 2 days )were counted from appearance of clinical symptoms to clinic visiting/testing. 71 of 91 (78. 0％ ) patients was medicated with macrolide antibiotics, 4 (4. 4％ ) with quinolones, 4 (4. 4％ ) with cephalosporin, and the rest 12 ( 13.2％ ) patients were medicated with other antibiotics or only symptomatic treatment. The average period of antibiotics medication was between 3 to 21 days (mean 8. 2 days). Medication effect results by follow-up were cure in 35 ( 38. 5％ ), improvement in 50 (54. 9％ ), and poor responses in 6 (6. 6％ ).ConclusionsMycoplasma pneumoniae positive rate in female patients was higher than in males, and peak rate was found in the fourth quarter and in school aged children. Samples from pediatrics clinic and ward were tested to have highest positive rates. Physicians could choose first line antibiotics according to laboratory test results of Mycoplasma pneumoniae, and gain good effect.
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Objective To establish plaque reduction assay and evaluate the activities of oseltamivir (tamiflu),amantadine,ribavirin and herb radix isatidis against influenza virus in vitro.Methods Plaque reduction assay was used to determine IC_(50) values of four studied drugs above in this susceptibility testing in which 8 clinical isolates(three influenza A virus isolates and five influenza B virus isolateds)were inoculated and tested.Results By testing of 8 clinical isolates of influenza virus A and B isolated between the year 2001 to 2008,oseltamivir and amantadine were found to be sensitive to influenza A virus with IC_(50) of 0.064 -0.128 mg/L and 0.5 mg/L,respectively.However,ribavirin(IC_(50)>8 mg/L)was not found to be sensitive,and herb radix isatidis had totally no activities.Unfortunately.all four studied drugs were not found to have activities against influenza B virus in vitro.Conclusions It Was indicated that oseltamivir and amantadine.but not ribavirin and herb radix isatidis.are sensitive to influenza A virus.All four studied drugs were not found to have activities against influenza B virus in vitro.
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ted by the ECI analyzer.