The Changes and clinical significance of platelet parameters in children with dengue fever / 国际检验医学杂志

Objective To investigate the variation characteristics of peripheral platelet parameters in children with dengue fever and to assess their use and value in diagnosis,prognosis and treatment for dengue fever.Methods Platelet parameters of 69 pediatric patients with dengue fever in acute febrile phase and remission period and 103 healthy controls were compared.The difference of platelet parameters between the liver function injury group and the normal liver function group,the coagulation dysfunction group and the coagulation function normal group,the severe group and the mild group with dengue fever was compared,the causes of thrombocytopenia in children with dengue was investigated so as to better understand the situation of bone marrow producing platelets.Results P-LCR,PDW,MPV were significantly higher in patients in acute febrile phase of dengue fever,compared with the healthy subjects(P＜0.01),while PCT,PLT were significantly lower in patients in acute febrile phase of dengue fever,compared with the healthy subjects(P＜0.01).MPV was significantly lower in patients with abnormal hepatic function when compared with patients with normal hepatic function(P＜0.05),while other platelet parameters did not show significant differences(P＞0.05).PLT and PCT were significantly lower in the severe patients than those in the mild patients(P＜0.05),while other platelet parameters did not show significant differences(P＞0.05).Peripheral platelet parameters did not show significant differences between patients with or without abnormal coagulation function (P＞0.05).Conclusion Peripheral platelet parameters may play a role in the diagnosis,treatment and prognosis of dengue fever in children.

Clinical analysis of 2 siblings with late-onset meningitis caused by group B streptococcus which were homogenous to the colonization bacteria of their mother / 中华实用儿科临床杂志

Objective To raise awareness of the late-onset meningitis caused by group B streptococcus (GBS) which was homogenous to the maternal colonization.Methods The clinical data of late-onset GBS meningitis in neonates twins whose pathogens were homogenous to their maternal colonization were collected from Department of Neonatology,Guangzhou Women and Children's Medical Center.The general conditions,clinical symptoms,laboratory tests and drug treatment of the twins and their mother were retrospectively analyzed,and the GBS homology during inpatient care was tested.And the progress of the twins' condition was investigated by telephone follow-up.Results The mother had two pregnancies without prenatal GBS screening or intrapartum antimicrobial intervention for GBS,everything was normal during pregnancy and delivery.Twins were born through cesarean section.The elder sister was discharged with Linezolid taken orally after 167 days in hospital without convulsions,shaking or other discomfort.The elder sister was followed up for every 2 weeks,and in the last time of follow-up,cerebrospinal fluid white blood cell counts were 45 × 106/L,protein level was 1.52 g/L and Linezolid was withdrawn.The younger brother was discharged after 58 days in hospital with follow-up for every 2 weeks,and in the last time of follow-up,cerebrospinal fluid white blood cell counts were 30 × 106/L,protein level was 0.66 g/L.During the hospitalization and follow-up without convulsions and irritation,and the cranial magnetic resonance imaging of the twin brother was normal.Test results showed that the GBS bacteria strain for twins and their mother were all serotype Ⅲ.The possibility of the GBS homology was more than 90％.Conclusions The toxicity of serotype Ⅲ GBS strain was strong.More proactive precautions should be considered to apply for the mother whose first birth already had GBS infection.Early identification and intervention of infection risk factors would help optimize the anti-infection treatment program and reduce nerve system damage and other adverse outcomes caused by invasive GBS infection.

Clinical analysis and serotypes distribution of neonatal purulent meningitis caused by group B streptococcus / 实用医学杂志

Objective To investigate the clinical characteristics,antibiotic susceptibilities and serotypes of Group B Streptococcus(GBS)isolated from neonatal meningitis to provide references for the prevention and treatment of neonatal GBS meningitis. Methods From June 2013 to June 2016,we surveyed the GBS strains iso-lated from purulent meningitis of < 90 days infants from Guangzhou Women and Children′s Medical Center. The GBS isolates were identified and the minimum inhibitory concentration of the antibiotics was determined by Vitek 2 Compact automatic bacterial identification system.GBS serotyping was performed using Strep-B-Latex?rapid latex agglutination test kit. Results A total of 46 cases of neonatal GBS meningitis,15 cases of early-onset infection and 31 cases of late-onset infection were diagnosed. 78.3% of GBS meningitis with varying degrees of complica-tions.Among 41 survivors with 3~24 months follow-up,50% of the early-onset and 44.8% of the late-onset GBS meningitis with varying degrees of neurological sequelae.Four capsular types were identified among the 46 isolates, serotype-Ⅲwas the most prevalent(73.9%),followed by Ib(19.6%),V(4.3%)and Ia(2.2%).All the isolates were susceptible to penicillins,cephalosporins,linezolid and vancomycin. Conclusion The highly pathogenic serotype-Ⅲ was the predominant serotype among neonatal GBS meningitis in Guangzhou,Therefore,it is neces-sary to strengthen the epidemiological surveillance of GBS invasive infection and the effective implementation of pre-ventive measures.

Interpretation of the guideline or consensus on screening strategy and detection methods for prevention of perinatal group B streptococcal infection in European and American countries / 中华检验医学杂志

Group B streptococcus ( GBS) is the most common cause of neonatal invasive infections in western countries , leading to severe pneumonia , sepsis and meningitis with high mortality and morbidity . Neonatal GBS infections are mainly transmitted from mother to baby .Since the end of 1990 s, prevention strategies of antenatal GBS screening and intrapartum antibiotic prophylaxis ( IAP) have been implemented by European and American area , decreasing the incidence of neonatal GBS disease significantly .The harm of GBS to neonates has been recognized and valued in recent years in China , but the authorized prevention measures are still lacking.Efficacy of IAP-based prevention depends on the accuracy of GBS screening results during pregnancy .Here, the GBS prevention guideline or consensus recommended by European and American CDC, including the screening strategies , detection methods, sample collection, storage and transportation were interpreted .

In vitro inhibitory effect of artesunate on the vascular endothelial growth factor secreted by mononuclear cells in hand-foot-and-mouth disease children complicated with encephalitis / 中华传染病杂志

Objective To investigate the dynamics of white blood cell count (WBC),prealbumin(PA),high sensitive C-reactive protein (hs-CRP),and vascular endothelial growth factor (VEGF) in hand-foot-and-mouth disease (HFMD) complicated with or without encephalitis and in vitro inhibitory effects of artesunate on VEGF secretion of mononuclear cells from HFMD patients.Methods Peripheral blood mononuclear cells from healthy control group,HFMD group and HFMD combined with encephalitis group were isolated by Ficoll density gradient centrifugation and treated with different concentrations of artesunate (25,50,100 mg/L).The expression of VEGF in the supernatant was examined by ELISA double antibody sandwich method.The levels of WBC,PA and hs-CRP in the three groups were also detected.Multiple samples were compared by one-way analysis of variance.Multiple comparison was performed by Dunnett T3 test.Correlation of two variables was analyzed by Spearman correlation test.Results There were significant differences in the levels of WBC,hs-CRP,PA and VEGF between the HFMD combined with or without encephalitis group and health control group (F=172.69,366.02,166.32 and 5 941.89,respectively,all P＜0.01).There were significant differences in the levels of VEGF secreted by mononuclear cells treated with three different concentrations of artesunate between the HFMD combined with or without encephalitis groups and health control group (F =194.265 and 4 750.69,respectively,both P＜0.01).Correlation analysis showed that the VEGF level secretion by mononuclear cells from HFMD patients with or without encephalitis were both negatively correlated with different concentrations of artesunate (r=-0.903 and-0.969,both P＜0.01).Conclusions Compared with HFMD without encephalitis,the secretion of VEGF by mononuclear cells,WBC and hs-CRP levels in HFMD complicated with encephalitis group all increase and PA decrease significantly.Artesunate can inhibit the secretion of VEGF by mononuclear cells of patients with hand-foot-and-mouth disease in a dosedependent manner in vitro.

Comparison of the effects of three different methods on cervical edema / 中国基层医药

Objective To compare the effect of phloroglucinol with lidocaine in treatment of cervical edema at the active stage.Methods 262 normal primiparae with cervical edema were randomly divided into three groups. Group A(89 cases)was intravenously given phloroglucinol,group B(83 cases)was injected lidocaine into the cervix, group C(90 cases)was wet compress lidocaine on the cervix.The cervical change,progression of labor and maternal and fetal outcomes were compared among the three groups.Results The disappearance ratio of cervical edema after 1h of group A,group B,group C were 79.8%,59.0%,57.8% respectively,there were statistically significant differ-ences between group A with group B and group C(χ2 =4.31,5.04,all P 0.05).The mean time period from drug administration to full dilation of the cervix of group A,group B,group C were (3.2 ±0.5)h,(4.1 ±0.6)h,(4.3 ±0.3)h,there were statistically significant differences between group A with group B and group C(t =0.91,1.06,all P 0.05).The disappearance ratio of cervical edema after 2h (group A:94.3%,group B:95.2%,group C:93.3%),vaginal delivery rate(group A:94.3%,group B:91.6%,group C:94.4%),asphyxia neonatorum(group A:1 case,group B:0 case,group C:1 case),and postpartum hemorrhage[group A:(187 ±90)mL,group B:(202 ±100)mL,group C:(199 ±94)mL]had no statistically significant differences among the three groups(χ2 =0.14,0.29,0.10,F =0.633,all P >0.05 ). Conclusion Phloroglucinol and lidocaine all can treatment of cervical edema,the phloroglucinol is the best,two uses of lidocaine have same effect,there are no adverse effect on mother and newborn.

Investigation on reference ranges of peripheral white blood cells and five classification parameters among 13 442 children / 国际检验医学杂志

Objective To investigate the reference ranges of peripheral white blood cells (WBC) and five classification parame‐ters among 13 442 apparently healthy children to provide reference for clinical diagnosis .Methods A total of 13 442 apparently healthy children aged from 1 month old to 5 years undergoing the health physical examination in the healthcare department of the Guangzhou Municipal Women and Children Medical Center were chosen according to the healthy children screening standard and the exclusion standard of hematological diseases ,infection diseases and drug administration history .The WBC analysis and its parame‐ters detection were performed by using the Sysmex XS‐800i automatic blood cell analyzer .Results WBC and its five classification parameters were not accorded with the normally distribution .By the Mann‐whitney test ,no statistically significant differences in WBC ,BASO# and NEU # were detected between different genders of children (P> 0 .05) ,while the differences in LYM # , MONO# and EOS# had statistical significance(P<0 .001) ,in which the LYM # level in females was significantly higher than that in males ,while the MONO# and EOS# levels in females were lower than those in males ;By the Kruskal‐Wallis test ,WBC and five classification parameters had statistically significant differences among different age groups (P<0 .001) .The parameters of WBC ,LYM # ,MONO# and EOS# were decreased with age increase ,while NEU # was constantly increased with age increase and BASO# was decreased with age increase before 4 years old .Conclusion All factors such as gender ,age should be The inde‐pendent reference rangesl of WBC parameters among children aged from 1 month old to 7 years old should be formulated on the ba‐sis of fully considering the factors such as gender ,age .

To explore the clinical of ovarian malignant tumor with increased count of platelet / 国际检验医学杂志

Objective To explore the clinical significance of platelet count increasing in patients with ovarian malignant tumor . Methods 80 cases of ovarian malignant tumor patients ,80 patients with ovarian benign tumor and 80 cases of healthy women were enrolled in the study as group A ,B ,C respectively .The group A was divided into FIGOⅠ group(n=30) ,and FIGOⅡ and above group(n=50) .Platelet count was detected by using fully automatic blood cell analyzer and the serum CA125 concentrations were also measured for all the groups .Results The platelet count and CA125 concentrations in group A were higher than group B and group C(P< 0 .05) .The positive rate of platelet increasing and serum CA125 were also higher than group B and group C(P<0 .05) .There were significant differences between FIGOⅠ group and FIGOⅡ and above group in platelet count and CA125 concen‐trations .Conclusion Ovarian malignant tumor complicated with increased platelet count is common in patients of advanced stage . The increased platelet count could indicate the malignant degree of ovarian malignant tumor .

Comparative study on influence of large platelet on platelet count difference of optical method and electrical impedance method / 国际检验医学杂志

Objective To know how large platelets influnece the platelet count difference of the optical and impedance methods so as to provide the support for the reasonable application of optical method and effectively increasing the accuracy of platelet count.Methods 132 blood routine specimens with normal RBC parameters were anaylzed by both electrical impedance and optical methods with the Sysmex-XE5000 fully automativ hematology analyzer.The data were divided into the large platelet group and the normal platelet group according to the platlet-large cell ratio(P-LCR)results.The RBC and platelet parameters were compared be-tween the two groups with the unpaired t-test and the platelet count results detected by the optical and electrical impedance methods were compared within group with the paired t-test.Results The extremely significant differences of platelet parameters existed be-tween the two groups.The P-LCR,MPV,PDW and IPF % of the large platelet group were significantly higher than those of the normal platelet group,but the RBC parameters had no obvious difference.The significant difference of the platelet count also existed between the electrical impedance and optical methods in the large platelet group(P <0.05 ),the platelet count results detected by the electrical impedance method was on the low side,but the normal platelet group had no significant difference.Conclusion P-LCR increase is related with the increase of immature platelet.The electrical impadence method conducts the differentiation according to the granular size,which is easy to exclude the large platelel with larger volume and leads to reduce the platelet count results.There-fore,when P-LCR is increased,the optical method should be adopted in conducting the platelet count for avoiding the false reduce caused by the electrical impedance method.

Diagnostic role of Golgi protein 73 and its gene determination in primary hepatic carcinoma / 中华检验医学杂志

Objective To explore the diagnostic value of GP-/3 protein in gene detection in the patient of primary hepatic carcinoma, to discuss the joint roles of serum GP73 and AFP, and provide a novel method for the diagnosis for PHC and screening for high-risk population. Methods ELISA was used to detect the serum level of GP73 and AFP in 73 cases of PHC, 13 cases of hepatic cirrhosis, 32 cases of hepatitis and 62 cases of health people. SYBR Green real time fluorescence quantitative PCR was used to detect the relative value of GP73 mRNA in the peripheral blood cells of each group. Comparative Ct method was used to evaluate the relative expression levels. Eight cases of normal liver tissues and 8 cases of PHC tissues were detected at the same time to compare the relative expression levels. Results Kruskal-Wallis test showed that the serum levels of GP73 and AFP had significant differences between four groups(H value were 89. 6 and 52.0, P ＜ 0. 01) and the whole blood GP73 mRNA had no significant differences(H =4. 33, P ＞ 0. 05). Mann-Whitney test showed that the serum levels of GP73 had significant differences among PHC groups[166. 7 (162. 7-231.8) μg/L] and liver cirrhosis[57. 3 (46. 6-113. 6) μg/L], hepatitis[29. 6(26. 2-54. 5) μg/L], health group[25.1 (20. 8-29. 4) μg/L] (U value were 246, 297, 349, P ＜ 0. 01).The A FP levels of the four groups were 380. 9 (258.5-503.2) μg/L, 3.8 (1.3-14. 5) μg/L, 5. 1 (2. 4-7. 8)μg/L and 2. 8(2. 2-5.7) μg/L. It also showed significant differences (U value were 246,419 and 790,P ＜0. 01). The GP73 mRNA expression of PHC liver tissues(12. 64) was significant higher than normal liver tissues (1.00). The critical values for GP73 and AFP was determined to be 123. 2 μg/L and 10. 6 μg/L through the 8OC curves. Under the critical value the sensitivity of GP73 and AFP were 65.8% and 53.4% ,and the specificity of CP73 and AFP were 95.3% and 92. 5% respectively. Joint detection could increase the sensitivity up to 79. 5%, and achieve the high specificity of 90. 7%. Conclusions As a new diagnositic marker of primary hepatic carcinoma, GP73 protein has the very good sensitivity and specificity. The GP73 mRNA in the whole blood sample could not be used for the diagnosis of PHC. But it woule be a good molecular marker for diagnosis of PHC in the liver tissue sample. The joint detection of GP73 and AFP could improve PHC diagnostic performance, and provide an effective approcach to the PHC high-risk screening.

Application of Procalcitonin Test in Lower Respiratory Tract Infection / 中华医院感染学杂志

OBJECTIVE To evaluate the diagnosis value of the procalcitonin(PCT) test in the lower respiratory tract infection(LRTI),and to provide the application of PCT in the bacterial infectious disease.METHODS Procalcitonin concentrations were measured using the quantitative immunofluorescence test in 93 patients and the results were compared with the levels of C-reactive protein(CRP) and white blood cell count(WBC).Samples were collected and divided into 2 groups,one including 63 cases(bacterial infected group) the other including 30 cases(non-bacterial infected group) corresponding to their clinical diagnosis(temperature,heart rate,bacteremia culture,CRP,WBC count).RESULTS The levels of PCT in bacterial infected group were significantly higher than in non-bacterial infected group(P