血球仪KX-21和XE-2100测定结果的比较

目的比较KX-21血液分析仪与XE-2100血液分析仪两者测定的结果并作评价。方法分别用血液分析仪KX-21与XE-2100同时测定住院患者和体检者静脉血标本共94例,并将两者结果分别按各项指标进行比较。结果精密度测定,KX-21各指标的变异系数CV值（%）位于0.14%-4.9%之间,XE-2100各指标变异系数CV值（%）位于0%-3.12%之间。携带污染率测定,KX-21测RBC为0.18%,Hb为0.63%,其余为0。XE-2100测WBC为0.29%,其余为0。两台仪器各参数相关系数位于0.9848-0.9995之间。结论两台仪器精密度,携带污染率符合设计要求,两者之间相关性较好。     

SYSTEM XE-2100全自动血细胞分析仪与流式细胞仪检测网织血小板结果比较

网织血小板(reticu lated p latelet,RP)是刚从骨髓中释放出来的一种新生血小板[1],胞质中含有残留核糖核酸(RNA)成分,体积较大,有更强的活性[2],外周血RP可以比较精确地反映骨髓血小板生成动力学。因此,准确、快速、简便的计数RP,具有重要的临床意义。但由于现有流式细胞仪检     

射频参数在细胞学形态分析中的应用

目的分析细胞形态学自动分析方法中的射频技术(RF),探讨在不同细胞簇,不同疾病时射频参数的变化。方法采用Sysmex XE2100全自动血细胞分析仪测定血细胞的射频值,然后用SPSS对不同种类细胞的射频结果进行统计学分析。结论细胞射频值与细胞胞体呈正相关,且与细胞种类无关;只与细胞成熟度有关。     

Renal hypouricaemia in insulin treated diabetes mellitus

Uric acid metabolism was investigated in 69 insulin-treated male diabetic outpatients and in 23 healthy male subjects, because of a reported coincidence between diabetes and gout. All subjects had normal serum creatinine concentrations and none received diuretic treatments.

Compared with normal, the diabetics had significantly lower mean serum uric acid concentrations (0.34 ± 0.08 (SD) mmol/l versus 0.23 ± 0.06 mmol/1, p < 0.001). 17% of the diabetic patients had serum concentrations below the normal mean—2 SD. In contrast, the diabetic patients had a 42% increase in renal uric acid excretion rate (p <0.01), and an 83% increase in the ratio of uric acid clearance/creatinine clearance (p < 0.001). These indices of renal uric acid excretion were both positively correlated to fasting blood glucose levels (r = 0.57, p < 0.001, and r = 0.50, p < 0.001, respectively), to the degree of glycosuria (r = 0.73, p < 0.001, and r = 0.63, p < 0.001, respectively), and to the magnitude of water diuresis (r = 0.60, p < 0.001, and r = 0.39, p < 0.01, respectively).

The hypouricaemia observed in these insulin-dependent diabetic male subjects may probably be caused by the increased renal excretion of uric acid in the presence of hyperglycaemia. The study gave no evidence of increased serum uric acid concentrations in insulin-dependent diabetics. It is therefore likely that any coincidence between gout and diabetes derives from other coexisting serum uric acid raising factors.     

应用ROC曲线制定XE-2100血液分析仪的白细胞分类复检标准

目的 应用ROC曲线分析建立XE-2100血液分析仪白细胞分类（difference of cell,DC）的复检标准。方法以手工法为金标准,对416份患者分别进行仪器和手工计数分类,对仪器结果进行判断,应用ROC（receiver operating characteristic curve）建立DC的复检标准,并评价复检标准。结果白细胞分类的复检标准为中性粒细胞（N）〉75％、淋巴细胞（L）〉45％、嗜酸性粒细胞（Eo）〉10％、嗜碱性粒细胞（B）〉2％、单核细胞（M）〉13％;血细胞形态异常：原始细胞（Blast）或异常淋巴细胞（Alan-BL）报警且研究参数other〉2％、或变异淋巴（Atypical Ly）报警且L≥50％且M≥13％,IG报警且研究参数IG〉3％、NRBC（有核红细胞）报警且N≥2个／100WBC。结论仪器对M、B、血细胞形态异常的报警提示较为敏感,建立适当的复检标准可以减少白细胞分类的复检率,提高实验室的工作效率。     

A pooled analysis of FEV1 decline in COPD patients randomized to inhaled corticosteroids or placebo

BACKGROUND: There is controversy about whether therapy with inhaled corticosteroids (ICSs) modifies the natural history of COPD, characterized by an accelerated decline in FEV(1). METHODS: The Inhaled Steroids Effect Evaluation in COPD (ISEEC) study is a pooled study of patient-level data from seven long-term randomized controlled trials of ICS vs placebo lasting >/= 12 months in patients with moderate-to-severe COPD. We have previously reported a survival benefit for ICS therapy in COPD patients using ISEEC data. We aimed to determine whether the regular use of ICSs vs placebo improves FEV(1) decline in COPD patients, and whether this relationship is modified by gender and smoking. RESULTS: There were 3,911 randomized participants (29.2% female) in this analysis. In the first 6 months after randomization, ICS use was associated with a significant mean (+/- SE) relative increase in FEV(1) of 2.42 +/- 0.19% compared with placebo (p < 0.01), which is quantifiable in absolute terms as 42 mL in men and 29 mL in women over 6 months. From 6 to 36 months, there was no significant difference between placebo and ICS therapy in terms of FEV(1) decline (-0.01 +/- 0.09%; p = 0.86). The initial treatment effect was dependent on smoking status and gender. Smokers who continued to smoke had a smaller increase in FEV(1) during the first 6 months than did ex-smokers. Female ex-smokers had a larger increase in FEV(1) with ICS therapy than did male ex-smokers. CONCLUSIONS: We conclude that in COPD in the first 6 months of treatment, ICS therapy is more effective in ex-smokers than in current smokers with COPD in improving lung function, and women may have a bigger response to ICSs than men. However, it seems that after 6 months, ICS therapy does not modify the decline in FEV(1) among those who completed these randomized clinical trials.     

职业女性工作压力-生活压力对健康状况的影响

目的 通过哥本哈根社会心理问卷和生活压力量表研究工作压力和生活压力对中国城市职业女性健康状况的影响.方法 抽取某市1045名女性职工进行横断面调查,运用协方差分析和多元线性回归分别研究工作、生活压力的单独及联合作用对职业女性身心健康的影响.结果 高工作压力女性身心健康得分比低工作压力人群显著降低,其中生理健康的校正均数按照工作压力由低到高依次为52.46,51.10,49.81和48.99,心理健康的校正均数按照工作压力由低到高依次为52.84,50.59,49.69和47.82;类似差异也出现在高、低生活压力人群间,其中生理健康的校正均数按照生活压力由低到高依次为51.21,51.12,50.17和48.20,心理健康的校正均数按照生活压力由低到高依次为51.39,50.58,49.63和47.32( P <0.01).此外,工作-生活压力联合作用的不同状态与女性不良的健康结局有关,按照工作/生活压力由低到高其与生理健康的均值差分别为-2.03,-2.49,-3.84,其与心理健康的均值差分别为-1.41,-2.46,-5.16( P <0.01),并可见一定的剂量-反应关系.结论 工作压力和生活压力对城市职业女性身心健康均造成不利影响,承受双重压力的女性尤其明显.     

Immature platelet fraction measurement in patients with chronic liver disease: a convenient marker for evaluating cirrhotic change

Platelet number is often used as an indicator of the severity of liver disease. Although inadequate thrombopoietin production and decreased platelet production have been proposed as major causes of cirrhotic thrombocytopenia, the underlying mechanism has not yet been fully clarified. We examined whether the measurement of the immature platelet fraction (IPF) in thrombocytopenic patients with liver dysfunction is useful as a rapid and noninvasive method for the differential diagnosis of chronic liver diseases. We examined 20 liver cirrhosis patients, 56 patients with chronic hepatitis, 9 patients with fatty liver, and 86 patients without liver disease. The percentage value of IPF (IPF%) was measured using an XE-2100 multiparameter automatic hematology analyzer. Using a receiver operating characteristic curve, we found diagnostic significance of the absolute platelet count and the absolute number of the IPF between cirrhotic patients and noncirrhotic patients, and developed a powerful multivariate discriminant analysis (MDA) function based on the platelet count and the IPF%. The diagnostic accuracy obtained by the MDA function was superior to that obtained by the absolute number of platelets and the IPF. We therefore propose our IPF% measurement for the diagnosis of liver cirrhosis.