Clinical Characteristics and Obstetric Outcomes of Pregnant Women Who Underwent Surgery for Adnexal Torsion / 中山大学学报(医学科学版)

ObjectiveTo explore the clinical characteristics and obstetric outcomes of pregnant women who underwent surgery for adnexal torsion at different gestational weeks. MethodsA retrospective study was done on 39 women who underwent surgery for adnexal torsion during pregnancy in the First Affiliated Hospital， Sun Yat-sen University between March 2013 and March 2023， with 18 cases in 1st trimester （<14 weeks）， 11 in 2nd trimester （14-27+6 weeks） and 10 in 3rd trimester （≥28 weeks）. The clinical characteristics， treatment and obstetric outcomes were compared among the three groups. ResultsThe 1st trimester group had higher proportion of assisted reproductive technology （ART） use than the 2nd and 3rd trimester groups （P=0.026）. There was no significant difference in the clinical manifestations， including abdominal pain， nausea， vomiting and fever among the three groups， while elevated white blood cells （WBC） counts was more commonly seen in the 2nd and 3rd trimester groups. Adnexal masses <5 cm in diameter occurred in 0， 18.2%， and 10.0% of cases in 1st， 2nd and 3rd trimester groups respectively （P=0.014）. No statistical significance was found in the location of twisted adnexa， number of circles or pathological nature. The 1st trimester group had a higher sensitivity of ultrasound in the diagnosis of adnexal torsion compared with the 2nd and 3rd trimester groups （77.8%， 36.4%， 20.0%； P=0.008）. More laparoscopic surgery were performed in the 1st trimester group than the other two groups （55.6% ， 27.3%， 0.0%； P=0.008）. There was no significant difference in gestational week of delivery， delivery mode， newborn gender， neonatal birth weight and follow-up of newborns among the three groups. The 3rd trimester group showed a higher risk of preterm delivery （P=0.050）. ConclusionsDuring the 1st trimester of pregnancy， adnexal torsion is more common in patients using ART and ultrasound plays a crucial role in the diagnosis. During the 2nd and 3rd trimester， adnexal torsion should be suspected in patients with abdominal pain and elevated WBC but no aspetic inflammation. Laparoscopic surgery is safe for adnexal torsion during pregnancy and can achieve a favorable maternal and neonatal outcome.

Role Of Raised C-Reactive Protein (CRP) As the Indicator for Surgical Intervention in Clinically Diagnosed Acute Appendicitis

Background: The diagnosis of acute appendicitis relies more on the clinical acumen of the surgeon than on the investigations. As the condition is associated with an acute-phase reaction the analysis of WBC, neutrophil percentage and serum level of CRP has been demonstrated to be important diagnostic tools. Surprisingly the level of CRP becomes proportionately raised with increasing severity of the histopathological variety of the appendix. Aim of the study: The aim of this study was to compare the preoperative CRP level with postoperative histological findings and find out a predictive value of CRP as an indicator for surgical intervention in acute appendicitis.Material & Methods:It was a prospective, cross-sectional, observational study executed in the Department of Surgery, Dhaka Medical College Hospital from January to December of 2015 where 107 patients were included in this study. Preoperative level of CRP and WBC count was done in all selected patients. Histopathological severity of the resected specimen of the appendix was determined postoperatively. The correlation between preoperative clinical factors and the actual histological severity and identification of surgical indication markers was assessed to determine whether only the CRP level significantly differs between the surgical treatment necessary group and the possible non-surgical treatment group.Results:54% (58) of the patients were female out of a total of 107. Peak incidence (25.2%) was in the 16-20 years age group. Neither age nor gender had any significance with the type of appendicitis. Among the patients 28.1% (30) had gangrenous appendicitis. In patients with histopathologically proven acute appendicitis, both the WBC count and serum CRP level were raised. But only the CRP level significantly differs between gangrenous appendicitis and uncomplicated appendicitis (p-value<0.0001). The specificity and sensitivity of serum CRP for gangrenous appendicitis were 97% and 71% respectively. The ROC curve indicated that the cutoff value of CRP for gangrenous appendicitis is 6.2 mg/dl. Conclusions:A normal pre-operative serum CRP measurement in patients with suspected acute appendicitis is most likely associated with a normal or uncomplicated inflammation of the appendix. The rate of unnecessary appendectomies would probably reduce in this patient group by deferring surgery. Only the CRP level is consistent with the severity of appendicitis and can be considered to be a surgical indication marker for acute appendicitis.

The comparison of methods of the microscopic examination with Sternheimer-Malbin stain and UF-5000 analyzer for urine sediment / Эрүүл мэндийн лаборатори

Background@#Chronic kidney disease (CKD) is a global health problem. In Mongolia, urine is analyzed by methods of urine chemistry and urine sediment to diagnose kidney disease. The currently automated urine sediment analyzers have been widely used in clinical laboratories and are replacing traditional manual microscopic examination. Nonetheless, visual microscopic examination is still required in many cases. When chemical and sediment analyzers are used together, urine sediment could be confirmed under a microscope, if the results are inconsistent. Sternheimer-Malbin stain has contained a variety of dyes that help to distinguish particles (white blood cells, red blood cells, epithelial cells, casts, crystals, fatty drops, bacteria, yeast, trichomonas) in urine sediment, improve the differentiation between cell nuclei and cytoplasm, and provide more information about cell shape and image. </br> Therefore, the low-cost method that can be used on a daily basis.Although there are more than 4,500 laboratories in Mongolia that need to perform urinalysis, which is an important part of clinical laboratories, less than 10 percent of hospitals have fully automated sediment analyzers. For this reason, one of the most important issues in the clinical laboratories, the search for low-cost and useful methods for the analysis of urine sediments in order to provide access to services to the public. Our aim was the comparison of methods of the microscopic examination with Shternheimer-Malbin stain and fully automated UF-5000 analyzer for urine sediment. @*Methods@#There was a comparative study, people who served the Clinical Central Laboratory of Mongolia-Japan Hospital received permission to participate in this research. One hundred five fresh, first morning, clean catch mid-stream urine samples were collected in accordance with standard operating instructions for urinalysis, between November 2020 and May 2021. Sternheimer-Malbin (SM) staining and direct microscopy observation methods with Fuchs-Rosenthal counting chamber were used to red blood cells (RBC), white blood cells (WBC) and epithelial cells (EC) in urine samples. The agreements between the automated urine analyzer and microscopic methods were calculated using Cohen’s kappa (k) with 95% confidence intervals (CI).@*Results@#A total of 105 samples were collected and analysed in this study. The average age was 46.97±15.0and gender by 18% (n=19)were male and 82% (n=86) were female. </br> Compared to traditional manual methods and automated analyzer, the agreement within the same grade was 99/105 (94.3%) for erythrocytes, 96/105 (91.4%) for leukocytes, 92/105 (87.6%) for epithelial cells. And compared to Sternheimer-Malbin staining microscopy observation and automated analyzer, the agreement within the same grade was 98/105 (93.3%) for erythrocytes, 99/105 (94.3%) for leukocytes, 96/105 (91.4%) for epithelial cells. Agreement between traditional manual method and automated analyzer was higher than 85% and between Sternheimer-Malbin staining microscopy observation and automated analyzer was higher than 90%. The concordance between traditional manual method and automated analyzer was substantial (k=0.74, p<0.001; k=0.79, p<0.001) for RBC and EC, almost perfect (k=0.92, p<0.001) for WBC. Whereas the concordance between SternheimerMalbin staining microscopy observation and automated analyzer was substantial (k=0.70, p<0.001) for RBC, almost perfect (k=0.94, p<0.001; k=0.89, p<0.001) for WBC and EC. Comparison of Sysmex UF-5000 with microscopic particle counting methods resulted specificity was 98.9/100% for RBC, sensitivity was 97.7/95.3% and negative predictive value was 98.4/96.8% for WBC, sensitivity was 87.5/68.8% and negative predictive value was 97.8/94.7% for EC.@*Conclusion@#The Cohen’s k analysis result of comparisons between the SternheimerMalbin staining microscopic method and automated urine sediment analyzer showed significant almost perfect agreement (k=0.70-0.94, p<0.001). </br> The sensitivity and negative predictive value were high for both of WBC and EC were determined by Sternheimer-Malbin (SM) staining microscopy observation method. Results indicate the ability of a test to correctly identify those with the true positive and individual with a negative test result is truly negative better than comparison of Sysmex UF-5000 with traditional manual microscopic method assessment.

Hyperbilirubinemia as a diagnostic tool in patients with perforated appendicitis: a prospective study

Background: This study was conducted to determine the effectiveness of hyperbililrubinemia as diagnostic tool to predict perforated appendicitis.Methods: Patients presenting to department of general surgery of SS Medical College and Hospital during the period from June 2017 to June 2019 with features of appendicitis and liver function tests on admission undergoing laparoscopic or open appendectomy were included in this study. Age, duration of symptoms, temperature, white blood cell counts, bilirubin levels and histological data were collected. Culture and sensitivity of peritoneal fluid was done. Patients were grouped according to histological examination of appendectomy specimens and comparison was made between the groups.Results: The mean bilirubin level of all patients was 0.95 mg/dl (range, 0.1-4.3 mg/dl). The mean bilirubin levels were higher for patients with simple appendicitis compared to those with a non-inflamed appendix (0.8 mg/dl and o.5 mg/dl, p<0.001). Hyperbilirubinaemia had a specificity of 88% and a positive predictive value of 88.89% for acute appendicitis. Patients with appendiceal perforation, however, had a mean bilirubin level of 1.5 mg/dl and were more likely to have hyperbilirubinaemia (p<0.001). The specificity of hyperbilirubinaemia for perforation or gangrene was 70%.Conclusions: patients with hyperbilirubinemia and clinical symptoms of appendicitis should be identified as having a higher probability of appendiceal perforation than those with normal bilirubin levels. Hyperbilirubinemia alone is not a strong enough predictor, but might be more useful when integrated into a scoring system.

The role of neutrophil/lymphocyte ratio in predicting the severity of sepsis in a tertiary care hospital in South India: a retrospective study

Background: Sepsis, a syndrome of dysregulated host response to infection leading to life-threatening organ dysfunction, is having a substantial burden in health system. The outcome in sepsis is often time dependent. None of the clinical manifestations nor the age-old markers like ESR, CRP, etc. have proven diagnostic or prognostic of sepsis. This study aims to assess the role of neutrophil: lymphocyte ratio (NLR) in assessing the severity of sepsis within the initial 24 hrs of admission.Methods: Authors did a retrospective observational study in 208 sepsis patients admitted in the MDICU. The NLR was calculated and the study population was grouped into those with an NLR of more than or equal to 5 and those with less than 5. The patients were also grouped based on the number of organs impaired due to sepsis. The association between these groups were then assessed.Results: 46 patients (60.5%) with single organ involvement had NLR <5; 30 patients (39.5%) had NLR >5; 27 patients (42.2%) with two organ involvement had NLR <5 and 37 patients (57.8%) had NLR >5. Among patients with more than two organ involvement, 8 patients (21.6%) had NLR <5 and 29 patients (78.4%) had NLR >5. It was found that there is statistically significant association between increase in number of organs involved and NLR more than 5. The chi square test value was 15.691 with a p value was less than 0.001.Conclusions: In the current study, we have evaluated the role of NLR in sepsis. NLR calculated on the day of admission is a simple parameter that helps to stratify patients into severe risk category. A significant association was found with higher NLR and the number of organs impairment in sepsis.

Prognostic value of laboratory and radiological parameters in kerosene poisoning

Background: Kerosene poisoning, a commonly encountered situation in pediatric emergencies, caused varied systemic manifestations ranging from asymptomatic state to altered sensorium and cardiac arrhythmias. Gupta score has been traditionally used to prognosticate such cases. Limited number of studies have been done previously despite high incidence rates pertaining to laboratory and radiological features. Present study aimed to determine association between these features and outcome in terms of duration of stay.Methods: A retrospective study consisted of all children presented with kerosene poisoning from May 2017 to May 2018. CBC was done within 12 hours of presentation and CXR was taken after 6 hours of exposure. These values were compared against duration of stay to predict prognosis.Results: Most children were in age group of 1-3 years, male predominance 62.9%. Quantity of consumption didn't have any effect on outcome. Large proportion of children were asymptomatic 60%, followed by hurried breathing 31.5% - most frequent presenting complaint. Peak duration of consumption was 4 pm to 8 pm. CBC parameters- Hemoglobin status and WBC counts failed to have correlation with outcome in terms of duration of stay. CXR taken after 6 hours exposure- was imperative to predict outcome.Conclusions: Radiological features on CXR in addition to clinical symptoms could be used to decide likely outcome after kerosene consumption.

Retrospective Analysis of Patterns of Donor Deferral among Blood Donors in a Tertiary Care Hospital

Introduction: Blood transfusion saves millions of lives.Donors undergo certain stringent selection criteria to ensuresafe and quality blood and blood products. During such processit is likely that donors may get deferred either temporarily orpermanently. Deferral leads to precious loss of donors andblood units. Morever rates and reasons of deferral vary fromregion to region. The aim of the study was to analyse rates andreasons of donor deferral in our hospital.Material and Methods: It is a retrospective study done overa period of 6 years from January 2012 to December 2017.Details of donors who were deferred either temporarily orpermanently during the study period was collected from thedonor registry.Results: Out of the 15,807 donors who registered for blooddonation during study period, 971 donors were deferreddue to several reasons both temporarily and permanently.Total deferral rate of 6% as comparable to other studies inliterature.Conclusion: Knowledge about rates and reasons of donordeferral may guide medical personnel to focus on donorscreening. Proper follow up measures can be carried out incase of temporarily deferred donors to bring them back todonor pool.

Prediction of difficult cholecystectomy, a study of 100 cases

Background: Cholelithiasis is a common problem in day to day surgical practice, which has a prevalence of 10-15%. The prevalence is more here in this part of the country as this is a pocket of sickle cell disease region. Laparoscopic cholecystectomy is the gold standard procedure for gall stone diseases. Out of many complications one of the most important complications of laparoscopic cholecystectomy is bile duct injury particularly in difficult cases.  Difficulties arise during creation of pneumoperitonium, releasing adhesion, identifying anatomy, anatomical variations and during extraction of gall bladder.Methods: A prospective study was carried out at VSS institute of Medical Science and Research, Burla, Sambalpur, a tertiary referral centre and a teaching hospital in the western Odisha. One hundred patients with symptomatic cholelithiasis were taken up for the study after due clearance from the institutional ethical committee. They were evaluated for risk factors such as-age of the patient, sex of the patient, previous abdominal surgery, number of previous attacks, total WBC count, gall bladder wall thickness and pericholecystic collection on ultrasonography.Results: Previous abdominal surgery, duration since acute attack, number of previous attacks, ultrasonography findings of increased wall thickness, stone impaction at neck and pericholecystic collection, increased total WBC count are associated with difficult laparoscopic cholecystectomy.Conclusions: The predictors for difficult cholecystectomy will make the surgeon extra cautious during the procedure so as to minimize the complications.

Serum bilirubin is negatively associated with white blood cell count

OBJECTIVE: Bilirubin is considered an important antioxidant, anti-inflammatory factor and immunomodulator. The current investigation aimed to explore the association between bilirubin and white blood cell (WBC) count in a large Chinese cohort. METHODS: A total of 61091 participants (29259 males, 31832 females) were recruited from a Chinese tertiary hospital. Data were sorted by sex, and the association between bilirubin and WBC count was analyzed after dividing bilirubin levels into quartiles. RESULTS: Most parameters (including age, body mass index, systolic blood pressure, diastolic blood pressure, alanine aminotransferase, total bilirubin, blood urea nitrogen, creatinine, uric acid, triglycerides and WBC count) were significantly higher in men than in women. Bilirubin displayed significant negative relationships with most other measured variables. Linear logistic regression analysis further indicated their negative relationships. Females showed a significantly higher frequency of leucopenia than males. Significant associations of leucopenia with high bilirubin quartiles were shown in binary logistic regression models for both sexes, with a much closer association in men than in women. For instance, for men with bilirubin levels in quartile 4, the adjusted likelihood of leucopenia was 1.600-times higher than that of men with values in quartile 1. For women with bilirubin levels in quartile 4, the adjusted likelihood of leucopenia was 1.135-times higher than that of women with values in quartile 1. CONCLUSION: Bilirubin is negatively related to WBC count. Significant associations exist between leucopenia and high bilirubin quartiles, and these associations are more obvious in men than in women.

Utility of radiolabeled leukocyte and bone marrow scintigraphy with SPECT/CT in the diagnostic work-up- of the painful prosthetic joint: A single-institution experience

@#In tbhe assessment of prosthetic joint pains, differentiating between aseptic loosening and infection can be challenging due to their similarities in clinical presentation and histopathology. Combined radiolabeled leukocyte and bone marrow scintigraphy and SPECT/CT is considered the most suitable nuclear imaging modality for this purpose. However, this is infrequently performed in our local setting. We present two cases where these studies were appropriately performed with different scan outcomes. The first case involved a 67-year-old male with painful right knee prosthesis and an alleged history of recurrent periprosthetic joint infection (PJI). The leukocyte tagging scan and marrow scan images were found to be congruent, which was more compatible with aseptic loosening. No emergent surgical intervention was done in our hospital, and the patient returned to this home territory for further management. The second case was a 72-year-old male with progressive pain in his left prosthetic hiip which began after surgery a year prior. Scan images were incongruent, suggestive of PJI; this was confired on joint aspiration and eventual surgical revision. Despite this imaging study's high sensitvity and high specificity, it has not been well-received in management algorihms of PJI. Collaboration between clinicans and nuclear imaging specilists is key in increasing the general use of these procedures.

Role of haematological parameters in oral potentially malignant disorders and oral squamous cell carcinoma-A comparative study

Context Oral squamous cell carcinoma (OSCC) is one of the most common cancers in human population and has a multifactorial aetiology. It is often preceded by oral potentially Malignant Disorders (OPMDs). Studies have shown that OSCC and OPMDs cause significant variations in various haematological parameters. Aim and objectives To assess the role of haematological parameters like haemoglobin, erythrocyte sedimentation rate, red blood cell count, white blood cell count and differential leukocyte count in OPMDs and OSCC and also to compare these parameters among OPMDs, OSCC and controls. Materials and methods Study comprises 30 diagnosed cases each of OPMDs and OSCC and 10 normal healthy age and sex-related individuals. Blood sample was collected from the patients and was evaluated for various haematological parameters by Sahli's acid haematin method, Westergren method and Coulter Counter ZF-6. Results There was a statistically significant difference in haemoglobin, red blood cell count, erythrocyte sedimentation rate, differential leukocyte count between OSCC, OPMDs and controls. Conclusion In the present study, haematological parameters were significantly altered in OPMDs and OSCC, and these variations may be useful in the prediction of malignant transformation and prognosis.

Rouleaux formation of white blood cells and platelets in leukemia / Formação de rouleaux de glóbulos brancos e plaquetas em leucemia

The objective of this study was to measure the effects of glucose and salt level on white blood cells, red blood cells and platelets (PLTs) in the blood of a leukemic patient by using a white light microscope. Different concentrations of glucose and salt in the range of 0 mM to 500 mM were admixed in the blood sample to prepare blood smear. We revealed that shape of erythrocytes, leukocytes and platelets changes and form aggregates. Increasing concentrations of glucose cause to increases aggregation process of white blood cells, red blood cells and platelets. And the increasing concentration of sodium chloride causes to increase rouleaux formation and aggregation of platelets but dehydration due to increased sodium chloride concentration causes to break the aggregation of white blood cells. Comparison of CBC reports of these samples with and without analytes shows that total leukocyte count (TLC) decreases gradually towards normal ranges of leukocytes which is favorable in the treatment of leukemia but at the same time decreasing level of hemoglobin HGB, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and increasing level of red blood cell (RBCs) causes to reduce oxygen supply which is in favor of cancer growth and anemia. This work provides us the base for translation this in vitro study towards the in vivo case of blood microvasculature as a non-invasive methodology.

O objetivo deste estudo foi medir os efeitos da glicose e do nível de sal nos glóbulos brancos, glóbulos vermelhos e plaquetas (PLTs) no sangue de um paciente leucêmico usando um microscópio de luz branca. Foram misturadas diferentes concentrações de glicose e sal na gama de 0 mM a 500 mM na amostra de sangue para preparar esfregaço de sangue. Descrevemos que a forma dos eritrócitos, leucócitos e plaquetas muda e forma agregados. O aumento das concentrações de glicose aumenta o processo de agregação de glóbulos brancos, glóbulos vermelhos e plaquetas. E a crescente concentração de cloreto de sódio causa o aumento da formação de rouleaux e a agregação de plaquetas, mas a desidratação devido ao aumento da concentração de cloreto de sódio causa a quebra da agregação de glóbulos brancos. A comparação dos relatórios de CBC dessas amostras com e sem analitos mostra que a contagem total de leucócitos (TLC) diminui gradualmente para os intervalos normais de leucócitos, o que é favorável no tratamento da leucemia, mas ao mesmo tempo diminui o nível de hemoglobina HGB, hemoglobina corpuscular média (MCH ), a concentração média de hemoglobina corpuscular (MCHC) e o aumento do nível de glóbulos vermelhos (RBCs) reduz o suprimento de oxigênio, o que é a favor do crescimento do câncer e da anemia. Este trabalho fornece a base para a tradução deste estudo in vitro para o caso in vivo de microvasculatura de sangue como uma metodologia não-invasiva.

Clinical value of urine heparin-binding protein in the diagnosis of urinary tract infection / 中华检验医学杂志

Objective To dectect urine level of heparin-binding protein(HBP)in screening urinary tract infection(UTI).Methods A case-control study was performed.From June 2016 to December 2016, urine levels of HBP were detected by enzyme linked immunosorbent assay in 119 patients with definite UTI, 18 patients with probable UTI,58 patients with no UTI and 52 normal controls who were enrolled at Fudan University Hua Shan Hospital North.Meanwhile,urine leukocyte esterase test(U-LE)and urine nitrite test (U-NIT)were performed by urine dipstick analyzer.And count of urine WBC(U-WBC)was performed by urine formed elements analyzer.The overall level of each group was compared using Kruskal-Wallis H test. Two independent samples were compared by Mann-Whitney U test.The correlation between U-HBP, U-LE and U-WBC were assessed using Spearman′s rank coefficient.Receiver operating characteristic curves were constructed to illustrate the diagnostic power of U-HBP, U-LE, U-NIT and U-WBC for UTI.Results In definite UTI group,probable UTI group,no UTI group and normal control group,the levels of U-HBP, U-LE,U-NIT and U-WBC were significantly different(H values were 166.73,126.88,47.92 and 144.05, respectively,P<0.05).Areas under the receiver-operating characteristics curves(AUC)of U-HBP, U-LE,U-NIT and U-WBC were 0.948,0.836,0.671 and 0.897 respectively for the diagnosis of UTI.When a cut-off value of 69.20 ng/ml was used in U-HBP, the sensitivity and specificity for detection of definite UTI were 89.9%(107/119)and 89.1%(114/128),respectively.When U-LE at a cut-off value of 4+, the sensitivity was 76.5%(91/119)and specificity was 81.3%(104/128).When U-NIT at a cut-off value of 1+,the sensitivity was 36.1%(43/119)and specificity was 97.7%(125/128).When U-WBC at a cut-off value of 233.6/μl,the sensitivity was 82.4%(98/119)and specificity was 82.8%(106/128). A strong correlation was detected between U-HBP and U-WBC(r=0.896, P<0.05).The correlation between U-HBP and U-LE was also strong(r=0.798, P<0.05).Conclusions Heparin-binding protein in the urine was significantly better in diagnosis of UTI,compared with the other markers.It could probably be acted as an important new biomarker for diagnosis of UTI.

Diagnosis and application of C-reactive protein, prealbumin and WBC count in neonatal infectious diseases / 重庆医学

Objective To explore the diagnostic and clinical application value of combined detection of C-reactive protein (CRP),serum prealbumin (PA) and white blood cell (WBC) count in neonatal infectious diseases.Methods A total of 187 fullterm newborns were collected in this study,including 92 newborns of bacterial infection as the infection group and 95 newborns of non-infection diseases as non-infection group.The abnormal rates of CRP,PA and WBC in the two groups were measured;the sensitivity,specificity,false positive rate and false negative rate were compared between the single detection and combined detection of WBC,PA,CRP;the changes of the three indexes in the infection group were compared between before and after treatment.Results The abnormal rates of CRP,PA and WBC in the infection group were significantly higher than those in the non-bacterial infection diseases group (P＜0.05).The sensitivity and specificity of combined detection of CRP+ PA + WBC were higher than those of single detection of CRP,PA and WBC;after treatment,the level of CRP in the infection group was significantly decreased,the level of PA was significantly increased and the WBC count returned to normal(P＜0.05).Conclusion The combined detection of CRP,PA and WBC has an important clinical value in the early diagnosis of neonatal bacterial infection.

Effect of ambroxol hydrochloride combined with budesonide in treatment of children bronchial pneumonia on C-reactive protein level in patients with C-, WBC / 中国生化药物杂志

Objective To explore and analyze the effect of ambroxol hydrochloride combined with budesonide in treatment of children bronchial pneumonia on C-reactive protein level and WBC levels.Methods 100 cases of patients with bronchial pneumonia treated in our hospital from May 2015 to December 2016, were randomly divided into observation group and control group, 50 cases in each group.The control group were given routine treatment, while the observation group were given ambroxol hydrochloride combined with budesonide treatment on the basis of the control group,the course of treatment was 14 days.C-reactive protein and WBC levels were measured before treatment and 14 days after treatment, the Resultswere observed and statistical.ResultsThere were significant differences in the content of CRP between groups and multiple time points(F=11.50, P=0.003;F=4.78, P=0.03;F=5.45, P=0.02).The content of CRP 14 days after treatment in the observation group were significantly lower than the control group(t=14.12,P<0.05), the difference was statistically significant.There were significant differences in the WBC counts between groups and multiple time points(F=11.52, P=0.003;F=4.73, P=0.03;F=5.44, P=0.02),the difference was statistically significant.The count of WBC 14 days after treatment in the observation group after treatment were significantly lower than the control group(t=8.12, P<0.05), the difference was statistically significant.The number of cured, effective and ineffective cases in the control group was 20, 13 and 15, respectively.The observation group was 30, 15, and 5 cases, respectively.By rank sum test, the difference of the effective rate between the 2 groups was statistically significant(u=2.33, P<0.05).And the total effective rate in observation group was 90.0%, which was significantly higher than the control group(70.0%)(x2=6.25, P<0.05), the difference was statistically significant.Conclusion Ambroxol hydrochloride combined with budesonide in the treatment of bronchial pneumonia in children is effective and can effectively reduce the CRP and WBC count, so it is worth popularizing widely in clinic.

Clinical research of neutrophil parameters Neut-X and Neut-Y in patients with blood stream infection / 国际检验医学杂志

Objective To investigate the clinical significance of neutrophil parameters Neut‐X and Neut‐Y in the diagnosis of blood stream infection(BSI) .Methods The data in106 patients with blood stream infection and 51 cases in the healthy control group were retrospectively analyzed .The results of WBC ,neutrophil percentage ,Neut‐X ,Neut‐Y and procaclitonin (PCT ) were compared .Results Neut‐X and Neut‐Y in the BSI group were 1 393 .5 ± 33 .4 and 416 .2 ± 30 .0 respectively ,which were signifi‐cantly higher than 1 371 .9 ± 32 .7 and 391 .7 ± 23 .7 in bacterial culture negative group and 1 347 .2 ± 26 .2 and 371 .9 ± 21 .5 in the healthy control group ,the differences were statistically significant (P<0 .05) .Neut‐X and Neut‐Y had good correlation with PCT . Neut‐X and Neut‐Y levels in the Gram‐negative bacterial group were higher than those in the Gram‐positive bacterial group .Conclu‐sion Neut‐X and Neut‐Y parameters in the patients with BSI are significantly increased and can be used as the assistant diagnosis parameters of blood stream infection .

Value of plasma D-dimer in early diagnosis of acute ischemic bowel disease / 国际检验医学杂志

Objective To study the value of D‐dimer for early diagnosing ischemic bowel disease(IBD) and to find more econom‐ic and more effective detection means for its diagnosis and control .Methods Ninety‐five patients with suspected acute IBD in our hospital from October 2014 to October 2015 were selected as the observation group ,and contemporaneous 74 individuals undergoing routine physical examination were selected as the control group .The differences in D‐dimer levels were compared between the con‐trol group and the patients with definitely diagnosed IBD in the observation group on 1 ,7 ,14 d after admission .At the same time the differences in initial WBC level and fecal occult blood were compared between the two groups .The sensitivity and specificity of plas‐ma D‐dimer level for early diagnosing IBD were calculated and their clinical application value was summarized .Results (1) Accord‐ing to plasma D‐dimer results ,the 74 cases of acute IBD were diagnosed and 21 cases were negative ,while 80 positive cases and 15 negative cases were diagnosed by adopting the CT inferior mesenteric arterial angiography and multislice spiral CT ,the sensitivity of plasma D‐dimer detection was 88 .75% and specificity was 80 .0% .(2) The D‐dimer level ,WBC count and fecal occult blood on 1 d after admission in the observation group were (5 480 .12 ± 876 .32)μg/L ,(17 .37 ± 2 .21) × 109/L and 81 .3% respectively ,which were far higher than those in the healthy control group ,the differences were statistically significant (P<0 .05) .(3)The D‐dimer levels on 1 ,7 ,14 d after admission in the observation group were significantly higher than those in the control group (P<0 .05) , while with the treatment duration extension ,the plasma D‐dimer level was gradually decreased .Conclusion The D‐dimer detection has a relatively higher sensitivity and specificity in the early diagnosis of acute IBD and has better clinical application value .

Correlation study between CD64 +neutrophils and infection of patients with burns / 医学研究生学报

Objective The in vitro studies of indicators in burn patients with complicated infection have been little studied till now.So this study aims to investigate the change of proliferation of CD64 +neutrophils from the peripheral blood of burn patients in vitro. Methods CD64+neutrophils from peripheral blood of healthy people were isolated and purified, which was followed by stim-ulating its proliferation with inactivated Staphylococcus in vitro.We further analyzed the proliferation index with Modfit 2 analysis soft-ware.86 burn patients were divided into two groups, 44 cases with complicated infection assigned to experimental group, 42 uninfected assigned to controls.We further detect the counts of WBC and the percentage of CD64 +neutrophils, and then analyzed the specificity and sensitivity by using the receiver operating characteristic ( ROC) curves. Results This in vitro study, the average proliferation index of CD64 +cells in experimental wells was significantly higher than controls (6.48 ±0.11 vs 2.63 ±0.02), the difference was statistically significant (P<0.05);the percentage of CD64 +cells in the peripheral blood of patients in experimental group(64.25 ± 13.11%) was significantly higher than patients without infection(16.33 ±2.77%);The sensitivity and specificity of diagnostic meth-od of CD64 +cells for the burn infection were respectively 94.2%and 76.8%, which was superior to the traditional diagnostic meth-od of WBC ( 68.5%, 64.7%) according to ROC curves. Conclusion CD64 + cells in peripheral blood of burn patients complicated by infection increased more significantly and earlier when compared with the traditional diagnostic method, which may be used as a useful diagnostic indicator for burns complicated infection.

WBC Increasing Medicine Usage Analysis in Cancer Patients in a Hospital / 中国药师

Objective:To investigate the application of leukogenic medicine in cancer patients and standardize the use of WBC increasing medicine in a hospital. Methods:A retrospective analysis of 579 patient records from January 2014 to December in a hospital diagnosed as malignant tumor and issued WBC increasing medicine . The kinds of drugs,timing of administration, dosage,frequency of administration,the use of medication,drug combination and the choice of solvent were analysed by collecting the patients’ essential information, chemotherapy, myelosuppression etc. Results: The l white blood drugs mainly oral preparations;There were 414 rational drug use medication orders,accounting for 71. 50 percent;irrational drug use medical record 165,accounting for 28. 50% . The dosage and duration of treatment in line with requirements,and unreasonable cases mainly suitable varieties and timing of administration based,42. 42% and 27. 88% ,respectively;followed by repeated dosing and combination therapy is not suitable,13. 33% 1and 2. 73,respectively;a lower incidence of solvent choice unsuitable,is 3. 64% . Conclusion:The use of WBC increasing medicine need to be standardized in cancer patients in the hospital. Clinicians need to strengthen studying the knowledge of the application of WBC increasing medicine and use WBC increasing medicine rationally.

A study of relationship between blood parameters with myocardial infractions.

Background: The aim of this study was to find out the changes in blood parameters in a group of myocardial infarction patients in Jamnagar, Gujarat. Methods: In this cross sectional study conducted at the medicine clinic in GGH general hospital, Jamnagar between May 2012 and April 2013, a total of 100 subjects were included. Parameters like hemoglobin, RBC count, WBC count, platelet count, hematocrit, ESR, Mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, packed cell volume, differential WBC count used. Results: The results of present study revealed that WBC count, ESR, the differential leukocyte count (e.g. neutrophil cells) in patients increased significantly (P <0.01) comparison to controls. While, the differential leukocyte count of lymphocyte & platelet count revealed to decrease significantly (P <0.01) in patients. Conclusion: Abnormal blood parameters are more common among diabetes patients. Elevated WBC count, ESR, neutrophils are present in patients as compared to control. While decreased in lymphocytes & platelets are seen in patients as compared to control.