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【Objective:】 To preliminary construct a scientific, systematic and applicable evaluation index system of the interest conflict for medical institutions ethics committee. 【Methods:】 Literature retrieval, interpretation of laws and regulations, expert group discussion and Delphi expert letter inquiry were used to screen indicators and determine the evaluation index system of interest conflict and the weight of various indicators. 【Results:】 The response rates of the two rounds of correspondence questionnaire were both 100%, the authority coefficient Cr values of the two rounds were 0.855 and 0.865, and the coordination coefficient W values of the two rounds were 0.817 and 0.826, which were statistically significant (P<0.05). The final formed system included 3 first-level indicators, 10 second-level indicators and 25 third-level indicators. 【Conclusion:】 The evaluation index system of interest conflict for medical institution ethics committee is scientific and reliable.
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Objective:To explore the expectations of different groups, including the vice president in charge of hospital infection, hospital infection management professionals, nursing managers, and department directors, on the core competence of head nurses in hospital infection prevention and control.Methods:Using the phenomenological research method, purposive sampling method was used to conduct in-depth semi-structured interviews with 25 interviewees from 5 tertiary general hospitals in Hangzhou City, Zhejiang Province, including vice presidents in charge of hospital infection, hospital infection management professionals, nursing managers, department directors, clinical staff and logistics supervisors. A total of 25 interviewers conducted in-depth semi-structured interviews, and the collected data were analyzed by Colaizzi′s 7-step analysis method.Results:Four themes were extracted, including the expectation of the head nurse′s infection control target management ability, the expectation of the head nurse′s infection control professional knowledge ability, the expectation of the head nurse′s infection control clinical practice ability, and the expectation of the head nurse′s infection control influence.Conclusions:In the sensory control management of the department, head nurses should have strong infection control target management ability, continue to learn and update the infection control knowledge and concepts, improve the clinical infection control practice ability, properly authorize, reasonably motivate and improve the infection control management. Team execution ability, create a good atmosphere of department sense control, and promote the development of infection control work.
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The infectious disease outpatient service as a frontier is an important fulcrum of public health service. Its standardized construction is an important support for ensuring medical safety, reducing nosocomial infections, and controlling the epidemic of infectious diseases. The sub-specialty outpatient service of infection diseases includes fever outpatient service, intestinal outpatient service, tuberculosis outpatient service, AIDS outpatient service, liver disease outpatient service, etc. According to the characteristics of each subspecialty outpatient service and combining with clinical practice, we elaborated the setting norms of subspecialty outpatient service for common infectious diseases from the perspective of planning and design, building layout, equipment and facilities configuration, staffing, daily management and demonstration.
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Objective@#To analyze the clinical features and microbial characteristics of patients with pyogenic liver abscess (PLA), and to determine the risk factors and biomarkers for early diagnosis of sepsis caused by PLA.@*Methods@#The demographic and clinical data of 198 patients with liver abscess admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2013 to June 2017 were analyzed retrospectively. Patients with non-bacterial liver abscess, death on admission and tumor metastasis were excluded. The 198 patients with liver abscess were divided into the sepsis group and non-sepsis group according to the disease progression. The general data of the two groups were analyzed to explore the risk factors of sepsis caused by liver abscess, biomarkers for early diagnosis, and the prognosis. Patients with positive culture were further divided into the Klebsiella pneumoniae group and non-Klebsiella pneumoniae group, and the general clinical data of the two groups were analyzed. Among the PLA patients with positive culture, 80.0% were Klebsiella pneumoniae, followed by E. coli. SPSS 19.0 software was used for statistical analysis, and univariate and logistic multivariate regression analysis was used to determined the risk factors of sepsis induced by PLA. The diagnostic value of white blood cell, neutrophil percentage and procalcitonin (PCT) at admission on the progression of liver abscess to sepsis was evaluated by the receiver operating characteristic (ROC) curve, area under the curve (AUC), sensitivity and specificity.@*Results@#The mortality of patients with sepsis caused by liver abscess was 20.8%. The white blood cell count, neutrophil percentage, and PCT at admission predicted the progression of sepsis in PLA patients, and the AUC were 0.76 (95%CI: 0.623-0.898), 0.818 (95%CI: 0.691-0.945), and 0.869 (95%CI: 0.765-0.974), respectively. Patients with diabetes were prone to develop sepsis after the occurrence of liver abscess. There was no significant difference in microbial characteristics between the sepsis group and non-sepsis group. Length of stay (LOS) in patients with sepsis was significantly prolonged [(19.6±12.5) d vs (16.0±9.3) d, P=0.033].@*Conclusions@#Diabetes is an independent risk factor for the progression of liver abscess to sepsis. Klebsiella pneumoniae is the first pathogen of liver abscess. Patients with elevated glycated hemoglobin (≥9.9%) are prone to develop sepsis. White blood cell count (≥12.55×109/L), percentage of neutrophils (≥84.8%), and PCT (≥6.96 ng/mL) in patients with liver abscess indicated the progresses to sepsis, and thus the LOS of patients with sepsis is significantly prolonged and the mortality is significantly increased.
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Objective@#To analyze the changes of peripheral blood leukocyte in patients with Behçet uveitis (BU) at different stages.@*Methods@#Case control study was performed.Twenty active stage BU patients and 21 quiet stage BU patients were enrolled from July to November 2015 in Peking Union Medical College Hospital.Ten active stage BU patients treated with glucocorticoid and/or immunosuppressive agents were served as improvement stage BU patients.Meanwhile, 82 healthy controls were collected from the physical examination center.Peripheral blood was obtained and then analyzed by using Hematoflow method.The percentages of leukocytes in peripheral blood of different stage BU patients were compared.This study was approved by the Ethics Committee of Peking Union Medical College Hospital (ZS-1341) and all participants signed informed consent.@*Results@#The percentage of mature neutrophils, eosinophils, basophils, B lymphocytes, non-cytotoxic T and NK lymphocytes, granular T and NK lymphocytes, T blasts, B blasts and immature granulocytes were all significantly different among active stage BU group, quiet stage BU group and healthy control group (F=42.324, 10.220, 8.660, 11.254, 29.795, 31.305, 23.742, 27.738 and 34.638, all at P<0.001). The percentage of mature neutrophils in active stage BU group and quiet stage BU group were (73.10±10.21)% and (62.40±12.09)%, which were significantly higher than (54.95±6.07)% in healthy control group.The percentage of mature neutrophils in active stage BU group was significantly higher than that in quiet stage BU group (P<0.05). The percentages of non-cytotoxic T, NK lymphocytes, granular T and NK lymphocytes in active stage BU group and quiet stage BU group were significantly lower than that in healthy control group, the percentage of non-cytotoxic T, NK lymphocytes and granular T, NK lymphocytes in active stage BU group were significantly lower than those in quiet stage BU group (all at P<0.05). The percentage of immature granulocytes after treatment was significantly higher than that before treatment in improvement stage BU group (t=-2.469, P=0.036).@*Conclusions@#Increase of peripheral blood mature neutrophil was observed in BU patients, which may help to monitor the inflammatory activity of BU.
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Objective To analyze the clinical features and microbial characteristics of patients with pyogenic liver abscess (PLA),and to determine the risk factors and biomarkers for early diagnosis of sepsis caused by PLA.Methods The demographic and clinical data of 198 patients with liver abscess admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2013 to June 2017 were analyzed retrospectively.Patients with non-bacterial liver abscess,death on admission and tumor metastasis were excluded.The 198 patients with liver abscess were divided into the sepsis group and non-sepsis group according to the disease progression.The general data of the two groups were analyzed to explore the risk factors of sepsis caused by liver abscess,biomarkers for early diagnosis,and the prognosis.Patients with positive culture were further divided into the Klebsiella pneumoniae group and non-Klebsiella pneumoniae group,and the general clinical data of the two groups were analyzed.Among the PLA patients with positive culture,80.0％ were Klebsiella pneumoniae,followed by E.coli.SPSS 19.0 software was used for statistical analysis,and univariate and logistic multivariate regression analysis was used to determined the risk factors of sepsis induced by PLA.The diagnostic value of white blood cell,neutrophil percentage and procalcitonin (PCT) at admission on the progression of liver abscess to sepsis was evaluated by the receiver operating characteristic (ROC) curve,area under the curve (AUC),sensitivity and specificity.Results The mortality of patients with sepsis caused by liver abscess was 20.8％.The white blood cell count,neutrophil percentage,and PCT at admission predicted the progression of sepsis in PLA patients,and the AUC were 0.76 (95％CI:0.623-0.898),0.818 (95％CI:0.691-0.945),and 0.869 (95％CI:0.765-0.974),respectively.Patients with diabetes were prone to develop sepsis after the occurrence of liver abscess.There was no significant difference in microbial characteristics between the sepsis group and non-sepsis group.Length of stay (LOS) in patients with sepsis was significantly prolonged [(19.6±12.5) d vs (16.0±9.3) d,P=0.033].Conclusions Diabetes is an independent risk factor for the progression of liver abscess to sepsis.Klebsiella pneumoniae is the first pathogen of liver abscess.Patients with elevated glycated hemoglobin (≥ 9.9％) are prone to develop sepsis.White blood cell count (≥ 12.55×109/L),percentage ofneutrophils (≥ 84.8％),and PCT (≥ 6.96 ng/mL) in patients with liver abscess indicated the progresses to sepsis,and thus the LOS of patients with sepsis is significantly prolonged and the mortality is significantly increased.
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Objective To observe the effect of ultrasound-guided transversus abdominis plane block combined with diclofenac sodium suppository in anus on postoperative analgesia and early recov-ery after laparoscopic hysterectomy.Methods Sixty-six patients of laparoscopic hysterectomy,aged 40-60 years,were randomly divided into group T and group D,33 cases in each group.Group T used ultrasound-guided bilateral transversus abdominis plane (TAP)block after surgery.Group D used TAP block and diclofenac sodium suppositories in anus.All patients received PCIA.Postoperative 24 h sufentanil dosage out of analgesia pump and the effective press times were recorded.The incidence of dysphoria,nausea and vomit within postoperative 24 h,the time of first out-of-bed activity,the time of first anal exhaust and the time of removing urine tube were measured.The plasma concentra-tion of interleukin-6(IL-6),C reactive protein (CRP)and cortisol (Cor)were recorded at the follow-ing four time points:before anesthesia,just postoperative moment,8 and 12 h after surgery. Results Compared with group T,the sufentanil dosage [(18.6±3.2)μg vs (40.8±5.1)μg]and the effective press times [(9.3±2.2)times vs (20.4±3.5)times]were fewer in group D (P<0.05).The incidence of dysphoria,and nausea and vomit were less in group D compared with group T (P<0.05).The IL-6,CRP and Cor of group D at 12 h were lower than those of group T (P<0.05). But the times of first out-of-bed activity,anal exhaust and removing urine tube in two groups were not significantly different.Conclusion Transversus abdominis plane block combined with diclofenac sodium suppositories in anus can provide safe and effective postoperative analgesia for laparoscopic hysterectomy,and promote the early fast recovery.
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Objective To investigate Yiqi Huatan Decoction(YHD), a compound recipe with the actions of tonifying Qi and resolving phlegm, on aquaporin 5(AQP5), tumor necrosis factor-alpha(TNF-α)and mucin 5AC(MUC5AC)in bronchoalveolar lavage fluid(BALF)of chronic obstructive pulmonary diseases(COPD)rats. Methods SD rats were randomized into blank control group, model group, and low-, middle- and high-dose YHD groups(in the dosage of 7.398, 36.99, 73.98 g·kg-1·d-1 respectively). The rat model of COPD was induced by cigarette smoking combined with intratracheal dripping of lipopolysaccharide(LPS). After COPD rats were treated with YHD for 30 days, the histological features of lung tissues were observed after hematoxylin-eosin (HE) staining, the expression of AQP5, TNF -α and MUC5AC in the lung tissue was detected by immunohistochemistry, the concentrations of AQP5, TNF-α and MUC5AC in BALF of rats were measured by enzyme-linked immunosorbent assay(ELISA). Results Compared with the blank control group, the concentration of AQP5 in BALF of the model group was decreased significantly(P<0.01), while the concentrations of TNF-αand MUC5AC were significantly increased(P<0.01). Compared with the model group, the pathological features of the lung tissue were relieved, and the concentration of AQP5 was increased significantly in low-, middle-, high-dose YHD groups (P<0.01), but the concentrations of TNF-α and MUC5AC were significantly decreased (P<0.01), and the effect of high-dose group was superior to low-and middle-dose groups(P<0.01). Conclusion The therapeutic mechanism of YHD for COPD is probably related with the regulation of fluid transport in aquaporin water channels of rats.
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Objective To evaluate the biological variations of 8 lymphocyte subsets using flow cytometric double-platform method.Methods Twenty healthy adults were recruited from Peking Union Medical College Hospital in September 2013.At 8:00 AM,12:00 PM,and 4:00 PM on days 1,3,and 5,venous blood was collected from the volunteers.The percent and absolute lymphocyte subset counts were measured using duel-platform method.The sample collection and handling techniques were standardized.Before each batch analysis,the instrument quality controls were performed using the same lots of reagents.The intra-individual coefficient of variation (CVI) and inter-individual coefficient of variation (CVG) were calculated by nested ANOVA with SPSS 13.0 software.The analytical coefficient of variation (CVA),index of individuality (Ⅱ) and reference change value (RCV) were calculated by Excel2003.A mean pairwise comparison was determined by one-way ANOVA and variance analysis.The values between groups were analyzed by independent sample t test.Results For T cells (CD3 +),helper T cells (CD3 + CD4 + CD8-),suppressor T cells (CD3 + CD4-CD8 +) and B cells (CD3-CD19 +),the intra-individual coefficient of variation (CVI) and inter-individual coefficient of variation (CVG) were 0.03,0.06,0.05,0.14 and 0.12,0.16,0.23,0.31 respectively,which were all similar to those in previous studies.However,the Ⅱ and RCV of the four lymphocyte subsets were very different from those in previous studies,which were 0.26,0.40,0.22,0.44 and 8.77,16.86,14.93,39.69,respectively.Moreover,variations in absolute count,CVI,CVG,and analysis coefficient of variation (CVA) of all 8 lymphocyte subsets were greater than those of relative count.Variations in the percent and absolute counts for the CD3 + CD4-CD8-,CD3 + CD4 + CD8 +,and CD3+ CD16+ CD56+ cell subsets were relatively high.The CVI,CVG and CVA for the cells of CD3 + CD4-CD8-were 0.12,0.49 and 0.16.The CVI,CVG and CVA for the cells of CD3+ CD4+ CD8+ were 0.40,0.93 and 0.55.The CVI,CVG and CVA for the cells of CD3 + CD16 + CD56 + were 0.28,1.11 and 0.16.Conclusions Investigation on the CVI,CVG and CVA may allow us to obtain Ⅱ and RCV,by which we can determine the utility of traditional population based reference ranges.Documentation of the RCV indices may be used as objective delta-check values in quality management and decide whether clinical significance existed in the continuously detected results.
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Objective To investigate influence of ulinastation in storage period on apoptosis of suspended erythrocyte.Methods RBCs were treated with saline (control group) and different doses of ulinastatin (5,000, 10,000 and 50,000 U/mL in group C1, C2 and C3, respectively).samples were detected when stored at 0,7,14,21,28,35 d,respectively.Indicators of corpuscular volume,phosphatidylserine extroversion rate and intracellular Ca2 +concentration were analyzed by flow cytometer.Results The phosphatidylserine (PS)-exposure levels of 4 groups started to increase on 14 day(P<0.05). Cells of the control group, group C1 and C2 began to shrink remarkably on day 21, while that of Group C3 on 28 day.The intracellular Ca2 +levels of the control group and group C1 started to increase significantly on day 35, (t=16.33,t=14.66,P<0.05).one Ca2 +levels of group C1,C2 and C3 increased on day 14.From 21 to 35 day, the intracellular Ca2 +levels of group C2 and C3 were no significant compared with control group.Conclusion During the storage period, suspended erythrocyteapoptosis increase with time prolonged, adding suitable amount of ulinastatin in stock solution can inhibit apoptosis in damage at some level.
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Objective To evaluate the clinical performance of an automated image analysis systems named CellaVision DM96 in classifying White Blood Cells.Methods A total of 2267 peripheral blood samples (male 1 235, female 1 034, average age 46) were obtained from outpatient and inpatient in Peking Union Medical College Hospital ( PUMCH ) . These samples were selected to evaluate the precision, sensitivity, specificity and the analytical error of the system.We first evaluated the coincidence rate of reclassification and manual microscopy.On the base of favourable coincidence rate, we then evaluated the correlations between the pre-classification and reclassification of segmented neutrophil, band neutrophil, lymphocyte, monocyte, eosinophile, basophile, blast cell, promyelocyte, myelocyte, metamyelocyte, plasma cell and reactive lymphocyte.Results The sensitivity and specificity of pre-classification of White Blood Cell were 46% -100% and 24%-92%, respectively.When studied on the cell level, the total coincidence rate of pre-classification was 88%.And the coincidence rates of pre-classification and reclassification of White Blood Cell were 6%-95% and 25%-100%, respectively.When assessed on the sample level, the coincidence rates of pre-classification and reclassification of leukocytes were 64%-98%and 84%-100%, respectively.The correlations of pre-classification and reclassification of leukocytes in order from high to low were: lymphocyte, segmented neutrophil, eosinophile, band neutrophil, monocyte, basophile, when r were 0.943 9, 0.915 2, 0.785 4, 0.775 6, 0.676 2 and 0.289 1, respectively.The correlations between reclassification and manual microscopy of White Blood Cell were higher than those between pre-classification and manual microscopy.Order from high to low was: eosinophile, segmented neutrophil, lymphocyte, monocyte, band neutrophil, basophile.And r were 0.972 1, 0.968 5, 0.957 0, 0.831 9, 0.800 6 and 0.648 7, respectively.The ability of this automated image analysis systems at pre-classification in distinguishing between band cell and segment cell, atypical lymphocyte and normal lymphocyte was not good. Conclusion The performance of reclassification was better than pre-classification.The reclassification can be substitute for the microscopy inspection, and be used in the Clinical practice.
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Guangdong province assumes the task of pilot exploration and demonstration for building the preventive health service system of Chinese medicine. In the pilot process of preventive treatment of disease, a health pro-ject of Chinese medicine, sectoral agreements and policy studies are focusing issues. This paper explores the pre-ventive health service system building of Chinese medicine in G uangdong province , from following aspects such as access policy of service agencies, access policy of professional service staff, evaluation mechanism and verify sys-tem, the revision of existing medical subjects of medical institutions, health insurance policies and compensation policies, price policies, proactive technology policies and fiscal policies, incentive policies for the introduction of private capital .
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Objective To investigate the appropriate setting up of normal reference ranges of lymphocyte subsets in some flow cytometry laboratories and to study the effects of different flow cytometers and various reagents by different manufacturers on the analysis of peripheral blood lymphocyte subsets. Methods Three FCM labs (named A, B and C) in Beijing region were selected representing 3 commonly used flow cytometers (Beckman Coulter Epics XL, Beckman Coulter Cytomics FC500, BD FACS Calibur). 50 samples from healthy donors were distributed to 3 labs and tested according to individual lab's standard operating procedure to verify whether the normal reference ranges of peripheral blood lymphocyte subsets established were appropriate. The application of internal quality control was also investigated. Commercial blood quality control reagents were given to the 3 FCM labs and tested within 20 working days paralleled with routine samples. In addition, 20 patients' samples were prepared using 4 different combinations of reagents ( a , b , c and d). The results from combination a, which used the Beckman Coulter reagents and instrument, were compared to the results from combination b, c and d, which used reagents from different manufacturers. Then the prepared samples were tested on Beckman Coulter Epics XL to evaluate the effects of different combinations of reagents on the results of peripheral blood lymphocyte subsets analyzed by the same instrument. Furthermore, 24 patients' samples prepared by same reagents from Beckman Coulter company were tested on both Beckman Coulter Epics XL and BD FACS Calibur respectively to assess the effects of different instruments on peripheral blood lymphocyte subsets. 20 patients' samples prepared by same reagents and instruments were analyzed by Beckman Coulter Epics XL analytic system and BD FACS Calibur analytic system respectively to assess the effects of the two analytic systems on the lymphocyte subsets. Results Over 10% of the results for NK and T4/T8 in lab A as well as T4 in labs B and C fell outside of their normal reference ranges. The probabilities exceeding corresponding normal reference ranges were 16% ( 9/50 ), 24% ( 12/50 ), 22% (11/50) and 12% ( 6/50 ), respectively. The results using internal blood quality control in 3 FCM labs within 20 working days were all within the reference ranges of the quality control provided by the kit. The biases from b and c reagent combinations were substantial compared with that of reagent a combination. Among the biases from b and c reagent combinations, the lowest probability of bias exceeding 10% was T8 of combination b, which had probability of 70% (14/20). The highest probabilities of hias exceeding 10% were T3 and T4 of b and c reagent combinations, which reached 100% (20/20) . Furthermore, the biases of T3, T8 and B of d reagent combination compared with that of reagent a combination were also substantial. The probabilities of bias exceeding 10% were 35% (7/20) ,85% (17/20) and 75% (15/20), respectively. Comparing the results of samples prepared and analyzed by reagents and instruments from different manufacturers to that of samples prepared and analyzed by the same company's reagents and instruments showed that there were great discrepancies in T3, T4 , T8 , B and NK. The probabilities of bias exceeding 10% were 71% ( 17/24), 80% (19/24) ,38% (9/24), 33% (8/24) and 92% (22/24), respectively. The biases of T8, NK and B were substantial when compared the results from Beckman Coulter Epics XL analytic systems and BD FACS Calibur analytic systems. The probabilities of bias exceeding 10% were 55% (11/20 ), 70% ( 14/20 ) and 55% (11/20), respectively. Conclusions FCM labs should set up their own normal reference range for peripheral blood lymphocyte subsets. The normal reference range should be verified periodically. It is important to apply internal blood quality control regularly and accumulate the quality control results. The reagents and instrument for preparing peripheral blood samples should be from the same manufacturers.
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Objective To investigate the correlation between RDW and disease activity in patients with IBD and evaluate clinical significance of RDW as a potential indicator to monitor IBD activity. Methods 256 patients with IBD were divided into two groups. One was UC group including 136 patients with 80 active period cases and 56 emission period cases. Another was CD group including 120 patients with 75 active period cases and 45 emission period cases. 60 bacillary dysentery diseases and 80 healthy controls were selected as bacillary dysentery group and healthy control group. RDW, Hb, WBC, PLT, CRP, ESR, MCV were tested and monitored with development of disease at different stages. We compared RDW with CRP,ESR, PLT, Hb, MCV parameters. By ROC curve analysis, the sensitivity and specificity of RDW was estimated in identifying the IBD's activity. Results The mean values of RDW in active UC group, remission UC group, bacillary dysentery group and control group were ( 16. 1 ± 2. 7), ( 13.5 ± 2. 1 ), ( 13.0 ± 2. 0)and ( 12. 8 ± 1.8), respectively. There was significant difference among four groups ( F = 51.9, P < 0. 01 ).RDW in active UC group was significant higher than that in remission UC group, bacillary dysentery group and healthy control group ( t = 8. 12, 9. 67, 11.85, P < 0.05) and RDW in remission UC group was significant higher than that in bacillary dysentery group and healthy control group as well ( t = 2. 45, 2. 67,P <0. 05). The mean values of RDW in active CD group, remissive CD group,bacillary dysentery group and control group were ( 16. 9 ± 2. 2 ), ( 13. 8 ± 1.1 ), ( 13.0 ± 2. 0), ( 12. 8 ± 1.8 ). There was significant difference among four groups ( F = 113.9, P < 0. 01 ). RDW in the active CD group was significant higher than that in remission CD group, bacillary dysentery group and healthy control group (t = 11.47,18.63,18. 72, P < 0. 05 ) and RDW in remission CD group was also significant higher than that in bacillary dysentery group and healthy control group ( t = 3.60, 3. 72, P < 0. 05 ). RDW in UC and CD groups demonstrated a positive correlation with CRP and ESR (r=0. 484, 0. 525, 0. 286, 0. 358 and P<0. 01, <0. 01, < 0. 05, < 0. 01, respectively) but an inverse correlation with Hb and MCV (r = -0. 378, -0. 271,- 0. 329, - 0. 298 and P < 0. 01, < 0. 01, < 0. 05, < 0. 01, respectively). In UC groups RDW represented a larger area under ROC curve (0. 8.54) compared with CRP, ESR, PLT, Fib and MCV. When the cut-off value of RDW was 14. 0, the sensitivity and specificity for identifying active UC were 82% (65/80) and 72% (40/56) respectively. In CD groups, the area of RDW under ROC curve was the largest (0. 925 )among all indicators. When the cut-off of RDW was 14.5, the sensitivity and specificity for identifying active CD was 88% (66/75) and 82% (37/45) respectively. Conclusion RDW in patients with IBD is a useful indicator to estimate the IBD activity and predict disease progression.