Evaluation of the performance of systems for whole blood C-reactive protein detection: a multi-center study / 中华检验医学杂志

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.

Application of PCR technique in etiological diagnosis of children with enterovirus and herpesvirus encephalitis / 中华检验医学杂志

Objective:To examine the infection of the enterovirus and human herpes virus in children with suspected encephalitis.Methods:A total number of 365 suspected encephalitis cases were included in this study from August 2017 to December 2019 in Hunan Children′s Hospital. The clinical samples, the cerebrospinal fluid (CSF), serum, sputum, stool and urine were collected and preserved at-80 ℃condition. The enterovirus (EV) and human herpesvirus (HHV) were examined by a one-step nested reverse transcription PCR(RT-PCR) and a real-time fluorescent quantitative PCR (qPCR), respectively. The positive rate of the two viruses in clinical specimens of children with suspected encephalitis was examined. Among all cases, 132 cases were diagnosed with EV encephalitis or HHV encephalitis.Results:the EV encephalitis were identified in 20.5% (75/365) children with suspected viral encephalitis; whereas HHV encephalitis infection was identified as 15.6% (57/365). Among the 75 cases of EV encephalitis, echo 6 was the main sub-type of these diseases 52.0% (39/75) and others were EV71 (30.7%, 23/75), echo11 (6.7%, 5/75), Coxsackie virus A group 6(CA6, 4.0%, 3/75), echo30 (1.3%, 1/75), echo9 (1.3%, 1/75), echo4 (1.3%, 1/75),Coxsackie virus B group 1(CB1, 1.3%, 1/75))and poliovirus(1.3%, 1/75).Human herpes virus type 6 (HHV6) was the most common pathogen in 57 cases of HHV encephalitis, accounting for 35.1% (20/57).The other pathogens were Cytomegalovirus (CMV, 31.6%, 18/57), Epstein-Barr virus (8.8%, 7/57), Herpes simplex virus 1 (HSV1, 10.5%, 6/57), HSV2 (8.8%, 5/57), and Varicella zoster virus (VZV, 1.8%, 1/57) .The virus in CSF detected significantly earlier than that in serum after onset. Virus could be detected in CSF 2-7 days after onset,but 7-26 days in serum. Conclusions:This study uses nested PCR and qPCR to detect pathogens in clinical specimens of children. This not only expands our understanding of the clinical examination and diagnosis of viral encephalitis in children, but also promotes the method of this study to benefit more children.

Investigation and analysis of anti-mullerian hormone, inhibin B and sex hormone levels in 101 children with disorders of sex development / 中国医师杂志

Objective:To compare anti-mullerian hormone (AMH) , sex hormone and inhibitor B (Inhibin B, INH-B) levels in children with different karyotypes, ages, and gender disorders of sex developmemt (DSD).Methods:A total of 101 patients with suspected gonadal dysplasia in children who underwent serological examination at the Children′s Hospital of Hunan Province from January 2019 to June 2019 were finally diagnosed by pathological biopsy. With reference to previous studies of the same type, the 101 patients included in this study were divided into 4 levels (<1 year old, 1-2 years old, 2-4 years old, >4 years old), and the social gender was divided into two levels: male and female. At the same time, 89 cases of normal gonadal development children without endocrine abnormality were selected as control. Serum levels of AMH, INH-B, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), prolactin (PRL) and testosterone (T) were measured by chemiluminescence method.Results:Among the 101 cases, 62 were male and 39 were female; aged 23 days to 12 years, with a median age of 3.3 years; karyotype: 52 cases were 46, XX; 21 cases were 46, XY; 12 cases were 45, X; 7 cases were 46X, del (Xq); 5 cases were 46X, i (Xq); 2 cases were 45X, inv9; 2 cases were 45X / 46XX. There were 65 cases of partial gonadal dysplasia, 25 cases of disappearing testicular syndrome, and 11 cases of mixed gonadal dysplasia. One patient had a family history of infertility. Among the causes of children′s consultation, the most common were abnormal appearance of the external genitalia (54 cases, 53.47%), followed by small penile development and / or scrotal emptiness (25 cases, 24.75%). Other reasons included primary amenorrhea, double lateral groin mass, hypertension, clitoral hypertrophy, and labia minora adhesions. The levels of serum AMH, INH-B, and T in the gonadal dysplasia group were significantly higher than those in the normal gonadal development group, while the levels of LH, FSH, E2, and PRL were significantly lower than those in the normal gonadal development group ( P<0.05). The INH-B level of children with gonadal dysplasia in different age groups was statistically significant ( P<0.05), in which the INH-B level was the highest in <1-year-old children with gonadal dysplasia, and the lowest in 2-4-year-old children with gonadal dysplasia; the LH, FSH, E2, PRL, T levels of 46, XX and other karyotypes were statistically significant ( P<0.05); Compared with other age groups, the levels of LH, FSH, E2, and PRL were relatively higher in >4 year-old children with gonadal dysplasia, while the level of T was relatively lower; There were significant differences in E2, PRL and T levels in children with gonadal dysplasia in different age groups of 46, XY karyotype ( P<0.05). Compared with other age groups, E2, PRL and T levels of children with gonadal dysplasia >4 year-old old were relatively higher and T levels were relatively lower. The levels of AMH, LH, FSH, E2 and PRL in boys with glandular dysplasia were lower than those in girls ( P<0.05), while the levels of INH-B and T were higher in boys than those in girls ( P<0.05). Conclusions:The levels of anti-mullerian hormones, inhibin B, and sex hormones in children with gonadal dysplasia are different from the normal population, and may be related to the age, chromosome karyotype, and gender distribution of the child, but there are some confounding factors (such as etiology, treatment Scheme), so more samples are needed to verify it.

Expert consensus on standardized TORCH laboratory detection and clinical application / 中华检验医学杂志

TORCH, which is considered as a series of pathogens, including the Toxoplasma gondii, Rubella virus, Cytomegalovirus or Herpes simplex virus, often infects the pregnant women to induce the the fetus or newborn infection by transplacental infection or exposure to contaminated genital tract secretions at delivery. Increasing evidence have been confirmed that the infection of TORCH may cause the miscarriage, premature birth, malformed fetus, stillbirth, intrauterine growth retardation, neonatal multiple organ dysfunction and other adverse pregnancy outcomes. For most TORCH-infections cases may lacking the effective treatments during pregnancy, and it is important to achieve the effacing monitoring of TORCH infections before and during pregnancy. The laboratory testing of TORCH has the great significance. However, the consensus opinions still need to improve the the standardization of TORCH testing process and the correct interpretation. Based on the characteristics of the TORCH detection method, this article gives a consensus opinion on the standardized detection and clinical application of TORCH from the laboratory perspective according to the characteristics and types of infection of different pathogens.

Clinical application of anti-Müllerian hormone in disorders of sex development in children / 中华检验医学杂志

The process of sex development in children is complex and sequential. The diseases and etiologies associated with sex development are various, and laboratory indexes evaluating the diseases are scarce, which lead to the difficulty in diagnosis. Anti-Müllerian hormone(AMH) is a kind of reproductive hormone closely related to sex development. At present, AMH is widely used to evaluate ovarian reserve and to assist in the field of reproduction. AMH takes part in the process of sex development regulated by hypothalamic-pituitary-gonadal axis, and the change of AMH level may indicate the occurrence of diseases associated with sex development in children. This review will focus on the clinical application of AMH in precocious puberty, delayed puberty and disorders of sex development.

Clinical value of determining heparin-binding protein of cerebrospinal fluid in children with purulent meningitis / 中华检验医学杂志

Objective@#To explore the clinical value of determining heparin-binding protein(HBP) of cerebrospinal fluid(CSF) in the diagnosis and prognostic prediction in children with purulent meningitis(PM).@*Methods@#76 children with PM, 55 children with viral encephalitis(VE) and 40 control children with non-infectious diseases, all admitted to Hunan Children′ Hospital from August 2018 to January 2019, were enrolled in this retrospective study. Children with PM were divided into favorable prognosis group and poor prognosis group according to the Glasgow Outcome Scale on discharge. CSF HBP, white blood cell count(WBC), percentage of neutrophilic granulocyte(N%), glucose(Glu), total protein(TP), lactic dehydrogenase (LDH) and serum procalcitonin(PCT) were analyzed on the first day of admission(DAY1) in PM group, VE group and control group, and on the seventh day of admission(DAY7) in PM group. Nonparametric tests were used to detect the differences of the laboratory indexes and Spearman rank correlation test was utilized to analyze the correlation between HBP and other markers. Receiver operating characteristic curves (ROC curves) were established to evaluate the values of the detection indexes in the diagnosis and prognosis of PM.@*Results@#The differences of CSF HBP[63.09(18.10-272.19)ng/mL, 5.90(5.90-6.40)ng/mL and 5.90(5.90-5.90)ng/mL], WBC[365.00(20.00-1285.00)×106/L, 21.00(8.00-30.00)×106/L and 13.50(7.25-21.00)×106/L], N%[0.65(0.50-0.79), 0.19(0.10-0.25) and 0.21(0.15-0.27)], Glu[1.97(1.07-3.08)mmol/L, 2.89(2.66-3.42)mmol/L and 3.04(2.68-3.42)mmol/L], TP[1.43(0.63-1.88)g/L, 0.23(0.16-0.32)g/L and 0.13(0.10-0.31)g/L], LDH[152.00(46.50-461.50)IU/L, 16.00(13.20-22.00)IU/L and 16.00(10.25-19.75) IU/L] and serum PCT[1.35(0.19-9.33)ng/mL, 0.06(0.03-0.11)ng/mL and 0.08(0.05-0.14)ng/mL] levels on DAY1 were statistically significant among PM group, VE group and control group(HHBP=138.62, HWBC=69.72, HN%=106.67, HGlu=34.08, HTP=68.00, HLDH=85.11, HPCT=79.20, P<0.001). HBP had the largest area under curve(AUC=0.997) for the diagnosis of PM, and had excellent sensitivity, specificity, positive predictive value, negative predictive value (98.70%, 97.90%, 97.40%, 98.94%, respectively) at the optimal cut-off value (11.84 ng/mL). Compared with DAY1,CSF HBP, WBC, N%, TP, LDH and serum PCT levels on DAY7 were statistically lower in favorable prognosis group(P<0.05). The differences for all the indexes between DAY1 and DAY7 in poor prognosis group were not statistically significant, however. It was not significant for all the indexes on DAY1 to predict poor prognosis(P>0.05). But the indexes on DAY7 for predicting poor prognosis were significant (P<0.05) and HBP still had the largest AUC (0.976) for predicting the poor prognosis with good sensitivity, specificity, positive predictive value, negative predictive value (100.0%, 93.8%, 76.3%, 100.0%, respectively) at the optimal cut-off value(128.84 ng/mL). CSF HBP was positively correlated to CSF WBC, N%, TP, LDH, serum PCT level(rWBC=0.670, rN%=0.802, rTP=0.562, rLDH=0.524, rPCT=0.436, P<0.001) and negatively correlated to CSF Glu level(r=-0.469, P<0.001).@*Conclusions@#CSF HBP is valuable in the diagnosis and prognostic prediction in children with purulent meningitis.

The value of common infection markers combined with cerebrospinal fluid routine analysis for identifying the etiology of intracranial infection in children / 中华检验医学杂志

Intracranial infection is a common central nervous system disease that seriously endangers children′s health. Early diagnosis and reasonable treatment in time are of great significance to improve the long-term prognosis of children. This paper describes the improvement of routine laboratory methods for intracranial infection, and discusses the role of common infection markers including C-reactive protein, procalcitonin, tumor necrosis factor-α, interleukin-6 and heparin binding protein in the differential diagnosis of intracranial infection.

The value of common infection markers combined with cerebrospinal fluid routine analysis for identifying the etiology of intracranial infection in children / 中华检验医学杂志

Intracranial infection is a common central nervous system disease that seriously endangers children's health. Early diagnosis and reasonable treatment in time are of great significance to improve the long-term prognosis of children. This paper describes the improvement of routine laboratory methods for intracranial infection, and discusses the role of common infection markers including C-reactive protein, procalcitonin, tumor necrosis factor-α, interleukin-6 and heparin binding protein in the differential diagnosis of intracranial infection.

The clinical value for plasma heparin-binding protein in the early diagnosis of the neonatal sepsis / 中华检验医学杂志

Objective To investigate the clinical value of plasmatic heparin-binding protein in early diagnosis and severity gradation of neonatal sepsis.Methods Thirty-nine patients with general sepsis,37 patients with severe sepsis and 16 patients with septic shock were recruited as corresponding study groups respectively,who all had been admitted to the Neonatal Intensive Care Units(NICU)of Hunan Children′s Hospital from December 2016 to August 2017,meanwhile,34 patients with local infection and 35 patients with non infection were enrolled as relevant control group respectively who all had been admitted to each neonatal ward in the retrospective study.The level of the heparin-binding protein(HBP), procalcitonin (PCT)and high sensitive C-reactive protein(hs-CRP)of all patients were detected respectively at the beginning of hospitalization.The difference of each group was compared by use of nonparametric statistics and the efficacy of every index on diagnosis of infection and sepsis was assessed with the receiver operating characteristic curve(ROC).Results The level of HBP in sepsis group,severe sepsis group and septic shock group HBP(H=91.764,P<0.01), PCT(H=51.757,P<0.01)and hs-CRP(H=28.418,P<0.01)are significantly higher than those in local infection group and non infection group;Plasmic HBP levels of severe sepsis group[52.35(33.65,88.15)(ng/ml)]and septic shock group[73.55(60.61,145.51)(ng/ml)]are statistically higher than general sepsis group[34.12(23.04,41.79)(ng/ml)](H=24.092, P<0.01).There are no statistically differences of serum PCT and hs-CRP among these three groups[(HPCT=1.909,Hhs-CRP=0.292),P>0.05].The area under the curve(AUC)of HBP in diagnosis of neonatal sepsis and infection are 0.885 and 0.904 respectively,more higher than PCT and hs-CRP;With the cut off value of 19.8 ng/ml,the sensitivity and specificity of HBP on diagnosis of infection are 85.7%and 82.9%respectively;the sensitivity and specificity 80.4% and 88.4% for neonatal sepsis with the cut-off value of 28.0 ng/ml respectively.Conclusion HBP probably has the better clinical value than PCT and hs-CRP in the early diagnosis and severity gradation of neonatal sepsis.

Investigation of the reference interval of neonatal nutrition assessment biochemical factor / 中国医师杂志

Objective To investigate the reference interval of neonatal nutrition assessment biochemical factor,including total protein (TP),serum albumin (ALB),serum prealbumin (PA) and serum retinol binding protein (RBP).Methods From December 2016 to August 2017,403 serum specimens were collected from health neonates in Hunan Children's Hospital and the serum concentration of TP,ALB,RBP and PA was detected.The results of each item were grouped according to sex and age,and then the reference interval of each item was established.Results When data was separated by gender of each item,there was no statistical significance between each group of each item (P ＞ 0.05).For the TP,ALB and RBP,separating the data of each item by weeks,there were also no statistical significance between each group (P ＞ 0.05).But there was statistical difference between one week old group and the rest groups in the data of PA (P ＜ 0.05).The normal reference interval of neonatal serum total protein,albumin,retinol binding protein and pre-albumin are as follow:(40.69-65.72) g/L,(28.77-42.3) g/L,(12.13-33.19) mg/L,(42.26-161.52) mg/L (no more than 7 days old) and (59.05-170.23) mg/L (range from 8 to 28 days old).Conclusions We can establish the reference interval of TP,ALB and RBP without differentiating gender and weeks.But for the PA,the reference interval of one-week-old neonate needs to differentiate from other neonates.

Change and clinical value of thrombomodulin in children with severe pneumonia / 国际检验医学杂志

Objective To study the change and clinical value of thrombomodulin (TM ) in children with se-vere pneumonia .Methods Sixty-five children cases of severe pneumonia were divided into the disseminated in-travascular coagulation (DIC) group and non-DIC group according to whether complicating DIC .And 30 healthy children were selected as the control group .Plasma TM levels were analysed and compared among the three groups .The receiver operating characteristic(ROC) curve was used to conduct the evaluation .Results The plasma TM level had statistically significant difference among the control group ,non-DIC group and DIC group(H=53 .14 ,P=0 .000) ,moreover the pairwise comparison also had statistical difference (P<0 .05) .A-mong sputum culture positive 24 cases of severe pneumonia complicating DIC ,the T M level had no statistical difference between the children patients with Gram-positive bacterial infection and children patients with Gram-negative bacterial infection(P>0 .05) .The area under ROC curve of TM for diagnosing DIC was 0 .74 . The sensitivity ,specificity ,positive likelihood ratio and negative likelihood ratio were 0 .76 ,0 .63 ,2 .05 and 0 .38 respectively .Conclusion The change of plasma TM level is associated with the severity of children with severe pneumonia ,and T M can be used as one of the reference indicators for the early diagnosis in children with severe pneumonia complicating DIC .

Identification and homology analysis of Ochrobactrum-like species infection in bloodstream of children / 临床检验杂志

Objective To identify and analyze the homology of Ochrobactrum isolated from clinical blood samples of children.Methods The 26 strains of Ochrobactrum anthropi were identified by Vitek 2 Compact and test strips of API 20 NE bacterial identification system.The biochemical phenotypes were identified by manual tests.The 16S rRNA and recA gene were amplified by PCR and sequenced.The drug sensitivity tests of Ochrobactrum anthropi were performed by Vitek 2 Compact and matched GN13 card.The homology was analyzed by pulsed field gel electrophoresis.Results Based on the identification of the instruments and the manual tests for biochemical phenotype,all the 26 experimental strains were Ochrobactrum anthropi.The results of sequencing for 16S rRNA and recA gene amplification products showed 25 strains were Pseudochrobactrum saccharolyticum and the other 1 was O.grignonensein.Drug sensitivity analysis showed that the all the 26 strains were resistant to aztreonam,but the sensitive rates to quinolones,aminoglycosides,trimethoprim sulfamethoxazole,four generation of cephalosporins and the antibiotics compound of piperacillin/tazobactam were all more than 80％.Pulsed field gel electrophoresis analysis showed that the 25 strains were highly homologous with differences of only 1 to 3 bands in fingerprint profiles.Conclusion Based on the biochemical phenotype and the sequencing of 16S rRNA and recA gene,the Ochrobactrum-like bacteria could be identified to the level of species.The highly homologous strains of Pseudochrobactrum saccharolyticum may be sourced from a clustered infection.

Study of 25-hydroxy vitamin D level and correlation in children with severe pneumonia / 国际检验医学杂志

Objective To investigate the level of 25-hydroxyvitamin D[25(OH)D]and relationship to C-reactive protein(CRP) and procalcitonin(PCT)in children with severe pneumonia.Methods Serum 25 (OH)D levels of 86 cases of children with severe pneumonia,81 cases of children with mild pneumonia and 85 cases of children in healthy control group on admission were deter-mined by ELISA respectively and compared.At the same time,CRP and PCT were tested and the correlation to 25(OH)D in chil-dren with severe pneumonia was analyzed.Results There are statistical differences among three groups(P <0.05,α=0.05 ).The mean values of serum 25 (OH)D were (62.03 ±17.94),(68.90 ±15.22)and (82.21 ±17.89)μmol/L in severe pneumonia pa-tients,mild pneumonia patients and healthy children respectively,furthermore,prevalence of vitamin D deficiency of the sever pneu-monia group was significantly higher than that of the case-control group and normal group (P < 0.05,α= 0.05 ).The level of 25(OH)D was not significantly related to CRP and PCT level in children with severe pneumonia(P <0.05,α=0.05).Conclusion The mean level of vitamin D in children with severe pneumonia was significantly lower,which may be associated with the occurrence and develop-ment of severe pneumonia in children.

Diagnostic signiifcance of ifbrin related markers for pre-disseminated intravascular coagulation state in children with severe pneumonia / 临床儿科杂志

Objectives To study the signiifcance of ifbrin related markers such as ifbrin monome (FM), D-dimer (D-D), fibrinogen and fibrin degradation products (FDP) in diagnosis of pre-disseminated intravascular coagulation (pre-DIC) state in children with severe pneumonia. Methods A total of 213 children with severe pneumonia in pediatric intensive care unit were divided into pre-DIC group and case control group according to the occurrence of pre-DIC. And 40 healthy children were included as normal control group. FM、D-D、FDP、prothrombin time (PT)、activated partial thromboplastin time (APTT)、ifbrinogen (FIB)、platelet count (PLT)、thrombomodulin (TM) levels were analyzed. Receiver operating characteristic curve was used to evaluate the above indexes. Results All the markers but FIB showed signiifcant difference among the three groups (P0 . 05 ). Compared with those in normal control group, TM and PLT levels were signiifcantly higher in the other two groups (P0 . 05 ). FM、D-D、FDP had larger area under curves (AUC) for pre-DIC than other indexes ( 0 . 84、0 . 76、0 . 64 , respectively). The AUC for the joint detection of the three indexes was 0 . 85 . Conclusions Fibrin related markers such as FM、D-D and FDP are valuable indexes in diagnosis of pre-DIC state in children with severe pneumonia, the joint detection of the three indexes would help to improve diagnostic accuracy.

Clinical Value of Mean Platelet Mass and the Procalcitonin in Diagnosis of Kawasaki Disease / 现代检验医学杂志

Abstact:Objective To investigate the clinical value of mean platelet mass(MPM)and the procalcitonin(PCT)in diagnosis of Kawasaki disease (KD).Methods A Total of 117 children with KD in the acute stage and 126 children of the control group were detected respectively and compared each other.The indexes contain MPM,PLT,MPV,PDW and PCT.Mean-while,the comparison of each index’s positive rate and the linear correlation analysis of each index were conducted.Results①The level of MPM of the KD group was significant lower than that of the control group,PLT,MPV and PCT significant higher than those (P0.05,α=0.05).②The positive rate of the MPM was significant higher than that of the other indexes (P<0.05,α=0.05). Conclusion The detection of MPM is helpful to the diagnosis of KD and can be used as an indicator of KD clinically.

Evaluation on platelet parameters and coagulation indicators in children with severe pneumonia / 中国感染控制杂志

Objective To study the changes and clinical value of platelet(PLT)parameters and coagulation indicators in children with severe pneumonia.Methods 97 children were divided into severe pneumonia groupⅠand severe pneumonia groupⅡ according to whether children were associated with other diseases besides severe pneumonia,and 30 healthy chil-dren were in control group.The levels of PLT count,mean platelet volume(MPV),prothrombin time(PT),activated par-tial thromboplastin time(APTT),fibrinogen(FIB),antithrombin-Ⅲ(AT-Ⅲ),and D-dimer(DD)among three groups were compared.Results The differences of PLT,MPV,DD and AT-Ⅲ activities were all significant among three groups (all P < 0.05).PLT,MPV and DD levels in group Ⅰ were all significantly higher than those of control group ([454.00±157.00]×109/L vs [300.00±63.00]×109/L ;[9.66±1.24]fL vs [8.90±0.37]fL;[0.47±0.37] mg/L vs [0.27±0.06]mg/L,respectively);AT-Ⅲ activity in groupⅠ was lower than control group([79.91 ± 20.34]% vs[107.03±8.11]%)(both P <0.05).AT-Ⅲ activity and PLT level in group Ⅱwas (66.11±11.12)%and (279.00±185.00)×109/L respectively,which were both significantly lower than group Ⅰ,MPV and DD level was (10.37± 1.51)fL and (0.70±0.46)mg/L respectively,which were both higher than groupⅠ (both P <0.05).Conclusion There is obvious coagulation dysfunction in children with severe pneumonia.The changes in PLT,MPV,AT-Ⅲ and DD levels are associated with the severity of pneumonia.

Relationship between vitamin D deficiency and infectious diseases in children / 中华检验医学杂志

Vitamin D deficiency is a global public health problem.Vitamin D is well known for its classic role in the maintenance of bone mineral density.In addition,vitamin D is also closely related to many infectious diseases.This article describes the physiology of vitamin D and methodology for 25-hydroxyvitamin D or 25(OH) D.The factors that influence vitamin D levels in children and the relationship between vitamin D deficiency in children and infectious diseases are introduced.

Change of coagulation and fibrinolytic function in neonatal sepsis / 国际检验医学杂志

Objective To study the change and clinical significance of coagulation and fibrinolytic function in neonatal sepsis. Methods 86 neonates inpatients in the neonatology department of our hospital were selected and divided into the ordinary infection group(30 cases)and the sepsis group(56 cases),and 30 healthy neonates were selected as the normal control group.Plasma AT-Ⅲactivity,DD level and PLT count were detected immediately after admission and the detection results were analyzed.Results Com-pared with the control group and the ordinary infection group,the AT-Ⅲ activity and the PLT count in the sepsis group were sig-nificantly decreased,while the DD level was significantly increase,the difference had statistical significance(P 0.05);however,the AT-Ⅲ activity and the PLT count in the DIC group were significantly decreased and the DD level was signifi-cantly increased(P <0.01),the occurrence rate of abnormal three indexes was 83.33%(15/18)in the DIC group,which was signifi-cantly higher than that in the non-DIC group(χ2 =17.75,P =0.00).Conclusion The obvious dysfunction of coagulation and fibri-nolysis exists in neonatal sepsis,which is related with the severity degree of disease.The joint detection of AT-Ⅲ activity,DD level and PLT count is helpful for the early diagnosis of DIC in neonatal sepsis.

Clinical value of detecting serum N-terminal pro-brain natriuretic peptide and cardiac troponin I in children with severe pneumonia / 临床儿科杂志

Objective To study the clinical value of serum N-terminal pro-brain natriuretic peptide (NT-ProBNP) and cardiac troponin I (cTnI) levels in children with severe pneumonia. Methods A total of 72 children with severe pneumonia in pediatric intensive care unit were divided into heart failure (HF) group and non-HF group according to the occurrence of heart failure, and 30 healthy children were selected as control group. Serum NT-ProBNP and cTnI levels were detected and analyzed. Results Compared with control group, NT-ProBNP and cTnI levels were signiifcantly higher (P<0.01) in HF and non-HF group. The levels of NT-ProBNP and cTnI in HFgroup were both signiifcantly higher (P<0.01) than that in non-HFgroup. Serum NT-ProBNP level was positively related to the level of cTnI(P=0.000) in children with severe pneumonia. The abnormal rate of cTnI in HF group was significantly higher (P=0.037) than that in non-HFgroup. The difference of the abnormal rate of NT-ProBNP between the two groups was not signiifcant (P=0.375), however, the abnormal rate of NT-ProBNP was signiifcantly higher (P=0.036) than that of cTnI in non-HF group. Conclusions There was obvious myocardial damage in children with severe pneumonia. NT-ProBNP and cTnI could be important serological markers to assist diagnosis of myocardial damage and its severity.

Diagnostic value of soluble transferrin receptor detection in non-adult ion deficiency anemia / 国际检验医学杂志

Objective To investigate the diagnostic value of the soluble transferrin receptor (sTfR)in non-adult iron deficiency anemia (IDA)and its differential diagnostic value between IDA and anemia of chronic disease(ACD).Methods 26 cases in the IDA group involved 12 males and 14 females,aged 1 month to 15.5 years;33 cases in the ACD group involved 17 males and 16 females, aged 2 months to 14.0 years;30 cases in the normal control group involved 15 males and 15 females,aged 1 month to 15.5 years. Serum sTfR and ferritin (SF)were detected by the immunonehelomitery,serum iron (SI)was detected by Ferrous Oxazine colori-metric method.Results The gender and age had no statistically significant difference among 3 groups;the SI mean value in the ACD group located between the IDA group′s and the normal control group′s;the SF mean value of the IDA group was significantly lower than that of ACD group (P <0.001)and that of control group (P <0.001),while the sTfR mean value of IDA group was significantly higher than that of the ACD group (P <0.001)and that of the normal control group (P <0.001).The best cutoff of sTfR for the differential diagnosis between IDA and ACD was 3.56 mg/L,its sensitivity,specificity,negative predictive value,posi-tive predictive value and accuracy were 95.12%,93.92%,94.11%,97.53% and 95.50% respectively.Conclusion sTfR has higher sensitivity and specificity for IDA and is conducive to diagnose IDA and differentially diagnose ACD.