Medical treatment after myocardial infarction. Results of studies using various methods.

Patients who have had myocardial infarction and are at risk for continued problems may benefit from several treatment methods (table 1). Beta-adrenergic blockers reduce subsequent cardiovascular morbidity and mortality through their effect on the myocardial supply-demand balance. Administration of angiotensin-converting enzyme inhibitors reduces morbidity and mortality rates in myocardial infarction survivors who have diminished left ventricular ejection fraction. Aspirin and other anticoagulants are beneficial through their antiplatelet effects. Cardiac rehabilitation methods and aggressive management of lipids levels are also useful.     

Evaluation of sputum decontamination methods for Mycobacterium tuberculosis using viable colony counts and flow cytometry

Continuous monitoring systems for the detection of Mycobacterium tuberculosis are reported to have higher contamination rates than traditional radiometric technologies. Multiple decontamination methods have recently been reported in an attempt to optimize contamination rates for these systems. In this study, several decontamination methods for sputum were evaluated using viable colony count and flow cytometry. The decontamination protocols evaluated include N-Acetyl-L-Cysteine-Sodium Hydroxide (NALC-NaOH), modified Petroffs's method, and the Yamane procedure. Several parameters of the NALC-NaOH method were analyzed including final NaOH concentrations of 0.5-3%, NaOH exposure times of 0-30 min, and variations in resuspension media for the resultant pellet. All decontamination methods were performed on pooled and sterilized sputum seeded separately with either a mixture of common contaminating bacteria or M. tuberculosis H37Ra. Viability of organisms following decontamination was assessed by both colony counts and flow cytometric analysis. Flow cytometry viability assays utilized a combination of viability dyes and reference beads to determine viable organism concentrations. The results indicated that no decontamination method was clearly superior, however a concentration of 1-2% NaOH and an increase in the time of NaOH exposure to 30 min will effectively kill contaminating bacteria without significantly affecting the viability of M. tuberculosis H37Ra. While flow cytometry viability analysis did not directly correspond to viable colony counts, it was a useful tool for rapid viability analysis M. tuberculosis.     

不同方法测量的颅内压值之差异

目的　比较在急性颅脑损伤患者使用不同方法测量的颅内压值 (intracranialpressure ,ICP)之差异。方法　 1 6例急性颅脑损伤在术后同时采用硬脑膜外压 (extraduralpressure ,EDP)监护、脑室内脑脊液压力 (ventnricle cerebrosinalfluidpressure,V CSFP)和腰蛛网膜下腔脑脊液压力 (lumber subarachnoidspaceCSFP ,L CSFP)方法测量ICP值 ,每天一次 ,共 6d。结果　V CSFP与L CSFP所测量的ICP值相似 ,而在多数时间段 ,EDP测量的ICP值低于上述两种方法的ICP值 ,有统计学差异 (P <0 0 5 )。结论　EDP测量的ICP值可能与V CSFP与L CSFP测量的ICP值有差异     

Flow cytometric reticulocyte counting: a comparison between two methods

The peripheral reticulocyte count is commonly used as an indicator of the erythropoietic activity of the bone marrow. Manual counting provides results with a high degree of inaccuracy and imprecision. Automation of counting is therefore needed. The increase in the number of methods available requires however that the results from the various methods agree with one another. The aim of our study was to evaluate the analytic performance of two automated hematology analyzers by a parallel study. We compared the analyzers between them and with manual counting. We enrolled in our study a total of 100 healthy subjects and an additional 80 patients affected by various hematological diseases. Difference between methods is statistically significant: the reference intervals of ADVIA2120 are higher than the Sysmex XE‐2100. The correlation between methods and correlation with the microscopic method are excellent and statistically significant. In conclusion, we can affirm that total automation of reticulocyte counts represents a definite improvement over microscopic counts. This study confirms the diversity of the reference intervals still exists in the new automated hematology analyzers. J. Clin. Lab. Anal. 24:252–255, 2010. © 2010 Wiley‐Liss, Inc.     

White blood cell counts by automated and manual methods with backlighting.

White blood cell (WBC) counts were compared in the presence of "backlighting" using the Coulter S-Plus Jr and a manual system. Platelet aggregates and large platelets in specimens anticoagulated with ethylenediamine tetraacetic acid (EDTA) cause interference and prompt the WBC count on the Coulter S-Plus Jr to backlight. This means that the background behind the count on the data terminal display lights up, alerting the operator to a questionable result. A total of 29 automated backlighted WBC counts of blood samples collected in sodium and potassium salts of EDTA tubes were compared with the results by hemocytometer method. Values for WBC count by both methods showed good agreement. Smear examination detected platelet clumps and large platelets in 66% of the Na 2EDTA tubes. Only low WBC counts prompted backlighting in K 3EDTA. tubes. Liquid K 3EDTA is a preferred anticoagulant for whole blood analysis because of its rapid solubility, eliminating clumping of platelets and thus backlighting.     

The influence of various hematology analyzers on component platelet counts

Hematology analyzers designed to count platelets in samples of whole blood are used to enumerate the total number of platelets in components prepared for transfusion. This report addresses the issue of variability in platelet counts obtained with different models of hematology analyzers. The influence of a common calibration procedure, involving one level of porcine platelets, on the extent of variability was also evaluated. Identical sets of samples of simulated and apheresis-derived human platelets were counted by multiple laboratories in 3 separate studies. In the first 2 exercises, 7 samples of both porcine platelets and modified goat erythrocytes with targeted platelets counts from 0.2 to 4.0 x 10(12)/L were counted without prior dilution. In both exercises, the samples were counted multiple times after routine calibration using instructions provided by the manufacturers of the various hematology analyzers used. In the second exercise, the samples were recounted after the hematology analyzers were recalibrated with a common calibrant consisting of porcine platelets at a targeted concentration of 0.5 x 10(12)/L. In the first and second exercises, 20 and 18 hematology analyzers were used, respectively. In the third exercise, 6 samples prepared from a single unit of apheresis platelets with targeted counts from 0.2 to 1.64 x 10(12)/L were shipped by an overnight courier and counted in triplicate on the day of arrival. Eleven hematology analyzers were used. The influence of recalibration was evaluated statistically by using the 95% prediction interval for the mean of a future set of observations. The platelet counts measured with a specific type of hematology analyzer provided the data to calculate the 95% prediction interval. With routine calibration, a wide variability in platelet counts was observed with all levels of both simulated and apheresis-derived human platelets. For example, with porcine platelets at a targeted level of 0.4 x 10 (12)/L, the platelet counts ranged from 0.31 to 0.47 x 10(12)/L. Recalibration reduced the extent of variability observed with all levels of simulated and apheresis-derived human platelets by increasing the observed platelet counts determined with a subset of hematology analyzers that produced platelet counts in the lower portion of the range. With recalibration, the mean platelet counts obtained with most hematology analyzers, especially with samples having targeted platelet levels no greater than 1.0 x 10(12)/L, were within or near the 95% prediction interval determined with the instruments that provided the highest platelet counts with routine calibration. With recalibration, the reproducibility of the platelet counts was considered to be good for all hematology analyzers with all levels of simulated and apheresis-derived human platelets for most of the instruments. The coefficient of variance did not exceed 6%, with most of the values ranging from 1% to 3%. This study therefore found that the platelet counts of platelet concentrates can be markedly influenced by the type of hematology analyzer used. A common calibration procedure designed specifically for the range of platelet counts in platelet products may be beneficial considering that many different hematology analyzers are being used to count platelets.     

Automated immature reticulocyte counts are early markers of engraftment following autologous PBSC transplantation in patients with lymphoma

The traditional indicators of engraftment following PBSC transplantation (PBSCT) are the rising total WBC count and ANC. Reticulocytes may be an earlier indicator, since as reticulocytes mature, there is a gradual loss of cellular RNA, which can be measured using methylene blue and light scatter with an Abbott CD 3500 automated counter (Abbott Laboratories, Maidenhead, U.K.). Reticulocytes can be divided into three fluorescence ratios depending on the amount of light scatter generated, high, medium, and low. The most immature are the high fluorescence reticulocytes (HFR). Standard engraftment parameters together with HFR were measured in a homogeneous group of 25 patients with lymphoma after PBSCT using a standard conditioning protocol. An ANC of 0.5 x 10(9)/L was achieved after a median of 10 days (mean 11.2 days, range 9-22). The recovery of the HFR to 2% of the total reticulocytes was significantly shorter, with a median of 8 days (mean 7.5 days, range 6-10) (p < 0.0001). The values of HFR to 2% preceded the ANC of 0.5 x 10(9)/L in 24 of the 25 patients by a median of 3 days (mean 3.8 days, range 2-12 days). On this basis, it can be determined that in 96% of cases, engraftment was indicated earlier by HFR measurement. The HFR to 2% even preceded the ANC of 0.1 x 10(9)/L in 23 of the 25 patients, showing that engraftment was indicated earlier in 92% of patients. Immature reticulocytes appearing in peripheral blood can be reliably measured by automated cytometers, and HFR can, therefore, be used as an earlier indicator of engraftment following PBSCT. This information provides the opportunity for earlier cessation of antibiotics and growth factors and could lead to earlier discharge from hospital, with cost savings.     

流式细胞仪与镜检法计数网织红细胞的比较

目的建立流式细胞仪计数网织红细胞的方法并应用于临床。方法5ul全血加入噻唑橙染液中，流式细胞仪计数10万个红细胞，分析其中的网织红细胞数并与镜检法比较。结果流式细胞仪法与镜检法计数网织红细胞结果差异无显著性。结论流式细胞仪计数网织红细胞快速．结果准确．且重复性好，适合临床常规检测网织红细胞。     

两种采样方法对洁净手术室空气细菌监测结果比较分析

摘要 目的 比较沉降法和撞击法在洁净手术室空气细菌监测结果,分析2种采样方法的应用价值。方法 采用沉降法和撞击法分别对天津市部分医疗机构洁净手术室室内空气中细菌数监测结果进行比较分析。结果 73间不同级别洁净手术室内空气监测结果表明,平板沉降法监测细菌总数为0～215 cfu/m3;撞击式采样器法监测细菌总数范围为0～453 cfu/m3,2组细菌总数间的差异有统计学意义(P＜0.01);2种监测方法所得数据间存在显著相关性,但2组间空气质量监测合格率差异无统计学意义(P=0.09)。结论 撞击采样器采样法对空气中细菌捕获率高于平板沉降法,但2组采样方法空气质量监测结果无明显差别。     

Treatment of cervical dentin hypersensitivity by various methods using pulsed Nd:YAG laser

OBJECTIVE: The purpose of this study was to evaluate the results of two irradiated regions, the cervical and apical, for cervical dentin hypersensitivity treatment using pulsed a Nd:YAG laser with or without black ink. SUMMARY BACKGROUND DATA: There has been no reports on the irradiated area(s) except the cervical region for dentin hypersensitivity treatment using pulsed Nd:YAG laser. METHODS: A total of 180 teeth diagnosed with cervical dentin hypersensitivity in 54 (39 females, 15 males, aged 21 to 73) healthy adult patients were included in this study, and teeth were randomly divided into four groups of 45 each. Sensitivity was rated using a blast from a fully depressed air syringe on a four-grade scale both before and up to 2 months after laser treatment. The effectiveness was evaluated on the change in the degree of hypersensitivity after laser treatment. The tooth surfaces in groups 1 and 2 were observed by the replica model method using scanning electron microscopy (SEM). RESULTS: The methods of irradiation at the cervical regions were better than those at the apical regions except for the period 2 months later. The laser effect was enhanced by black ink at both areas. The effective (excellent and good) rate was decreased depending on the time in every group. SEM observation at the tooth surfaces from group 2 showed that dentinal tubules were occluded or narrowed after laser irradiation. CONCLUSIONS: These results show that the method of irradiation by a pulsed Nd:YAG laser at cervical regions with black ink is the most effective for cervical dentin treatment of hypersensitivity and recurrence by this method is less than in other methods.     

自动血细胞分析仪测定网织红细胞的初步应用

ＣＯＵＬＴＥＲ ＳＴＫＳ－２Ｂ全自动血细胞分析仪测定血液中的网织红细胞，并与国际血液标准化委员会（ＩＣＳＨ）所推荐的网织红细胞活体染色目测计数法－Ｍｉｌｌｅｒ窥盘法进行比较，ｒ＝０．９４，ｔ检验Ｐ〉０．０５，差异无显著意义，批内平均ＣＶ＝８．３３％，批间平均ＣＶ＝１１．３１％。结果表明血细胞分檄仪法测定网织红细胞具有准确度、精密度高、检测速度快的特点，尤其适合大批标本的快速测定。同时操作简便、标本     

三种流式细胞术计数血小板方法的比较研究

目的　探讨 3种流式细胞术计数血小板方法的临床应用价值。方法　用二维激光散射法 (ADVIA 12 0法 )、红细胞与血小板比值法 (RBC/PLT R法 )、荧光微球绝对计数法 (TruCOUNT法 ) 3种流式细胞术 (FCM)方法计数血小板 ,并与电阻抗法比较。结果　 3种FCM方法计数血小板具有高度相关性 (P <0 0 0 1) ,血小板计数在 ( 1～ 6 46 )× 10 9/L的较宽范围内时 ,相关系数 (r) >0 99;血小板计数在 ( 1～ 89)× 10 9/L的较低范围内时 ,相关系数 (r) >0 95。与TruCOUNT法血小板计数相比 ,ADVIA12 0法计数值偏高 ,RBC/PLT R法偏低。TruCOUNT法与ADVIA 12 0法的相关性最好 (P <0 0 0 1) ,在较低范围血小板计数时的相关系数 (r) >0 98。低血小板计数时 ,ADVIA 12 0法的变异系数 ( 3 46 % )最小 ,TruCOUNT法 ( 5 2 % )次之 ,RBC/PLT R法 ( 5 84% )稍高。电阻抗法与 3种FCM法均有相关性 (P <0 0 0 1) ,但血小板计数比 3种FCM法偏低 (P <0 0 1) ,而且对部分病例标本的血小板计数存在较大误差。结论　 3种FCM法计数血小板均优于电阻抗法。ADVIA 12 0全自动血细胞分析系统最适合于临床常规计数血小板 ,TruCOUNT法是较为低血小板计数和校准血细胞分析仪。对严重血小板减少症的患者 ,若临床需要采取预防性血小板输血时     

不同方法治疗疤痕临床效果分析

目的探讨各种疤痕的有效治疗方法。方法回顾性分析215例疤痕的诊治和转归情况。结果随访半年至4年，治愈184例，显效22例，无效9例。结论疤痕应及早治疗，不同疤痕应采用不同方法治疗。     

Comparison of various methods for the enumeration of blood cells in urine.

This study compared the use of conventional urine microscopy, the KOVA system, Neubauer hemacytometry, and the Yellow IRIS for the determination of white blood cell (WBC) and red blood cell (RBC) counts in urine samples. Both KOVA WBC and RBC counts correlated better with the IRIS counts than with conventional microscopy. KOVA WBC counts correlated with Neubauer hemacytometry to the same degree as they did with IRIS WBC counts. The RBC count correlation was fairly similar between KOVA, hemacytometry, and the conventional method. It was concluded that the KOVA system is a suitable replacement for conventional urine microscopy.     

Effectiveness of various methods of chemotherapy of lymphosarcoma

Different methods of poly- and monochemotherapy applied to the treatment of 601 lymphosarcoma patients admitted to the All-Union Cancer Research Center, Academy of Medical Sciences of the USSR, over the recent years have been studied and compared. The treatment results have been analyzed in accordance with the morphological pattern of lymphosarcomas and the degree of tumor spreading. The most efficacious methods for drug treatment of recurrent lymphosarcomas have been defined.