Value of the biomarkers derived from cerebrospinal fluid in the diagnosis of Alzheimer disease / 中华检验医学杂志

Alzheimer disease (AD) is a neurodegenerative disease in the elderly. Early intervention is the only reliable means to delay the progress of the disease. Referring to the diagnostic criteria of AD, this paper summarizes and analyzes the representative literatures of various AD biomarkers derived from cerebrospinal fluid in recent years, and reviews the efficacy of various cerebrospinal fluid biomarkers in the diagnosis and differential diagnosis of AD. Results show that CSF Aβ42, Aβ42/Aβ40, T-tau, p-tau, Aβ42/p-tau, growth-associated protein 43, synaptosomal-associated protein 25, neurogranin and visinin-like protein-1 are of great value in the diagnosis and differential diagnosis of AD. The above CSF biomarkers can be used in the diagnosis and differential diagnosis of AD. The laboratory should select appropriate AD CSF biomarkers according to its own conditions in daily laboratory works.

Reconceptualization of the value of blood markers for the diagnosis of Alzheimer disease / 中华检验医学杂志

Alzheimer disease (AD) is the most common cause of dementia, and its early diagnosis is of great importance to delay the disease and improve the prognosis. Compared with cerebrospinal fluid, blood tests have the advantages of being less invasive and easier to obtain. In recent years, with the application of ultrasensitive detection technology, the diagnostic value of blood markers for AD has been continuously explored, which is expected to provide more direct and effective evidence for early diagnosis and early intervention of AD.

Preliminary study on the changes of Pole2 expression in the lymphocytes with aging as well as in the age-related diseases / 中华检验医学杂志

Objective:To explore the age-related changes of Pole2 expression levels in peripheral blood lymphocytes of healthy people, and analyze the differences of Pole2 expression levels in peripheral blood lymphocytes of four common senile disease patients between normal peers.Methods:Healthy people and patients in the physical examination center of Xuanwu Hospital of Capital Medical University from December 2018 to December 2019 were selected as the research objects, the mRNA and protein level of Pole2 in heathy individual as 20-29,30-39,40-49,50-59,60-69,70-79 y were checked by RT-PCR and Western blot,and the age-related curve was drew. The mRNA and protein expression levels of Pole2 were also detected in the peripheral blood lymphocytes of patients of DM,CHD,AD,CVD. And the deviation with healthy people of the same age was analyzed from one way ANOVA and repeated measurement were used to compare the mean of multiple groups.Results:The mRNA and protein levels of Pole2 increased in the lymphocytes of healthy people at 20-29 y and 50-59 y grouy, and decreased after 60-69 y and 70-79 y ( P<0.001). The Pole2 levels of mRNA and protein in the lymphocytes of patients of CHD,AD,DM and CVD cerebral atherosclerosis were significantly higher than that of healthy people of the same age. Moreover, the Pole2 level of lymphocytes of AD patients was significantly higher than that of other patient groups ( P<0.001). Conclusion:The expression level of Pole2 in peripheral blood lymphocytes increases with age before the age of 60 years old and decreases with age after 60 years old ;and the expression in four common senile diseases was higher than that in normal people.

Chemical screen identifies a geroprotective role of quercetin in premature aging

Aging increases the risk of various diseases. The main goal of aging research is to find therapies that attenuate aging and alleviate aging-related diseases. In this study, we screened a natural product library for geroprotective compounds using Werner syndrome (WS) human mesenchymal stem cells (hMSCs), a premature aging model that we recently established. Ten candidate compounds were identified and quercetin was investigated in detail due to its leading effects. Mechanistic studies revealed that quercetin alleviated senescence via the enhancement of cell proliferation and restoration of heterochromatin architecture in WS hMSCs. RNA-sequencing analysis revealed the transcriptional commonalities and differences in the geroprotective effects by quercetin and Vitamin C. Besides WS hMSCs, quercetin also attenuated cellular senescence in Hutchinson-Gilford progeria syndrome (HGPS) and physiological-aging hMSCs. Taken together, our study identifies quercetin as a geroprotective agent against accelerated and natural aging in hMSCs, providing a potential therapeutic intervention for treating age-associated disorders.

Clinical value of polymerase chain reaction in diagnosis of bacterial and fungal infection of central nervous system / 中国感染与化疗杂志

Objective To examine the clinical value of polymerase chain reaction (PCR) in rapid diagnosis of bacterial and fungal infection of central nervous system.Methods The cerebrospinal fluid (CSF) samples were collected from 137 patients for DNA extraction.PCR was used to amplify the DNA of pathogenic bacteria and fungi using universal primers.The PCR products were subjected to DNA sequencing analysis for identifying microbial species.The conventional culture of pathogens was carried out simultaneously as control.Results PCR revealed bacterial pathogen in 50 of the 137 CSF samples,fungal pathogen in 6 of the 137 CSF samples.Conventional culture of CSF reported positive bacterial infection in 38 cases,fungal infection in 5 cases.PCR provided diagnostic sensitivity of 40.9％,specificity 100％,positive predictive value 100％,negative predictive value 38.2％.The diagnostic efficiency was 56.7％.In contrast,the conventional culture achieved the results of 31.4％,100％,100％,34.7％,44.4％,respectively.The sensitivity,negative predictive value,and diagnostic efficiency of PCR were significantly better than conventional culture method.The coincidence rate between PCR and conventional culture was 97.7％.Conclusions Universal primer-based PCR is characteristic of short turnaround time,specificity,sensitivity and accuracy,which is very useful for rapid diagnosis of the pathogenic bacteria and fungi in central nervous system infections.

Research progress on the genetic mutations in Alzheimer′s disease and Parkinson′s disease / 中华检验医学杂志

With the rapid development of medical technology , the precision medicine appears .The accurate analysis of the genetic mutations provides the accuracy of diseasesis prediction diagnosis and targeted therapy.Alzheimer′s disease and Parkinson′s disease are two of the most common neurodegenerative diseases.

Analysis of the Causes on PDW Results Disappeared in Automatic Hematology Analyzer and the Evaluation of Platelet Result / 现代检验医学杂志

Objective To investigate the causes on platelet distribution width (PDW)results not shown in the automatic he-matology analyzer and evaluate the accuracy of the platelet results of these samples with the automatic hematology analyzer. Methods The platelet morphology was observed in microscope for the specimen which PDW were not shown in the auto-matic hematology analyzer.And the platelet results counted in microscope were statistically compared with that in the auto-matic hematology analyzer.Results In the 200 specimens which PDW were not shown in automatic hematology analyzer, there were 104 specimens(52%)in which large platelet was found,36 cases(18%)in which platelet aggregation was visible, 28 cases(14%)in which the microcytes or erythrocyte debris could be seen,32 cases(16%)in which the obvious abnormal was not found.The platelet results counted in microscope for the specimens,in which large platelets,platelet aggregation or microcytes were found,were very different with the results counted with the automatic hematology analyzer(P < 0.05).The PDW of the 200 specimens were rechecked in the automatic hematology analyzer.And 64 cases (32%)PDW results were got,of which 55 cases(85.9%)PDW results were beyond the normal range.Conclusion The main causes for the PDW not shown in automatic hematology analyzer includes large platelets,platelets aggregation and microcytes etc.The platelet re-sults in these specimens by automatic hematology analyzer were different with that counted in microscope.Therefore,the platelet of these specimens should be counted in microscope.

Value of universal primer PCR for diagnosing bacterial and fungal infec-tion of central nervous system / 中国感染控制杂志

Objective To understand pathogen spectrum of bacterial and fungal infection of central nervous system (CNS),and evaluate the etiological diagnostic value of universal primer polymerase chain reaction (PCR).Methods Data about patients with suspected or confirmed bacterial and fungal infection of CNS from January 2009 to March 2015 were collected,species of pathogens from cerebrospinal fluid (CSF)were analyzed,DNA from patients’CSF were performed PCR amplification and sequencing with universal primers of bacterial 16S rRNA and fungal 28S rRNA, PCR detection results were compared with CSF culture during the same period.Results A total of 400 patients were with confirmed or suspected bacterial or fungal infection of CNS,132 of whom were with positive CSF culture.150 pathogenic isolates were detected,including 48 isolates of gram-positive bacteria,90 gram-negative bacteria,and 12 fungi;the top three isolated bacteria were Acinetobacter baumannii (n =32 ),coagulase negative staphylococcus (n=16)and Klebsiella pneumoniae (n=13);the most common fungus was Cryptococcus neoformans (n=8).CSF from 88 infected patients and 20 non-infected patients were selected for PCR amplification,the sensitive of PCR am-plification assay was higher than the culture method (35.23% [31/88]vs 28.41 %[25/88],χ2 =4.17,P <0.05).

Value of 16S rRNA gene amplification for identification of clinical rare pathogens / 中国感染控制杂志

Objective To evaluate the value of amplification and sequencing of 16S rRNA gene in the identification of clinical rare pathogenic bacteria,and guide the diagnosis and treatment for related clinical infection.Methods 12 bacterial isolates that were difficult,or unable to be identified with conventional laboratory methods,or with special phenotypes were collected. The 16S rRNA gene was amplified by polymerase chain reaction (PCR),then sequenced for identifying bacterial species through BLAST comparison,clinical characteristics of related infection were ana-lyzed.Results 12 clinical isolates were all positive for PCR amplification (about 1500 bp),species were all identi-fied (similarity≥99% ),the identified strains were Listeriamonocytogenes(n= 2),Brucellamelitensis(n= 2),Fu-sobacteriummortiferum(n= 1),Rothiaaeria(n= 1),Nocardiafarcinica(n= 1),Staphylococcussaccharolyticus (n= 1 ),Rhizobiumradiobacter(n= 1 ),Prevotellabivia(n= 1 ),Ralstoniamannitolilytica(n= 1 ),and Atopobium vaginae(n= 1 ). The sensitivity of 16S rRNA gene amplification was high,and the minimum detection limit of Escherichiacoli ATCC 25922 was 1.5×101 CFU/mL. Clinical data of 12 patients revealed that these strains can cause multi-sites and multi-types of infection,after patients received targeted antimicrobial therapy,11 improved, and 1 died.Conclusion Sequencing for 16S rRNA gene can rapidly and accurately identify rare,anaerobic,and difficult cultured bacteria,provide laboratory evidence for etiological diagnosis and treatment of different types of infection.

Predictors of Survival in Children With Methymalonic Acidemia With Homocystinuria in Beijing, China: A Prospective Cohort Study.

Objective: (i) To determine whether clinical features and biochemical parameters help to predict survival of methylmalonic acidemia with homocystinuria; (ii) To find the cutoff values of biochemical parameters for predicting survival of methylmalonic acidemia with homocystinuria. Design: A prospective cohort study. Setting: A pediatric tertiary hospital in Beijing; all patients were followed until death or June 2013. Subjects: 45 pediatric patients diagnosed with methylmalonic acidemia with homocystinuria between 2006 and 2012. Outcome measures: The data of clinical characteristics and pretreatment biochemical parameters were collected. The Cox regression analysis was performed to identify independent risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The best cutoff values for these independent factors were determined by the receiver characteristic curve. Results: Newborn onset (OR=6.856, 95%CI=2.241-20.976, P=0.001), high level of methylmalonic acid in urine (OR=1.022, 95%CI=1.011-1.033, P<0.001), and high level of urea in serum (OR=1.083, 95%CI=1.027-1.141, P=0.003) were independent negative risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The cutoff values of maximum predictive accuracy of methylmalonic acid in urine and urea in serum were respectively 5.41 mmol/mmol creatinine and 7.80 mmol/L by receiver operating characteristic curve analysis. Conclusion: The patients of methylmalonic acidemia with homocystinuria tend to have an adverse outcome if they have newborn onsets. Elevated urea and urinary methylmalonic acid are predictors of adverse outcomes for the patients. They show similar effect for predicting severe adverse prognosis. The combination of methylmalonic acid in urine concentration and urea in serum concentration provided the most accurate predictive tool.

Application of interactive online teaching in the laboratory diagnostics teaching / 中华医学教育探索杂志

Objective In order to investigate the impact of interactive online teaching in Laboratory Diagnosis, a randomized experimental study was conducted among the medical students in Grade 2009.Methods A total of 65 subjects were randomized into the experimental group (N=31) and the control group (N=34).In addition to the standard in-class presentation/discussion and school-wide refined online courses offered in the control group, interactive online teaching was added to experimental group.After completion of the course, the impact of interactive online teaching in the experimental group was compared to that in the control group through a final exam and a question-naire concentrating on motivation of study, problem solving and team working skills.Statistical signifi-cance of the comparison was evaluated using t-test.Results The results from the final exam showed that the average score in the experimental group was higher than the control group (87.20 ± 5.25 vs.82.69 ± 5.76), It is statistically significant (P=0.002).The average scores of short answer and case study questions in the experimental group was higher than the control group (26.16 ± 1.57 vs.25.31 ± 1.73, 18.94 ± 1.05 vs.15.53 ± 1.15), It is statistically significant (P=0.043,P=0.000).The satisfaction evaluation of interest in learning, timely answers to questions, learning, analytical skills, teamwork culture reflected by the questionnaire indicated statistically higher (P=0.041,0.000,0.000,0.000,0.000) average scores in the experimental group as compared to its counterparts in the control group (4.30 ± 0.65 vs.3.97 ± 0.62, 4.63 ± 0.49 vs.3.25 ± 0.88, 4.43 ± 0.57 vs.3.49 ± 0.65, 4.46 ± 0.57 vs.3.37 ± 0.73, 4.33 ± 0.66 vs.3.68 ± 0.58).Conclusion Interactive online teaching helps to improve the study performance of medical students in Laboratory Diagnosis.Incorporating interactive online teaching into the current course regarding Laboratory Diagnosis merits recommendation.

Distribution and antimicrobial resistance of pathogens isolated from sur-gery patients with infection / 中国感染控制杂志

Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from surgi-cal patients with infection.Methods Distribution and antimicrobial resistance of 1 208 pathogens isolated from sur-gical patients with infection from January 2013 to January 2014 were analyzed retrospectively.Results Of 1 208 pathogenic isolates,gram-negative bacteria,gram-positive bacteria and fungi accounted for 64.57% (n = 780 ), 24.92%(n = 301 )and 10.51 % (n = 127 )respectively.The main specimens were sputum (44.78%),urine (21 .11 %),blood(11 .51 %),and pus(10.26%).Antimicrobial susceptibility testing results showed that the produ-cing rate of extended-spectrumβ-lactamases (ESBLs)of Escherichia coli and Klebsiella pneumoniae was 62.60%and 33.61 % respectively,resistant rate to imipenem was 0.76% and 15.57%,respectively.The resistant rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem was 38.93% and 75.80% respectively.Methi-cillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus was 71 .68% and 87.93% respectively.Conclusion The major pathogens isolated from surgical patients with infection are gram-neg-ative bacteria,the main infection sites are respiratory tract and urinary tract in this hospital;multidrug resistance is serious,especially carbapenem resistance,which should be paid attention.

Measurement uncertainty evaluation of 23 clinical biochemical items by top-down method / 医疗卫生装备

To evaluate the measurement uncertainty of 23 items of clinical biochemistry. Internal quality control and external quality assessment were used to determine the uncertainty and standard uncertainty for the 23 items detected by Hitachi 7600 automatic biochemical analyzer. The uncertainties met the requirements of CLIA'88 for allowable error before correction except those of Cl-, P, TCH and TG, and correction made those of P, TCH and TG satisfy the requirements. The top-down method contributes to the understanding of the uncertainty of clinical biochemical items, while further efforts have to be performed for the uncertainty assessment standard.

The analysis of position and personal training in the clinical laboratories in China / 中华检验医学杂志

The reasonable setting and the understandable duties of position is essential to the management of clinical laboratory.Moreover,the personal quality needed by the position and the training related with the qualification is the basis for the duties of the positions.This paper pays more attention to the polices and the documents of the position and training of clinical laboratory,and analyzes the difference of characteristics of position and training in the clinical laboratories of china and American.Some suggestions are proposed.

Applying ISO15189 related factors into clinical biochemistry teaching of undergraduate students / 中华医学教育探索杂志

In-depth application of the combination of theory and practice is one of the keys to improve the clinical undergraduate teaching quality of clinical laboratory diagnosis.Xuanwu Hospital used ISO15189 standards as a guide to make students fully participate in establishing performance verification and recording registration form,partly participate in the gage calibration,external quality assessment and inter-laboratory comparison etc.It also used the combined form of practice with teaching to make students learn the file writing and the equipment calibration.An orderly teaching model composed of knowledge reserve,file learning,calibration and verification was established,which was a closed-loop system that enabled students to become more deeply and extensively involved in the system and more deeply understand the connotation of clinical laboratory quality.

Role of platelet function testing in the prevention and treatment of ischemic stroke / 国际脑血管病杂志

Platelet function testing is essential for the prevention and treatment of ischemic stroke.Only simple and convenient method of platelet function testing can become the conventional detection method for patients with ischemic stroke and can be used to the prevention and treatment of ischemic stroke in clinical practice.

The discussion on several problems regarding critical values / 中华检验医学杂志

Laboratories are required to develop and put into practice critical value policies by numerous regulatory agencies,such as,the Clinical Laboratory Improvement Amendment of 1988 (CLIA'88),Joint Commission on Accreditation of Healthcare Organizations (JCAHO),College of American Pathologists (CAP),International Standard Organization (ISO EN15189) and National Patient Safety Goals,etc.However,there is little standardization of procedures,which are related with equipment,assay,patient population,recognition and skill of physician.This paper is to describe the proceedings on regulations,critical value items and their limits,critical value identification and reporting,critical value reporting assessment as well as monitoring,etc.Several related factors and the optimum options on critical value reporting are analyzed and discussed.Some suggestions are put forward to be consulted.

Detection of urine neural thread protein for diagnosis of Alzheimer disease and its clinical significance / 中华检验医学杂志

Objective To develop urine AD7C-NTP diagnostic kit,analyze and evaluate its application value on AD.Methods Immunogenicity AD7C-NTP peptide fragments had synthesized by solidphase methods.The animals immunized to prepare antibodies.After matching screening.mouse antibody was uesed as coating antibody.biotin-labeled rabbit antibody wag used as testing antibody,and horseradish peroxidase was labeied with avidin.The urine AD7C-NTP ELISA detective method was established.The AD7C-NTP levels in morning urine samples of 121 AD patients and 118 age-matched controls were collected.Results AD7C-NTP antibodies were identified.Mouse anti-AD7C-NTP antibody titer in ELISAwas 1:8 000,and rabbit anti-AD7C-NTP antibody titer in ELISA was 1:32 000:WB was uesd to detect human brain specimens and there was a single band with molecular weight of 41 000.The lowst detection limit of ELISA methodology was 0.5μg/L The linear range was 0-10μg/L,normal reference value ≤1.5μg/J,the average recovery rate was 100.2%.The intra and inter of CV were 3.8%,4.5%,7.6%,6.8% respectively.The AD7C-NTP levels[2.25(0.43-8.62)μg/L]of urine in AD group was higher than those in contorl group[0.82(0.47-2.77)μg/L,P<0.01].The positive rates in AD group and control group were 89.3% and 15.3% respectively.The sensitivity Was 89.3%and specificity was 84.7%.Conclusions The animals are immunized with the self-designed synthetic peptide fragment to prepare AD7C-NTP antibodies successfully.The established ELISA method for detection of urine AD7C-NTP with high sensitivity,and precision can be used as an assistant examination in clinical diagnosis of AD.

Effects of Morroniside on Rats Neurons in Focal Cerebral Ischemia/Reperfusion Injury / 中国康复理论与实践

@#ObjectiveTo investigate the effects of morroniside on super oxide dismutase (SOD) and neurons in rats cortex with focal cerebral ischemia/reperfusion. MethodsThe animal model was induced by middle cerebral artery occlusion with suture embolus, cerebral ischemia 30 min and reperfusion 3 d or 7 d. Vitamin E for the positive control. The content of SOD was detected with spectrophotometry and the nerve cells was observed with immunohistochemistry. ResultsCompared with model group, morroniside （270 mg/kg）increased the activity of SOD and the number of neurons （30 mg/kg, 90 mg/kg, 270 mg/kg） significantly. ConclusionMorroniside may have neuroprotective effect and increasing the activity of SOD in rats cortex.

Effects of Morroniside on Apoptosis in Rats with Focal Cerebral Ischemia/Reperfusion Injury / 中国康复理论与实践

@#Objective To investigate the effects of morroniside on glutathione (GSH) and Caspase-3 in rats with focal cerebral ischemia/reperfusion. Methods The animal model was induced by middle cerebral artery occlusion with suture embolus with 30 min for cerebral ischemia and 7 d for reperfusion. The content of GSH was detected with spectrophotometry and Caspase-3 expression was observed by Western blot.Results Compared with model group, the GSH increased and Caspase-3 expression reduced significantly at 270 mg/kg of morroniside.Conclusion Morroniside may have neuroprotective effect by increasing GSH in rats cortex and reduce the apoptosis in focal cerebral ischemia/reperfusion injury.