Relationship between blood indicators and course of nontraumatic osteonecrosis of femoral head in different stages:multiple logistic regression analysis / 中国组织工程研究

BACKGROUND:Up to now,there is no literature on the relationship between blood laboratory tests and the course of nontraumatic osteonecrosis of femoral head in different stages.It is necessary to further explore and analyze so as to better clarify the influencing factors of nontraumatic osteonecrosis of femoral head. OBJECTIVE:To analyze the relationship between blood laboratory indicators and the course of nontraumatic osteonecrosis of the femoral head by the Association Research Circulation Osseous(ARCO),thus exploring the influencing factors of blood laboratory indicators on the course of nontraumatic osteonecrosis of the femoral head. METHODS:This study used a retrospective study design.A total of 2 103 patients with osteonecrosis of the femoral head were retrieved from Wangjing Hospital of China Academy of Chinese Medical Sciences database,and 1 075 patients with nontraumatic osteonecrosis of the femoral head were ultimately included based on inclusion and exclusion criteria.Patient age,gender,body mass index,and blood laboratory test results were collected.Blood laboratory tests included low-density lipoprotein,total cholesterol,triglycerides,high-density lipoprotein,apolipoprotein β,apolipoprotein α1,uric acid,total protein quantitative,alkaline phosphatase,activated partial thromboplastin time,prothrombin time,prothrombin time International Normalized Ratio,prothrombin time activity,fibrinogen quantitative,coagulation time of thrombin,D-dimer,total iron binding capacity,and platelet count.The indicators of patients with different age groups and different ARCO stages were compared,and multiple Logistic regression analysis was applied to explore the influencing factors of ARCO stages in osteonecrosis of the femoral head. RESULTS AND CONCLUSION:(1)There were statistical differences in total cholesterol,uric acid,prothrombin time,prothrombin time International Normalized Ratio,and D-dimer among ARCO stages in the young group(P<0.05).Among young patients in ARCO stage II,total cholesterol levels were higher than those in ARCO stage III(P<0.05).Uric acid levels in ARCO stage IV were higher than those in ARCO stage II and III(P<0.05).Prothrombin time and prothrombin time International Normalized Ratio were shorter in ARCO stage IV and II than in ARCO stage III(P<0.05).D-dimer levels were higher in ARCO stage III and IV than in ARCO stage II(P<0.05).(2)There were statistically significant differences in high-density lipoprotein,coagulation time of thrombin,and D-dimer among ARCO stages in the middle-aged group(P<0.05).Among middle-aged patients in ARCO stage IV,high-density lipoprotein levels were higher than those in ARCO stages II and III(P<0.05).Coagulation time of thrombin was shorter in ARCO stage IV than in ARCO stage III(P<0.05).D-dimer levels were higher in ARCO stages IV than in ARCO stages II and III(P<0.05).(3)The uric acid,activated partial thromboplastin time,D-dimer,and platelet count in the elderly group showed statistically significant differences(P<0.05).The uric acid level in ARCO stage IV was higher than that in ARCO stage II and III patients in the elderly group(P<0.05),while the activated prothrombin time in ARCO stage II patients was shorter than that in ARCO stage III patients in the elderly group(P<0.05).The D-dimer level in ARCO stage III and IV patients was higher than that in ARCO stage II patients in the elderly group(P<0.05).The platelet count in ARCO stage IV was lower than that in ARCO stage III patients in the elderly group(P<0.05).(4)Multiple logistic regression analysis showed that total cholesterol and platelet count may be protective factors for course of nontraumatic osteonecrosis of the femoral head,while D-dimer,uric acid,overweight,and young and middle age may be risk factors for course of nontraumatic osteonecrosis of the femoral head.(5)It is indicated that total cholesterol,high-density lipoprotein,uric acid,prothrombin time,prothrombin time International Normalized Ratio,and D-dimer are statistically significant among patients with different ARCO stages.Total cholesterol and platelet count may be protective factors for the course of nontraumatic osteonecrosis of the femoral head,while D-dimer,uric acid,overweight,and middle-aged and young age groups may be hazard factors for the course of nontraumatic osteonecrosis of the femoral head.

Clinical characteristics of brucella bloodstream infection in patients of different age groups / 中华地方病学杂志

Objective:To study the clinical characteristics of patients with brucella bloodstream infection in different age groups, and provide a basis for clinicians to take targeted diagnosis and treatment measures. Methods:Demographic data and general condition (age, sex, occupation, location, onset season, source of infection, clinical stage), clinical characteristics (main clinical symptoms and complications), and laboratory test results (routine and pathogenic tests) of adult patients with brucella bloodstream infection admitted to the Affiliated Hospital of Chengde Medical College from January 2015 to January 2020 were collected. According to the age stratification standards recommended by the World Health Organization, the patients were divided into a young group (18 - 44 years old), a middle-aged group (45 - 59 years old), and an elderly group (≥60 years old), and various indicators among different age groups were compared and analyzed. Results:A total of 75 patients were included, including 15 cases (20.00%) in the young group, 37 cases (49.33%) in the middle-aged group, and 23 cases (30.67%) in the elderly group. Among them, 61 cases (81.33%) were males and 14 cases (18.67%) were females, with statistically significant differences in gender ratios among different age groups (χ 2 = 7.28, P = 0.021). The majority of patients were farmers (64 cases, 85.33%), and 92.00% (69/75) of the patients came from rural areas. The main sources of infection were infected cattle and sheep, and contaminated food (39 cases, 52.00%). The main season of onset was spring and summer (45 cases, 60.00%). The clinical staging was mainly in the acute phase (66 cases, 88.00%). In terms of clinical symptoms, the young group of patients had no symptoms of low back pain, while the incidence rates of low back pain in the middle-aged and elderly groups were 35.14% (13/37) and 30.43% (7/23), respectively. There was a statistically significant difference between the three groups (χ 2 = 6.98, P = 0.031). In terms of complications, there were no cases of concurrent spondylitis in the young group of patients. The incidence rates of spondylitis in the middle-aged and elderly groups were 32.43% (12/37) and 34.78% (8/23), respectively. There was a statistically significant difference among the three groups (χ 2 = 6.86, P = 0.032). In terms of routine laboratory examinations, there were statistically significant differences in the proportion of blood lymphocytes and albumin levels among patients of different age groups ( F = 3.41, 3.27, P = 0.038, 0.044). In terms of pathogenic examination, there was a statistically significant difference in the median alarm time for positive blood culture among patients of different age groups ( H = 9.54, P = 0.008), with the middle-aged group having the longest (66.24 h) and the elderly group having the shortest (58.80 h). Conclusions:The clinical characteristics of patients with brucella bloodstream infection vary among different age groups, middle-aged and elderly patients are prone to low back pain symptoms, accompanied by spondylitis. Clinicians should pay attention to the patient's own characteristics and provide targeted diagnosis and treatment.

Analysis of external quality assessment results of quality indicators for national emergency examination turnaround time / 中华检验医学杂志

Objective:To establish preliminary quality specifications for emergency examination turnaround time (TAT).Methods:The National Center for Clinical Laboratories organized 31 provinces (autonomous regions and municipalities directly) and Xinjiang production and Construction Corps centers to launch a synchronous Quality Indicators (QIs)-External Quality Assessment (EQA) program and the collected data were reported via developed online EQA system. The essential information of the clinical laboratories, the data of pre-examination and intra-laboratory TAT quality indicators of emergency departments at each specialty (biochemistry, automatic immunity, three routines tests and coagulation) and four specific tests (blood potassium, troponin I/T, white blood cell count and international normalized ratio (INR)) were collected from 2019 to 2021. TAT returned the median and 90th percentile ( P90) of the specified month were calculated. The median (lower quartile, upper quartile) of the TAT returned laboratories were calculated and second result grading statistics for 2021 (2 422 tertiary hospital and 5 088 secondary hospital) were performed to understand the difference of pre-examination and the laboratory TAT between different tertiary hospitals. Results:From 2019 to 2021, there were 9 540 laboratories, 9 709 laboratories and 10 653 returned laboratories. The pre-examination TAT of each specialty was similar, and the results were relatively stable. The median distribution was about 15 (10, 30) min, and the monthly P90 distribution was about 20 (10, 30) min. The distribution results of the median intra-laboratory TAT in each specialty were as follows: automatic immunity≥biochemistry>coagulation>three routine tests. The distribution of the latest (second result in 2021) survey results of each specialty were as follows: automatic immunity 53 (30, 60) min, biochemistry 45 (30, 60) min, coagulation 30 (23, 40) min, and three routine tests 20 (11, 30) min. The median results of monthly P90 of intra-laboratory TAT were as follows: 60 min for automatic immunity and biochemistry specialty, about 38 min for coagulation specialty, and about 27 min for three routines tests. The hierarchical statistical results showed that the monthly P90 distribution of laboratory TAT of the pre-examination and intra-laboratory TAT from the tertiary hospital was higher than that of the secondary hospital. The pre-examination TAT of each specialty of the tertiary hospital/secondary hospital was as follows: biochemistry 35 (22, 60)/20 (11, 30) min, automatic immunity 33 (20, 60)/20 (10, 30) min, three routine tests 30 (20, 49)/20 (10, 30) min and coagulation 31 (20, 58)/20 (10, 30) min, the intra-laboratory TAT of each specialty of the tertiary hospital/secondary hospital was as follows: biochemistry 65 (50, 91)/60 (40, 70) min, automatic immunity 75 (55, 113)/60 (40, 90) min, three routine tests 30 (23, 38)/28 (19, 30) min and coagulation 53 (36, 72)/35 (30, 57) min. In terms of the distribution results of the median of intra-laboratory TAT of the four specific tests, 96.76% (9 484/9 801) of the blood potassium and 95.96% (8 733/9 101) of the troponin I/T medical institutions were TAT within 69 min in the laboratories, 95.34% (9 679/10 152) of the white blood cell count medical institutions were TAT within 31 min in the laboratories, and 98.85% (9 462/9 572) of the INR medical institutions were TAT within 66 min in the laboratories. Conclusions:This survey provides a preliminary quality specification for the emergency department turnaround time at each specialty. Lower quartile, median and upper quartile of the monthly P90 at the tertiary and secondary hospitals can be used to define the best, appropriate and minimum performance levels, respectively.

Clinical manifestations and genetic mutation analysis of 20 patients with congenital Fibrinogen disorders / 中国输血杂志

【Objective】 To retrospectively analyze the clinical manifestations, related laboratory examinations and gene mutation of 20 patients with congenital Fibrinogen disorders (CFD) admitted to our hospital from February 2017 to December 2021, so as to improve the understanding of CFD diagnosis. 【Methods】 Clinical characteristics and laboratory examination of 20 CFD patients were collected, and common secondary hypoFibrinemia factors were excluded. Gene sequencing was performed on all exons and flanks of FGA, FGB and FGG genes of 20 patients to find gene mutation sites. The peripheral blood genomic DNA was collected from the family members of two CFD patients, and the genes of the corresponding mutation sites of the proband were detected. 【Results】 The 20 CFD patients had no history of bleeding; 11 female patients had no history of spontaneous abortion; all 20 patients had reduced Fib and prolonged thrombin time (TT). There were 13 gene mutations of different types in 20 patients, among which 90% (18/20) were missense mutations, 5% (1/20) was deletion mutation, and 5% (1/20) was frameshift mutation. Seven patients (35%) had Arg35His mutation at site 104 of the FGA chain, among which 3 new gene mutations have not been reported in China. 【Conclusion】 Most CFD patients with mild or asymptomatic symptoms can be diagnosed by genetic testing and screening. FGA chain Arg35His is a mutation hotspot in this region, and all of them are Uyghur. Whether the mutation of this site is related to ethnicity needs to be confirmed by further studies.

Research progress on laboratory examination index of clinical prognosis in individualization of cyclosporine A / 中国药房

Cyclosporine A is widely used in organ transplantation and autoimmune diseases . Due to the obvious differences in metabolism between individuals ，the dosage should be adjusted according to the patient ’s blood concentration during clinical use . But the blood concentration does not reflect accurately its clinical prognosis . This article focuses on the four laboratory examination indexes following aspects ：the cyclosporine A concentration of peripheral blood mononuclear cells ，calcineurin activity ，T cell function and metabolite concentration of cyclosporine A . The relationship between them and the pharmacokinetics of cyclosporine and clinical prognosis were reviewed . It’s found that the above indicators have a certain predictive effect on the clinical prognosis of patients receiving cyclosporine A ，which can make up for the insufficiency of blood drug concentration monitoring ，and the clinical practicability needs to be further improved .

Clinical evaluation on idiopathic pulmonary fibrosis / 中南大学学报(医学版)

Idiopathic pulmonary fibrosis (IPF) is a chronic fatal pulmonary disease characterized by complex illness condition. There is no effective treatment at present except lung transplantation. The comprehensive evaluation is helpful for the management of patients with IPF in hierarchical stages. Therefore, it is very important to evaluate IPF by various independent factors. At present, the commonly used methods for clinical evaluation on IPF include assessment of health-related quality of life, assessment of physiological function, assessment of imaging, assessment of laboratory examination, and multi-dimensional assessment system. However, there are different advantages and disadvantages on diverse evaluation methods for the evaluation of IPF.

False-Negative Results of Real-Time Reverse-Transcriptase Polymerase Chain Reaction for Severe Acute Respiratory Syndrome Coronavirus 2: Role of Deep-Learning-Based CT Diagnosis and Insights from Two Cases

The epidemic of 2019 novel coronavirus, later named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still gradually spreading worldwide. The nucleic acid test or genetic sequencing serves as the gold standard method for confirmation of infection, yet several recent studies have reported false-negative results of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR). Here, we report two representative false-negative cases and discuss the supplementary role of clinical data with rRT-PCR, including laboratory examination results and computed tomography features. Coinfection with SARS-COV-2 and other viruses has been discussed as well.

Pre-analytical variables evaluation in laboratory tests of patients attended at the Vitória da Conquista Central laboratory, Bahia, Brazil / Avaliação de variáveis pré-analíticas em exames laboratoriais de pacientes atendidos no Laboratório Central de Vitória da Conquista, Bahia, Brasil

ABSTRACT Introduction: Laboratory tests are intended to provide information necessary to clarify diagnoses or specific situations that cannot be elucidated by other means. Laboratory analyses are subject to several interferences. Even healthy individuals could suffer variations in laboratory tests due to biological factors, which may lead to misinterpretation of the results. Objective: Assess the pre-analytical variables in patients' laboratory tests at the Vitória da Conquista Central Laboratory, Bahia, Brazil. Material and method: This is a cross-sectional study with a descriptive approach and the use of a questionnaire as a research instrument. Data were collected through individual interviews, carried out at the laboratory. Results: The sample consisted of 425 patients, with female predominance (76.5%). Regarding patient instructions for laboratory tests, 94.6% had not been given any previous guidance, and 68.5% used some kind of medication, which could produce alterations in the exams. The use of the antihypertensive agents captopril, enalapril, hydrochlorothiazide or propranolol was associated with increased serum urea [odds ratio (OR) = 7.2, confidence interval (CI) = 95%, 1.87-27.58; p = 0.002], and smoking was associated with increased red blood cells count (OR = 3.7, CI = 95%, 0.86-15.75; p = 0.02). Conclusion: The findings indicate that pre-analytical variables remain an important focus for attention to the clinical laboratory. The correct data collection of patients' conditions is critical to support the post-analytical phase with useful information for the production of reliable exams and serve as a useful interpretation to diagnosis.

RESUMEN Introducción: Las pruebas de laboratorio tienen como objetivo proporcionar información necesaria a la aclaración de diagnósticos o situaciones específicas que no se pueden esclarecer por otros modos. Los análisis de laboratorio están sujetos a diversos interferentes. Incluso individuos sanos pueden presentar variaciones en las pruebas derivadas de factores que pueden crear equivocaciones en la interpretación de los resultados. Objetivo: Evaluar la influencia de variables preanalíticas en pruebas de laboratorio de pacientes atendidos en el Laboratório Central de Vitória da Conquista, Bahía, Brasil. Material y método: Estudio transversal con enfoque descriptivo y empleo de cuestionario como herramienta de investigación. Los datos fueron recogidos mediante entrevistas individuales, realizadas en el establecimiento investigado. Resultados: La muestra se compuso por 425 pacientes, con predominio de mujeres (76,5%). En cuanto a instrucciones para realización de las pruebas, el 94,6% de los pacientes no recibieron ningún tipo de orientación previa y el 68,5% utilizaban algún tipo de medicamento que puede producir alteraciones en pruebas. El uso de los antihipertensivos captopril, enalapril, hidroclorotiazida o propranolol estuvo asociado con el aumento de la urea sérica [oportunidad relativa (OR) = 7,2; intervalo de confianza (IC) = 95%, 1,87-27,58; p = 0,002]. El tabaquismo se ha asociado al aumento de eritrocitos (OR = 3,7; IC = 95%, 0,86-15,75; p = 0,02). Conclusión: Los hallazgos clínicos indican que variables preanalíticas son importante causa de atención para el laboratorio clínico. La correcta recogida de datos acerca de las condiciones de los pacientes es esencial para instrumentar la fase postanalítica con información relevante para la realización de pruebas fiables y que sean útiles para el proceso del diagnóstico.

RESUMO Introdução: Os exames laboratoriais têm como objetivo fornecer informações necessárias para o esclarecimento de diagnósticos ou situações específicas não passíveis de serem elucidadas por outros meios. As análises laboratoriais estão sujeitas a diversos interferentes. Mesmo indivíduos saudáveis podem apresentar variações nos exames decorrentes de fatores que podem gerar equívocos na interpretação dos resultados. Objetivos: Avaliar a influência de variáveis pré-analíticas em exames laboratoriais de pacientes atendidos no Laboratório Central do município de Vitória da Conquista, Bahia, Brasil. Material e método: Trata-se de um corte transversal com abordagem descritiva e utilização de questionário como instrumento de pesquisa. Os dados foram coletados por meio de entrevistas individuais, realizadas na instituição pesquisada. Resultados: A amostra foi composta por 425 pacientes, com predomínio de indivíduos do sexo feminino (76,5%). No que se refere a instruções para realização dos exames laboratoriais, 94,6% dos pacientes não receberam nenhum tipo de orientação prévia e 68,5% utilizavam algum tipo de medicamento que pode produzir alterações em exames. O uso dos anti-hipertensivos captopril, enalapril, hidroclorotiazida ou propranolol esteve associado ao aumento da ureia sérica [odds ratio (OR) = 7,2; intervalo de confiança (IC) = 95%, 1,87-27,58; p = 0,002]. O tabagismo associou-se ao aumento de eritrócitos (OR = 3,7; IC = 95%, 0,86-15,75; p = 0,02). Conclusão: Os achados indicam que variáveis pré-analíticas são importante fonte de atenção para o laboratório clínico. A correta coleta de dados acerca das condições dos pacientes é fundamental para instrumentar a fase pós-analítica com informações relevantes para a produção de exames fidedignos e que sejam úteis ao processo do diagnóstico.

Kennedy disease: A case report and a systemic review of research in China / 第二军医大学学报

Objective To report a case of Kennedy disease confirmed by gene diagnosis and to retrospectively reviewed the clinical features of genetically-confirmed patients with Kennedy disease in China. Methods The clinical data of this patient from our hospital were collected. Two electronic databases (Wanfang Data and CNKI) were searched using keywords “Kennedy disease” and “X-linked recessive hereditary amyotrophy of spinal cord and medulla oblongata” from Jan. 2007 to Dec. 2017. And a total of 63 articles (170 cases) were finally identified, including one case reported by us. The clinical data and biochemical indicators of Kennedy disease in China were summarized and analyzed. Results All the 170 patients were male. The average age of onset was (39.12±10.21) years old in 164 patients with described age of onset, mainly ranging 30-50 years old, and the average age of treatment was (48.04±8.94) years. We also noticed that the age of onset was negatively correlated with the number of CAG repeats in 161 patients (r＝－0.272, P＝0.001). In 170 Kennedy disease patients, the most common symptoms were proximal weakness of the lower extremities (93 cases, 54.71%), followed by weakness of limbs (38 cases, 22.35%). With the progression of the disease, 93 (54.71%) patients had breast development and/or decreased sexual function; and 143 (84.12%) patients had atrophy and fibrillation of tongue muscles, but no obvious drinking water choking was found in the literature. The main signs of lower motor neuron were mild muscle atrophy, fascicular fibrillation, mild muscle degeneration, especially the proximal limb, with diminished or disappeared tendon reflex. We also noticed that 91.18% (155/170) of the patients had increased creatine kinase. Some patients had diabetes, elevated blood lipids, thyroid dysfunction and/or mild liver dysfunction. Conclusion The diagnosis of suspected Kennedy disease patients can be confirmed by genetic tests with the deep understanding of the disease by physicians and the popularization of genetic examination, although there have been no effective methods for treatment of Kennedy disease.

Value of 18F-FDG PET-CT imaging features in the prognosis evaluation of newly diagnosed patients with multiple myeloma / 白血病·淋巴瘤

Objective To explore the relevance between 18F-FDG PET-CT imaging features and laboratory parameters of multiple myeloma (MM) and its prognostic value. Methods The clinical data of 75 MM patients who received 18F-FDG PET-CT examination at the time of initial diagnosis in Tianjin Medical University Cancer Institute & Hospital from September 2008 to August 2016 were retrospectively analyzed, including their clinical features, survival time, PET-CT imaging and laboratory results. The correlation between imaging changes and laboratory results was analyzed. Kaplan-Meier method and log-rank test were used to make survival analysis. Results Of 75 patients, there were 48 patients (64.0%) who had lytic bone lesions everywhere of the bodies, especially in axial skeleton. Twenty-six patients (34.7%) had pathological fracture, which were either rib or spinal pathologic fracture. PET-CT at initial diagnosis showed that the osteolytic lesions were associated with anemia (χ2＝ 0.455, P ＝ 0.032), while pathological fractures were associated with C-reactive protein levels (χ 2 ＝ 0.976, P ＝ 0.007). The existence of pathologic fracture or lytic bone lesions showed no relevance to abnormal cytogenetics, extramedullary lesion, lactic dehydrogenase, albumin or β2-macroglobulin (β2-MG) levels as well as the survival time (all P＞0.05). Twenty-eight patients (37.3%) with

Brucellosis: clinical analysis of 35 cases / 中华地方病学杂志

Objective To analyze the clinical and laboratory data of brucellosis patients in Peking University Third Hospital,and to promote clinician's understanding and diagnosis and treatment of brucellosis,and to reduce misdiagnosis and missed diagnosis.Methods The clinical characteristics of patients with acute brucellosis in Peking University Third Hospital from January 1994 to December 2016 were retrospectively analyzed,including departments division,demographic characteristics,epidemiology,clinical manifestation,laboratory examination,diagnosis and treatment.Results There were 35 patients,27 males and 8 females,with an average age of (46 ± 14) years.Patients with brucellosis were distributed in multiple departments of the hospital.There were 23 cases (65.7％) whose occupation were farmers or herdsmen,and 13 cases (37.1％) that lived in the outer suburbs of Beijing,and 19 cases in other provinces (54.3％).There were 18 cases having sheep (cattle) and pig contact history (51.4％).The main symptoms were fever in 35 cases (100.0％),the highest temperature was (39.42 ± 0.66)℃,other symptoms including muscle and joint pain (22,62.9％),fatigue (16,45.7％),sweating (13,37.1％),hepatosplenomegaly (15,42.9％) and lymphadenopathy (13,37.1％).The positive rate of serum agglutination test was 62.9％ (22/35),and the positive rate of blood culture was 65.7％ (23/35).The course of disease was more than 30 d in 24 cases (68.6％).Multi-drug treatment was common before diagnosis;the cases were treated with doxycycline and rifampicin based,combined quinolone/ceftriaxone two,triple and quadruple therapy.After treatment for 4 days (1-6 days),the body temperature was returned to normal and the total course of treatment was 4 months (2-12 months).Twenty-five patients were followed up,and 23 cases had no recurrence.Conclusions In general hospital,brucellosis patients distributed in a number of departments,the conditions are relatively complex,a considerable number of patients do not have a clear epidemiological history,lack of specific clinical manifestations,the process of diagnosis and treatment is tortuous,and easily misdiagnosed.Doctors' understanding of brucellosis needs to be improved,in order to improve their level of diagnosis and treatment.

Application of LIS management group in hospital software and hardware management / 医疗卫生装备

Objective To explore the application of LIS management group in hospital software and hardware management.Methods The objective,responsibilities and management procedure of hospital LIS management group were introduced,and its effects were studied in hospital software and hardware management.Results Hospital LIS management group optimized LIS management procedure,decreased fault rate and shortened the time for fault handling.Conclusion LIS management group promotes hospital digitalization and clinical laboratory department management.

Epidemiologic features and laboratory findings of acute and chronic brucellosis / 中华临床感染病杂志

Objective To analyze the epidemiologic features and laboratory findings of acute and chronic brucellosis.Methods Two hundred and ninety-two patients with brucellosis admitted in Heilongjiang Agricultural Reclamation Bureau General Hospital during June 2015 to February 2017 were retrospectively reviewed,including 170 acute cases and 122 chronic cases;95 healthy subjects undergoing health check-up at the same period were randomly selected as control group.Epidemiological characteristics,clinical symptoms and findings of laboratory tests of acute and chronic brucellosis were analyzed with SPSS 18.0 software.Results The male to female ratio were 3.15 to 1 and 3.21 to 1 for acute and chronic brucellosis,respectively.The patients were mainly rural residents (74.12％ and 77.05％) and the majority of them were farmers (62.94％ and 66.39％).The onset time was mainly from March to June of the year (47.06％ and 46.72％).The proportion of acute brucellosis patients ≤ 14 years was higher than that of chronic brucellosis group (x2 =5.022,P ＜ 0.05);the proportion of acute brucellosis patients ＞ 64 years old was lower than that of chronic brucellosis group (x2 =3.900,P ＜ 0.05).The symptom of sweating and myosalgia in acute brucellosis was more frequent than that in chronic brucellosis (x2 =10.764 and 10.479,both P ＜ 0.01);while the symptom of weakness in chronic brucellosis was higher than that in acute brucellosis (x2 =5.347,P ＜ 0.05).The AST,ALT,γ-GT,ALP,LDH and HBDH levels in patients with acute and chronic brucellosis were significantly higher than those in the control group (t =3.602 and 5.205;2.529 and 2.682;2.669 and 1.941;5.169 and 7.068;3.601 and 2.240;3.469 and 3.954;P ＜ 0.05 or 0.01);while TP and ALB levels were reduced (t =-5.880 and-8.923;-8.106 and-8.774;all P ＜ 0.01).The CRP in the acute brucellosis group was significantly higher than that in the chronic brucellosis group (t =6.717,P ＜0.01).The therapeutic regimes for acute brucellosis and chronic brucellosis were same,the symptoms dissolved after successful treatment.Conclusion There are different clinical manifestations between acute and chronic brucellosis.Medication for brucellosis should be cautious and the changes of myocardial enzymes should be monitored.

Design and application of remote printing mode of hospital clinical report / 医疗卫生装备

Objective To propose a remote printing mode for hospital clinical report to enhance the efficiency of clinical staffs.Methods A function module for report export was developed based on scheme demonstration,and the obstacles between internal and external networks were eliminated.Results The mode had the clinical requirements satisfied,medical errors avoided and medical cost saved.Conclusion The mode can be implemented in some hospital with multi sections and ununified information systems,and thus has practical values.

Study on value range of urine analyzer quality control / 医疗卫生装备

Objective To study the reference range of the urine analyzer and the target value of the common quality control object.Methods The reference ranges of urine analyzer test items from different mnanufacturers were investigated,and laboratory bias proportion was used as an indicator of the evaluation of the target value scheme.EQA raw data of Guangxi clinical examination center in 2014 were analyzed.Results The target value ranges of pH,specific gravity,bilirubin and nitrite were found reliable,while the ones for WBC,URO,RBC,ketone body,glucose and protein needed improving.Conclusion The target values and evaluation indexes of EQA have to be reselected for mutual recognition of the results.

Laboratory analysis in patients with severe acute respiratory syndrome after ten years of convalescence in Tianjin / 天津医药

Objective To investigate the changes of blood test indexes in patients with severe acute respiratory syndrome (SARS) after 10 years of rehabilitation, and to evaluate the effects of SARS on blood system. Methods Twenty-five cases of SARS confirmed in our hospital (SARS group) and 25 healthy personnel (control group) were included in this study. Values of blood routine test, liver and kidney function, blood lipids, blood glucose, thyroid function, tumor marker and T cell subset index were compared between two groups. Results The serum level of calcium was higher in SARS group than that of control group (mmol/L:2.32 ± 0.08 vs. 2.29 ± 0.08,t=2.072,P<0.05). The level of thyroxine was also higher in SARS group than that of control group (nmol/L: 119.95 ± 29.09 vs. 96.39 ± 14.26, t=3.681,P<0.05), but the results were in the normal range, there was no clinical significance. The level of neuron specific enolase (NSE) was higher in SARS group than that of control group (μg/L, 10.368 ± 3.684 vs. 3.282 ± 1.828, t=9.012, P<0.05), in which only 2 cases were slightly higher than the normal range, but did not exceed more than 1 times of the normal value. The imaging was only part of the old change, and there was no clinical significance. There were no significant differences in other results between two groups. Conclusion Virus of SARS cause no long-term effects on blood system, liver and kidney function, thyroid function and immunity in patients with SARS, and do not increase the probability of cancer.

Brucellosis the characteristics of clinical manifestation and laboratory examination of change / 中国医师杂志

Objective To explore clinical manifestation and laboratory examination of brucellosis change characteristics.Methods Selection in January 2014 to December 2014 admitted during the period of 100 cases patients with brucellosis as the research object,with the method of retrospective analysis to an-alyze the data of all patients were analyzed and summarized,and on this basis,summarizes the characteris-tics of these changes.Results The incidence of brucellosis in the countryside and unexplained transmis-sion rates rise more apparent,clinical irregular fever,adopt the way of combination treatment,the effect was relatively good.Conclusions The clinical manifestations of brucellosis is relative to the diversity of the attending physician to strengthen the understanding of the disease,is the key to reduce the incidence of mis-diagnosis,adhere to the specification of antimicrobial therapy is the basic requirement of treatment.

Laboratory examination of invasive fungal disease in children and its evaluation / 中国小儿急救医学

Pediatric invasive fungal disease( IFD)often lacks characteristic clinical manifestations and imaging changes. It is a severe disease in ICU and is unlikely to be diagnosed early. The diagnosis of IFD is typically based on laboratory tests targeting at the population at risk. The laboratory tests for IFD generally include direct tests( smear microscopy,fungal culture,histopathologic examination,etc. ),serologic tests( tests for 1,3-β-D dextran and galactomannan,etc. ),and certain progresses have been made in molecular biologi-cal tests in recent years. It is key to diagnosis of IFD to use laboratory tests rationally and accurately interpret the laboratory results.

Laboratory examination of autoimmune and autoinflammatory diseases / 中华实用儿科临床杂志

Autoimmune disease is an own organization inflammatory lesions,mainly caused by destroying the adaptive immune tolerance mechanism of differentiatingself andnon-self,whose character is appearing the autoantibodies and self-reactive T cells in the body.Autoinflammatory disease is a group of genetic,recurrent and noninvasive inflammatory disease,whose characteristics are fever,rash,joint pain,arthritis,ophthalmic pathological changes and increasing of acute phase proteins,and it can affect many organ systems.These diseases are different in the mode of onset and clinical manifestations,but also can have similar and overlapped symptoms and signs,and often confused with other systemic diseases.Therefore,clinical misdiagnoses or missed diagnoses easily occur.To understand correctly and master the laboratory examination characteristics and its clinical is essential,which has significant value in the clinical diagnosis,differential diagnosis,evaluation and treatment of these diseases.

Analysis of clinical features of brucellosis complicated with nervous system damage / 中华地方病学杂志

Objective To evaluate the clinical features of central nervous system involvement in brucellosis,and to provide references for clinical treatment and diagnosis.Methods A retrospective review was carried out in 14 hospitalized patients who were diagnosed as neurobrucellosis from October 2008 to September 2011 at the First Hospital of Jilin University.Patients' clinical manifestation,pathogen characteristics,cerebrospinal fluid analysis and imaging data were recorded.Results Among the 14 cases of patients with neurobrucellosis,10 cases had the clinical manifestations of headache and vomiting,11 cases meningeal irritation,2 cases dysphoria and seizures,3 cases apathia,3 cases coma,3 cases positive pathological sign,and 2 cases lower extremities weakness.From the perspective of clinical diagnosis of 14 patients with neurobrucellosis,4 cases were meningitis,of which,meningitis with both lower extremities paralysis were 2 cases; encephalitis in 2 cases; meningoencephalitis in 6 cases; abducent paralysis,decreased vision,myelitis and ataxic gait in 1 case,respectively.All patients were in acute phase and had irregular fever.After combination therapy with antibiotics for 2 to 9 days,body temperature of all patients returned to normal,and they were discharged from the hospital after 1 to 2 weeks.All cases were followed up for 12 months,finding no sequelae.Conclusions Due to the diversity of central nervous system involvement in brucellosis,in case of a patient with long-term fever and neurological symptoms,medical and epidemiological history should be inquired and diagnosis would be made easy based on combination of cerebrospinal fluid with laboratory tests.Early treatment of acute neurological brucellosis has showed a good prognosis.