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A young female patient with paradoxical cerebral embolism caused by pulmonary arteriovenous fistula,mainly presented the right limbs asthenia,and brain magnetic resonance imaging examination showed multiple acute cerebral infarctions in the left hemisphere,which belongs to left middle cerebral artery and left posterior cerebral artery blood areas.After excluding the common risk factors of cerebrovascular disease,foaming test suggested the right-to-left shunt.The esophageal ultrasound examination excluded the patent foramen ovala.The lung CT angiography examination confirmed the intracranial embolism caused by pulmonary arteriovenous fistula.There was no recurrence of ischemic stroke after the patient was treated with pulmonary arteriovenous fistula embolization.
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Objective To observe and analyze the change state of serum inflammatory mediators of patients with secondary septic shock after chemotherapy for acute leukemia .Methods 56 patients with secondary septic shock after chemotherapy for acute leukemiawere were selected as the group A,56 patients without secondary septic shock after chemotherapy for acute leukemia were selected as the group B ,56 healthy persons of the same age were selected as the group C,then the serum inflammatory mediators levels of three groups were detected and compared,and the serum indexes of group A with different severity degree of shock were compared, then the detection results of group A and group B with different types ( lymphocytic leukemia and nonlymphocytic leukemia)were compared.Results The serum inflammatory mediators levels, including TNF-α, IL-4, IL-6, IL-10 and other inflammatory factors, including PGE2 , sICAM-1, sVCAM-1 and sCD44, there were group A >group B >group C, severe shock >moderate shock>mild shock ( all P<0.05 ) .The above serum inflammatory mediators and other inflammatory factors levels of different types in group A were higher than those in group B, and the above mediators in lymphocytic leukemia of group A and group B were higher than those in nonlymphocytic leukemia (all P<0.05).Conclusion The serum inflammatory mediators of patients with secondary septic shock after chemotherapy for acute leukemia show higher expression state,and the influence of shock degree and leukemia types for the expression are great.
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Objective To observe the dynamic expression of Nogo receptor (NgR) in spinal cord of rats after spinal cord injury. Meth-ods 108 Sprague-Dawley rats were randomly assigned into normal group, sham operated group and model group, with 36 rats in each group. The model of spinal cord injury was established with the modified Allen's method. The rats were killed 24 h, 3 days, 7 days and 14 days re-spectively after intervention (9 rats from each group), and expression of NgR in the spinal cord tissue of the rats was detected with immuno-histochemistry and Western blotting, and expression of NgR mRNA was detected with fluorescence quantitative PCR. Results There was no significant change in the expression of NgR in the normal group and the sham operated group (P>0.05). The expression of protein and mRNA of NgR was less in the model group 24 h after modeling, dropped to the lowest on the 3rd day, then rapidly peaked on the 7th day, and gradually declined on the 14th day after spinal cord injury. Compared with the normal group, there were significant differences in ex-pression of NgR in immunohistochemistry and Western blotting in the model group at each time point after spinal cord injury (P<0.05). Compared with the sham operated group, there were significant differences in expression of NgR mRNA in the model group at each time point after spinal cord injury (P<0.01). Conclusion The expression of NgR and mRNA peaks on the 7th day after spinal cord injury in the rats, and maintains at high level for a long time, which may associated with the difficulty of axonal regeneration after spinal cord injury.
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Objective To observe the effect and the influence on carotid atherosclerotic plaques,C-reactive protein,lipids,coagulation of atorvastatin and xuesaitong injection in the treatment of elderly patients with acute cere-bral infarction.Methods 100 elderly patients with acute cerebral infarction met inclusion criteria were randomly divided into 50 cases of the observation group and 50 cases of the control group,the control group were given conven-tional therapy,the observation group were given atorvastatin and xuesaitong injection on the basis of the control group, atorvastatin calcium 20mg/d,qd,Xuesetong 400mg/times,qd,both groups had been treated for 3 weeks for a course of treatment,the serum C-reactive protein,serum lipids and coagulation parameters were detected before and after treat-ment,the IMT and carotid plaque area were determined by color Doppler ultrasonography,NIHSS score were calculat-ed.Results The PT,APTT,CRP,IMT,carotid plaque area,NIHSS score of the observation group were (18.07 ± 2.24)s,(36.59 ±3.52)s,(11.2 ±3.6)mg/L,(0.57 ±0.16)mm,(1.36 ±0.32)cm2,(9.31 ±2.06)point,the observation group were (15.24 ±1.88) s,(31.84 ±2.55) s,(26.4 ±6.7) mg/L,(0.68 ±0.13) mm,(1.55 ± 0.37)cm2,(15.86 ±2.25)point,both groups were significantly improved after treatment than before treatment (all P<0.05),The total efficiency of observation group and control group were 96%and 72%,the observation group was significantly higher than those of the control group, the difference was statistically significant (χ2 =10.867, P <0.01).Conclusion The method containing atorvastatin and Xuesaitong injection can effectively regulate blood lipid levels and blood coagulation,inhibit vascular inflammation,Stabilizing or reversing carotid artery plaque,reduce carot-id intima-media thickness,can inhibit thrombosis and progress,improve cerebral hypoxia and ischemia parts neurologi-cal defects,improve clinical outcomes,significantly improved clinical outcomes.
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Objective To evaluate the accuracy and comparability of secondary hematology analyzer for platelet enumeration in order to determine the accuracy and reliability of assigned value of fresh blood.Methods The results between secondary standard hematology analyzer and the reference method of platelet enumeration of 40 specimens were compared according to the document from CLSI EP9-A2.The correlation and bias were calculated.At the same time,the results of secondary standard hematology analyzer between our laboratory and Japan reference laboratory were compared.The fresh blood from normal people was prepared to be used as calibrator after assigned value by secondary standard hematology analyzer.And 36 hematology analyzers were performed correctness validation and calibrated by 36 fresh bloods.Results The results of 40 specimens by secondary standard hematology analyzer and the reference method were ( 108 -326) × 109/L and( 110 -327 ) × 109/L respectively.Correlation coefficient between the secondary standard hematology analyzer and the reference method was 0.993.The bias between two methods was from -3.8％to 3.4％.The results of NCCL and Japan reference laboratory from 2009 to 2010 were( 185 -203) × 109/L and (185 - 198) × 109/L The bias range between our laboratory and reference laboratory in Japan was from - 1.4％ to 3.7％.The ranges of coefficient variations of two laboratories were from 2.0％ to 3.0％ and from 2.6％ to 3.4％,respectively.The biases of 20 hematology analyzers were from - 2.6％ to 2.1％ and they passed the correctness validation.The biases of 16 hematology analyzers were decreased from 3.4％ - 12.6％of pre-calibration to 0％ - 2.8％ of post-calibration.Conclusions The results of secondary standard hematology analyzer are assured to be accurate and comparable by the comparison of reference laboratories.It is feasible that fresh blood assigned value by secondary standard hematology analyzer can be used as calibrator for the hematology analyzer.
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Objective To evaluate the efficacy and safety of low-dose erythromycin for the prevention of feeding intolerance in preterm infants. Methods Fifty-two preterm infants (30-31 weeks' GA group) and 68 preterm infants (32-34 weeks' GA group) were randomly subdivided into prevention groups and control groups. From the second day the prevention groups received intravenously erythromycin [3 mg /(kg·d)] for 10 days,the control groups received placebo of glucose. Results In 30-31 weeks' GA group,days to achieve full enteral feeding (DAFEF) ,days to regain birth weight (DRBW) and duration of hospitalization (DH) were shorter in the prevention group as compared to those in the control group, the incidence of feeding intolerance was lower too,but there was no significant difference (P >0.05). In 32-34 weeks' GA group, DAFEF [(13.8±4.5) d],DRBW [(10.5±1.6) d],DH [(28.5±6.8) d] were significantly shorter in the prevention group than those in the control group [(17.2±4.2), (13.8±1.5), (35.5±7.2) d],the incidence of feeding intolerance in the prevention group was lower too[ 17.6%(6/34) vs 35.3%( 12/34) ], there was significant difference (P < 0.05 ). Conclusion In 32-34 weeks' GA, low-dose erythromycin can be a safe and effective method to promote food tolerance in preterm infants, but not sure in 30-31 weeks' GA.
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In 48 postoperative cases using ear-clinoidal line positioning in radiofrequency thermocoagulation for treatment of trigeminal neuralgia,observing its recurrence and postoperative pain and complications in a five-year review. The successful rate of puncturing one time was 100%. Pain disappeared completely in 46 cases with one therapy. Two cases alleviated pain and decreased outbreak times. No recurrence and postoperative complications were observed. The vertical distance between the needle tip and the ear-clinoidal line were confirmed 8-10 mm in the third branch, 6-7 mm in the twice branch, 4-5 mm in the first branch. In order to avoid the first branch of trigeminal nerve injury, the vertical distance must be less than 6 mm, and the needle tip can not exceed ear-clinoidal line.
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Objective To establish the national standard materials for haemiglobincyanide (HiCN) for the traceability assays of hemoglobin. Methods HiCN national standard materials were established according to the document of International Committee for Standardization in Haematology (ICSH). The standard materials were certificated according to ISO Guide 35, including homogeneity and stability. Then they were characterized by the calibrated spectrophotometer which can be traceable to National Institute of Standards and Technology (NIST). The international reference materials of HiCN were compared with the result of the WHO reference laboratory to confirm the reliability. Results The uncertainty of the HiCN standard materials was 0.000 4 g/L and the variation coefficient (CV) was 0.09%. The uncertainty of long-term stability was 0.000 6 g/L; the certificated value of the standard materials was 0.615 9 g/L with uncertainty of 0.000 4 g/L. The combined uncertainty was 0.000 9 g/L and the expanded uncertainty was 0.001 8 g/L when the cover factor was 2. The relative error was 0.08% between the result of the standard materials and the international certificated value. Conclusion The homogeneity and stability of the standard material is acceptable and the method of characterization is accurate and reliable.
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A reference system for the completed blood count (CBC) have been established in National Center for Clinical Laboratory (NCCL) according to the standards published by International Council for Standardization in Hematology (ICSH) and International Organization for Standardization (ISO) in order to calibrate hematology analyzer.The contents of our study mainly include:(1)Establishment of calibration laboratory for CBC, which is the first calibration laboratory accepted by China National Accreditation Board for Laboratories in all medical laboratories.(2)We firstly set up the reference method for CBC in China. In addition, the data between NCCL and a foreign reference laboratory have been compared. (3)We have calibrated some instruments from routine laboratories by the fresh blood or calibrator valuated by the reference system, which acts as a new way to calibrate hematology analyzer.(4) A secondary standard assay system has been established and the data between it and the foreign reference laboratory have been compared chronically. The experience has been introduced to local laboratories in 26 provinces.(5) We have drafted out several documents about technical standard for laboratory medicine. The main institution of applications includes: local center for clinical laboratory, clinical laboratories for routine examination, institutions for identification to instruments and reagents, centers for disease control and prevention, and so on.