念珠菌乳胶免疫层析法的性能评价

目的评价念珠菌乳胶免疫层析法检测试剂盒(以下简称念试剂)检测阴道分泌物中念珠菌的性能和种属特异性。方法采用涂片/革兰染色法和念试剂检测354例怀疑为念珠菌阴道炎妇女阴道分泌物和9种属22种阴道常见感染微生物,并与涂片/革兰染色法半定量比较,评价念试剂的临床标本检测性能及种属特异性。结果与涂片/革兰染色法相比,念试剂的灵敏度为93.81%,特异度为99.10%,准确性97.31%,阳性预期值为98.14%,阴性预期值为96.90%;与涂片/革兰染色法半定量相比,该念试剂检测阴道分泌物中的念珠菌在标本中念珠菌浓度较低时仍然具有较高的特异度、可接受的灵敏性;在种属特异度评价,6种念珠菌阳性,其他16种阴道常见感染微生物均为阴性。结论念试剂检测阴道分泌物中念珠菌具有较高的临床和种属特异度、灵敏度、阳性预测值和阴性预测值。     

淋巴结细针穿刺标本的流式细胞术分析

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL     

自动全血细胞分析和白细胞分类复检规则的制定及评价

目的制定合理的全血细胞分析和白细胞分类复检规则并对其评价。方法利用Sysmex XE-2100自动血细胞分析仪自身的报警系统，参考国际一致性工作组（the international consensus group）的41条规则，制定暂定复检规则。按临床标本的检测流程和方法对2795份门诊和住院标本进行全血细胞分析检测和推片染色，由本室技术人员进行镜检，对各条暂定规则和仪器提示细胞数量异常和形态异常的报警分别进行了统计学评估。结果各暂定规则中出现假阳性、假阴性最多的复检规则是仪器出现未成熟粒细胞／核左移和异型淋巴细胞报警，其次为仪器出现有核红细胞报警。反映白细胞各类细胞数量变化的评估显示假阳性率和假阴性率均很低。形态学评估结果为真阳性占标本总数的17．44％，假阳性占15．82％，真阴性占63．49％，假阴性占3．25％。异型淋巴细胞、未成熟粒细胞和原始细胞报警是最常见的假阳性报警。根据以上统计结果并结合临床医师的意见最终制定出了本室的血细胞分析和白细胞分类复检规则。该规则的临床应用复检率为36％，镜检率为26％。结论制定的血细胞分析和白细胞分类复检规则可提高标本检测的真阳性率。对于使用五分类自动全血细胞分析仪的临床血液实验室，能够减轻复检工作量，降低漏检率，提高工作效率。     

淋巴结细针穿刺标本的流式细胞术分析

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL     

淋巴结细针穿刺标本的流式细胞术分析

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL     

重铬酸钾复合酸液杀菌作用观察

目的观察重铬酸钾复合酸液杀菌作用及其影响因素。方法采用悬液定量杀菌试验方法对其杀菌效果进行检测。结果重铬酸钾复合酸液的ORP值为最高、pH值最低,加入中和剂可明显降低溶液的ORP值和增加pH值。单独用50 g/L重铬酸钾溶液对大肠杆菌作用12 min,杀灭率为10.69%;单独用硫酸稀释液和盐酸稀释液的杀灭率分别为99.941%和75.50%;以50 g/L重铬酸钾、体积分数10%浓硫酸组成的复合溶液作用12 min,对大肠杆菌杀灭率达到100%。结论高氧化还原电位对杀菌效果有促进作用。重铬酸钾与硫酸的复合溶液的ORP值达到1048 mV,对大肠杆菌具有较强的杀灭作用。     

丙硫氧嘧啶致甲状腺增生的量效关系初探

[目的]研究丙硫氧嘧啶(propylthiouracil,PTU)致甲状腺增生的量效关系,为以PTU为模型药物的甲状腺激素干扰物体内短期甄别方法体系的建立提供实验室依据。[方法]SD大鼠100只,雌雄各半,随机分为1个对照组和4个实验组。对照组用玉米油灌胃;实验组用不同剂量的PTU的玉米油溶液灌胃。于实验期11d麻醉后股动脉放血处死动物,甲状腺组织称重后进行组织病理学观察。[结果]在PTU剂量为5mg/(kg·d)的实验组,雌雄鼠甲状腺脏器系数均高于对照组(P﹤0.05);组织学观察发现随着PTU剂量增加,甲状腺增生程度有所加重;组织学观察到的最小有作用剂量分别比脏器系数提前3和2个剂量组。[结论]选择甲状腺增生的组织学早期改变为实验观察敏感性终点,建立以PTU为模型药物的甲状腺激素干扰物体内短期甄别方法体系是可行的。     

早发型妊娠肝内胆汁淤积症10例分析

目的分析早发型妊娠肝内胆汁淤积症(ICP)患者的发病特点,有助于临床治疗及预后判断。方法对该院4年来收治的10例早发型ICP患者的临床资料进行回顾性分析。结果早发型ICP发病孕周最早在孕10周,以皮肤瘙痒为首发症状,皮肤瘙痒的部位以四肢为重。对于早发型ICP患者采用中西医结合的综合治疗方法,同时进行密切的胎儿监护,安宝抑制宫缩,地塞米松促胎肺成熟,适时终止妊娠。终止妊娠孕周为孕33～37周,终止妊娠的方式均采用剖宫产。其中1例在孕30周放弃治疗要求引产。无1例围生儿死亡,随访病例中无脑瘫及智力障碍发生。结论早发型ICP发病虽早,但经中西医结合综合治疗后到晚期妊娠有好转趋势,母婴预后良好。     

尼美舒利颗粒致头面部肿大1例

病例:女,29岁,因“感冒发烧两日,加重一日伴咽喉肿痛一周”,于2011年2月17日在零售药店购买尼美舒利颗粒(南京新港联合制药有限公司,生产批号:20100102)口服,每日两次,每次0.1g,服用1日后,出现头面部片状发红、肿大,巩膜充血,头面局部发热,伴全身躯干部分多处片状发红、瘙痒等症状,躯干部位片状红斑直径达4～6厘米.     

男性酒依赖患者酒精依赖程度及影响因素

目的 探讨酒精依赖患者认知、情绪、睡眠现状和酒精依赖程度及其影响因素.方法 采用横断面研究,连续选取2020年9月至2021年6月在云南省3家医院精神科住院的酒精依赖患者作为酒精依赖组,同时期在社区招募年龄和受教育年限相匹配的普通居民为对照组.通过问卷调查收集患者的人口学信息、饮酒情况与认知、情绪、睡眠状况.比较2组人...