血液分析仪计数儿童血小板结果偏高原因浅析

目的分析血液分析仪对儿童血小板计数产生误差的原因。方法用两种血液分析仪及手工显微镜计数法对600例血液标本进行血小板计数，并进行对比分析。结果成人血小板值高于正常参考上限（300×10^9／L）的比率低于儿童，两种血细胞分析仪测的儿童血小板值无显著性差异（P〉0．05），血液分析仪分析血小板时出现异常报警（URI），直方图尾部有异常升高的血小板值与显微镜计数的结果有显著性差异（P〈0．05=。结论使用血液分析仪计数儿童血小板时如出现：计数有警示信号（URI）；MCV〈70fl，且RBC直方图显示有〈50fl的小红细胞存在；血小板直方图出现尾部升高的表现或血小板直方图曲线呈齿状等以上情况时要进行手工显微镜计数血小板以得到准确的结果。     

血细胞分析仪血小板计数结果假性降低的原因及纠正方法

目的：探讨血细胞分析仪血小板（PT）计数结果假性降低的原因及纠正方法。方法：对血细胞分析仅PT计数结果降低的样本进行手工目视显微镜计数和涂片染色镜检并进行比较。结果：在对66273人次血细胞计数时发现38例患者存在PT计数结果假性降低现象。结论：对PT计数结果降低的样本进行涂片染色镜检和目视显微镜计数，发现问题采用相应纠正方法，血细胞分析仪PT计数结果假性降低的现象是可以避免的。     

血液分析仪的正确认识和应用

1 正确认识血液分析仪 目前虽然血液分析仪已经从二分类、三分类，发展到了五分类。从半自动到全自动。分析原理从单纯的电阻抗，发展到VCS技术、细胞染色技术，多角度偏振光散射技术、流式细胞分析技术等。但是仪器的分析毕竟不能代替显微镜的形态识别和分析方法。国际血液学标准化委员会仍然将血涂片的人工显微镜检查作为白细胞分类计数的参考方法。此外，由于仪器故障和试剂质量问题，也会导致分析结果准确性和精密度的问题。病人血液成分的异常变化也会干扰分析结果，出现细胞计数假性增高或假性降低以及血细胞直方图的异常。为此，仪器生产厂家在设计时设立了警告符号，一旦仪器自检发现分析不确定时，会自动发出警告，以提示检验人员进行人工计数和血涂片显微镜检查。     

血液分析仪XE5000检测血小板的影响因素及纠正方法

目的分析血液分析仪XE5000检测血小板结果假性增高和假性降低的原因及纠正方法。方法对血小板直方图异常,IMI(未成熟细胞指数)图形异常,标本外观异常,根据不同原因采取重新采集血样复检;37℃水浴15 min;人工计数血小板;更改抗凝剂等措施进行血小板计数。结果在27 006人次血液分析结果中有169人次的血小板直方图异常、IMI(未成熟细胞指数)图形异常、标本外观异常,对这些样本进行相应的处理。发现25例患者血小板结果假性增高;85例患者血小板结果假性降低。结论通过相应的纠正方法,血液分析仪XE5000对特殊样本血小板计数偏差是可以避免的。     

血细胞分析仪测定血小板影响因素的探讨

目的探讨血细胞分析仪测定血小板（PLT）的因素，排除“假性增高”和“假性降低”的情况，为临床提供准确可靠的诊治依据。方法使用Sysmexkx-21全自动血细胞仪及显微镜检查同时对400余例血小板数量与直方图不符病例进行检查，对比分析。结果血小板凝聚、小红细胞数量，抗凝剂的种类及比例、试剂的质量、标本放置时间及反复混匀次数、血小板体积异常等均可影响血小板的测定。结论全自动血液分析仪并不能完全代替手工计数，对PLT计数与直方图不符标本，应分析原因，重新采血后手工计数。     

血小板直方图在血小板计数中的临床意义

目的:探讨异常血小板直方图对血小板计数的作用。方法 :在2014年1月~2月间收集门诊LH-7502上血小板直方图异常且仪器分析结果提示有血小板聚集,巨血小板,小红细胞的病人标本和血小板直方图正常且仪器无提示的病人标本,记录仪器测得的血小板数值和异常血小板直方图的图形,然后将标本制备成良好的血涂片进行瑞氏染色并通过显微镜油镜进行血小板计数,最后根据不同异常的血小板直方图和仪器结果提示可将标本分类归纳成组。可分为正常组、血小板聚集组、巨血小板组及小红细胞组。结果:正常组:仪器法与手工法无统计学意义(P0.05),两者计数一致。巨血小板组:仪器法与手工法有统计学意义(P0.05)且仪器法计数小于手工法。小红细胞组:仪器法与手工法有统计学意义(P0.05)且仪器法计数大于手工法。血小板聚集:仪器法与手工法有统计学意义(P0.05)且仪器法小于手工法。结论:血小板直方图正常且仪器无提示,仪器法和手工法计数无差异。当血小板直方图异常且仪器提示存在巨血小板和血小板聚集时,仪器法计数小于手工法,而血小板直方图异常且仪器提示存在小红细胞时,仪器法计数大于手工法。     

血小板异常直方图在判断血小板计数结果中的应用分析

目的 观察分析血小板异常直方图在判断血小板计数结果中的临床应用价值.方法 选取我院2009年5月至2011年5月220例静脉血标本,分别采用血细胞分析仪进行测定,并采取显微镜下人工计数法进行血小板计数.结果血小板凝集、大血小板、小红细胞干扰的情况下,异常的血小板直方图呈异常分布,血细胞分析仪与显微镜下的正常血小板计数比较差异显著(P＜0.05),具有统计学意义.结论采取血细胞分析仪进行血小板计数测定,容易受到多种因素所影响,因此,对于异常的血小板直方图,应结合直方图的特点及血小板计数的结果进行原因分析,并采取显微镜下手工计数法进行血小板计数,减少误差,为临床提供可靠科学的诊断依据.     

探析血小板检测的影响因素

目的:探讨血细胞分析仪测定血小板(PLT)的影响因素,为临床提供准确可靠的检验数据。方法:使用血细胞分析仪(迈瑞5380)对100例血小板数与直方图不符标本进行计数,对比分析。结果:标本放置时间和反复混匀次数、采血时间等均可影响血细胞分析仪准确计数PLT。结论:血细胞分析仪检测血小板的影响因素有很多,应结合血小板的直方图进行判断,必要时进行显微镜计数或重新采血。     

抗凝剂EDTA及枸橼酸钠导致血小板假性减少现象的分析

目的:分析抗凝剂EDTA及枸橼酸钠所致血小板聚集对血小板计数结果的影响及观察仪器法和手工计数法两种方法检测EDTA及枸橼酸钠所致血小板聚集标本的不同结果。方法:血小板仅对EDTA发生聚集反应的标本为一组,血小板对EDTA及枸橼酸钠均发生聚集反应的标本为二组。用Sysm ex-2100血液分析仪检测上述两组EDTA抗凝血和枸橼酸钠抗凝血,同时采指血手工计数血小板和抗凝血涂片显微镜镜检。结果:一组中EDTA抗凝血血小板数值明显低于枸橼酸钠抗凝血,枸橼酸钠抗凝血血小板数值与手工计数法结果相接近。二组中EDTA抗凝血血小板数值与枸橼酸钠抗凝血结果相近,均明显低于血小板手工法结果。结论:除EDTA引起的血小板聚集可导致血小板数值假性减低外,极个别情况下,血小板也对枸橼酸钠发生聚集反应引起血小板假性减低。对于首次检测血小板数值减低的标本均应手工计数血小板或涂片镜检,以确认是否存在抗凝剂所致血小板聚集现象。     

血液分析不同的MCV值与PLT报警结果和镜检的分析

先进的血分析仪法逐渐取代手工法，但仪器计数血小板存在着许多干扰因素导致结果的不可靠，必要时需人工复检才能得到准确的结果。我院使用的三台血液分析仪都存在着不同的平均红细胞体积、血液分析血小板报警结果，我们就此问题进行了显微镜计数结果分析如下。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.