精子对Diasys R/S 2003尿沉渣定量分析工作站流动计数室的影响

Diasys尿沉渣分析工作站可连续检测尿沉渣,具有稳定、精确、快速、安全、标准化等优点。我院于2002年12月引进该系统,在工作中发现尿液中的精子对流动计数室影响较大。报告如下。     

DiaSys R/S2003尿沉渣定量分析工作站特殊故障两例分析

DiaSys R/S2003尿沉渣定量分析工作站是由美国临床检验标准委员会(NCCLS)推荐,美国食品药品管理局(FDA)认证的,集标准化、定量化、自动化于一体的尿沉渣定量分析仪器。该仪器自引进我科以来,在临床检测中发挥了重要作用,但也曾出现过两例较为特殊的故障,现介绍如下:1故障一的分     

Diasys R/S 2003尿沉渣定量分析工作站检测健康人尿沉渣参考值范围调查

目的确定Diasys R/S 2003尿沉渣定量分析工作站检测健康人尿沉渣参考范围.方法按NCCLS要求,用Diasys R/S 2003尿沉渣定量分析工作站对426名健康人进行尿沉渣中白细胞、红细胞的定量检测.结果①尿白细胞:各年龄组和男女性别的检测值经F检验均有显著性差异(P＜0.05).浓缩尿:男性0～91个/μl,女性0～121个/μ1.混匀尿:男性0～2个/μl,女性0～3个/μl.②尿红细胞:各年龄组和男女性别的检测值经F检验均有显著性差异(P＜0.05).浓缩尿:男性0～25个/μl,女性0～32个/μl.混匀尿:男性0～1个/μl,女性0～1个/μl.结论健康人尿液中白细胞、红细胞数与年龄、性别有关.该参考值的确定,有助于尿液检验的标准化.     

Diasys R/S 2003尿沉渣工作站检测健康成人尿沉渣参考值

ｉａｓｙｓＲ/Ｓ 2 0 0 3尿沉渣定量分析工作站已成为ＮＣＣＬＳ推荐用于尿沉渣定量分析的仪器。关于其正常参考值国内报道有差异 ,为此 ,我们进行相关调查。1　材料与方法1 1　仪器　美国ＤｉａｓｙｓＲ/Ｓ 2 0 0 3尿沉渣定量分析工作站(Ｕ .ＳＤｉａｓｙｓＣｏｒｐｏｒａｔｉｏｎ生产 )及专用离心管。1 2　试剂　生理盐水 ,5 %次氯酸钠溶液。1 3　研究对象　选择来本院进行健康体检无明显心血管、肝、肾疾病 ,无传染病 ,无遗传性疾病的健康成人 ,共 4 4 2例 ,年龄 14～ 6 3ｙ ,平均 4 3ｙ ,其中男 2 80例 ,女 16 2例。1 4　实验方法　收集…     

Dia Sys R／S 2003尿沉渣定量分析工作站临床应用评价

目的评价DiaSysR／S2003尿沉渣定量分析工作站性能及其在临床上的应用。方法用新鲜尿配制红细胞、白细胞理论值5个数量级单位作准确性鉴定；运用双盲法对同一标本的有形成分重复计数10次，计算其均值、标准差及变异系数值；随机选择126例尿标本分别用工作站法、牛鲍氏计数板法对红、白细胞及管型作可比性比较。结果红细胞5个数量级的理论与实测值的误差≤1，1％，白细胞5个数量级的理论值与实测值的误差≤1．2％，与牛鲍氏计数板法比较红细胞、白细胞和管型无显著意义（P〉0．05）。结论DiaSysR／S2003工作站的主要指标符合要求，准确度高，精密度好，操作简单，安全可靠，在临床应用中其结果与，临床符合，是目前理想的尿沉渣分析仪。     

DiaSys R/S 2003尿沉渣工作站在精子计数中的应用分析

目的探讨DiaSys R／S 2003尿沉渣定量分析工作站在精子计数中的应用价值。方法用同一标本在工作站及计数板上进行计数,比较两种方法的相关性。结果两种方法对同一标本进行精子计数呈高度相关性,相关系数r＝0．9996。结论工作站法有良好的精密度和准确性,并且操作简便,报告清晰,完全适用于精液检查中的精子计数。     

DiasysR／S 2003尿沉渣定量分析工作站检测健康人尿沉渣参考值范围调查

目的 确定Diasys R／S 2003尿沉渣定量分析工作站检测健康人尿沉渣参考范围。方法 按NCCLS要求．用Diasys R／S 2003尿沉渣定量分析工作站对426名健康人进行尿沉渣中白细胞、红细胞的定量检测。结果 ①尿白细胞：各年龄组和男女性别的检测值经F检验均有显著性差异（P〈0．05）。浓缩尿：男性0-91个/μl，女性0-121个μl。混匀尿：男性0-2个/μl，女性0-3个/μl。②尿红细胞：各年龄组和男女性别的检测值经F检验均有显著性差异（P〈0．05）。浓缩尿：男性0—25个/μl，女性0-32个/μl。混匀尿：男性0-1个/μl，女性0-1个／μ1。结论 健康人尿液中白细胞、红细胞数与年龄、性别有关．该参考值的确定．有助于尿液检验的标准化。     

尿液干化学检测和尿沉渣定量分析对原发性高血压患者的临床意义

目的探讨尿液干化学检测和尿沉渣定量分析对原发性高血压(EH)患者的临床意义。方法按中华医学会检验分会推荐的尿液干化学检测方法和《尿液沉渣检查标准化的建议》要求,用德国拜耳公司的CLINITEK 500型尿液干化学检测仪和美国DiaSays R/S 2003型尿沉渣定量分析工作站对160例EH患者和60例正常对照者尿液标本进行检测,并进行统计分析。结果EH组尿液分析阳性参数按例数多少由高到低分别为蛋白,潜血、WBC、LEU、RBC、葡萄糖、酮体、管型、结晶。其中蛋白、葡萄糖的阳性率与对照组比有显著差异(p<0.05),但所有羽性率均未超过15%。结论EH患者的尿液分析结果能从一定程度上反映高血压引起的肾脏功能的改变,但敏感性不高,需结合其它检查指标进行综合分析。     

US2100R尿干化学分析仪反射率在尿液白蛋白定量分析中的应用

目的研究US2100R自动尿分析仪蛋白试纸反射率在尿液白蛋白定量分析中应用的可行性。方法建立血浆白蛋白含量与试纸反射率的标准曲线,测定139份蛋白等级高于可疑尿液样本的白蛋白含量、总蛋白含量和蛋白试纸反射率,计算尿液样本白蛋白预测值,对所得结果进行统计学分析。结果采用CCD传感器为光检测元件的尿分析仪较使用传统光电管为光检测元件的尿液分析仪具有更宽的尿白蛋白检测范围,可达6000～9000mg/L左右;仪器蛋白标准曲线和白蛋白标准曲线符合S型曲线模型;白蛋白标准曲线预测值与白蛋白实际测定值无差异,与仪器蛋白标准曲线预测值有差异;尿液中白蛋白含量与总蛋白含量有差异。结论US2100R蛋白试纸主要反映尿液白蛋白含量变化,基于US2100R反射率的白蛋白标准曲线可用于尿液白蛋白初步定量分析。     

IQ 200全自动尿沉渣分析仪与人工镜检的比较和评价

目的对IQ200全自动尿沉渣分析仪与人工镜检这两种方法进行比较和评价。方法随机收集102份尿液标本,用IQ200全自动尿沉渣分析仪与人工镜检对其中的红细胞、白细胞、上皮细胞、结晶等进行计数,然后再对数据进行比较分析。结果IQ200尿液分析结果与镜检结果符合率：红细胞为84.31%,白细胞为86.27%,上皮细胞为91.18%,结晶为87.25%。灵敏度：红细胞为95.24%,白细胞为92.86%,上皮细胞为94.44%,结晶为92.11%。特异度：红细胞为78.33%,白细胞为78.26%,上皮细胞为90.48%,结晶为84.38%,IQ200携带污染率为0。尿液中某些草酸钙结晶和真菌孢子会干扰IQ200对红细胞的检测。结论IQ200全自动尿沉渣分析仪依然无法代替人工镜检,需与显微镜检查联合应用以提高检验质量,保证结果的准确度。     

基于计算机视觉的尿液定量分析系统在白蛋白尿筛检中的应用效能分析CSCD

目的探讨基于计算机视觉算法的尿液定量分析系统在白蛋白尿筛检中的应用效果。方法选取2021年2月在北京大学第一医院接受尿液检验分析,不同尿微量白蛋白肌酐比值范围的143例受试者纳入研究。采集受试者的随机尿液样本,分别送到医院临床检验实验室和使用尿液定量分析系统进行检测分析。以实验室检测结果为金标准,从筛检的真实性、可靠性、预测值和受试者工作特征曲线下面积(AUC)4个方面评价基于计算机视觉算法的尿液定量分析系统用于白蛋白尿筛检的效果。结果共纳入143例受试者,白蛋白尿A1分级的59(41.3%)例,A2分级的39(27.3%)例,A3分级的45(31.5%)例。基于计算机视觉算法的尿液定量分析系统在白蛋白尿筛检的真实性、可靠性、预测值和AUC方面均表现良好。以白蛋白尿A1分级为阴性,A2和A3分级为阳性,尿液定量分析系统准确率达到88.8%,灵敏度和特异度分别达到94.0%和81.4%,阳性预测值和阴性预测值分别达到87.8%和90.6%,AUC达到0.962。结论基于计算机视觉算法的尿液定量分析系统在白蛋白尿筛检中的应用效果较好,诊断准确率、AUC和灵敏度均较高。由于其便捷性与低成本,该分析系统在我国大规模人群调查用于慢性肾脏病初筛中有较大的应用推广价值。     

Test-retest and interobserver reliability of quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain (DFNS): a multi-centre study

Quantitative sensory testing (QST) is an instrument to assess positive and negative sensory signs, helping to identify mechanisms underlying pathologic pain conditions. In this study, we evaluated the test-retest reliability (TR-R) and the interobserver reliability (IO-R) of QST in patients with sensory disturbances of different etiologies. In 4 centres, 60 patients (37 male and 23 female, 56.4 ± 1.9 years) with lesions or diseases of the somatosensory system were included. QST comprised 13 parameters including detection and pain thresholds for thermal and mechanical stimuli. QST was performed in the clinically most affected test area and a less or unaffected control area in a morning and an afternoon session on 2 consecutive days by examiner pairs (4 QSTs/patient). For both, TR-R and IO-R, there were high correlations (r = 0.80-0.93) at the affected test area, except for wind-up ratio (TR-R: r = 0.67; IO-R: r = 0.56) and paradoxical heat sensations (TR-R: r = 0.35; IO-R: r = 0.44). Mean IO-R (r = 0.83, 31% unexplained variance) was slightly lower than TR-R (r = 0.86, 26% unexplained variance, P < .05); the difference in variance amounted to 5%. There were no differences between study centres. In a subgroup with an unaffected control area (n = 43), reliabilities were significantly better in the test area (TR-R: r = 0.86; IO-R: r = 0.83) than in the control area (TR-R: r = 0.79; IO-R: r = 0.71, each P < .01), suggesting that disease-related systematic variance enhances reliability of QST. We conclude that standardized QST performed by trained examiners is a valuable diagnostic instrument with good test-retest and interobserver reliability within 2 days. With standardized training, observer bias is much lower than random variance.     

Effects of (R,R)- and (R,R/S,S)-Formoterol on Airway Relaxation and Contraction in an Experimental Rat Model

Background: Racemic (R,R/S,S)-formoterol is a long-acting β-agonist composed of a 50:50 mixture of (R,R)- and (S,S)-enantiomers.Objective: The aim of this study was to determine whether (R,R)-formoterol and (R,R/S,S)-formoterol have differing effects on airway contraction and relaxation in vitro.Methods: Cylindrical airway segments 3-mm long were isolated from the mid-trachea of healthy Sprague-Dawley rats and placed in a modified Krebs-Henseleit solution. Dose-response curves of bethanechol-induced contraction (measured as milligrams of tension) and the concentration of bethanechol that elicited 50% to 75% of maximal contraction (EC_50-75) were determined. The air-way cylinders were then precontracted with bethanechol at the EC_50-75 and exposed to different concentrations of (R,R)-formoterol (0.0001-1.0 μM) or (R,R/S,S)-formoterol (0.0002-2.0 μM). Each concentration of the 2 formoterol formulations contained the same amount of (R,R)-enantiomer (eg, [R,R]-formoterol 0.0001 μM and [R,R/S,S]-formoterol 0.0002 1JM contained the same amount of [R,R]-enantiomer). The relaxation percentage in response to formoterol was calculated as a reduction in tension (in milligrams) in relation to baseline tension in the precontracted state, with each tracheal cylinder serving as its own control. To determine the effect of (R,R)-formoterol on airway contraction, tracheal cylinders were incubated with (R,R)- or (R,R/S,S)-formoterol before electrical field stimulation (EFS).Results: Tracheae from 56 three-week-old Sprague-Dawley rats were used in the study. The relaxation percentage of precontracted trachea was significantly greater after exposure to (R,R)-formoterol than to (R,R/S,S)-formoterol at a 2-fold higher concentration (P = 0.03; general linear model with repeated measures analysis comparing the 2 groups of animals). However, in a post hoc analysis, the mean (SE) relaxation percentage of precontracted trachea was significantly greater only after exposure to (R,R)-formoterol 0.01 μM than to (R,R/S,S)-formoterol 0.02 μM (15.6% [5.8%] vs 39.0% [5.6%]; P < 0.05, unpaired t test). EFS-induced airway contraction was significantly less in tracheal cylinders incubated in (R,R)-formoterol compared with those incubated in (R,R/S,S)-formoterol at a 2-fold higher concentration (P = 0.05; general linear model with repeated measures analysis comparing the 2 groups of animals). However, in the post hoc analysis, mean (SE) EFS-induced tracheal contraction was significantly less only in (R,R)-formoterol 0.01 μM compared with (R,R/S,S)-formoterol 0.02 μM at 10 V (1070 [55] mgvs 1225 [28] mg; P < 0.05, unpaired t test).Conclusion: We found that (R,R)-formoterol may induce greater relaxation of precontracted airway smooth muscle cells than (R,R/S,S)-formoterol and that (R,R)-formoterol may have a greater inhibitory effect on the endogenous cholinergic and excitatory nonadrenergic, noncholinergic contractile airway responses than (R,R/S,S)-formoterol. We speculate that the presence of the (S,S)-enantiomer in (R,R/S,S)-formoterol may impair airway relaxation of pre-contracted trachea in rats.     

The Effect of Insulin on the Intracellular Distribution of 14(R,S)-[18F]Fluoro-6-thia-heptadecanoic Acid in Rats

Purpose The aim of this study was to determine the effect of hyperinsulinemia on myocardial and hepatic distribution and metabolism of 14(R,S)-[¹⁸F]fluoro-6-thia-heptadecanoic acid ([¹⁸F]FTHA).Procedures Mitochondrial retention and intracellular lipid incorporation of [¹⁸F]FTHA were compared to that of [¹⁴C]-2-bromopalmitate or [¹⁴C]palmitate during hyperinsulinemic clamp vs. saline infusion in male Wistar rats.Results Mitochondrial ¹⁸F activity was increased in the heart (1.7 ± 0.4 vs. 0.5 ± 0.1% ID/g, P < 0.05), whereas it was reduced in the liver (1.1 ± 0.3 vs. 1.8 ± 0.4% ID/g, P < 0.05) during insulin vs. saline infusion, respectively. Mitochondrial [¹⁴C]-2-bromopalmitate activity was affected by insulin in a similar way in both tissues. The fractional esterification of [¹⁸F]FTHA into triglycerides was impaired compared to [¹⁴C]palmitate in both tissues, and [¹⁸F]FTHA was insensitive to the shift of esterification of fatty acids into complex lipids in response to insulin.Conclusions [¹⁸F]FTHA is sensitive to insulin-induced modifications of free fatty acid oxidative metabolism in rats but is insensitive to changes in nonoxidative fatty acid metabolism.     

潮气量对极低出生体重儿高频震荡通气时p(CO2)的影响及最佳设置分析

目的观察极低出生体重儿高频震荡通气(high-frequency oscillation ventilation, HFOV)时血p(CO₂)的变化,探讨潮气量对血p(CO₂)的影响及最佳潮气量值。方法接受HFOV治疗的极低出生体重儿80例,记录通气过程中各项参数,包括呼吸频率、呼吸幅度、平均气道压、吸入氧浓度、潮气量、每分通气量、p(CO₂)、二氧化碳扩散系数(carbon dioxide diffusion coefficient, DCO₂),共监测毛细血管血气数据812个,其中p(CO₂)≥55 mm Hg的血气数据439个为观察组,p(CO₂)<55 mm Hg的血气数据373个为对照组,比较2组呼吸参数;采用多因素logistic回归分析极低出生体重儿p(CO₂)升高的影响因素;绘制ROC曲线,评估潮气量及其他通气参数对极低出生体重儿p(CO₂)升高的预测效能。结果观察组吸入氧浓度(0.49±0.13)高于对照组(0.32±0.14)(P<0.05),潮气量[(1.62±0.37)mL/kg]、每分通气量[(0.61±0.29)mL/kg]及DCO₂[(32.49±14.92)mL²/s]均低于对照组[(2.18±0.52)mL/kg、(0.92±0.23)mL/kg、(68.47±31.44)mL²/s](P<0.05);潮气量(OR=0.028,95%CI:0.006~0.132,P<0.001)、每分通气量(OR=0.003,95%CI:<0.001~0.028,P<0.001)、DCO₂(OR=0.936,95%CI:0.910~0.963,P<0.001)是极低出生体重儿p(CO₂)升高的影响因素;潮气量、每分通气量、DCO₂的最佳截断值分别为1.81 mL/kg、0.62 mL/kg、38.84 mL²/s时,预测极低出生体重儿p(CO₂)升高的AUC分别为0.833(95%CI:0.766~0.887,P<0.001)、0.596(95%CI:0.516~0.673,P<0.001)、0.830(95%CI:0.762~0.885,P<0.001),灵敏度分别为81.25%、93.75%、72.50%,特异度分别为75.00%、31.25%、93.75%,潮气量及DCO₂预测极低出生体重儿p(CO₂)升高的AUC明显高于每分通气量(P<0.05)。结论潮气量对使用HFOV呼吸支持的极低出生体重儿p(CO₂)有明显影响,保持潮气量不低于1.81 mL/kg对控制p(CO₂)水平有较好指导价值。