A multicenter research on validation and improvement of the intelligent verification criteria for routine urinalysis / 中华检验医学杂志

Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.

Automatic recognition and analysis of hemiplegia gait / 生物医学工程学杂志

In this paper, the research has been conducted by the Microsoft kinect for windows v2 for obtaining the walking trajectory data from hemiplegic patients, based on which we achieved automatic identification of the hemiplegic gait and sorted the significance of identified features. First of all, the experimental group and two control groups were set up in the study. The three groups of subjects respectively completed the prescribed standard movements according to the requirements. The walking track data of the subjects were obtained straightaway by Kinect, from which the gait identification features were extracted: the moving range of pace, stride and center of mass (up and down/left and right). Then, the bayesian classification algorithm was utilized to classify the sample set of these features so as to automatically recognize the hemiplegia gait. Finally, the random forest algorithm was used to identify the significance of each feature, providing references for the diagnose of disease by ranking the importance of each feature. This thesis states that the accuracy of classification approach based on bayesian algorithm reaches 96%; the sequence of significance based on the random forest algorithm is step speed, stride, left-right moving distance of the center of mass, and up-down moving distance of the center of mass. The combination of step speed and stride, and the combination of step speed and center of mass moving distance are important reference for analyzing and diagnosing of the hemiplegia gait. The results may provide creative mind and new references for the intelligent diagnosis of hemiplegia gait.

Investigation on Sulfur-fumigated TCM and Its Decoction Piece of China from 2013 to 2017 and Suggestions on the Limit Standard of Sulfur Dioxide Residue / 中国药房

OBJECTIVE： To investigate the status of sulfur fumigation of TCM and its decoction pieces， and to put forward the suggestions on limit standard of sulfur dioxide residue. METHODS： The information of 374 varieties of TCM and sulfur dioxide residue were collected from the provincial and municipal drug inspection institutions of 27 provinces，municipalities and autonomous regions in China during 2013-2017， and then summarized and analyzed. The average value，median value，maximum value，qualification rate and detection rate of sulfur dioxide residue of 121 varieties with the sample number ≥10 batches were classified and statistically analyzed. RESULTS： This investigation involved 374 varieties of TCM and its decoction pieces， and a total of 13 776 batches of samples. The average content of sulfur dioxide was 242 mg/kg，the median value was 27 mg/kg，and the maximum value was 8 782 mg/kg. The overall qualified rate was 79.7％. According to the results of classified statistics， among the 10 varieties whose limit shall not exceed 400 mg/kg，5 varieties，including Codonopsis pilosula， Radix Trichosanthis， Asparagus cochinchinensis， Pueraria lobata， Achyranthes bidentata， were seriously affected by sulfur fumigation，and the qualified rate was less than 80％. Among the varieties with the sample number≥30 batches， there was no or very little abuse of sulfur fumigation in 16 varieties， such as Carthamus tinctorius； 19 varieties， such as Eupolyphaga Steleophaga， had excessive sulfur fumigation， but it was not serious； 25 varieties，such as Lonicera japonica，had severe excessive sulfur fumigation. Among the varieties with the sample number of 10-29 batches，33 varieties including Ziziphus jujube seed had no or very little abuse of sulfur fumigation； 8 varieties including Cuscuta chinensis had excessive sulfur fumigation but were not serious； 10 varieties including Pericarpium Trichosanthis had serious excessive sulfur fumigation. CONCLUSIONS： For the varieties with no or very little excessive sulfur fumigation，it is recommended that batch testing should not be carried out and a single list should be made； for the varieties with sulfur fumigation or severe sulfur fumigation， it is suggested to increase the sulfur dioxide residue limit under all varieties in the 2020 edition of Chinese Pharmacopoeia， and set the limit for the varieties with severe sulfur fumigation to be no more than 400 mg/kg，while the limit for the 2025 edition of Chinese Pharmacopoeia can be reduced to no more than 150 mg/kg. Other varieties should retain the provisions of “sulfur dioxide residue of sulfur dioxide medicinal materials and decoction pieces （except for minerals） shall not exceed 150 mg/kg” in the general rules 0212 “for the identification of medicinal materials and decoction pieces” in the 2015 edition of Chinese Pharmacopoeia （part Ⅳ）.

The clinical study of atorvastatin calcium in the treatment of chronic congestive heart failure / 中国基层医药

Objective To explore the clinical efficacy of atorvastatin calcium in the treatment of chronic congestive heart failure(CHF).Methods According to the order of admission with single and double,132 CHF patients were randomly divided into control group and study group,66 cases in each group.The control group was given routine treatment,and the study group was treated with atorvastatin calcium on the basis of routine treatment.The clinical efficacy was assessed.Before and after treatment,the serum TC level was measured,the left ventricular ejection fraction(LVEF) and heart left ventricular end diastolic diameter(LVDD),heart index(CI) were assessed by echocardiography.The adverse reactions during treatment were observed.Results The total effective rate of the study group was 92.42%,which was higher than 83.33% of the control group,the difference was statistically significant(x2=9.35,P0.05).Conclusion Atorvastatin calcium in the treatment of CHF patients on the basis of routine treatment has better clinical effect.It can significantly reduce TC and significantly improve cardiac function,and has high safety.

Value of 131I SPECT/CT on the re-staging and recurrence risk stratification and its impact on subsequent treatment strategy in post-surgical patients with differentiated thyroid carcinoma / 中华核医学与分子影像杂志

Objective To evaluate the role of 131I SPECT/CT in post-surgical re-staging and recurrence risk stratification in patients with DTC and its impact on subsequent treatment strategy.Methods 131I-WBS and 131I SPECT/CT were performed at the same time 5 to 7 d after 131I treatment in 118 patients (33 males,85 females,average age 45 years) with DTC.Difference in the localization and qualitative diagnosis of 131I uptake lesions between 131I-WBS and 131I SPECT/CT were compared.Value of 131I SPECT/CT in the diagnosis of TNM staging,risk stratification and impact on the treatment strategy was evaluated.Paired χ2 test was used for data analysis.Results A total of 509 foci with 131I uptake were detected.131I-WBS found 449 foci with 131I uptake,354 of which (78.84％) were correctly diagnosed.131I SPECT/CT found 509 foci with 131I uptake,and 504(99.02％) were correctly diagnosed.The difference was statistically significant (χ2=21.51,P<0.01).131I-WBS changed the clinical staging in 13 cases with diagnostic accuracy of 5/13.131I SPECT/CT changed the clinical staging in 19 cases and with diagnostic accuracy of 19/19 (χ2=74.41,P<0.01).131I-WBS changed the risk stratification of 13 patients after operation and the accuracy was 5/13,the corresponding data were 22 and 100％(22/22) for 131I SPECT/CT (χ2=74.41,P<0.01).The treatment strategy was changed in 50 patients with 131I SPECT/CT.Conclusions Compared with 131I-WBS,131I SPECT/CT could provide more accurate positioning and qualitative information for 131I treatment and is more accurate in re-staging and risk stratification.

Application of immature granulocyte count in the diagnosis and the assessment of prognosis of systemic inflammatory response syndrome / 国际检验医学杂志

Objective To evaluate the value of immature granulocytes count in diagnosing and monitoring the systemic inflam-matory response for patients with systemic inflammatory response syndrome,and to provide a new indicator of systemic inflammato-ry response.Methods 207 patients suspected of systemic inflammatory response syndrome were enrolled.The dynamic changes of immature granulocytes counts and the disease situation were recorded for all subjects.The blood samples were collected in vacuum tubes with EDTA-K2 anticoagulant.Blood cell count and immature granulocytes count were performed in Sysmex XE-2100 hema-tology analyzer.The determination of C-reactive protein and procalcitonin were also completed.The performance of immature granu-locytes in diagnosing systemic inflammatory response syndrome was evaluated by receiver operating characteristic curve analysis. Results The area under the curve of immature granulocyte count (IG #)was 0.78 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 62.2 % and a specificity of 73 % at IG #> 0.1 65.The area under the curve of immature granulo-cyte percent (IG%)was 0.771 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 54.1 % and a specifici-ty of 94.6 % at IG%>2.55 %.The area under the curve of C-reactive protein was 0.71 6 in diagnosing systemic inflammatory re-sponse syndrome,with a sensitivity of 67.6% and a specificity of 75.7 % at C-reactive protein> 64.15 mg/L.The area under the curve of procalcitonin was 0.772 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 75.7 % and a speci-ficity of 70.3 % at procalcitonin> 0.33 mg/L.Conclusion Immature granulocyte count is beneficial for the diagnosis and the as-sessment of prognosis of systemic inflammatory response syndrome.

Three Determination Methods for Residual Sulfite in Traditional Chinese Medicinal Materials and Pieces / 中国药师

Objective:To determine residual sulfite in traditional Chinese medicinal materials or pieces processed by sulfur fumi-gation respectively by iodine titration, acid-base titration and ion chromatography and compare the results. Methods:The three meth-ods were used to determine four kinds of Chinese herbal medicines including Codonopsis radix, Dioscoreae rhizoma, Achyranthis bident-atae Radix and Atractulodis Macrocephalae Rhizoma, the recovery tests were also performed and the results were analyzed and compared to summarize the characteristics and quality control requirements of each method. Results:Iodine titration and acid-base titration had the advantages of simple operation process and low cost. However, there were many interference factors in the two methods, and due to different principles, they were suitable for the determination of different varieties of herbal medicines. Ion chromatography method had the advantages of high sensitivity and strong specificity, while the cost was high. Conclusion: It is suggested that proper methods should be chosen for the determination of sulfur dioxide residues according to actual situations.

The application of plasma D-dimer in the diagnosis of spontaneous peritonitis in cirrhotic patients with ascites / 国际检验医学杂志

Objective To investigate the application value of plasma D-dimer(D-D )in the diagnosis of spontaneous bacterial per-itonitis(SBP)in patients with liver cirrhosis .Methods 137 cases of cirrhotic patients with ascites were selected and divided into SBP group and non SBP(NSBP) group .30 cases of patients with chronic liver disease and 30 healthy individuals were selected as chronic liver disease group and normal control group ,respectively .The levels of D-D and C-reactive protein(CRP) were measured in specimens from all the groups .Results The D-D levels of SBP group ,NSBP group ,chronic liver disease group and normal control group were (7 .82 ± 5 .68) ,(5 .55 ± 4 .55) ,(0 .45 ± 0 .26) and (0 .06 ± 0 .04) mg/L ,respectively .And the serum CRP levels were (30 .0 ± 29 .6) ,(16 .4 ± 20 .5) ,(5 .3 ± 1 .8) and (2 .1 ± 0 .9)mg/L ,respectively .The levels of D-D and CRP were both higher in SBP group and NSBP group than in chronic liver disease group and normal control group(P<0 .01) .The D-D and CRP levels of SBP group were both significantly higher than those of NSBP group (P<0 .05) .The ROC curve showed that the AUC ,sensitivity and specificity of D-D were 0 .650 ,0 .604 and 0 .709 ,respectively ,and those of CRP were 0 .705 ,0 .792 and 0 .582 ,respectively .Conclu-sion Plasma D-D detection was beneficial to the early diagnosis of SBP in cirrhotic patients with ascites .

Application of lymphocyte parameters in screening lymphocyte proliferation and reactive hyperplasia disease / 国际检验医学杂志

Objective To investigate the application of lymphocyte parameters in screening the lymphocyte proliferation and re-active hyperplasia disease.Methods 128 cases as the healthy control,100 cases of lymphoma,35 cases of multiple myeloma(MM), 34 cases of lymphocytes reactive hyperplasia(RL)and 5 cases of chronic lymphocytic leukemia(CLL)were selected and performed the peripheral blood cells analysis by the Sysmex XE-2100 hematology analyzer.The relevant lymphocyte parameter values were re-corded and the comparative analysis in the difference between the disease groups and the control group was performed.The role of each lymphocyte parameter in screening the lymphocyte proliferation and reactive hyperplasia diseases was evaluated by the receiver operating characteristic curve(ROC curve).Results The high fluorescence lymphocytes(HFL),in the control group was 0.008 ± 0.008,in the lymphoma group was 0.016±0.058,in the MM group was 0.019 ±0.063,in the RL group was 0.040 ±0.070,and CLL group was 0.388±0.158.Compared with control group,the difference of RL and CLL group was statistically significant(P morphological changes of lymphocytes sensitively and contribute to screening the patients with lymphocyte proliferation and reactive hyperplasia disease.