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Objective@#To assess the value of different equations for estimating glomerular filtration rate (GFR) for evaluating renal function in people aged 70 years and older.@*Methods@#A retrospective study was conducted involving 11 966 elderly people aged 70 years and older, including 5 741 males (48.0%), who underwent routine physical examinations in Beijing Hospital from January 2012 to December 2014 and were followed up for 3 years.Baseline data, including the age, gender, and serum creatinine, were recorded.@*Results@#function was assessed using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD) Study, Chinese Modification of Diet in Renal Disease (MDRD) Study, full age spectrum (FAS) equation and Berlin Initiative Study (BIS) equation, respectively.Results The serum creatinine level increased with age in male and female subjects, and the standard deviation also increased with age, indicating greater variability of serum creatinine in the elderly.Of all equations, the FAS and BIS equations had the lowest GFR estimates.The five equations showed good consistency.In males, the Kendall's W coefficient was 0.796 (P = 0.000); the female Kendall's W coefficient was 0.715 (P = 0.000). Based on three ranges of serum creatinine (<88.4 μmol/L, ≥88.4 μmol/L and <132.6 μmol/L, ≥132.6 μmol/L), all patients were divided into three groups.The BIS, MDRD, MDRDc and FAS equations were all consistent in staging CKD at any creatinine level; however, the CKD-EPI equation significantly overestimated renal function at higher levels of serum creatinine.There was no clear age-related trend when each of the five equations was used to calculate the average 3-year eGFR rate.@*Conclusions@#The CKD-EPI, MDRD, MDRDc, FAS and BIS equations can be used to assess renal function, but the results vary among different populations.Which equation has the best accuracy for the elderly in China remains inconclusive and further research is urgently needed.
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Objective To assess the value of different equations for estimating glomerular filtration rate (GFR) for evaluating renal function in people aged 70 years and older.Methods A retrospective study was conducted involving 11 966 elderly people aged 70 years and older,including 5 741males (48.0％),who underwent routine physical examinations in Beijing Hospital from January 2012 to December 2014 and were followed up for 3 years.Baseline data,including the age,gender,and serum creatinine,were recorded.Results function was assessed using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI),Modification of Diet in Renal Disease (MDRD) Study,Chinese Modification of Diet in Renal Disease (MDRD) Study,full age spectrum (FAS) equation and Berlin Initiative Study (BIS) equation,respectively.Results The serum creatinine level increased with age in male and female subjects,and the standard deviation also increased with age,indicating greater variability of serum creatinine in the elderly.Of all equations,the FAS and BIS equations had the lowest GFR estimates.The five equations showed good consistency.In males,the Kendall's W coefficient was 0.796 (P =0.000);the female Kendall's W coefficient was 0.715 (P =0.000)Based on three ranges of serum creatinine (＜88.4 μmol/L,≥88.4 μmol/L and ＜132.6 μmol/L,≥132.6 μmol/L),all patients were divided into three groups.The BIS,MDRD,MDRDc and FAS equations were all consistent in staging CKD at any creatinine level;however,the CKD-EPI equation significantly overestimated renal function at higher levels of serum creatinine.There was no clear age-related trend when each of the five equations was used to calculate the average 3-year eGFR rate.Conclusions The CKD-EPI,MDRD,MDRDc,FAS and BIS equations can be used to assess renal function,but the results vary among different populations.Which equation has the best accuracy for the elderly in China remains inconclusive and further research is urgently needed.
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Objective To investigate age-related changes in serum tumor markers carbohydrate antigen 125 (CA125),CA153 and CA199,and the clinical significance of separate and combined detection of these markers for screening endometrial carcinoma(EC) in elderly women with intrauterine abnormalities on transvaginal ultrasound (TVS).Methods Cross-sectional data of 420 elderly women suspected of having an intrauterine abnormality by TVS and undergone hysteroscopy with dilation and curettage from January 2010 to December 2017 were retrospectively analyzed.Patients were divided into a 60-64 years-old group and a 65-83 years-old group.Aging-related changes in positive rates of CA125,CA153 and CA199 were compared between the two groups.Differences in positive rates of tumor markers were compared between different pathological types.Using postoperative pathological diagnosis as the gold standard for EC,the diagnostic sensitivity,specificity and accuracy of serum CA125,CA153 and CA199 alone or in combination for EC were calculated.Results The positive rates of CA125,CA153 and CA199 were 3.9％(16/412),0％(0/172)and 5.0％ (20/404),respectively.The positive rate of CA125 was higher in the 65-83 years-old group(6.5％,16/246)than in the 60-64 years-old group(0.0％,0/166) (P =0.001).The positive rates of CA125 and CA199 in patients with EC were 14.3％ (4/28)and 42.9％ (12/28),which were higher than those in patients with other pathological types.However,the sensitivity of single and combined detection of CA125 and CA199 was too low for the diagnosis of EC(14％、43％).Conclusions The single and combined detection of CA125,CA153 and CA199 for screening EC is of limited value in elderly women.New tumor markers need to be identified and used in combination with TVS for screening EC in elderly women.
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Objective To perform a methodological evaluation study of 4 HPLC based systems and a capillary electrophoresis based system , with the International Federation of Clinical Chemistry and Laboratory Medicine ( IFCC) glycated hemoglobin reference method as a comparative method .Methods 40 hemolysis samples of variety concentrations were prepared .The samples were measured by IFCC reference method and 5 glycated hemoglobin testing systems , respectively and trueness verification was performed according to the Clinical &Laboratory Standards Institute (CLSI) guideline EP9-A3.Whole blood samples were used to test the systems'precision, linearity and analytical interferences .Results The average CV of IFCC reference method results of 40 hemolysis samples was 1.4％( range from 0.2％to 2.5％).No outlier was found in the results of the 5 testing system.The slopes ranged from 0.9902 to 1.0267, and intercepts from -0.1526 mmol/mol to +0.1512 mmol/mol, squared correlation coefficient from 0.9962-0.9971, biases at two medical decision level were less than 0.3％HbA1c.Within-laboratory precisions were less than 2％ (NGSP unit).Bias between all test results and predicted results were less than 5％.High concentration of glucose showed certain interference to glycated Hemoglobin tests but had little influence in clinical practice.Conclusions The results of the 5 testing system are comparable to the IFCC reference method , the results of precision and linearity evaluation meet the requirements of related guidelines .
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Objective To build anautoverification system for hematology analysis system and validate the system based on commercialized labXpert software.Methods Preliminary validation rules was established base on 41 Items of International Consensus Review Rules and instructions for Mindray CAL8000 auto hematology analyzer,and input the rules into labX pert sample validation system.999 clinical samples were collected from Beijing Hospital Ministry of Health to test the preliminary rules and parameters including false positive rate,false negative rate and autoverification pass rate were calculated,based on which to adjust and customize the original protocol.Then 15 934 samples were tested,respectively,for autoverification by calculating the autoverification pass rate,proportion of manual verification and microscopic verification.Autoverification were compared as well as the turnover time (TAT,timefrom receipt of sample to report of result) before and after application of autoverification system.Results Preliminary verification results showed that false negative rates in both hospitals were less than 2％,and the false negative mainly caused by low promyelocytic cells value (blasts and promyelocytes less than 3 ％),abnormal erythrocyte morphology,and abnormal platelet morphology.No sample with excess blasts or percentage of blasts and promyelocytes higher 3％ with tested with false negative result,indicating relatively low clinical risks.Both hospitals reported with relatively high false positive rates,up to nearly 18％,using preliminary programs,which may affect the autoverification rate of the system.Based on the analyzing result of false positive results,the program was adjusted to significantly reduce the false positive rate while remaining the false negative rate low,therefore resulted with 4 remarkable increase of autoverification pass rate.Over 10,000 samples were tested with improved program,and the autoverification pass rates for hospital was 78.4 ％,respectively.Primary reason causing failure of autoverification included increased IMG％,flag for immature cells and WBC exceeding set limit.Application of system reduced the TAT by 5 min (P＜0.05).Conclusion Autoverificationsystem using Mindray CAL8000 auto hematology analyzer andlabXpert has been confirmed effective in reducing TAT and enhancing working efficiency while remaining low false negative rate.The autoverification pass rate tested 75％,which suggested that laboratory workers can spare more time on reexamination of abnormal samples for better blood routine report.
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Objective To determine the normal reference values for thromboelastography (TEG) in Chinese healthy elderly people in Beijing and compare them with those provided by the manufacturer and with people under the age of 55 years.Methods The healthy elderly people aged over 65 years were enrolled from March 2014 to April 2014.4 ml of peripheral vein blood samples were taken from each person.All subjects underwent the laboratory tests of prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT) and fibrinogen (FIB).TEG parameters including reaction time (R),coagulation time (K),angle (alpha) and maximum amplitude (MA) were determined by using a Heamoscope 5000 device.Results A total of 119 healthy elderly subjects were enrolled in this study.The mean values (95％ CI) of TEG parameters for them were R:6.29 min (4.4-8.2 min),K:1.63 min (0.8-2.5 min),α-Angle:66.09° (55.0-77.1°),MA:63.43mm (54.5-72.3 mm).There were significant differences in the values of R,K and α-Angle between the elderly and non-elderly groups (P＜0.001 or 0.05).There were significant differences in the values of K,α-Angle and MA between males and females (P＜0.05 or 0.001).According to the normal reference values provided by the manufacturer,16.1％ (19/119) of the healthy elderly volunteers had at least one abnormal parameter beyond its normal range.3％ (3/119) of the healthy elderly people were diagnosed as coagulation abnormalities,yielding a specificity of 84％.Compared with normal reference values provided by the manufacturer,the value of R was lower and the value of MA was higher in the healthy elderly people in Beijing.Conclusions The normal reference values for TEG should be established based on the local population characteristics.
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Objective To assess the effects of fenofibrate on myocardial remodeling in obese rats by echocardiography.Methods Twenty-six SD rats were fed with high fat chow to establish twenty obese rats models,which were randomly divided into two groups:obesity group (OB group,n =10) and fenofibrate group(F group,n =10).The same week-old SD rats group (n =10) was also randomly selected as normal control group.F group was given fenofibrate 60 mg · kg-1 · d-1 for 8 weeks,the other groups were given normal saline.Echocardiographic scan was performed in each group at the beginning and ending of the experiment.Twenty-four weeks later,all rats were executed and the cardiac muscle was used to histological inspect.Results After the experiment,compared with the control group,the body weight,the ventricular thickness,interventricular septal thickness and the left ventricular mass in OB group were significantly increased than those of control group(P ＜0.01),the E/A ratio was significantly decreased(P ＜0.01).Histological detection showed that myocardial structure was disordered,and that interstitial collagen was deposited in the myocardium.Compared with OB group,the parameters all above in F group were significantly improved (P ＜0.01).Left ventricular mass from echocardiography correlated well with the results from pathologic specimen (r =0.98,P ＜0.01).Conclusions Fenofibrate has beneficial effects on preventing myocardial remodeling.By general echocardiography,the effects can be assessed comprehensively and accurately.
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Objeetive To explore change of platelet glycoproteins Ⅵ(GPⅥ)in patients with type 2 diabetes mellitus and its clinical significance.Methods The surface expression of platelet glycoprotein Ⅵ was determined by flow cytometry in 56 patients with type 2 diabetes mellitus and 61 normal individuals.Plasma GP Ⅵ concentration was measured by ELISA in 30 patients with type 2 diabetes mellitus.Platelet surface CD62P was analyzed by flow cytometry and HbA1c was determined in Datients with type 2 diabetes mellitus.Results The geometric mean fluorescence of platelet surface GPⅥ in Datients with type 2 diabetes mellitus was 93.66±35.24,which was significantly enhanced compared with normal subjects (62.83±24.2)(t=-4.927,P＜0.05).Nine patients were positive in plasma GPⅥ among 30 Datients with type 2 diabetes mellitus.Plasma GP Ⅵ concentrations in 9 positive patients were conversely correlated with platelet surface GPⅥ expression(r=-0.633,P＜0.05).However,there was no correlation between platelet Surface CD62P and plasma HbA1c concentrations, and the correlation coemcient is -0.333 and -0.417,respectively(P＞0.05).There was no correlation between platelet surface GP Ⅵ expression with C062P and HbA1c in patients with type 2 diabetes mellitus and the conrrelation coefficient is -0.009 and -0.217,respectively(P＞0.05).Conclusions GPⅥ expression on platelet surface is elevated in Datients with type 2 diabetes mellitus and the determination of platelet surface GPⅥ and plasma GPⅥ concennlation may helP to prognosticate the risk of thrombotic events and may play an important role in evaluating platelet activation in patients with type 2 diabetes mellitus.
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Objective To establish a new flow cytometric immuno-bead array assay (FCIBA)to detect several platelet-specific autoantibodies simultaneously in a single serum sample.Methods A series of beads of different red fluorescent intensity were used for coating with different anti-platelet membrane protein monoclonal antibodies(anti-GP Ⅱb/a,anti-GP Ⅰ a/Ⅱ a,anti-GP Ⅳ,anti-GP Ⅰ b/Ⅸ and anti-HLAABC)to detect five platelet-specific autoantibodies in serum. The beads captured platelet antigenautoantiboay complex.Subsequently,different platelet-specific autoantibodies in a patient serum can be detected simultaneously by the flow cytometry.In addition,we evaluated the new FCIBA,and compared its results with modified antigen capture ELISA method(MACE).The new FCIBA was used to detect five platelet-specific autoantibodies in serums of autoimmune thrombocytopenic purpura(AITP)and nonautoimmune thromboeytopenic purpura patients.Results The new FCIBA can be used to detect five plateletspecific autoantibodies simultaneously(Anti-GP Ⅱ b/Ⅲ a,Anti-GP Ⅰ a/Ⅱ a,Anti-GP Ⅳ,Anti-GP Ⅰ b/Ⅸand Anti-HLA-ABC).The coefficient of variation(CV)of intra-repetition are 4.82%,6.09%,5.04%,5.73%and 5.30%,respectively.The dilution test results are in good logarithm linearity which are 0.997 2,0.996 6,0.998 8,0.996 5 and 0.998 2,respectively. The resuhs of the new FCIBA are highly correlated with those with MACE method,and the coefficient correlation were 0.928 9,0.922 4,0.889 4,0.910 0 and 0.913 4,respectively(P＜0.01).51.69%samples of AITP patients show positive for platelet-specific autoantibodies as detected by the new FCIBA.Among the AITP patients,the positivity of specific autoantibodies for anti-GPⅡb/ Ⅲ a,anti-GP Ⅰ a/Ⅱ a,anti-GP Ⅳ,anti-GP Ⅰb/Ⅸ and anti-HLA-ABC were 40.82%,24.45%,19.39%,32.65%and 17.35%.Among the 40 non-autoimmune thrombocytopenic purpura patients,none of platelet-specific autoantibodies in serum samples can be detected.Conclusion A new FCIBA is established successfully to detect five platelet-specific autoantibodies coefficient correlation.
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Objective To express and purify recombinant human platelet glycoprotein Ⅵ extracellular domain and prepare the polyclonal antibody against it.Methods Human platelet glycoprotein Ⅵ extracellular domain fragment (123~268 residues) was amplified by polymerase chain reaction and cloned into the prokaryotic expression vector pGEX-3x.The recombinant plasmid was constructed and expressed in E.coli after induction with isopropyl-?-D-thiogalactopyranoside (IPTG).The fusion protein was identified by Western blot analysis after purification by affinity chromatography.Rabbits were immunized with the purified fusion protein, and the collected rabbit antiserum was evaluated by sandwich ELISA, Western blot and flow cytometry.Results The coding sequence of GPVI extracellular domain was successfully inserted into pGEX-3x.Sequencing result showed that the cloned gene was identical as reported.After induction, a Mr 42kd fusion protein was expressed and confirmed by Western blot, which was identical to that expected.The titers of the antisera were up to 1∶[KG-*2]128. Sandwich ELISA result demonstrated that the prepared antibody recognized GPVI in human platelet. Western blot and flow cytometry revealed that the prepared antibody reacted with GPVI of platelet lysate and the native GPVI on human platelet surface.Conclusions Using purified prokaryotic expressed the fusion protein as antigen, the specific antibody was elicited in the immunized animals. The prepared polyclonal antibodies react specially with GPVI on human platelet surface and can be used for further studies of GPVI.