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Objective To assess quality of the clinical hematology laboratory technique examination papers and to explore the teaching methods, in order to improve the quality of the course. Methods After gathering 27 clinical hematology laboratory technique theoretical and experimental papers of the first session four-year laboratory medicine students in China Medical University of Grade 2014, we adopted the method of SPSS 19.0 on test scores for statistics of distribution frequency and mean, and applied the corre-lation function formula to calculate the difficulty and discrimination of various types of test questions, and then evaluated the level of knowledge according to the score distribution, and analyzed the quality of the papers based on the difficulty and discrimination. Results The average score of theoretical papers was (76.81±9.12) points, the proposition scheme is reasonable, the overall difficulty was 0.78, and the discrimi-nation is 0.41. The average score of experimental papers was (14.33±1.21) points, the overall difficulty is 0.72, and the discrimination is 0.10. Conclusion The difficulty of the theoretical papers is moderate, equipped with better capacity to discrimination, the difficulty of the experimental papers is also moderate, otherwise with poor discriminatory ability. We should learn from advanced management concept of ISO 15189 and combining professional training requirements of the four-year laboratory medicine , and strengthen students' ability of using theoretical knowledge flexibly to further perfect the mechanism of the experimental exam, improve experimental teaching methods, and finally help further improvement of teaching work.
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Objective To explore the clinical effect of detection of serum procalcitonin (PCT), C-reactive protein (CRP)and white blood cell (wBC)on diagnosis and treatment of severe pneumonia in children.Methods A total of 189 cases of pediatric patients with pneumonia including 51 severe pneumonia cases (severe pneumonia group)and 138 common pneumonia cases (common pneumonia group)treated from Mar 2014 to Dec 2014 and 30 healthy cases (control group)were enrolled,and the level of PCT,CRP and wBC of all cases were detected.Results The levels of PCT before treatment in severe pneumonia group,common pneumonia group,and control group were 1.12(0.44 ~3.07)ng /ml,0.14 (0.09 ~0.26) ng /ml and 0.03(0.01 ~0.06)ng /ml respectively,and there were significant differences among three groups (P ﹤0.05,respectively).The levels of CRP before treatment in severe pneumonia group,common pneumonia group,and control group were 82.2(25.9 ~120.3 )mg /L,10.8 (5.3 ~23.9)mg /L and 3.2 (2.1 ~6.9) mg /L respectively,and there were significant differences among three groups (P ﹤0.05,respectively).The counts of wBC before treatment in severe pneumonia group,common pneumonia group,and control group were 10.1 (9.1 ~14.1 )×109 /L,8.8(6.8 ~1 1.7)×109 /L and 6.2(4.8 ~7.9)×109 /L respectively,and there was significant difference only between severe pneumonia group and control group (P ﹤0.05 ).The level of PCT and CRP significantly decreased in severe pneumonia group after one week of treatment[PCT:0.15(0.09 ~0.24)ng /ml,CRP:9.9(3.6 ~19.0)mg /L](P ﹤0.05),but there was no significant differ-ence of wBC counts in severe pneumonia group between after and before treatment[8.5(6.3 ~9.8)×109 /L vs.10.1 (9.1 ~14.1 )×109 /L](t =1.312,P =0.205 ).After two days of anti-inflammatory treatment in severe pneumonia group,serum PCT dropped to 44% of the level before treatment,and smoothly dropped to nearly 10% of the basic value every two days.Serum PCT was correlated with serum CRP in children with pneumonia(R2 =0.550 4,P ﹤0.05).Conclusion The combined detection of PCT and CRP could provide important guidance for the differential diagnosis,treatment and prognosis for severe pneumonia in children.
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Objective:To investigate the applied value of serum Cyfra21-1,NSE,CRP and SCCA and pleural effusion Cyfra21-1, NSE in pathological types, clinical stages and combination detection for diagnosis of lung cancer.Methods: Based on chemiluminescence immunoassay,the levels of serum NSE,Cyfra21-1,SCCA,CRP and pleural effusion NSE,Cyfra21-1 in 100 patients with lung cancer (case group) and 50 patients with benign diseases(control group) were determined.Results:The positive rates of serum Cyfra21-1,NSE,SCCA and pleural effusion NSE,Cyfra21-1 were significantly higher in case group than those in control group ( P0.05).Conclusion:The serum NSE, Cyfra21-1, CRP, SCCA and pleural effusion NSE, Cyfra21-1 play an important role in the diagnosis of lung cancer and contribute to the pathological type and TNM stage of lung cancer, the combination detection of tumor markers is helpful for the early diagnosis of lung cancer.
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Objective To evaluate the relationship between lactate,lactate clearance rate and prognosis of children with septic shock.Methods A total of 42 children with septic shock admitted in the PICU from Oct 2009 to Jun 2011 were enrolled in the study.All the children were given goal-directed therapy early according to the treatment routine of septic shock.The blood lactate levels before resuscitation and at 1h,2h,6 h after resuscitation were detected,the lactate clearance rates at 1 h,2 h,6 h after resuscitation were calculated.All the patients were divided into the survival group ( n =20 ) and the non-survival group ( n =22 ) by prognosis.The relationship between the early lactate level,lactate clearance rate and prognosis of the children with septic shock was evaluated.Results ( 1 ) The lactate levels before resuscitation and at 1 h,2 h,6 h after resuscitation in the survival group were significantly lower than those in the non-survival group [ (3.92 ± 2.58) mmol/L vs (6.91 ± 4.16) mmol/L,( 2.79 ± 1.89 ) mmol/L vs ( 7.93 ± 4.39 ) mmol/L,( 2.20 ±1.83) mmol/L vs (9.20 ±4.97) mmol/L,( 1.32 ±0.51 ) mmol/L vs (9.94 ±5.02) mmol/L,P ＜0.05].(2) The lactate clearance rates at 1 h,2 h,6 h after resuscitation in the survival group were significantly higher than those in the non-survival group [ (26.31 ± 20.82) ％ vs ( - 24.28 ± 53.39 ) ％,(43.46 ± 17.85 ) ％ vs (-34.31±58.98)％,(61.04±16.71)％ vs ( -45.33 ±83.51)％,P＜0.05].(3) The area under curve of the lactate and the lactate clearance rate at 6 h after resuscitation were 99.4％ and 96.7％ according to the receiver operating characteristic curve.The children had high mortality if the lactate value ＞ 2.20 mmol/L and lactate clearance rate ＜ 18.65％ at 6 h after resuscitation.Conclusion It is important to dynamicly monitor the lactate of the children with septic shock,the lactate and the lactate clearance rate at 6 h after resuscitation can be used to evaluate the prognosis.
