Anti-interference hemoglobin analysis system by high performance liquid chromatography / 生物医学工程学杂志

High performance liquid chromatography (HPLC) is currently the mainstream technology for detecting hemoglobin. Glycated hemoglobin (HbA1c) is a gold indicator for diagnosing diabetes, however, the accuracy of HbA1c test is affected by thalassemia factor hemoglobin F (HbF)/hemoglobin A2 (HbA2) and variant hemoglobin during HPLC analysis. In this study, a new anti-interference hemoglobin analysis system of HPLC is proposed. In this system, the high-pressure three-gradient elution method was improved, and the particle size and sieve plate aperture in the high-pressure chromatography column and the structure of the double-plunger reciprocating series high-pressure pump were optimized. The system could diagnose both HbA1c and thalassemia factor HbF/HbA2 and variant hemoglobin, and the performance of the system was anti-interference and stable. It is expected to achieve industrialization. In this study, the HbA1c and thalassemia factor HbF/HbA2 detection performance was compared between this system and the world's first-line brand products such as Tosoh G8, Bio-Rad Ⅶ and D10 glycosylated hemoglobin analysis system. The results showed that the linear correlation between this system and the world-class system was good. The system is the first domestic hemoglobin analysis system by HPLC for screening of HbA1c and thalassemia factor HbF/HbA2 rapidly and accurately.

Clinical features of DRESS， AOSD， HLH with liver injury: An analysis of 58 cases / 临床肝胆病杂志

ObjectiveTo investigate the clinical features of adult liver injury patients with drug reaction with eosinophilia and systemic symptoms (DRESS), adult-onset Still’s disease (AOSD) or hemophagocytic lymphohistiocytosis (HLH) and the correlation of the degree of liver injury with inflammatory indices and immune indices. MethodsRelated clinical data were collected from 58 patients with liver injury caused by the above three systemic inflammatory diseases who were admitted to Peking University First Hospital from January 2008 to April 2019, among whom 7 had DRESS, 29 had AOSD, and 22 had HLH. General information, liver biochemical parameters, inflammatory indices, and immune indices were collected before treatment. The t-test was used for comparison of normally distributed continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the Kruskal-Wallis H test was used for comparison between multiple groups, and the Bonferroni method was used for further comparison between two groups. Four inflammatory indices were compared between the groups with different alanine aminotransferase (ALT) levels (≤200 U/L or ＞200 U/L), and a Spearman correlation analysis was used to investigate the correlation of ferritin and immune indices with ALT level. ResultsThe median age of the patients with DRESS or AOSD was 38 years, and the median age of the patients with HLH was 34 years. DRESS patients were mostly male (5/7, 71%), while most of AOSD patients (20/29, 69%) and HLH patients (12/22, 55%) were female. For liver injury indices, there were no significant differences between the three groups in ALT peak, aspartate aminotransferase level, and alkaline phosphatase level (all P＞0.05). For the indices for the synthetic function of the liver, there were no significant differences in blood glucose, albumin, and prothrombin activity between the three groups (all P＞0.05). For inflammatory indicators, there were significant differences between the three groups in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (all P＜0.001), while there were no significant differences between the three groups in lactate dehydrogenase, ferritin, and procalcitonin (all P＞0.05); the AOSD group had significantly higher median CRP and ESR than the other two groups (all P＜0.05). For the patients with the three diseases, there were no significant differences in the four inflammatory indices between any two the groups with different ALT levels (all P＞0.05), and the level of ferritin was positively correlated with ALT level (R2=0.702 1, P＜0000 1). As for immune indices, there were no significant differences in IgG, IgA, C4, and the counts of NK and B cells between the three groups (P＞0.05), and CD8+ T cells were positively correlated with ALT level in HLH patients (R2=0.969 6, P＜0.000 1). ConclusionVarying degrees of liver injury are observed in patients with DRESS, AOSD or HLH. Ferritin and CD8+ T cells are well correlated with ALT level and can reflect liver injury, systemic inflammation, and immune status in patients with the three diseases, and therefore, they may become important indices for evaluating disease condition, guiding treatment, and judging treatment outcome and prognosis.