[目的]探讨尿肾功能指标在糖尿病肾病(DN)早期肾损伤中的评估价值.[方法]选择2017年6月至2018年6月在本院诊治的2型糖尿病(T2DM)患者50例.根据患者尿微量白蛋白(MA)水平分为糖尿病肾脏损伤组(MA ＞23 mg/L,观察组,n=18)和糖尿病无肾脏损伤组(MA≤23 mg/L,对照组,n=32).比较两组患者N-乙酰-D-氨基葡萄糖苷酶(NAG)、MA、β2-微球蛋白(β2-MG)、胱抑素-C(Cys-C)、视黄醇结合蛋白(RBP)水平的差异,分析各检测指标确诊DN早期肾损伤的ROC曲线.[结果]两组患者肌酐(Cr)、血尿素氮(BUN)水平比较差异无统计学意义(P＞0.05);观察组患者NAG、RBP、β2-MG、Cys-C水平高于对照组,其差异有统计学意义(P＜0.05).NAG、RBP、β2-MG、Cys-C在ROC曲线中的AUC分别为0.894、0.926、0.937、0.984;Cr、BUN的AUC分别为0.513、0.433.[结论]NAG、RBP、β2-MG、Cys-C在DN早期肾损伤患者中表达水平较高,且对DN早期肾损伤诊断具有较高的敏感性,可为疾病早期诊治提供依据.

[目的]探讨超氧化物歧化酶(SOD)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)、胱抑素C(Cys-C)在妊娠期糖尿病(GDM)患者血清中的表达及其意义.[方法]选取2018年3～8月本院收治的GDM患者20例(GDM组),另外选取同期正常孕妇24例为对照组.检测并比较两组受试者血清中空腹血糖(FPG)、SOD、CRP、Hcy、Cys-C、血清胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)水平,并分析SOD、CRP、Hcy、Cys-C与HOMA-IR、HOMA-β相关性.[结果]GDM组FPG、CRP、Hcy、Cys-C水平及HOMA-IR显著高于对照组,而SOD显著低于对照组,其差异具有统计学意义(P＜0.05),但两组HO-MA-β比较差异无统计学意义(P＞0.05).GDM组中HOMA-IR与CRP、Hcy、Cys-C呈正相关,与SOD呈负相关,其差异具有统计学意义(P＜0.05),而与HOMA-β无明显相关性(P＞0.05).[结论]GDM孕妇血清中CRP、Hcy、Cys-C水平显著增高,SOD显著降低,且其HOMA-IR与CRP、Hcy、Cys-C呈正相关,与SOD呈负相关,故此四项血清指标监测可反映GDM患者疾病动态.

目的:探讨铁调素(Hdpcidin)、总铁结合力(TIBC)、血清铁(SF)等相关红细胞参数在缺铁性贫血(IDA)及慢性病贫血(ACD)中的诊断和鉴别诊断价值. 方法:选取我院2017年01月~2017年12月100例于我院就诊的贫血患者的临床资料,依据患者贫血类型分为缺铁性贫血(IDA)组例和慢性病贫血(ACD)组,另纳入50例同期健康体检人群作为对照组;比较三组患者血清Hdpcidin、TIBC、SF、血红蛋白(Hb)、红细胞平均体积(MCV)、平均红细胞血红蛋白浓度(MCHC)、网织红细胞百分比(RET)、未成熟网织红细胞比率(IFR)差异;探讨血清Hdpcidin、TIBC、SF对鉴别缺铁性贫血和慢性病贫血的诊断价值,分析血清Hdpcidin与血清TIBC和SF的相关性. 结果:共纳入IDA组和ACD组患者各50例、同期健康体检患者50例.IDA组和ACD组患者SF、Hb、MCH、MCHC水平均显著低于对照组;ACD组患者SF、Hb、MCV、MCH、MCHC水平均显著高于IDA组,ACD 组患者MCV水平与对照组比较无统计学差异;IDA组和ACD组患者TIBC、RET、IFR水平均显著高于对照组;IDA组患者TIBC、RET低于ACD组, IFR水平高于ACD组;ACD组患者Hdpcidin水平均显著高于对照组和IDA组;ROC曲线分析显示:血清Hdpcidin在鉴别IDA与ACD的最佳阈值为91.1ng/mL,其敏感性为88.32%,特异性为86.51%;血清TIBC在鉴别IDA与ACD的最佳阈值为59.01μmol/L,其敏感性为74.12%,特异性为72.35%;血清SF在鉴别IDA与ACD的最佳阈值为8.84μmol/L,其敏感性为72.63%,特异性为71.28%;相关性分析显示:IDA组患者血清Hdpcidin与TIBC呈显著显著负相关关系,与SF呈显著正相关关系;ACD组患者血清Hdpcidin与TIBC呈显著显著正相关关系,与SF呈显著正相关关系.结论:铁调素在鉴别缺铁性贫血及慢性病性贫血的鉴别诊断价值优于总铁结合力和血清铁,血液学指标结合血清铁调素能够更加准确的诊断贫血类型,值得临床推广.

Objective To analyze the combination characteristics between Tir-IBD( intimin binding domain) and its ligand intimin or mutant intiminN916Y of EHEC O157 ∶H7.Methods The gene of TirIBD (tir-ibd) from EHEC O157 ∶H7 chromosome was cloned into pMD18-T vector.Thereafter,the amplified gene was cloned into prokaryotic expression plasmid pET-21 a (+).The recombinant pasmid pET-21 a( +)-tir-ibd was transformed into E.coli BL21 (DE3).After inducement,the protein Tir-IBD was successfully expressed and analyzed with SDS-PAGE and Western blot.It was purified by affinity chromatography and ionexchange chromatography and was coupled on the Ni-NTA chip of BIACore 3000.Then the ligand intimin and mutant intiminN916Y were flow through the chip and their combination characteristics were detected.Results In the present study,the gene of Tir-IBD(tir-ibd) was successfully cloned into pET-21a(+).The results of SDS-PAGE and Western blot assay showed that the protein was successfully expressed,which accounts for 15％ of total expression products,and its molecular weight was about 10×103.The purity was above 95％ after purification.After coupled on the Ni-NTA chip of BIACore 3000,their combination characteristics with ligand intimin and mutant intiminN916Y were successfully detected.The equilibrium binding constants Ka was obtained by fitting the data with the BIACore evaluation program ( Version 4.1 ).The result showed that the combination characteristics between Tir-IBD and intimin have some difference compared with that of mutant intiminN916Y and the difference is temperature dependent.Conclusion Tir-IBD of EHEC O157 ∶H7 was successfully constructed and purified.The method to analyze the combination characteristics between Tir-IBD and its ligand intimin or mutant was established.The combination characteristics between Tir-IBD and intimin or mutant intiminN916Y have some temperature dependent difference and the mutated amino acids residue is crucial for their receptor-ligand binding.

Objective To observe the distribution of hepatitis B virus(HBV) markers(HBV-Ms),and understand the immune status of HBV infection in Hengyang Hunan.Methods HBV surface antigen(HBsAg),HBV surface antibody(HBsAb),HBV e antigen(HBeAg),HBV e antibody(HBeAb) and HBV core antibody(HBcAb) were tested in 2462 serum samples by enzyme-linked immunosorbent assay(ELISA).The ratios of HBV-M modes in the studied crowd,and the distribution of these modes in the groups of different ages and genders were analyzed.Results Twenty different HBV-M modes were detected in the present materials.All negative,HBsAb positive and HBsAg-HBeAb-HBcAb positive were the main modes of HBV infection.These modes had different distributions in groups of different ages and most infected subjects were males.Conclusion HBV-Ms in Hengyang district of Hunan province exhibits diversity and complexity.Much attention should be paid to the abnormal modes in clinic.

Objective To establish a nephelometric immunoassay for the rapid automatic detection of Stenotrophomonas maltophilia. Methods The specific antiserum was prepared by rabbits immunized with Stenotrophomonas maltophilia and the magnetic beads coated with SPA binding to the specific IgG from the antiserum were used to capture the Stenotrophomonas maltophilia from the samples..SPA-rich Staphylococcus aureus killed by formalin was also combined with the specific IgG from the antiserum and then used as a nephelometric immunoassay reagent.The rapid automatic quantitative detection of Stenotrophomonas maltophilia was performed on the Hitachi 7060 biochemical analyzer. Results In the present study,the high quality antiserum with agglutination titer of 1:240 and high specificity of Stenotrophomonas maltophilia was got from the immunized rabbits.Immunomagnetic beads had some enrichment effects of Stenotrophomonas maltophilia,and the colony counting of plate culture was performed after enriched by immunomagnetic beads,indicating that the capture efficiency was about 35%.The rapid automatic quantitative detection method of Stenotrophomonas maltophilia was established on the Hitachi 7060 analyzer with the SPA-rich Staphylococcus aureus combined with the specific IgG used as the nephelometric immunoassay reagent.This immunoassay has a good sensitivity and relatively satisfied specificity and linear range. Conclusion With the immunomagnetic beads and the SPA-rich Staphylococcus aureus combined with the specific IgG of the antiserum,the rapid automatic quantitative immunoassay for the detection of Stenotrophomonas maltophilia is well established,which provides a new way for the diagnosis of pathogenic bacteria.

Objective To establish a nephelometric immunoassay for the rapid automatic quantitative detection of Shigella flexneri. Methods The specific antiserum was prepared by rabbits immunized with Shigella flexneri 1a,while the magnetic beads coated with SPA binding to the specific IgG from the antiserum were used to capture the S. flexneri from the sample. SPA-rich Staphylococcus aureus killed by formalin was also combined with the specific IgG from the antiserum,and then used as nephelometric immunoassay reagent. The rapid automatic quantitative detection of Shigella flexneri was performed on the Hitachi 7060 biochemistry analyzer. Results In the present study,the high quality antiserum with agglutination titer of 1:320 and high specificity of Shigella flexneri 1a was obtained from the immunized rabbits. Immunomagnetic beads had shown some enrichment effect of Shigella flexneri 1a,while the colony counting of plate culture after enriched by immunomagnetic beads indicated that the capture efficiency was about 30%. The rapid automatic quantitative detection method of Shigella flexneri was established on the Hitachi 7060 analyzer with the SPA-rich Staphylococcus aureus combined with the specific IgG used as nephelometric immunoassay reagent. This immunoassay had a detection limit of 1000 cfu and relatively satisfied specificity and linear range. Conclusion With the immunomagnetic beads and the SPA-rich Staphylococcus aureus combined with the specific IgG of the antiserum,the rapid automatic quantitative immunoassay for the detection of Shigella flexneri is established,which provides a new way for the rapid diagnosis and automatic quantitative analysis of pathogenic bacteria.

<正> 恶性肿瘤患者常发生凝血、抗凝和纤溶系统的失衡,使血液处于高凝状态,对肿瘤的生长和转移起着重要的作用,同时在恶性肿瘤诊断与治疗过程中,凝血指标的检测越来越受到重视。为探讨肝癌、结直肠癌患者凝血功能的变化及其意义,我们对我院近3年肝癌、结直肠癌患者进行凝血功能检测,现报告如下。1 对象与方法1.1 仪器和试剂应用德国Becompactx115000全自动凝血仪。试剂由上海太阳生物技术有限公司提供,主要适用于血凝分析仪仅供体外诊断使用。1.2 对象 2006年1月至2009年1月

2005年我院从一患儿骨髓涂片中找到尼曼-皮克细胞,根据临床症状细胞形态学分析,确诊为尼曼-皮克病,现报告如下:

Objective To discuss the repeatability and the consistency of blood routine test so as to provide correct report to doctors. Methods Routine tests with venous and peripheral (ending) finger’s bloods were synchronously conducted on 60 healthy adults. The samples were laid up for various intervals and tested repeatedly (eight times).Results Significant differences in blood routine test exited between venous blood and ending finger’s blood. The white blood cell count was higher in ending finger’s blood than in venous blood, while red blood cell and platelet counts were higher in venous blood than in ending finger’s blood. The routine tests of venous blood were more repeatable and consistent than that of ending finger’s blood within six hours. Conclusion It is suggested that venous blood be utilized for clinical blood routine test and the lay-up duration be paid attention to, so that the veracity can be ensured.

为防止血液传播性疾病导致医患之间的交叉感染,减少医患纠纷,我院自1997年以来对创伤性外伤及普通外科病人需进行手术治疗以及受血患者的血液,按照总后卫生部1997医字第62号文件精神例行抗人类免疫缺陷病毒抗体(HIV抗体)、梅毒抗体(抗TP)及丙型肝炎抗体(抗HCV)的术前检查,近两年共检出HIV抗体阳性患者19例,梅毒抗体阳性患者26例,HCV阳性患者114例,现将我院2004～2005年血液标本对上述三项指标的检测结果报告如下:

Objective To discuss the changes in peripheral hemogram of the patients with malignant digestive tumor and their significance.Methods The blood routine test parameters of 173 patients with malignant digestive tumor between Jan.2003 and Dec.2006 were compared with that of 9,766 subjects from local enterprises who experienced physical examination.Results Erythrocyte count,hemoglobin concentration and hematocrit of all the patients with malignant digestive tumor decreased,mean corpuscular volume and mean corpuscular hemoglobin increased,and there was unconspicuous change in total leukocyte count.The indications of megaloblastic anemia and proliferative anemia in bone marrow hemogram were found in the patients.It was common that the percentage of neutrophils was higher and that of lymphocytes was lower than that of the normal controls.Conclusion The changes in peripheral hemogram of the highly risky group with malignant digestive tumor,which need to be differentiated from that of benign or malignant anemia,should be paid more attention to,so that misdiagnosis can be avoided.

CRP定量检测在急性感染性疾病的诊断和治疗监测方面发挥了重要作用,尤其是在鉴别细菌感染还是病毒感染方面有较高的临床应用价值.我们采用受试者操作特性曲线(ROC)对309例急性腹痛患者的血清CRP水平、白细胞总数和中性粒细胞分类计数进行分析各指标对急性阑尾炎的诊断价值,报告如下.

病人,男,55岁.呕血、黑便2 d.查体:血压70/40mmHg,脉搏108次/min,体温37.6℃,急性病容,贫血貌,浅表淋巴结无肿大,肝脾未扪及,心肺(-),腹平软,剑突下轻压痛,无肌紧张及反跳痛,肠鸣音6～8次/min.血常规:WBC 15.0 ×109/L,RBC 2.74×1012/L,Hb 59g/L,PLT156×109/L;肝肾功能未见明显异常.患者1年前因消化性溃疡出血,输浓缩红细胞2 U,当时血型鉴定为B型.此次急性大出血,拟输红细胞4 U.

Objective To investigate into the correlation between three kinds of cancer (gastric cancer, liver cancer and lung cancer) and ABO blood type. Methods Using analysis on disease correlativity, the ABO blood type data of 286 patients with malignant tumor, admitted to our hospital between Jan. 2004 and Dec. 2005, were compared with those of 5,419 normal locals.Results Those with antigen A (blood type A or AB) ran more risks of gastric cancer, and those with antigen B ran more risks of liver cancer. The ABO blood type distribution of the patients with lung cancer was the same as that of the normal subjects.Conclusion The genetic tendency of malignant tumor can be peeped into by blood type analysis.

病人,女,37岁,已婚,农民.3年前,患者无明显诱因出现全身皮肤瘙痒,伴多处浅表淋巴结肿大,无畏寒、发热,无气促、乏力,曾在衡阳、广州等地医院多次就诊,经CT检查及淋巴结活检诊断为"淋巴瘤",因经济原因,未接受正规治疗,在家间断自服中草药(具体药物不详),病情时好时坏.近1个月来,患者感上述症状明显加重,活动后气促,口腔疼痛,在当地医院予以抗感染、止痛、补液(具体药物不详)等处理,未见明显好转.查体:体温37.8℃,脉搏84次/min,呼吸22次/min,血压130/90 mmHg(1 mmHg=0.133kPa).意识清楚,营养不良,慢性面容.双侧腹股沟可扪及多个淋巴结,大小不等,质韧,无压痛及粘连,活动度可.