The clinical application of artificial intelligence assisted blood cell morphological examination should be promoted and expanded / 中华检验医学杂志

Morphological examination of blood cells is an important re-examination method of blood cell analysis, and it is also the basis of diagnosis of hematological diseases with cytopathic changes. Artificial intelligence assisted blood cell morphological examinationcan effectively make up for the shortcomings of artificial microscope examination methods, greatly improve the working efficiency of cell morphological examination, solve the problems of manpower shortage and labor intensity to a great extent, obviously improve the repeatability of examination results, facilitate the review of the examination results, and realize remote blood cell morphological examination and diagnosis online. However, at present, the main method of blood cell morphological examination in China is still manual microscope examination. In order to promote and expand the clinical application of artificial intelligence-assisted blood cell morphological examination, the R&D manufacturers and clinical laboratory experts of automatic blood cell morphological analyzer should work together to promote the standardization of automatic blood cell morphological analysis, strengthen its performance evaluation and verification, continuously improve its analytical performance, expand its clinical application scope, and promote the construction of blood cell morphological database in China.

Progress of hypertension pharmacological treatment / 中国临床药理学与治疗学

Hypertension is a common cardiovascular disease. Chinese guidelines for the management of hypertension, the global practice guidelines for hypertension of the International Hypertension Society (ISH) and the guidelines for the treatment of adult hypertension drugs of the World Health Organization have been issued successively, which play an important role in guiding the clinical medication of hypertension. Calcium channel blockers (CCB), angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), angiotensin receptor neprilysin inhibitor (ARNI), thiazide diuretics and β-receptor blockers are commonly used in clinical antihypertensive drugs. The goal of hypertension drug control, the application timing of hypertension drugs, the selection of combined medication scheme, the drug selection of hypertension complicated with other diseases, and the medication of gestational hypertension are all problems that clinicians need to master.

Thinking and prospect of the application of flow cytometry in laboratory testing of chimeric antigen receptor T cell immunotherapy / 中华检验医学杂志

Chimeric antigen receptor (CAR)-T cell immunotherapy is one of the most remarkable achievements in the field of cancer therapy for the past few years. Flow cytometry (FCM) plays an important role in the design and construction of CAR-T cells, patient enrollment, performance test of CAR-T products, evaluation of post-treatment efficacy and immune function, exploration of relapse mechanism, and selection of subsequent treatment. In order to further promote and standardize the application of FCM in laboratory testing related to CAR-T cell immunotherapy, the special issue on "Application and Research Progress of flow cytometry in CAR-T cell immunotherapy" were organized by The Chinese Journal of Laboratory Medicine. A number of articles related to this topic were published, which covered expert consensus, continuing education, expert review, detection of minimal residual disease, immune function, and cytokine detection. We intend to promote the standardization of FCM in CAR-T cell immunotherapy and provide greater assistance for clinical application.

Thinking of flow cytometry in the diagnosis and treatment of tumors of hematopoietic and lymphoid tissues / 中华检验医学杂志

Flow cytometry (FCM) plays an important role in clinical diagnosis and immune function evaluation. In recent years, with the progress of instruments, antibody, immunity, diagnosis and treatment technology, the clinical application of FCM is more and more extensive. Aiming to promote the standardization and further development of FCM,combined with several reports in the topic "Application of flow cytometry in the diagnosis and treatment of tumors of hematopoietic and lymphoid tissues", the paper reviews and comments in the application of FCM in acute leukemia immunophenotyping, detection of minimal residual disease, diagnosis and follow-up of lymphoma, detection of complications after transplantation, immune function and immune reconstruction after transplantation, quality control, and the prospect of FCM.

Preliminary establishment of reference interval for non-fasting serum triglycerides among healthy middle-aged and elderly people in some communities Beijing / 中华检验医学杂志

Objective:To establish the reference interval of serum triglyceride (TG) for 4 hours after meal in healthy middle and old people of Beijing community, and to provide the diagnostic basis for the judgment of dyslipidemia after meal.Methods:Selected 369 elderly people from January to October 2018 in the health examination of Guang′anmen Hospital of the Chinese Academy of Traditional Chinese Medicine. The subjects collected fasting venous blood samples in the morning the next day after fasting for 12 hours, then ate a standard breakfast that conformed to the local dietary habits, and collected venous blood samples again 4 hours after eating. Serum TG levels were measured 4 h after meal using AU5822 fully automatic biochemical analyzer and matching reagents. The comparison of postprandial TG between different age and sex groups was statistically significant using the nonparametric test of two independent samples, and the comparison between postprandial and fasting TG using the nonparametric test of two paired samples with P<0.05 as the difference. The 95% confidence interval was calculated using a nonparametric method according to the relevant requirements of the CLSI EP28-A3c file, and the reference interval was expressed as P2.5, P97.5. Results:The median 4-hour post-prandial TG of the middle-aged and elderly aged 45-59 years and those aged ≥ 60 years at health checkups were 1.65 (1.25, 2.13) mmol/L and 1.58 (1.25, 2.00) mmol/L, there was no significant difference between the two groups ( Z=-1.040, P>0.05). There was no statistical difference between males 1.69 (1.22, 2.31) mmol/L and females 1.63 (1.26, 2.12) mmol/L at 4 hours postprandial TG levels in the 45-59 year-old group ( Z=-0.179, P>0.05),there was also no statistical difference between 1.64 (1.22, 2.06) mmol/L for men and 1.53 (1.28, 1.99) mmol/L for women aged 60 years or older ( Z=-0.256, P>0.05).Compared with the median fasting TG of 1.05 (0.87, 1.29) mmol/L, the median serum TG of 1.61 (1.25, 2.09) mmol/L at 4 hours after meal was significantly increased ( Z=-16.449, P<0.01). The difference between postprandial and fasting was 0.52 (0.30, 0.85) mmol/L.The reference range of serum TG at 4 hours after meal was 0.82 to 3.02 mmol/L. Conclusion:In this study, the reference range of serum triglycerides for 4 hours after meal was established in some healthy elderly population groups in Beijing.

Animal models of Klebsiella Pneumonia infection and their applications in anti-infection of Chinese traditional medicine / 国际检验医学杂志

Klebsiella pneumoniae is one of the most common bacteria in nosocomial infections, and the second pathogen in bloodstream infections and urinary tract infections.In recent years, the emergence of Carbapenem-Resistant Klebsiella Pneumonia has become the focus in the field of anti-infection.At present, the treatment of Carbapenem-Resistant Klebsiella Pneumonia is mainly combined drug use, but which exists possible drawbacks including many side effects, higher cost, and more serious drug resistance and so on.With the increasing attention of the therapeutic effect, Chinese traditional medicine begins to come into researchers′sight as an alternative therapy or combination of traditional Chinese and Western medicine.Therefore, animal models used to evaluate the efficacy of drugs have been attracted wide attention.This article reviews animal models of Klebsiella Pneumonia infection and their applications in anti-infection of Chinese traditional medicine.

Some understanding on improving the skill and disense diagnosis ability red blood cell morphology test / 中华检验医学杂志

As the reference method, microscopic examination is still the most basic method of red cell morphology examination.There are several ways to improve the laboratory personnel's skill and ability on abnormal erythrocyte morphology diagnosis, including deep understanding of pathological mechanisms of abnormal red cell morphology, raising the ability of recognizing abnormal red blood cell that are of great clinical value, following and implementing rules to ensure the accuracy and repeatability of the examinations, standardizing reports of abnormal erythrocyte morphology.

Isolation and Identification of L·adecarboxylata Producing IMP-1 Metallo-beta-lactamase / 现代检验医学杂志

Objective To investigate the phenotype and genotype in a carbapenem resistant L.adecarboxylata strain.Methods Microbial identification and drug susceptibility test was done with VITEK II Compact.Carbapenemases genes were detec-ted by PCR methods.Results The strain of carbapenem resistant L.adecarboxylata produced IMP-1 carbapenemase.Con-clusion L.adecarboxylata was found only rarely in the clinical isolates.This was the first Isolate of L.adecarboxylata pro-ducing IMP-1 metallo-beta-lactamase.

Ratio analysis of ERβ isoforms in paired cancerous and adjacent normal breast tissues / 肿瘤研究与临床

Objective To illustrate the composition ratio of ERβ isoforms in paired cancerous and adjacent normal tissues from breast cancer patients.Methods Eighty-seven pairs of cancerous and adjacent normal tissues were obtained from breast cancer patients.RT-qPCR was used to determine the relative mRNA expression levels of ERβ isoforms (ER[β1,ERβ2 and ERβ5),and the composition ratios of ERβ isoforms were analyzed.Results The expression levels of all tested ERβ isoforms (ERβ1,ERβ2 and ERβ5) in breast cancer tissues were much lower than those in adjacent normal breast tissues (P ＜ 0.01).Isoform ratio analysis showed that ERβ5 was the dominant isoform in both cancerous and adjacent normal tissues with a positive detection rate of 54.02 ％ and 75.84 ％,respectively.Meanwhile,ERβ1 had the lowest detection rate (9.74 ％ and 6.77 ％ in cancerous and adjacent normal tissues,respectively).The positive rates for both ERβ1 and ERβ2 were much lower in adjacent normal tissues than those in cancer tissues (Z =-2.24,P =0.025 and Z =-4.85,P ＜ 0.01,separately),while more cancerous tissues were ERβ5-positive in comparison to adjacent normal tissues (Z =-5.32,P ＜ 0.01).Conclusions The expression levels of all the ERβ isoforms are differentially down-regulated with significant alterations in their composition ratios during breast carcinogenesis.Further understanding on molecular mechanisms underlying the differential down-regulation of ER[β isoforms will shed new light on breast carcinogenesis.

The signification and method of HBeAg gray zone setting and its cut-off verification in chemiluminescent assay / 中华检验医学杂志

Objective To explore the signification and method of Cut-off verification and gray zone setting in chemiluminescent assay.Methods NCCLS EP-12 A2 document defines that C50 is the analyte concentration of cut off value for immunology qualitative test and C5-C95 interval is the range of analyte concentration that yields 5％ positive results to 95％ positive results for immunology qualitativc test.The C50 and C5-C95 interval of HBeAg in ARCHITECT i2000 were worked out according to the cut off value provided by HBeAg reagent calibrated in ARCHITECT i2000,which were verified to approve the character declaimed by manufactory or not.Gray zone was set and the procedure of cut off verification and gray zone set in chemiluminescent were built; A set of quality control was detected 20 times with two different lot HBeAg reagent kits,S/CO was caculated and compared with t test.Results C50 and C5-C95 interval of reagent (lot 06087L100,96378HN00) were 0.171 PEI U/ml,0.125 PEI U/ml; ＞0.154 PEI U/ml to 0.188 PEI U/ml,0.119 PEI U/ml to ＜0.150 PEI U/ml,respectively.S/CO of negative quality control and positive quality control were (0.550 ±0.038),(2.422 ±0.084) and(0.334 ±0.063),(3.587 ±0.321),respectively.They all approved the character (the sensitivity at cut off was less than 0.5 PEI U/ml)declaimed by manufactory,and the results of S/CO between two lot kits were obvious difference (t =9.944,15.499,P ＜0.01).Conclusion C50 and C5-95 interval can be used to verify cut off value and set gray zone in chemiluminescent assay;They may vary in different lot reagents and they must be verified to approve the character declaimed by manufactory.

The laboratory diagnosis of thalassemia:selection and evaluation of tests and methods / 中华检验医学杂志

The incidence of α-thalassemia and β-thalassemia is high in Guangxi,Guangdong,Sichuan and other province in China.Because no effective approach to thalassemia treatment could be used clinically now,the most cost-effective strategy to control this disease is to prevent the birth of babies with severe form of thalassemia.It is important to make effective screening and correct diagnosis of thalassemia by laboratory test.Laboratory diagnosis of thalassemia includes routine diagnosis and genetic diagnosis.The laboratory routine tests are some hematology examination,comprising red blood cell indices,erythrocyte osmotic fragility test,hemoglobin analysis,and others.Anyone alone of these laboratory parameters can not be used to diagnose the carrier of thalassemia.It is necessary to combine these tests to make screening diagnosis.The final diagnosis of thalassemia need to perform the gene mutation examination or globin train analysis.Technologies for gene mutation detection have been the main and gold standand method of diagnosing thalassemia now.

The progression of laboratory diagnosis for urinary tract infection / 中华检验医学杂志

Urinary tract infection (UTI)is a commonly encountered disease during routine clinical care. In the mean time, it is also a commonly encountered hospital acquired infection. UTI possesses various clinical symptoms, and usually the symptoms are atypical. The detection of leukocyturia and bacteriuria is an essential index for screening and confirmatory diagnosis of UTI. This article summarized the pathogenesis of UTI, diagnostic criteria, clinical significance and application evaluation of detection of the WBC and bacteria in urine.

Evaluation of urine analysis by flow cytometry and strip test in diagnosing urinary tract infection / 中华检验医学杂志

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.