Analyzer Research Articles

Clinical observation on combined use of dry chemical method and urinary sediment in routine urine examination

Objective To study the clinical effect of dry chemical method combined with urinary sediment in routine urine examination. Methods From January 2018 to October 2018, 200 patients with suspected urinary tract infection who underwent routine urine examination in the Traditional Chinese Medicine Hospital of Yuyao were selected for prospective study, and fresh morning urine samples were collected from 200 patients.Urine samples were detected by urine dry chemistry analyzer and urine sediment analyzer respectively, and the urine routine indicators of urine dry chemistry method and urine sediment method were compared.According to the results of urine bacterial culture, the sensitivity, specificity and accuracy of urine dry chemical method, urine sediment method and urine dry chemical method for the diagnosis of urinary tract infection were calculated and compared.Then, the consistency test was used to analyze the consistency of results of urine dry chemistry method, urine sediment method, urine dry chemical method+ urine sediment method with urine bacterial culture. Results (1)There were no statistically significant differences between the results of urine dry chemical method and urine sediment method on the urine red blood cell, white blood cell, transparent tube type and other indicators (t=0.562, 0.343, 0.901, all P>0.05). (2)Among 200 suspected patients with urinary tract infection, 157 patients were confirmed to have urinary tract infection by urine bacterial culture, and the remaining 43 patients had no urinary tract infection.The sensitivity, specificity, accuracy of urine dry chemistry method and urine sediment method in the diagnosis of urinary tract infection had no statistically significant differences (χ2=0.120, 0.081, 0.022, all P>0.05). But the sensitivity, specificity, accuracy of urine dry chemistry method + urine sediment method in the diagnosis of urinary tract infection were 96.18%, 97.67%, 96.50%, respectively, which were higher than those of the urine dry chemistry method and urine sediment method (χ2=6.497, 6.081, 11.923, 8.219, 4.962, 12.858, all P<0.05). According to the consistency analysis, the diagnosis results of urinary tract infection by urine dry chemical method and urine sediment method were in good consistency with the results of urine bacterial culture, with the Kappa value of 0.854, while the consistency of urine dry chemical method, urine sediment method with the urine bacterial culture results were all moderate, with the Kappa value of 0.642 and 0.637, respectively. Conclusion The combination of urine dry chemical method and urine sediment method can improve the accuracy of urine routine examination and improve the value of urine routine examination in the diagnosis of urinary tract infection. Key words: Urinary tract infection; Urine routine; Medical examination; Urine dry chemistry; Urine sedimentation method; Diagnosis; Red blood cell; Leukocyte; Hyaline tube type

Association of T-wave amplitude on electrocardiogram with left ventricular ejection fraction in children with dilated cardiomyopathy

To study the association of T-wave amplitude on electrocardiogram (ECG) with left ventricular ejection fraction (LVEF) in children with dilated cardiomyopathy. A retrospective analysis was performed for the clinical data of 44 children who were diagnosed with dilated cardiomyopathy from May 2009 to June 2018. According to LVEF, they were divided into two groups: LVEF ≥50% group (n=26) and LVEF <50% group (n=18). After treatment, 25 children were followed up for 3-42 months (mean 14±9 months). The Guangdong Zhongshan SR-1000A ECG Automatic Analyzer was used to obtain the 12-lead body surface ECG results in the supine position. T-wave amplitude on ECG was evaluated by software and manual measurement. Compared with the LVEF ≥50% group, the LVEF <50% group had a significant reduction in the T-wave amplitude in leads II, V4, V5 and V6 (P<0.05). The increased-LVEF group (an increase in LVEF > 5% after treatment) had a significant increase in the T-wave amplitude in leads aVR, V5, and V6 after treatment (P<0.05), while the unchanged-LVEF group (an increase in LVEF ≤ 5% after treatment) had a significant reduction in the T-wave amplitude in lead aVR after treatment (P<0.05). The receiver operating characteristic curve analysis showed that the T-wave amplitude in leads II, V4, V5 and V6 had a certain value in predicting LVEF <50% in children with dilated cardiomyopathy (P<0.05). A combination of T-wave amplitude of ≤0.20 mV in lead II, ≤0.40 mV in lead V4, and ≤0.30 mV in leads V5 and V6 had a sensitivity of 88.2% and specificity of 76.0% in the predication of LVEF <50% in children with dilated cardiomyopathy. T-wave amplitude on ECG can be used as the indexes for the evaluation of the left ventricular systolic function in children with dilated cardiomyopathy.

Role of central corneal thickness in intraocular pressure changes after corneal refractive surgery

Objective The aim of the study was to assess importance of central corneal thickness (CCT) in the intraocular pressure (IOP) variation after corneal refractive surgery. Patients and methods This prospective, interventional study contains 75 patients who were divided into three equal groups. Group I had undergone femtosecond laser-assisted in-situ keratomileusis (femto-LASIK); Group II had undergone laser in-situ keratomileusis (LASIK); and group III had undergone photorefractive keratectomy (PRK). The evaluated parameters included age, sex, spherical equivalent refraction (preoperative and postoperative), CCT preoperatively and postoperatively and IOP preoperatively and postoperatively at 1, 3, and 6 months by Goldmann applanation tonometry (GAT) and ocular response analyzer. Result The mean CCT reductions were 56.6 ± 34.1, 52.8 ± 25.5, and 40.5 ± 25.9 μm after femto-LASIK, LASIK, and PRK surgery. The mean IOP reductions by GAT were 2.42 ± 1.9, 2.46 ± 2.56, and 1.14 ± 1.31 mmHg after 1 month in femto-LASIK, LASIK, and PRK; however, after 3 months 3.14 ± 1.87, 3.22 ± 2.99, and 2.7 ± 2.23 mmHg after femto-LASIK, LASIK, and PRK. After 6 months the mean IOP reduction was 3.22 ± 1.83, 3.44 ± 2.91, and 2.84 ± 2.32 mmHg after femto-LASIK, LASIK, and PRK. The mean IOPg reduction was 2.53 ± 1.81, 3.19 ± 1.76, and 3.29 ± 1.87 mmHg at 1, 3, and 6 months after femto-LASIK. However, the mean decrease in IOPg was 2.67 ± 2.08, 3.28 ± 1.95, and3.52 ± 1.89 mmHg at 1, 3, and 6 months after LASIK. The mean decrease in IOPg was 1.26 ± 1.98, 2.85 ± 1.98, and 2.98 ± 1.79 mmHg at 1, 3, and 6 months after PRK. IOPcc is not correlated with CCT. Conclusion The IOP by GAT and IOPg reduction after corneal refractive surgery significantly depends on CCT changes, but IOPcc measurements are not associated with CCT.

Relationship between hemodynamics with hepatic reserve function in cirrhotic patients with portal hypertension

Objective To investigate the relationship between hemodynamics with hepatic reserve function in cirrhosis patients complicated with portal hypertension (PHT), and to explore the significances of the two in evaluating the disease. Methods According to the Child score, 80 cirrhosis patients complicated with PHT from January 2016 to January 2018 in our hospital were divided into three grades: A, B and C, 35 healthy persons in the same period were selected as normal control group. The parameters of liver hemodynamics were detected by color Doppler ultrasound, and the items of liver reserve function were detected by automatic biochemical analyzer. The correlation between hemodynamic indexes and liver reserve function was analyzed by Pearson method, and the risk factors of liver cirrhosis with PHT were analyzed by logistic multiple regression. Results The diameter of portal inner vein (DPV), maximum speed of blood flow in the portal vein (PVX), mean speed of blood flow in the portal vein (PVM), quantity of blood flow in the main portal vein (QPV), albumin (ALB), cerealthirdtransaminase (ALT), aspartate transaminase (AST) and prothrombin time (PT) in the observation group were significantly higher than those in the control group (P<0.05), while the total bilirubin (TBIL) was significantly lower than that in the control group (P<0.05). The levels of DPV, PVX, PVM and QPV in patients with grade C were significantly higher than those in grade A and grade B (P<0.05); the levels of DPV, PVX, PVM and QPV in patients with grade B of liver function were significantly higher than those in grade A (P<0.05). The level of TBIL in patients with grade C liver function was significantly lower than that in grade A and grade B patients (P<0.05); ALB, ALT, AST and PT were significantly higher than those of grade A and grade B (P<0.05); the level of TBIL in patients with grade B of liver function was significantly lower than that of grade A (P<0.05), while the ALB, ALT, AST and PT were significantly higher than those in group A (P<0.05). DPV, PVM and QPV were significantly positively correlated with PT in cirrhosis patients with and PHT (P<0.05), PVM and QPV were significantly negatively correlated with TBIL (P<0.05). Regression analysis showed that hemodynamic indexes in DPV, PVX, PVM, QPV and liver reserve function indexes TBIL, ALB, ALT, AST, PT were risk factors for portal hypertension in cirrhosis. Conclusions Hemodynamics and hepatic reserve function indicators have certain regularity in different degrees of cirrhosis complicated with PHT patients, they are closely related and can be used as an important index in the evaluation and monitoring of cirrhosis with PHT. Key words: Liver cirrhosis; Portal hypertension; Hemodynamics; Hepatic reserve functional

An observational study on the involvement of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3 in aerobic glycolysis in lung fibroblasts and lung tissue induced by lipopolysaccharide

Objective To observe the effects of lipopolysaccharide (LPS) on the expression of a key enzyme during aerobic glycolysis, 6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3 (PFKFB3), and its relationship with aerobic glycolysis, so as to explore the potential mechanism of aerobic glycolysis in lung fibroblasts and lung tissue during LPS-induced pulmonary fibrosis. Methods Human embryonic lung fibroblasts (MRC-5 cell line) were divided into two groups according to the random number table method (n=3): a PBS control (PBS) group and an LPS group. After LPS stimulation for 6 h, the expression of PFKFB3 was detected by Western blot, while the intracellular localization of PFKFB3 was determined by immunofluorescence. The oxygen consumption rate (OCR) and the extracellular acidification rate (ECAR) were mea-sured by the Seahorse Extracellular Flux Analyzer, and the colorimetric method was used to detect the production of lactic acid, a product of aer-obic glycolysis. Meanwhile, the synthesis of collagenⅠwas detected by Western blot after LPS stimulation for 48 h. Twenty-four C57BL/6 mice were divided into two groups according to the random number table method (n=12): a normal saline control group (group C), and an LPS group(group L). Groups L and C were intraperitoneally injected with 5 mg/kg LPS or an equal volume of normal saline for five consecutive days. Six mice of each group were sacrificed on Day 7 after modeling to obtain the plasma and lung tissue. The expression of PFKFB3 in lung tissue of each group was detected by Western blot and immunofluorescence, and the colorimetric method was used to detect the content of lactic acid in the plasma of mice in each group. Lung tissues were collected from the remaining mice on Day 28 after modeling, where a lung was collected to detect collagen Ⅰ synthesis by Western blot, while the other lung were taken to prepare paraffin sections for pathological examination. Results Compared with the PBS group, the expression of PFKFB3 in lung fibroblasts significantly increased after LPS stimulation for 6 h (P< 0.05). After LPS stimulation for 48 h, compared with the PBS group, the LPS group presented a decreased OCR, an increased ECAR, and a re-markably increased amount of lactic acid (P<0.05), with significantly increased synthesis of collagen Ⅰin the cells (P<0.05). Compared with group C, the expression of PFKFB3 in lung tissue significantly increased after intraperitoneal injection of LPS into the mice of group L for seven days (P<0.05), with a significantly increased content of lactic acid in the plasma (P<0.05). After LPS injection for 28 days, the mice in group L presented significantly increased expression of collagenⅠ (P<0.05), with obvious fibrosis in lung tissue. Conclusions LPS can induce the ex-pression of PFKFB3 in lung fibroblasts and lung tissue during LPS-induced pulmonary fibrosis, which is related to aerobic glycolysis. The upreg-ulated expression of PFKFB3 may be a key step of LPS-induced aerobic glycolysis and pulmonary fibrosis in lung fibroblasts and lung tissue. Key words: Lung; Lipopolysaccharide; Fibroblasts; 6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3; Aerobic glycolysis; Pulmonary fibrosis

Analysis of the oxidative products of DNA(8-oxo Gsn) and RNA(8-oxo dGsn) in patients with essential hypertension

Objective Analysis of the oxidative products of DNA and RNA in patients with hypertension by determination of 8-oxo Gsn and 8-oxo dGsn, respectively. Methods This is an observational study. During August and December, 2018, 139 hypertension patients without other chronic diseases with an average age of (49.6±12.4) years old, and 139 apparently healthy volunteers without hypertension with an average age of (48.5±11.7) years old were recruited. Fasting morning urine were collected. The oxidative products of DNA: 8-oxo Gsn and the products of RNA: 8-oxo dGsn were analyzed using liquid chromatography tandem mass spectrometry. Urine Cr(U-Cr), and other serum biomarkers such as ALT, Cr, UA, Glu, TG, TC were analyzed using automatic biochemical analyzers. Results of 8-oxo Gsn and 8-oxo dGsn were presented as median(quartile). Statistical analysis was performed using SPSS 22.0 and GraphPad Prism 5. Nonparametric test was used to compare the difference of 8-oxo Gsn and 8-oxo dGsn between the hypertension patients and the healthy controls. Results The DNA and RNA oxidative products of 8-oxo Gsn and 8-oxo dGsn in patients with hypertension and their U-Cr-corrected 8-oxo Gsn/U-Cr and 8-oxo dGsn/U-Cr were 14.38(10.39-19.91)ng/ml, 12.97(7.92-18.96)ng/ml, 1.10(0.88-1.38)μg/μmol and 0.96(0.75-1.30) μg/μmol, respectively, which were significantly higher than those in the healthy controls: 11.95(7.52-18.01) ng/ml, 10.12(6.42-15.04) ng/ml, 0.86(0.59-1.21) μg/μmol and 0.72(0.50-1.02) μg/μmol, respectively. After grouped by sex, 8-oxo Gsn in males, 8-oxo Gsn and 8-oxo dGsn in females showed no significant difference between patients with hypertension and healthy controls, however, after U-Cr correction, both males′ and females′ 8-oxo Gsn/U-Cr and 8-oxo dGsn/U-Cr in patients with hypertension were higher than that in the healthy controls. Conclusion The oxidative products of DNA and RNA in patients with hypertension were significantly higher than that in healthy controls. Key words: Hypertension; DNA; RNA; Guanosine; Deoxyguanosine; Chromatography, liquid; Tandem mass spectrometry

Study on the evaluation of Rivaroxaban′s blood concentration by anti-FX activity assay

Objective The anti-FⅩa assay can be used to monitor the blood concentration of Rivaroxaban. The aim is to evaluate the critical value and diagnostic performance of this test on bleeding risk assessment. Methods From September 2017 to June 2019, 368 patients were enrolled for retrospective cohort study, including 201 males and 167 females, aged (62.8±15.7) years old. They were divided into groups by age:≤60 years old group 105 cases,61-70 years old group 135 cases,≥71 years old group 128 cases. Anti-FⅩa was detected on ACL TOP 700 coagulation analyzer using chromogenic substrate method to quantitatively determine the plasma concentration of rivaroxaban. Anti-FⅩa data were expressed as M (P25-P75);Kruskal-Wallis H test was used for comparison among groups; Mann-Whitney U test was for data comparison between two groups; positive rate comparison was performed by χ2 test; the diagnostic performance of anti-FⅩa to assess bleeding risk was evaluated by ROC curve;Kaplan-Meier curve was used for the survival analysis;the risk ratio (HR) was obtained by Cox proportional hazard regression model. Results Both the peak and trough plasma concentrations were higher in patients aged 61-70 years old than ≤60 years old (U values were 5 618 and 5 725,respectively, P values were 0.006 and 0.011, respectively); higher in patients ≥71 years old than 61-70 years old (U values were 6 438 and 6 317, respectively, P values were 0.05).Both peak and trough blood concentrations were higher in patients with bleeding than without bleeding(U values were 1 429 and 2 185, respectively, P<0.001 and 0.001, respectively).ROC showed that the cut-off values of peak blood concentration in evaluation of the overall and the ≥61 year-old population′s bleeding risk were 200.8 ng/ml and 209.9 ng/ml,respectively, corresponding respectively with the sensitivity of 90.9% and 95.0%; the trough cut-off values were 35.1 ng/ml and 39.1 ng/ml, respectively, corresponding respectively with the sensitivity of 72.7% and 70.0%. However, all the above cut-off values gave a low diagnostic specificity. Survival analysis showed with 35.1 ng/ml as the trough cut-off value, the cumulative risk of bleeding significantly increased in patients above the cut-off value (Log-rank χ2=4.513,P=0.034). The Cox proportional regression model demonstrated that the hazard ratios for peak and trough blood concentration predictions of bleeding risk were 1.023 (95%CI: 0.834-1.256) and 0.948 (95%CI: 0.773-1.164). respectively. Conclusions Both the peak and trough values of blood concentration in bleeding patients are higher than non-bleeding patients. The peak blood concentration is highly sensitive to the risk of bleeding, and the elevated trough blood concentration levels indicate that the probability of bleeding risk increases in the short term. However, the specificity of both peak and trough values is relatively low in bleeding risk assessment. When used alone, the prediction of bleeding events does not have direct guiding significance. Dynamic monitoring and joint evaluation are recommended. Key words: Factor Ⅹa; Rivaroxaban; Plasma concentration; Blood coagulation tests; Hemorrhage; Forecasting

Preliminary establishment of reference interval for non-fasting serum triglycerides among healthy middle-aged and elderly people in some communities Beijing

Objective To establish the reference interval of serum triglyceride (TG) for 4 hours after meal in healthy middle and old people of Beijing community, and to provide the diagnostic basis for the judgment of dyslipidemia after meal. Methods Selected 369 elderly people from January to October 2018 in the health examination of Guang′anmen Hospital of the Chinese Academy of Traditional Chinese Medicine. The subjects collected fasting venous blood samples in the morning the next day after fasting for 12 hours, then ate a standard breakfast that conformed to the local dietary habits, and collected venous blood samples again 4 hours after eating. Serum TG levels were measured 4 h after meal using AU5822 fully automatic biochemical analyzer and matching reagents. The comparison of postprandial TG between different age and sex groups was statistically significant using the nonparametric test of two independent samples, and the comparison between postprandial and fasting TG using the nonparametric test of two paired samples with P<0.05 as the difference. The 95% confidence interval was calculated using a nonparametric method according to the relevant requirements of the CLSI EP28-A3c file, and the reference interval was expressed as P2.5, P97.5. Results The median 4-hour post-prandial TG of the middle-aged and elderly aged 45-59 years and those aged ≥ 60 years at health checkups were 1.65 (1.25, 2.13) mmol/L and 1.58 (1.25, 2.00) mmol/L, there was no significant difference between the two groups (Z=-1.040, P>0.05). There was no statistical difference between males 1.69 (1.22, 2.31) mmol/L and females 1.63 (1.26, 2.12) mmol/L at 4 hours postprandial TG levels in the 45-59 year-old group (Z=-0.179, P>0.05),there was also no statistical difference between 1.64 (1.22, 2.06) mmol/L for men and 1.53 (1.28, 1.99) mmol/L for women aged 60 years or older (Z=-0.256, P>0.05).Compared with the median fasting TG of 1.05 (0.87, 1.29) mmol/L, the median serum TG of 1.61 (1.25, 2.09) mmol/L at 4 hours after meal was significantly increased (Z=-16.449, P<0.01). The difference between postprandial and fasting was 0.52 (0.30, 0.85) mmol/L.The reference range of serum TG at 4 hours after meal was 0.82 to 3.02 mmol/L. Conclusion In this study, the reference range of serum triglycerides for 4 hours after meal was established in some healthy elderly population groups in Beijing. Key words: Non-fasting serum Triglyceride; Healthy population; Middle-aged and elderly people; Reference range

Preliminary study of serum 2019-nCoV IgM and IgG antibodies in the diagnosis of COVID-19

Objective To analyze the clinical value of serum 2019 New Coronavirus (2019-nCoV) immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies in the diagnosis of novel coronavirus pneumonia (NCP). Methods A total of 116 patients diagnosed with NCP in the First Affiliated Hospital of Hunan University of Chinese Medicine and the First Affiliated Hospital of Xiamen University were enrolled from January to February 2020 as the disease group. A total of 134 cases, including 84 non-NCP inpatients and 50 healthy individuals served as the control group. Serum samples from all subjects were collected. A fully-automated chemiluminescence immunoassay analyzer was used to detect the concentration of 2019-nCoV IgM and IgG antibodies in serum. The sensitivity and specificity of the 2019-nCoV IgM and IgG antibody single test and combined detection were compared using the χ2 test. χ2 test and Wilcoxon’s rank sum test were used to compare the positive rates and concentrations of IgM and IgG antibodies in NCP patients before and after their 2019-nCoV nucleic acid tests turning negative, respectively. The change trend of 2019-nCoV antibody concentration in the process of NCP patients was analyzed by Wilcoxon’s rank sum test. Results The sensitivity of 2019-nCoV IgG (90.5%, 105/116) was higher than that of 2019-nCoV IgM (75.9%, 88/116), the difference was statistically significant (χ2=8.91, P<0.05); The specificity of 2019-nCoV IgG (99.3%, 133/134) was higher than that of 2019-nCoV IgM (94.0%, 126/134), the difference was statistically significant (χ2=5.63, P<0.05). The sensitivity (89.7%, 87/97) of 2019-nCoV IgM combined with IgG was higher than that of 2019-nCoV IgM, the difference was statistically significant ( χ2=6.89, P<0.05). The specificity (100%, 125/125) of 2019-nCoV IgM combined with IgG was higher than that of 2019-nCoV IgM, the difference was statistically significant ( χ2=7.70, P<0.05). After 2019-nCoV nucleic acid test converted to negative, the positive rate (52.9%, 9/17) and concentration [13.0 (4.9, 24.7) AU/ml] of serum 2019-nCoV IgM antibody were significantly lower than those when the nucleic acid test was positive, positive rate (88.2%, 15/17) and concentration [29.5 (14.0, 61.3) AU/ml] , respectively (χ2=5.10, Z=-3.195, both P<0.05). In the course of NCP, patients' serum samples were collected from the first day of diagnosis to every three days, three times in total. The first 2019-nCoV IgM and IgG antibody concentrations [19.4 (12.4, 63.7) AU/ml, 105.8 (74.8, 126.1) AU/ml, respectively] were significantly higher than the second concentrations [15.8 (7.1, 40.3)AU/ml, 80.5 (66.7, 105.9) AU/ml], Z were -2.897, -3.179, both P<0.05. Conclusions 2019-nCoV IgG antibody has a good application value in the diagnosis of NCP; The concentration of 2019-nCoV IgM antibody has a certain correlation with the detection of 2019-nCoV nucleic acid; The combination of 2019-nCoV IgM and IgG antibodies with 2019-nCoV nucleic acid test may be the best laboratory index for the diagnosis of NCP at present. Key words: Coronavirus; Pneumonia, viral; Immunoglobulin M; Immunoglobulin G; Nucleic acids; Sensitivity and specificity; Real-time polymerase chain reaction

Effect of nurse-led multiple disciplinary team-based intervention in the prevention of venous thromboembolism in paitents undergoing general surgery

Objective To investigate the effect of nurse-led multiple disciplinary team-based intervention in the prevention of venous thromboembolism in paitents undergoing general surgery. Methods A total of 118 patients who underwent general surgery in the Tianjin First Central Hospital from May 2017 to October 2018 were divided into study group and control group by random digits table method, with 59 cases in each group. The control group received routine thrombosis prevention nursing, the study group carried out nurse-led multiple disciplinary team-based intervention. The condition of lower limbs deep venous hemodynamic was detected by color Doppler ultrasonography at 3 days after surgery, the levels of D-dimer, thrombelastograph coagulation analyzer (TEG) coagulation parameters were also measured at after 24 hours of admission and postoperative day 3, respectively. Results The vein blood stasis rate was 94.9% (3/59) in the study group, 79.7% (12/59) in the control group, the venous blood flow of the lower 1imbs in the study group was better than that in the control group (Z value was 2.477, P<0.05). At 3 days after surgery, the levels of D-dimer were (5.26±1.42) mg/L in the study group, (6.36±1.58) mg/L in the control group, D-dimer was decreased in study group compared to the control group, the difference was statistically significant (t value was 3.991, P<0.05). Coagulation reaction time(R) value and solidification angle(Angel), maximum thrombus intensity(MA), composite coagulation index(CI) levels were (5.30±0.91) min, (69.64±21.93) deg, (65.40±13.76) mm and (1.23±0.20) in the study group, those index were (4.41±0.75) min, (76.64±16.02) deg, (70.98±13.39) mm, (2.09±0.36) in the control group, R value were increased and Angel, MA, CI levels were decreased in the study group compared to the control group (t value was 2.001-15.997, P<0.05). Conclusions Nurse-led multiple disciplinary team-based intervention improves the lower limbs deep venous hemodynamic and coagulation function, as well as reduce the incidence of venous thromboembolism. Key words: Nurses; Multiple disciplinary team; Venous thromboembolism; Prevention

Indirect Method for Determination of Paracetamol in Pure and Pharmaceutical Drugs using CFIA with Homemade Ayah 3SBGRX3-3D Solar Cell Microphotometer Analyzer

Indirect Method for Determination of Paracetamol in Pure and Pharmaceutical Drugs using CFIA with Homemade Ayah 3SBGRX3-3D Solar Cell Microphotometer Analyzer

Epidemiological study on respiratory syncytial virus-caused respiratory infection in children and preliminary analysis of changes in immune function

Objective To analyze the epidemiological characteristics of respiratory syncytial virus (RSV)-caused respiratory diseases in children in Hebei Province and the changes in peripheral blood lymphocyte subsets and inflammatory indexes. Methods A total of 9 491 sputum specimens and 9 491 paired peripheral blood specimens were collected from children admitted to Hebei Children′s Hospital for respiratory infection in 2018. RSV-positive sputum specimens were screened by multiple detection reagents for 13 kinds of respiratory pathogens. Flow cytometry was uses to detect T and B lymphocytes and NK cells in peripheral blood samples of randomly screened RSV-positive children. Procalcitonin (PCT) was measured by Roche E411 luminescence analyzer. Hypersensitive C-reactive protein (hs-CRP) was detected by Roche Cobas 8000 C701 biochemical analyzer. White blood cells (WBC) were measured by Sysmex XN-BN3 hematometer. Results The positive rate of RSV in children with respiratory diseases was 13.08% in Hebei Province in 2018. There were significant differences in RSV-positive rates among different age groups (χ2=479.297 6, P<0.000 1). The positive rate of RSV decreased gradually with age (χ2=-20.282 7, P<0.000 1) and was higher in male than in female (χ2=34.552 7, P<0.000 1). The incidence of co-infection of RSV with other respiratory pathogens was 29.49% (366/1 241), mainly caused by human rhinovirus (HRV, 150/1 241) and adenovirus (ADV, 40/1 241). The main epidemic seasons of RSV infection were winter and spring. The epidemic trends of simple RSV infection and co-infection were consistent. There were significant differences in inflammatory indexes, WBC (P<0.01), CD4+ (P=0.015) and CD4+ /CD8+ cells (P=0.016) between simple RSV infection and co-infection groups. Conclusions RSV was a common pathogen causing respiratory diseases in children in Hebei Province. The younger the children were, the more likely they were to be infected with RSV. RSV infection was easily complicated by HRV or ADV infection. The epidemic seasons of RSV infection in Hebei were winter and spring. Both simple infection and co-infection of RSV might result in immune dysfunction. Key words: Respiratory syncytial virus; Lymphocyte subsets; Molecular epidemiology; Immunity

Value of ultrasound combined with serum CA125, CA199 and CEA in the differential diagnosis of ovarian benign and malignant tumors

Objective To investigate the diagnostic values of ultrasonography combined with serum cancer antigen 125 (CA125), serum carbohydrate antigen 199 (CA199), serum carcinoembryonic antigen (CEA) in ovarian malignant tumors. Methods From November 2015 to December 2017, 140 patients with ovarian cancer admitted to the hospital were selected as subjects, and ultrasound examination was carried out with IU22 ultrasound diagnostic instrument. The patients were divided into 92 cases of benign ovarian tumors and 48 cases of malignant ovarian tumors through pathological diagnosis. The serum CA125, CA199 and CEA of all patients were detected by automatic biochemical analyzer, and receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of four combined detection in ovarian malignancies. Results The coincidence rate of ultrasound diagnosis in ovarian benign tumor patients was significantly higher than that in ovarian cancer patients (P<0.05). The levels of serum CA125, CA199 and CEA in benign ovarian tumors were significantly lower than those in malignant ovarian tumors (P<0.05), and the levels of serum CA125, CA199 and CEA in patients with stage Ⅰ to Ⅱ were significantly lower than those in stage Ⅲ to Ⅳ (P<0.05). The area of serum CA125, CA199 and CEA under the ROC curve was 0.788, 0.750 and 0.708, respectively. The boundary points of diagnosis were 50.61 U/ml, 36.47 U/ml and 4.32 ng/ml, respectively. The area under the combined diagnosis curve of the serum CA125, CA199 and CEA was 0.832. The sensitivity, specificity and accuracy of the combined detection were higher than that of single index detection and serum combined detection. Conclusions Ultrasound combined with serum CA125, CA199 and CEA levels detection can improve the sensitivity, specificity and accuracy of diagnosis of ovarian benign and malignant tumors, which has certain clinical value. Key words: Ultrasonography; CA125; CA199; Carcinoembryonic antigen; Ovarian neoplasms

Investigation and analysis of dry eye status of nursing students

Objective To evaluate the dry eye status of nursing school students and understand their ocular surface health. Methods Using the convenience sampling method, a total of 90 nursing students studying in the Nursing College of Capital Medical University in March 2018 were selected as the research objects. The OCULUS Jenvis-OSDI dry eye questionnaire and OCULUS ocular surface comprehensive analyzer were used subjectively and objectively to analyze the heath of ocular surface. Results According to the OSDI dry eye questionnaire, mild dry eyes were 21 cases accounted for 23.3%, moderate dry eyes were 42 cases accounted for 46.7%, and severe dry eyes were 21 cases accounted for 23.3%. The main symptom of dry eye was foreign body sensation, accounting for 53.3%. The secondary symptoms were photophobia and blurred vision, which accounted for 46.7% and 40%, respectively. The OCULUS ocular surface comprehensive analyzer showed that the amount of tear secretion in both eyes was normal. In dry eye grading based on average tear film break-up time, critical dry eye accounted for about 60% and dry eye accounted for about 10%. Eye red analysis showed that 9 patients (10%) with hyperemia score>2.0 were dry eye caused by inflammation. Conclusions The nursing school students have a high incidence of dry eye and subjective symptoms. It indicates that the students overuse eye and do not pay attention to eye hygiene. It is the responsibility of the nursing teacher to carry out health education for students, popularize scientific and rational use of eye knowledge, and pay attention to eye health. Key words: Students, nursing; Dry eye; Ocular surface disease; Investigation

Distribution characteristics and risk factors of infectious pathogens after open limb fracture surgery

Objective To investigate the distribution characteristics and risk factors of infectious pathogens after open limb fracture surgery. Methods From January 2016 to December 2018, 180 patients with open limb fracture admitted to Hangzhou Hospital of Zhejiang Medical and Health Group were selected to observe the infection after operation.Pathogens were isolated and identified by automatic biological analyzer and bacterial identification system, and drug resistance test was carried out by K-B method.Multivariate logistic regression analysis was used to analyze the risk factors of infection after open limb fracture surgery. Results Among 180 cases of open limb fracture, 29 cases had postoperative infection, the infection rate was 16.11%.Among 29 cases of post-operative infection, 34 strains of pathogenic bacteria were isolated, including 19 strains of Gram-positive bacteria, 13 strains of Gram-negative bacteria and 2 strains of fungi.The resistance rate of Staphylococcus aureus to penicillin G was high, and the resistance rate was 80.00%.Univariate analysis showed that there were no statistically significant differences in gender, BMI, injury site, smoking history, hypertension and intraoperative bleeding between the two groups (χ2=0.252, 0.416, 0.734, 0.856, 0.572, all P>0.05). There were statistically significant differences in age, diabetes mellitus, operation time, hospitalization time, wound contamination and drainage tube placement time between the two groups (χ2=21.537, 9.664, 17.244, 15.459, 24.327, 19.804, all P 60 years old, diabetes mellitus, operation time>3h, hospitalization time>14d, wound contamination and drainage tube placement time>4d were independent risk factors for infection after open limb fracture surgery. Conclusion Postoperative infection rate of open limb fracture is high.Gram-positive bacteria are the main pathogenic bacteria.Postoperative infection is affected by many factors.In order to prevent postoperative infection, specific measures should be taken and antibiotics should be used reasonably in strict accordance with drug sensitivity test. Key words: Fractures, open; Extremities; Infection; Gram-positive bacteria; Gram-negative bacteria; Fungi; Risk factors

Role of inflammatory mediators (TNF-α, IL-6, CRP), biochemical and hematological parameters in type 2 diabetes mellitus patients of Kashmir, India.

Background: Type II Diabetes mellitus (T2DM) is a multifactorial disease and a leading cause of premature deaths. Inflammatory cytokines are reported that they have potential to enhance insulin resistance and hence T2DM. Assessment of immunological profile in T2DM patients of Kashmir valley is unclear. So, detection of cytokines is relevant to determine the extent and direction of immune responses. The current research was taken to study the role of inflammatory mediators in T2DM along with insulin sensitivity, biochemical and hematological parameters in mountainous valley of Kashmiri population. Methods: A total of 340 subjects were selected in this study among them 160 were T2DM cases and 180 were healthy controls. Serum expression of inflammatory mediators (TNF-α and IL-6 ) were quantified by ELISA technique, WBC count was measured on Sysmax (Germany) hematology analyzer, biochemical and Immunoassay parameters were done on Abbott c4000 (USA) and Abbott C1000 (USA) fully automatic analyzer. Data was analyzed using statistical ‘software SPSS 16.1’ (Chicago, IL). For all assessments, p<0.05 were considered statistically significant. Results: The expressions of candidate cytokines (TNF-α, IL-6, CRP, and WBC) were highly significant (p<0.001) in T2DM. Among inflammatory mediators, TNF-α shows a positive correlation (p<0.001) with glycemic profile and insulin sensitivity in T2DM cases in comparison with healthy normal. Biochemical (fasting sugar, HbA1c, insulin resistance, lipid profile) and anthropometric (BMI) parameters were highly significant (p<0.001) in T2DM cases as compared to non-diabetic normal. Conclusion: Low grade inflammation and up regulation of inflammatory mediators has been purported to play a significant role in pathogenesis of T2DM. Our findings confirm that positive correlation of TNF-α and IL-6 with T2DM and insulin sensitivity. These can act as early prediction biomarkers of T2DM. Further studies on wider range of pro and anti- inflammatory cytokines i.e. mediators, in association with other biochemical, immunoassay and hematological parameters are needed to help clinicians manage and treat T2DM effectively.

신조어 및 띄어쓰기 오류에 강인한 시퀀스-투-시퀀스 기반 한국어 형태소 분석기

신조어 및 띄어쓰기 오류에 강인한 시퀀스-투-시퀀스 기반 한국어 형태소 분석기

Role of macrophage polarization in lung injury in obese rats with acute necrotizing pancreatitis

Objective To investigate whether obesity aggravates acute lung injury and its mechanism in acute necrotizing pancreatitis. Methods Twenty-four male Sprague-Dawley rats were randomly divided into a normal diet control group (N-control), a normal diet-ANP group (N-ANP), and a high-fat diet control group (H-control), and a high fat diet-ANP group (H-ANP). Serum amylase (AMY), lipase (LIP), triglyceride (TG) and total cholesterol (TC) were determined by automatic biochemical analyzer. CD68, CD11c, CD206, toll like receptor-4 (TLR4), myeloperoxidase (MPO), interleukin (IL)-1β and nuclear factor-κB (NF-κB) in the lung tissue were detected by immunofluorescence or immunohistochemistry. The pancreas and lung tissues were observed under microscope and scored. SPSS 22.0 software was used. The data were expressed as mean±standard deviation. The t test, one-way ANOVA and SNK test were used. Results The TG and TC of the H-control group were (1.00±0.36) and (2.51±0.41) U/L, which were higher than those of the N-control group (0.53±0.19) and (1.72±0.52) U/L. The differences were statistically significant (t=-3.288, -3.062, P<0.05); AMY and LIP of the N-ANP group were (8 690.00±1 951.35), (9 650.00±1 810.19) U/L, which were higher than the N-control group (2 018.50±382.05), (90.26±7.00) U/L, the difference was statistically significant (q=9.452, 18.090, P<0.05); the LIP of the H-ANP group was (39 705.75±1 345.55) U/L, which was higher than the N-ANP group (q=59.940, P<0.05). The pancreas and lung scores in the N-ANP group were (11.40±1.80) and (6.62±1.06) points, which were higher than those in the N-control group (0.31±0.29) and (0.75±0.88). The difference was statistically significant (q=21.950, 17.160, P<0.05). The lung score of the H-ANP group was (8.19±1.07) points, which was higher than that of the N-ANP group (q=4.017, P<0.05), and the difference was statistically significant. The lung NF-κB of N-ANP group was (0.38±0.02), which was higher than that of N-control group (0.23±0.02) and lower than that of H-ANP group (0.48±0.01). The difference was statistically significant (q=21.830, 13.030, P<0.05). The number of IL-1β, MPO, CD68+ , CD68+ /CD11C+ , CD68+ /TLR4+ cells in the N-ANP group was (43.80±4.29), (105.81±5.37), (34.17±3.27), (13.32±1.83), (18.43±1.06), higher than the N-control group (4.93±1.13), (10.37±1.77), (20.16±2.42), (1.54±0.75), (8.37±1.40), the difference was statistically significant (q=29.530, 51.010, 15.261, 17.952, 20.965, P<0.05), lower than the H-ANP group (92.58±5.83), (175.71±8.85), (41.61±2.56), (16.92±1.96), (22.91±2.10), the difference was statistically significant (q=36.820, 37.100, 8.176, 8.079, 6.467, P<0.05). The number of lung CD68+ /CD206+ cells in the N-ANP group was (20.43±1.30), which was higher than that in the N-control group (11.65±1.51) and H-ANP group (14.83±1.83). The difference was statistically significant (q=16.613, 10.682, P<0.05). Conclusion Obesity can aggravate ALI in ANP, which may be related to the degree of activation of TLR4 signaling pathway in lung macrophages, leading to the polarization of macrophages to proinflammatory direction and release of more inflammatory mediators. Key words: Obesity; Acute necrotizing pancreatitis; Acute lung injury

Investigating the Effects of Ibuprofen on the Gene Expression Profile in Hippocampus of Mice Model of Alzheimer's Disease through Bioinformatics Analysis.

Non-steroidal anti-inflammatory drugs (NSAIDs) are identified as effective in many diseases. One of which is neurodegenerative diseases including Alzheimer disease (AD). In this study gross alteration of gene expression in AD mice by ibuprofen treatment is investigated via Protein-protein interaction network (PPI) analysis. Expression profiling of microarray dataset GSE67306 was retrieved from GEO database and analyzed via GEO2R tool. PPI analysis was performed via Cytoscape 3.7.0. and its plug-ins including Network Analyzer, Gene MANIA, and CluePedia. Numbers of 10 central genes including Htr1a, Sstr2, Drd2, Htr1b, Penk, Pomc, Oprm1, Npy, Sst, and Chrm2 were identified as potential biomarkers. However, the role of Penk gene was highlighted. The finding indicates that ibuprofen changes gene expression level of several genes that are involved in AD.

Randomized controlled trial to compare the tolerability and efficacy of treatment with Icodextrin 7.5% versus Dextrose 2.5% in chronic peritoneal dialysis patients with high/high average solute transport characteristics and low residual renal function

Aim: Comparison of tolerability and efficacy of treatment with icodextrin vs. dextrose 2.5% amongst high risk cohort of chronic peritoneal dialysis patients (high/high average solute transport characteristics and low residual renal function) over 3 months. Study Design and Methodology: The study was an open-label, comparative, prospective, randomized controlled trial, conducted at department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. A total of 349 end stage renal disease patients on chronic peritoneal dialysis were screened for eligibility over a period of 6 months and 41 patients with high / high average solute transport characteristics and low residual renal function were randomized to receive either icodextrin 7.5% solution or 2.5% dextrose solution in long dwell. Patients were assessed for adequacy of peritoneal dialysis (creatinine & urea clearance), peritoneal membrane transport characteristics including solute clearance (standard peritoneal equilibration test), body composition, total body water, fat mass and fat free mass (using whole body tetrapolar bioimpedance analyzer) at baseline and at the end of 3 months. Statistical Analysis: Continuous variables were compared with independent samples paired t test if normally distributed, or with Mann–Whitney U test if the distribution was skewed. Categorical variables were analyzed with Chi-square test or Fisher exact test as appropriate. Pearson's correlation coefficient was calculated between different quantitative variables. Paired t test and Wilcoxon signed-rank test were used for within-group comparisons. Repeated measure ANOVA was used to compare bioelectrical impedance between intervention groups. Results: The study has shown that use of icodextrin based continuous ambulatory peritoneal dialysis resulted in better ultrafiltration and improved solute clearance when compared to 2.5% dextrose based peritoneal dialysis in a select cohort of patients having high/high average transporter characteristics with poor residual renal function, however, it didn't significantly alter total body water and failed to translate into improvements in either patient's or physician's assessment of global health of response to therapy atleast at 3 months. Conclusions: Although use of icodextrin based peritoneal dialysis solution for long dwell resulted in significant improvement in solute clearance and ultrafiltration nevertheless failed to translate into better hydration status or subjective improvement scores atleast at 3 months.