Evaluation of Sysmex XN-3000 for Detection of Schistocyte / 中国实验血液学杂志

OBJECTIVE@#Compared with the method of optical microscopy, to evaluate the accuracy of fragmented red cells(FRC) detection by Sysmex XN-3000.@*METHODS@#A total of 111 samples were collected from patients diagnosed as thrombotic thrombocytopenic purpura, autoimmune disease, hematological disease, malignant tumor and health examination in our hospital from June 2019 to February 2021, including 74 cases in the case group and 37 cases in the healthy control group. All samples were detected by optical microscope and Sysmex XN-3000, respectively. ROC was used to evaluate the detection ability of Sysmex XN-3000 for schistocyte. Bland-Altman method was used to evaluate the consistency of the results of the two methods for detection of schistocyte, and Pearson correlation analysis was conducted for the difference of the results.@*RESULTS@#The area under the ROC curve was 0.890(95% CI: 0.828-0.952, P<0.01). Sysmex XN-3000 count did not quantitatively agree with schistocyte counts by microscopy in the case group(mean of difference:-1.53, 95% limits of agreement: -8.78~5.72). There was a weak positive correlation between platelet count and the difference of analyzer and microscopic results (r=0.32,P<0.05).@*CONCLUSION@#Sysmex XN-3000 can be used as a reference for qualitative determination of schistocyte. However, the sensitivity of Sysmex XN-3000 should be improved. It is still necessary to combine with manual microscopy. The quantitative results are not reliable now and cannot be used as a reference for monitoring the results of schistocyte in clinical patients after treatment.

Clinical characteristics and prognostic factors after percutaneous coronary intervention of women with the first non-ST-segment elevation myocardial infarction / 实用医学杂志

Objective To investigate the clinical characteristics and prognostic factors after percutaneous coronary intervention of women with the first non-ST-segment elevation myoeardial infarction.Methods A total of 123 female patients with AMI,including 70 patients with NSTEMI and 53 patients with ST-segment elevation myocardial infarction (STEMI),who received PCI within 24 hours of onset were selected from June 2013 to June 2015.The clinical data were compared between patients with NSTEMI and with STEMI.Cox regression model was used to analyze the prognostic factors for the elderly patients with NSTEMI.Results The female patients with NSTEMI had more cases of patients with hypertension (48 vs.26),diabetes (38 vs.38) and hyperlipidemia (52 vs.29)than the female patients with STEMI.Significant differences in systolic blood pressure [(134.31±22.26)mmHg vs.(125.04 ± 19.63) mmHg],levels of white blood cell [(9.02 ± 3.75) 109/L vs.(11.37 ± 3.63) 109/L] and troponin Ⅰ [(8.63 ± 18.34) μg/L vs.(18.79 ± 27.76) μg/L] were observed in the above two groups (l P ＜ 0.05,respectively).The rates of revascularization,major adverse cardiovascular events in NSTEMI group were higher than those in STEMI group during 1 year after discharge (47.7％ vs.28.0％,62.9％ vs.35.8％) (P ＜ 0.05,respectively).Cox survival analysis showed that white blood cell (HR =1.241) and troponin-Ⅰ (HR =1.026) elevation were the risk prognostic factors after PCI for women with the first NSTEMI.Conclusion More hypertension,diabetes,hyperlipidemia and higher levels of systolic blood pressure,lower levels of white blood cell and troponin Ⅰ were observed in women with the first NSTEMI.The long-term prognosis of female patients with NSTEMI is poor.And elevated levels of white blood cell and troponin-Ⅰ were the risk prognostic factors after PCI for women with the first NSTEMI.

Characteristics of hospitalized patients with anaphylaxis during different eras at Peking Union Medical College Hospital / 中华全科医师杂志

To analyze the incidence,clinical manifestations and causes of 42 in patients with anaphylaxis from 1990 and follow its change before and after 2005 retrospectively.The mean age was (39 ± 16) years.The ratio of male and female was 1:2.2.The incidence increased obviously after 2005 (30 vs.12).A majority of patients were females after 2005 (24 vs.5).The proportions of patients with impaired nerve system,circulatory system and hypotension decreased after 2005 (P ＜ 0.01,P ＜ 0.05,P ＜ 0.01).Anaphylaxis attacked more often intra-operatively after 2005 (43.3 ％ vs.1 / 12).The most common cause was drug(35/42),especially antibiotics(14/35).

Association between serum YKL-40 levels and endothelial function in hypertensive patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the relationship between serum YKL-40 levels and endothelial function in patients with essential hypertension (EH).</p><p><b>METHOD</b>Sixty EH patients [34 male, aged between 43 - 76 years, mean (59 ± 7) years] and 30 healthy subjects [17 male, mean age (57 ± 5) years] were enrolled in this study. Serum YKL-40 levels were measured by enzyme immunoassay (ELISA). Endothelial function [endothelin-1 (ET-1), nitric oxide (NO), flow-mediated dilatation (FMD)] was also measured. EH patients were further divided to no metabolic syndrome and metabolic syndrome group.</p><p><b>RESULTS</b>Serum uric acid, ET-1, hs-CRP were significantly higher while serum NO, FMD and NMD were significantly lower in EH group than in control group (all P < 0.05). YKL-40 was significantly higher in EH group than in the control group [51.7 (35.6 - 341.9) µg/L vs. 33.2 (23.3 - 167.3) µg/L, P < 0.05] and significantly higher in EH patients with metabolic syndrome than in EH patients without metabolic syndrome (152.3 µg/L vs. 94.2 µg/L, P < 0.05). In this cohort, serum YKL-40 level was positively correlated with SBP, DBP, BMI, TG and hsCRP(r = 0.360, 0.303, 0.281, 0.216, 0.530, all P < 0.05)but not correlated with FMD, ET-1 and NO (all P > 0.05).</p><p><b>CONCLUSIONS</b>Serum YKL-40 levels are increased compared to normal controls and positively correlated with blood pressure level but not with endothelial function parameters in hypertensive patients. Serum YKL-40 level might thus be used as a biomarker reflecting inflammation status other than endothelium function in hypertensive patients.</p>

Activation and coreceptor expression of T lymphocytes induced by highly active antiretroviral therapy in Chinese HIV/AIDS patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>At the end of 2005, 650,000 people lived with human immunodeficiency virus type-1 (HIV-1) in China, of whom 75 000 were AIDS patients. Many AIDS patients received highly active antiretroviral therapy (HAART) supported by the "China CARES" program but the immune responses of HAART were seldom reported. This study investigated the effect of HAART on the activation and coreceptor expression of T lymphocytes in Chinese HIV/AIDS patients and evaluated its effect on immune reconstitution.</p><p><b>METHODS</b>Seventeen HIV/AIDS patients were enrolled and three-color-flow cytometry was used to detect the activation of HLA-DR CD38 and the coreceptor CCR5, CXCR4 expression on T lymphocytes in whole blood samples taken from the patients before and after 3- or 6-month HAART.</p><p><b>RESULTS</b>The activation percents of CD4(+), CD8(+) T lymphocytes were significantly higher before therapy than the normal controls (HLA-DR/CD4: 40.47 +/- 18.85 vs 11.54 +/- 4.10; CD38/CD4: 81.34 +/- 10.86 vs 53.34 +/- 11.44; HLA-DR/CD8: 63.94 +/- 12.71 vs 25.67 +/- 9.18; CD38/CD8: 86.56 +/- 11.41 vs 58.84 +/- 6.16, all P < 0.01). After 6-month combined antiretroviral treatment, the activation of T lymphocytes in HIV/AIDS patients was significantly decreased (HLA-DR/CD4: 28.31 +/- 13.48; CD38/CD4: 69.88 +/- 12.64; HLA-DR/CD8: 46.56 +/- 18.64; CD38/CD8: 70.17 +/- 14.54, all P < 0.01 compared with the pre-treatment values). Before the treatment, CCR5 expression on CD8(+) T lymphocytes was up-regulated while CXCR4 expression on CD8(+) T lymphocytes downregulated in HIV/AIDS patients compared with the normal controls (CD8/CCR5: 70.91 +/- 10.03 vs 52.70 +/- 7.68; CD8/CXCR4: 24.14 +/- 11.08 vs 50.05 +/- 11.68, all P < 0.01). After 6-month HAART, CCR5 expression on CD8(+) T lymphocytes significantly decreased (56.35 +/- 12.96, P < 0.01), while CXCR4 expression on CD8(+) T lymphocytes increased (36.95 +/- 9.96, P < 0.05) compared with the pre-treatment and the normal controls. A significant statistical relationship was observed between the expression of activation markers, CCR5 and the CD4(+) T lymphocyte counts after HAART (P < 0.05).</p><p><b>CONCLUSIONS</b>Reduced activation of T lymphocytes and a normalization of coreceptor expression were observed in Chinese HIV/AIDS patients after HAART. Immunity can be restored in HIV/AIDS patients receiving HAART.</p>

Study on the relationship between the polymorphisms and secondary structure of tat exon-1 gene and HIV/ AIDS progress in subtype B' and B'/C / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the polymorphisms and secondary structure of human immunodeficiency virus (HIV-1) tat exon 1 among subtype B' and B'/C HIV-1 infected people in China and to explore the relationship between the polymorphism of tat exon 1 and the disease progression.</p><p><b>METHODS</b>8 subtype B' and 5 B'/C HIV-1 infected patients with slow disease progression were selected from Liaoning, Jilin and Yunnan province. 26 subtype B' and 9 B'/C HIV-1 infected patients with similar sex, age but with typical disease progression were selected. Provirus was extracted from the whole blood. The gene sequences of the Tat exon 1 were amplified by nest-polymerase chain reaction (nest-PCR). Products were purified and sequenced directly. The sequences were aligned, translated, amino acid substitution were analyzed and secondary structures were predicted.</p><p><b>RESULTS</b>Many amino acid substitution could be found in the exon 1 of Tat in HIV-1 subtype B' and B'/C recombinant strain infected persons with different disease progression except A58T,none of them showed definitely relationship with HIV viral load and disease progression. 23N, 31S, 32Y and 46F were subtype-specific substitutions. No characteristic secondary structure of exon 1 of Tat was found.</p><p><b>CONCLUSION</b>Some of the mutations of tat exon 1 might be related to HIV viral load and disease progression. However, there was no relationship found between the secondary structure of Tat protein and the disease progression.</p>