网织红细胞参数在贫血性疾病鉴别诊断中的应用

 目的探讨网织红细胞参数在各类贫血性疾病鉴别诊断中的临床应用。方法采用Sysmex XE-2100 血液分析仪检测各类贫血患者和健康体检者网织红细胞百分率（RET%）、网织红细胞绝对值（RET裕）、未成熟网织红细胞比率（IRF）、低荧光强度网织红细胞百分率（LFR%）、中荧光强度网织红细胞百分率（MFR%）和高荧光强度网织红细胞百分率（HFR%）。结果溶血性贫血组RET%、RET#、IRF、MFR%、HFR%显著高于其他各类型的贫血（P < 0.01）,而LFR%显著减低（P < 0.01）。缺铁性贫血组、肾病性贫血组及肝病性贫血组与健康对照组比较,RET# 的差异无统计学意义,而缺铁性贫血组MFR%、HFR%及IRF 比健康对
照组显著升高（P < 0.01）,且升高的程度高于肾病性贫血组及肝病性贫血组。再生障碍性贫血组和白血病贫血组RET%、RET#低于其他各类型的贫血,白血病贫血组IRF 较再生障碍性贫血组显著升高。结论网织红细胞新型参数可以反映网织红细胞的成熟度,对不同类型贫血的鉴别诊断具有实用价值。     

网织红细胞参数在不同类型贫血中的临床意义

目的 通过Sysmex XE-2100型全自动血细胞分析仪对几种不同类型贫血的检测,探讨网织红细胞参数在评价骨髓造血功能中的临床价值.方法 应用全自动血细胞分析仪测定贫血患者网织红细胞参数,包括:网织红细胞百分率(RET%)、网织红细胞绝对值(RET#)、高荧光强度网织红细胞百分率(HFR%)、未成熟网织红细胞比率(IRF),将结果 与正常对照组进行比较分析.结果 溶血性贫血和失血性贫血RET% 、RET#、HFR%、IRF 明显高于正常对照组(p<0.01);缺铁性贫血患者的RET# 增高(p<0.05),但HFR%、IRF与正常对照组比较差异无统计学意义;肾性贫血患者除RET低于正常对照组外,RET#、HFR%、IRF与正常对照比较差异无统计学意义;再障患者 RET%、RET#、HFR%、IRF都明显低与正常对照组,差异有统计学意义(p<0.01).结论 网织红细胞多参数可以更准确、更全面地反映网织红细胞成熟状态,从而更好地评价骨髓造血功能,对不同类型贫血的早期诊断有重要的临床价值.     

红细胞与网织红细胞参数在缺铁性贫血与地中海贫血患儿中的意义

目的探讨红细胞参数:平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDW)与网织红细胞6项参数:网织红细胞百分率(RET%)、网织红细胞绝对值(RET#)、未成熟网织红细胞比率(IRF)、低荧光强度网织红细胞百分率(LFR%)、中荧光强度网织红细胞百分率(MFR%)、高荧光强度网织红细胞百分率(HFR%)在地中海贫血与缺铁性贫血患儿中的筛查与临床鉴别诊断价值。方法收集中山大学孙逸仙纪念医院门诊及住院的地中海贫血与缺铁性贫血儿童患者共计108例,另选取50名正常儿童作为对照组,用Sysmex XE-5000全自动血液分析仪检测患儿与正常儿童的红细胞参数与网织红细胞相关参数。结果缺铁性贫血组、地中海贫血组MCV、MCH、MCHC出现降低,与对照组比较差异均有统计学意义(P0.05)。缺铁性贫血组RDW升高,与地中海贫血组和对照组比较差异均有统计学意义,而地中海贫血组与对照组比较差异无统计学意义(P0.05)。缺铁性贫血组、地中海贫血组RET#、RET%、IRF、MFR%、HFR%均升高,LFR%降低,且地中海贫血组变化更为显著。结论 MCV、MCH、RDW三项指标可对地中海贫血与缺铁性贫血进行初步鉴别。网织红细胞相关参数对临床筛查地中海贫血和缺铁性贫血有提示作用,且其变化在地中海贫血中比缺铁性贫血更显著。结合运用红细胞参数与网织红细胞相关参数,可以提高两种疾病的筛查率和初步鉴别。     

地中海贫血患者网织红细胞参数检测的临床意义

目的:探讨网织红细胞参数在地中海贫血检测的临床意义。方法:应用XE-2100全自动血细胞分析仪检测了46例地中海贫血患者的网织红细胞百分比(RET%)、网织红细胞绝对值(RET#)、未成熟网织红细胞比率(IRF%)、低荧光强度网织红细胞比率(LFR%)、中荧光强度网织红细胞比率(MFR%)、高荧光强度网织红细胞比率(HFR%)等六项网织红细胞参数,并对检测结果均数进行t检验分析。结果:地中海贫血患者网织红细胞各参数与对照组相比差异具有显著性(P<0.05)。其中网织红细胞百分比、网织红细胞绝对值、未成熟网织红细胞比率、中荧光强度网织红细胞比率、高荧光强度网织红细胞比率显著性增高(P<0.05),LFR%明显下降(P<0.05)。结论:地中海贫血患者网织红细胞中未成熟细胞的增高可能是导致“无效造血”的主要原因之一,同时也能提示贫血的严重程度和更好的评价骨髓的造血功能。     

152例健康儿童静脉血网织红细胞6项参数参考范围调查

目的:确定网织红细胞6项参数的参考范围。方法:利用RAM-1全自动网织红细胞分析仪检测152名健康儿童的网织红细胞百分比(RET%)、网织红细胞绝对值(RET#)、低荧光强度网织红细胞(LFR%)、中荧光强度网织红细胞(MFR%)、高光强度网织红细胞(HFR%)、网织红细胞成熟指数(RMI)。结果:男性RET#为(45.64±14.92)×109/L,女性RET#为(44.94±15.87)×109/L,男性RET%为(1.21±0.52);女性RET%(1.18±0.48),RMI为(11.3±5.075);LFR%为(89.99±3.98);MFR%为(9.05±3.46);HFR%为(1.15±0.78)。结论:网织红细胞6项参数参考范围因性别、仪器等因素的影响而有差异,各实验室应根据具体情况建立自己的参考范围。儿童RET#男、女无显著性差异。网织红细胞分群与性别无关。     

XE-5000全自动血液分析仪测定网织红细胞的临床价值的分析

目的探讨XE-5000全自动血液分析仪测定网织红细胞的临床价值。方法用XE-5000全自动血液分析仪测定网织红细胞的几项指标：网织红细胞百分比（RET％），网织红细胞绝对值（RET#），未成熟网织红细胞指数（IRF），低荧光强度网织红细胞（LFR％），中荧光强度网织红细胞（MFR％），高荧光强度网织红细胞（HFR％）。结果正常健康人网织红细胞参数参考范围：RET#为（57±36）×10^9／L，RET％为（1．23±0．71），LFR％为（94±5），MFR％为（11±6），HFR％为（1．36±1．05），IRF％为（12±7）。缺铁性贫血（IDA）：IRF（16±3），RET#（68±41），RET％（1．61±0．56），LFR％（72±6），MFR％（14±4），HFR％（3．82±1．33）。IDA患者除LFR指标外，其他结果均明显高于正常健康人。结论XE-5000血液分析仪测定网织红细胞可以用于临床贫血性疾病的诊断。     

结肠癌38例化疗前后网织红细胞参数变化及意义

目的:探讨结肠癌患者化疗前后网织红细胞参数的变化及临床意义.方法:采用XE-2100型血细胞分析仪检测结肠癌38例患者化疗前后及正常人30例网织红细胞参数,并对结果进行对比分析.结果:结肠癌患者化疗前网织红细胞百分数(RET%)、高荧光网织红细胞百分数(HFR%)和未成熟网织红细胞指数(IRF)3个参数与对照组比较差异...     

广州地区成人网织红细胞相关参数参考区间的调查研究

目的 调查广州地区成人网织红细胞相关参数的参考区间。方法 选择2022年12月1日至2023年5月25日在南方医科大学南方医院体检的1 064名健康者进行网织红细胞检测,参数为网织红细胞计数(RET#)、网织红细胞百分比(RET%)、未成熟网织红细胞比率(IRF%)、低荧光网织红细胞百分比(LFR%)、中荧光网织红细胞百分比(MFR%)、高荧光网织红细胞百分比(HFR%)、网织红细胞血红蛋白量(RET-He),健康志愿者按性别分组。另外,收集男女健康者各20份静脉血,进行参考区间验证。结果 网织红细胞相关参数呈偏态分布(P<0.05),采用百分位数法建立参考区间,男性组RET%、RET#、IRF%、LFR%、MFR%、HFR%、RET-He的参考区间分别为0.93%～2.95%、(47.1～147.4)×109/L、5.60%～20.20%、79.86%～94.40%、5.00%～14.76%、0.30%～6.28%、32.60～37.88 pg,女性组以上参数参考区间分别为0.92%～2.64%、(41.57～118.56)×109/L、4.47%～18.53%、81.47%～...     

兰州市新生儿网织红细胞计数与分类参考范围调查

目的建立兰州市新生儿网织红细胞计数与分类的参考范围。方法用SysmexXT-20000i血液分析仪,对201例正常新生儿做了网织红细胞计数与分类参考范围的调查,所得数据用SPSS10.0软件进行统计学处理。结果1～7天男性新生儿的网织红细胞百分数(RET%)与绝对数(RET#)分别为(2.317±1.628)和(0.115±0.078)×1012/L;女性新生儿的RET%与RET#分别为(3.271±2.060)和(0.162±0.117)×1012/L,男性新生儿与女性新生儿的RET%和RET#的参考范围有显著性差异,而参数IRF%、LFR%、MFR%、HFR%男女比较无显著性差异。各项参数因日龄不同而存在差异,除LFR%随着日龄的增加而升高外,其余各项参数均随着日龄的增加而降低。结论网织红细胞各参数数值的大小与日龄、性别有关,该参考范围的确定为网织红细胞各参数在实验室操作和临床应用提供了依据。     

蒙古族儿童网织红细胞正常参考范围的调查

目的调查探讨蒙古族儿童网织红细胞5项参数的参考范围,为临床诊断和治疗提供相关依据。方法按仪器说明书操作SYSMEXXE-5000血细胞分析仪,检测611名健康蒙古族儿童网织红细胞,并以±1.96s计算其5项参数参考值范围。结果内蒙古地区蒙古族儿童,网织红细胞绝对数(RET#)参考范围:9.84～71.63×109/L;网织红细胞百分数(RET%)参考范围:0.19%～1.61%,低荧光强度网织红细胞(LFR%)参考范围:89.65%～102.51%、中荧光强度网织红细胞(MFR%)参考范围:0%～9.16%、高光强度网织红细胞(HFR%)参考范围:0%～0.87%。结论蒙古族儿童网织红细胞值及各项参数无性别差异,但与蒙古族成人比较有差异,应建立正常儿童网织红细胞各项参数参考范围。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.