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Objective To construct a rapid identification method of bacteria in clinical plcural and peritoneal effusion by using matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI TOF MS) combined with short-term culturing.Methods A total of 360 samples of bacterial pleural and peritoneal effusion were collected,including 163 plcural effusion and 197 ascites.Each sample was divided into three parts.One was used for routine culturing and identification,the second was directly identified by MALDI-TOF MS after centrifugal washing,the last was short term culturled for 2 hours mixed with nutrient broth,then identified by MALDI-TOF MS after centrifugal washing.The identification efficiency of MALDI TOF MS combined with short-term culture method for clinical pleural and peritoneal effusion of pathogenic bacteria was evaluated by using microbial identification instrument as a gold standard.Results The correct detected rates of MALDI-TOF MS combined with short term culture method were 94.5％ and 90.9％ in the two kinds of samples,while the undetected rate was only 7.5％.The coincidence rate between identification results of single bacterial growth samples and the con ventional method was 94.1 ％.The predominant bacteria could be accurately identified from samples grown with mixed bac teria.Conclusion After short-term cultured,MALDI TOF MS has a high detection rate,and the result was reliable.The time required for this method was shortened by at least 12 hours compared with hydrothorax and ascitcs routine colturing.It could provide accurate and rapid reports of pathogenic bacteria for the clinical.
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Objective To explore the clinical application of humoral mode of the Sysmex XE-5000 automatic blood cell analyzer in the count and differential count of hydrothorax and ascites white blood cell(WBC).Methods The 196 clinical specimens of hy-drothorax and ascites from the hospitalized patients were collected and conducted the WBC count and differential count by the hu-moral mode of the Sysmex XE-5000 automatic blood analyzer (streaming technology with semiconductor laser-instrument method) and the artificial microscope counting method (manual method).The specimens were divided into two groups according to the in-strument counting results,the group A:(0 -1 500)× 106/L and the group B:>1 500 ×10 6/L and the correlation between two methods was analyzed.Results The data analysis demonstrated that the two kinds of methods for detecting the WBC count and dif-ferential count of hydrothorax and ascites had good correlation,and the difference had no statistical significance (P >0.05).Conclu-sion The humoral mode of the Sysmex XE-5000 automatic blood cell analyzer has a good application value for detecting WBC count and differential count of hydrothorax and ascites.
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Objective To investigate the clinical application value of the determination of carcinoembryonic antigen (CEA),car-bohydrate antigen 125 (CA125)and lactate dehydrogenase (LDH)in the differential diagnosis of malignant hydrothorax and asci-tes.Methods The Beckmancoulter ACCESS2 automatic micro particle chemiluminescence immunoassay analyzer was adopted to determine the CEA and CA125 levels in hydrothorax and ascites,and the Roche C501 automatic biochemical analyzer was used to determine the LDH level in hydrothorax and ascites.The clinical application value of these three indicators in the evaluation of be-nign and malignant hydrothorax and ascites was evaluated.Results The differences in the expression levels of CEA,CA125 and LDH between benign and malignant hydrothorax and ascites had statistical significance (P <0.01 );the positive rate of CEA, CA125 and LDH in malignant hydrothorax and ascites were 84.21%,92.98%,75.44%.Conclusion The combined detection of CEA,CA125 and LDH has an important value in differential diagnosis of benign and malignant hydrothorax and ascites.
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To study the value of high-fluorescent cell for the screening of malignant hydrothorax or ascites. The clinical diagnosis results and hydrothorax or ascites specimens of 400 outpatients registered from January to December in 2014 were collected, and high-fluorescent cells were counted with Sysmex XE-5000 blood cell analyzer, and then stained for microscopy. Receiver operating characteristic (ROC) curve was used to explore the sensitivity, speci-ficity, positive likelihood ratio and negative likelihood ratio of high-fluorescent cell for screening malignant hydrothorax or ascites. The numbers of high-fluorescent cells of the cancer patients were significantly higher than those of the non-cancer patients, with Z equal to -7.372 and P less than 0.05. The values of the area under curve (AUC), sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 0.801, 70.67%, 84.31%, 4.50 and 0.35 respective-ly. Detection of high-fluorescent may be used to screen malignant hydrothorax or ascites, and further exami-nation and follow-up have to be performed in case the number of high-fluorescent cells in the hydrothorax or ascites is not less than 68.