This article analyzed the laboratory indicators during the clinical diagnosis and treatment of two adolescents with mental disorders who developed rhabdomyolysis during hospitalization， so as to explore the risk of rhabdomyolysis occurring after mild to moderate exercise during treatment for adolescent with mental disorders and to provide references for clinical diagnosis and treatment.

目的 对不同厂家生产的3种实时荧光PCR仪检测的同一批新型冠状病毒检测标本结果进行比较分析,考察3种实时荧光PCR仪对新型冠状病毒核酸检测结果的差异.方法 采用同一厂家同一批号新型冠状病毒核酸检测试剂,运用3种不同型号实时荧光PCR仪对120例新型冠状病毒肺炎患者及密切接触者的咽拭子、尿液、唾液、粪便标本进行检测,采用SPSS20.0统计软件对检测结果和检测一致性进行分析.结果 3种仪器检出率分别为42.50％、35.00％、38.33％.有95例患者标本通过3种仪器扩增后检测结果一致.以仪器A检测结果为参照,仪器B有21例检测结果不同,两者检出率差异无统计学意义(P>0.05),检测结果一致性一般(K=0.732);仪器C有14例检测结果不同,两者检出率差异无统计学意义(P>0.05),检测结果一致性好(K=0.821).结论 由于不同厂家生产的仪器原理和仪器使用维护状况不同导致检测结果存在一定差异,提示仪器厂家需进一步优化仪器性能,提高检测准确性;同时各检测机构应按照要求对PCR仪进行校准维护,确保仪器状态正常,并尽可能采取多种质控手段以确保检测结果准确性.

目的 分析注意力缺陷多动障碍(ADHD)患儿血清中游离三碘甲状腺原氨酸(FT3)和25羟维生素D[25(OH)D]水平特征.方法 选取48例ADHD患儿纳入观察组,选取60例健康体检儿童纳入对照组,以化学发光法检测血清25(OH)D和FT3、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平,并进行比较.结果 观察组血清25(OH)D水平明显低于对照组,FT3水平明显高于对照组,差异均有统计学意义(P<0.05).两组FT4和TSH水平比较,差异均无统计学意义(P>0.05).56.25％ 的ADHD患儿FT3高于参考值上限,68.75％ 的患儿25(OH)D低于参考值下限.观察组男性患儿与女性患儿FT3、FT4、TSH和25(OH)D水平比较,差异均无统计学意义(P>0.05).结论 ADHD患儿FT3和25(OH)D水平存在一定异常,FT3和25(O H)D水平对该疾病的发生、发展可能存在影响.

目的 对常见的消化道肿瘤标志物CA19-9、AFP、CEA、CA724等采用蛋白芯片法和化学发光法进行检测,评价蛋白芯片法多肿瘤标志物与贝克曼或罗氏化学发光法的检测的可比性.方法 对照方法(考核试剂盒)采用蛋白芯片多肿瘤标志物("男芯")检测试剂盒,标准方法(参比试剂盒)采用贝克曼或罗氏化学发光试剂,分别用这两种试剂对恶性肿瘤患者,良性疾病患者和正常患者血清进行CA19-9、AFP、CEA、CA724检测,对结果进行分析处理.结果 两种试剂在恶性肿瘤组、良性疾病组和正常对照组各组血清样本中检测的CA19-9、AFP、CEA、CA724各单指标阳性率无显著差异,两者符合率均大于90％,相关系数r均大于0.95.结论 对于常见的消化道肿瘤标志物CA19-9、AFP、CEA、CA724采用蛋白芯片法(考核试剂)与化学发光法(参比试剂)测得结果有较高的一致性,采用蛋白芯片法检测上述指标结果可靠.

Objective To explore the drug resistance and risk factors of imipenem-resistant Pseudomonas aeruginosa infections in order to provide evidence and reference for clinical prevention and treatment.Methods The drug resistance and risk factors of imipenem-resistant Pseudomonas aeruginosa isolated from January 2015 to December 2016 were retrospectively analyzed.Results A total of 798 strains of Pseudomonas aeruginosa were isolated,of which 217 strains of imipenem-resistant Pseudomonas aeruginosa resistant to imi-penem were isolated,and the isolation rate was about 27.2％.The main source of specimen was sputum(71.9％).The infected patients were mainly from the intensive care unit(ICU)(52.1％).The resistant rate to Amikacin was the lowest(10.1％)followed by gentamicin(29.5％),and the other resistance rates were more than 45.0％;the resistance rate of imipenem-resistant Pseudomonas aeruginosa to common antibiotics was significantly higher than that of non imipenem-resistant Pseudomonas aeruginosa,the difference was sta-tistically significant(P＜0.05).The main risk factors for imipenem resistant Pseudomonas aeruginosa infec-tion were venerable age,hospitalized for more than 2 weeks,using antibiotics for more than 2 weeks,using car-bapenems,diabetes,ICU,mechanical ventilation,deep vein catheterization,indwelling catheterization and co-ma.Conclusion The surveillance of drug resistance of imipenem resistant Pseudomonas aeruginosa should be strengthened,and the prevalence of drug-resistant bacteria should be intervened,prevented and controlled in hospitals.

目的 探讨运动手环对2型糖尿病(T2DM)患者并发非酒精性脂肪性肝病(NAFLD)患者脂糖代谢、胰岛素抵抗和体质量指数(BMI)的影响.方法 选取该院68例诊断为T2DM并发NAFLD的患者为研究对象,随机分为对照组与观察组,每组34例.患者入院后均予以降血糖、护肝等药物治疗及健康宣教,包括饮食指导、运动指导、药物指导等综合治疗,观察组在对照组治疗基础上联合使用运动手环.两组于干预后3个月比较糖脂代谢及肝功能情况,并检测脂肪因子瘦素、脂联素,评估胰岛素抵抗、BMI改善情况.结果 干预后两组空腹血糖(FPG)、低密度脂蛋白-胆固醇、高密度脂蛋白-胆固醇水平比较差异均无统计学意义(P＞0.05),但对照组餐后2小时血糖、糖化血红蛋白及总胆固醇、三酰甘油水平均明显高于观察组(P＜0.05);干预后两组脂联素水平比较差异无统计学意义(P＞0.05),但对照组天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、瘦素均显著高于观察组(P＜0.05);干预后对照组稳态模型评估-胰岛素抵抗指数、BMI依次是(5.6±1.1)、(26.3±4.6)kg/m2,均显著高于观察组的(4.2±0.8)、(24.2±3.5)kg/m2 (P＜0.05).结论 运动手环可以为T2DM并发NAFLD患者提供科学、有效的康复指导,显著改善机体糖脂代谢,缓解胰岛素抵抗情况,延缓疾病发展.

Objective To investigate the clinical distribution and drug resistance of carbapenem resistant Acinetobacter baumannii in order to provide reference for clinical rational use of antibiotics and prevention and control of nosocomial infection. Method From January 2013 to December 2015,the distribution and drug sensitive data of clinical isolates of carbapenem resistant Acinetobacter baumannii were retrospectively analyzed. Results A total of 706 strains of Acinetobacter baumannii were isolated. Among them,523 strains of carbapenem resistant Acinetobacter Bauman,and the isolation rate was about 74. 1%. The main source of specimenwas sputum ( 81. 8%) . They were mainly distributed in the intensive care unit ( 40. 3%) and respiratory medicine (22. 2%) . Drug resistance rate showed an overall upward trend. The resistant rate of Cefoperazone / Shubatan was the lowest( <38. 0%) . The second was minocycline( <43. 0%) ,highly resistant to other antimicrobial agents. In addition to compound sulfame-thoxazole,the resistance rate of carbapenem resistant Acinetobacter baumannii was significantly higher than that of non carbapenem resistant Acinetobacter baumannii(P<0. 01). Conclusion We should strengthen the monitoring of drug resistance of carbapenem resistant Acinetobacter baumannii,carefully use carbapenem antibiotics,and take effective measures to prevent and control it.

Objective To detect mycoplasma pneumoniae antibody in children having the upper respiratory tract infection.And then investigate mycoplasma pneumoniae infection status of different season different age children.Methods In 5 403 cases of suspected pneumonia mycoplasma infection of 0 to 14 years old children using the method of passive particle agglutination determination of mycoplasma pneumoniae antibody,and analysis of the statistical results.Results The positive rate was 67.8％ in the groups of children.The rates of infection was biggest during 2 to 3 years old children and 3-4 years old children,14.9％ and 18.4％,respectively.In addition,we found that the highest rate of mycoplasma pneumoniae infection arised from October to January every year of the following year.Conclusion The infection of mycoplasma pneumoniae is on the rise,and children aged 0 to 6 years old are the main population.

目的 评估全自动采血管条码标注仪的临床应用效果.方法 选用两种准备采血管的方法,分别为全自动采血管条码标注仪(仪器法)与传统法.比较两种方法的标本布置时间及标本条形码的不合格率.结果 传统法标本布置时间为(5.00±3.50)s,仪器法标本布置时间为(1.00±0.55)s,仪器法短于传统法,差异有统计学意义(P<0.05).传统法条形码标注不合格例数多,不合格率高于仪器法,差异有统计学意义(P<0.05).结论 在准备采血管时应用全自动采血管条码标注仪,可规范条形码的管理及使用,并简化采血工作流程,提高工作效率,保证了检验分析前的质量控制.

Objective To investigate the correlation between interleukin 10(IL‐10) ,tumor necrosis factor (TNF‐α) and serum CD4+ T‐lymphocytes cell in people who infected HIV .Methods The HIV antibody screening test ,IL‐10 and TNF‐αmeasurement adopted enzyme‐linked immune‐sorbent assay(ELISA) .The HIV antibody confirm test adopted western blot(WB) and CD4+ cell count determination used flow cytometry .Results Compared with the normal control group(NC group) ,the concentration of TNF‐αand IL‐10 in patients group have statistically significant difference(P<0 .05) .Moreover ,the extent of the increase in group A(pa‐tients with the CD4+ T cell count less than 3 .5 × 105 cells/mL) was higher than that in group B(patients with the CD4+ T cell count no less than 3 .5 × 105 cells/mL) .Conclusion Due to the defect of the immune system ,the serum concentration of TNF‐αand IL‐10 in people infected with HIV would increased ,and the increase of the concentration could be more significant in patients whose CD4+cell count obviously decrease .This study have shown that dynamic measurement of TNF‐α and IL‐10 concentration would provide data to konw the patients′immune status and illness development .

Objective To investigate the HCV patients with HCV‐RNA and AFP different plastid percentage (AFP‐L3/AFP) correlation ,analysis of liver cirrhosis to liver cancer caused by hepatitis c in the process of the development of HCV‐RNA and AFP‐L3/AFP change characteristics .Methods Collected clinical confirmed simple HCV patients 80 cases ,including 44 patients with cir‐rhosis of the liver and 36 cases of HCV liver cancer group and liver cirrhosis group were followed up at 3 ,6 months ,follow‐up re‐sults are divided into transfer of liver cancer group and treatment group ,in addition to choose 60 cases of healthy people as control group .Using case‐control study .Between different groups of HCV‐RNA and AFP‐L3/AFP compared by t test .Results The liver cirrhosis group average HCV‐RNA ,AFP‐L3/AFP for 7 .15 × 103 copy/mL ,44 .3% ,compared with the control group 400 copy/mL ,1 .1% ,the difference was statistically significant(P< 0 .05) .Liver cirrhosis group average HCV‐RNA ,AFP‐L3/AFP for 8 .33 × 109 copy/mL ,3 .35% ,and HCV liver cancer group (5 .71 × 107 copy/mL ,94 .33% ) ,the difference was statistically signifi‐cant(P<0 .05) .3 months follow‐up of patients with liver cirrhosis have 4 cases for the development of liver cancer ,8 cases after 6 months for the development of liver cancer .Conclusion The patients with cirrhosis caused by hepatitis c virus (HCV) should be combined ,dynamic detection of HCV RNA and AFP‐L3/AFP ,in order to early discover the liver cancer .

Objective To explore the diagnosis value of urinary molecular markers of Kidney injury molecule 1(Kim-1),heat shock protein 72(Hsp72),plasminogen activator inhibitor 1(PAI-1),neutrophil gelatinase associated lipocalin(NGAL)joint detec-tion in the diagnosis of early type 2 diabetes renal damage.Methods Totally 187 cases of type 2 diabetes mellitus patients were sep-arate into two groups based on combination of four urine proteins[Microalbumin(MA),urinary transferrin(TRU),urine immuno-globulin(IGU),urine alpha 1 microglobulin (A1M)].Group A had 48 cases,and the urine protein of patients were negative.Group B had 139 cases,and the urine protein of patients were positive.The normal control group(NC group)selected 50 cases of urinary protein negative healthy people.MA,TRU,IGU,A1M were detected by rate scattering turbidimetric method,and Kim-1,Hsp72, PAI-1and NGAL were detected by enzyme-linked immunosorbent.Results Compared with NC group,the levels of urine Kim-1, Hsp72 and PAI-1 had significant increase in group A(P <0.01),but the variation in content of NGAL had no statistical significance (P >0.5).The levels of Kim-1,Hsp72,PAI-1 and NGAL significantly increased in group B(P <0.01),and the increase value was more significantly in group B(P <0.01).The positive rates l of Kim-1,Hsp72,PAI-1 and NGAL joint detection reached 66.70% in group A,which was significantly higher than single detection(P <0.01 ).Conclusion The levels of Hsp72,PAI-1,Kim-1 NGAL protein have been a significant exception before urinary protein in type 2 diabetes mellitus patients,and the abnormal is obvious with the increase of renal damage degree.Kim-1,Hsp72,PAI-1,NGAL can be used as early biomarkers of kidney injury in type 2 diabe-tes,the joint detection will greatly increase the positive detection rate.

Objective To compare the clinical values of serum human epididymal protein 4(HE4)and carbohydrate anti-gen 125(CA125)for differential diagnosis of ovarian cancer and benign pelvic disease. Methods The levels of serum HE4 and CA125 were measured in 75 patients with ovarian cancer and 80 patients with benign pelvic disease. Results The levels of HE4 and CA125 were significantly higher in patients with ovarian cancer than those in patients with benign pelvic diseases(P<0. 05). In comparison with patients with benign pelvic disease, the diagnosis sensitivity, specificity and accuracy of HE4 were 70. 7%, 91. 3% and 81. 3%, respectively. The diagnosis sensitivity, specificity and accuracy of CA125 were 78. 7%, 81. 3% and 80. 0%, respectively. The diagnosis sensitivity, specificity and accuracy of HE4/CA125 parallel detection were 88. 0%,78. 8% and 83. 2%,respectively. The diagnosis sensitivity of HE4 for ovarian cancer stageⅠwas significantly higher than that of CA125. Con-clusion For differentiation of benign and malignant pelvic mass,HE4 was a better marker than CA125.

Objective To explore the effect of hypoalbuminemia ,hyperbilirubinemia on determination of glycosylated serum protein(GSP) ,and then provide reliable reference data for clinical diagnosis and monitoring of blood glucose control level .Methods According to the need ,all cases were divided into 3 groups .Eighty healthy individuals were chosen as the normal control group . A total of 159 cases who have been initially diagnosed with diabetes were selected for low Alb test ,including 83 cases of diabetic pa‐tients with normal Alb(DM group) and 76 diabetic nephropathy patients with hypoalbuminemia(DN group) .The patients with hy‐perbilirubinemia ,but being normal in Alb and glucose were selected as hyperbilirubinemia group .Beckman AU2700 automatic bio‐chemical analyzer was used to determine of GSP ,Alb ,total bilirubin(TBIL) and blood sugar levels .Results (1)The Welch′s cor‐rection t test analysis showed that the GSP levels in DM group were significantly higher than those in normal control group (P<0 .01) .On the contrary ,the GSP in DN group was lower than that of normal control group and DM group(P<0 .01) .(2)The linear correlation analysis showed that the level of GSP was positively correlated with TBIL(r2 =0 .434 ,P<0 .01) .Conclusion Either the concentration of serum Alb is lower than 40 .0 g/L ,or the measured value of TBIL is higher than 55 .0μmol/L ,the determination of GSP prote with nitro blue tetrazolium colorimetric method can not be used to judge in short‐term (2 to 3 weeks) average blood glu‐cose level .The assessment of blood glucose level should be combined with clinical or determination of glycosylated hemoglobin .

临床检验分析中质量控制指由实验室接收标本开始 ,包括方法的选择和评价、仪器与试剂的管理、环境及实验用水、室内质量控制、室间质评等 ,直至分析过程结束 ,是临床检验质量保证过程中实验室工作人员可以控制的部分 ,也是实验室质量保证的难点 , 需要实验室工作人员提高自我素质 ,通力合作 ,为临床提供正确可靠的检测结果.

Objective To explore how does the biochemical index change in the patients with earthquake related crush injury,and for providing scientifical data for disaster medicine..Methods We tested 19 conventional biochemical indexes of 230(male 120,female 110)patients with 5.12 earthquake related crush injury and 205(male 105,female 100)healthy people in BeiChuan.Results The serum ALT level of patients was significantly higher than that of the healthy people,as well as the AST、BUN、CREA、UA、CK、CK-MB、LDH、K+、Mg2+ levels(P<0.05 and P<0.01);The serum TP、ALB 、Na+、Cl-and Ca2+ levels are lower than the healthy people′s(P<0.05 and P<0.01)while there was no significant difference in the rest biochemical indexes between groups and in all indexes between sex(P>0.05).Conclusion Patients with earthquake related crush injury have an abnormal levels of biochemical indexes,Monitoring them should play an important role in clinical treatment guiding.

Objective To explore how does the biochemical index change in the patients with earthquake related crush injury,and for providing scientifical data for disaster medicine..Methods We tested 19 conventional biochemical indexes of 230(male 120,female 110)patients with 5.12 earthquake related crush injury and 205(male 105,female 100)healthy people in BeiChuan.Results The serum ALT level of patients was significantly higher than that of the healthy people,as well as the AST、BUN、CREA、UA、CK、CK-MB、LDH、K+、Mg2+ levels(P0.05 and P0.01);The serum TP、ALB 、Na+、Cl-and Ca2+ levels are lower than the healthy people′s(P0.05 and P0.01)while there was no significant difference in the rest biochemical indexes between groups and in all indexes between sex(P0.05).Conclusion Patients with earthquake related crush injury have an abnormal levels of biochemical indexes,Monitoring them should play an important role in clinical treatment guiding.

Objective To investigate the effect of interval between the addition to serum sample and anti-HBe-horseradish peroxidase(HRP)conjugate on the detection result of total anti-HBe antibody. Methods Serum anti-HBe was detected by domestic enzyme-linked immunosorbent assay f EI.ISA) kits and by Abbott chemiluminescent immunoassay(CLIA) system as acontrol method.72 pretested anti -HBe negative samples were divided into three groups.GroupA;anti-HBe-HRP was added after the addition of serum sample and deposited at room temperature for different time(unfair competition); Group B:the serum sample and anti-HBe-HRP were added simutaneously and then deposited at room temperature for diferent time(fair competition);Group C:the positive samples in group A were detected by another domestic ELISA reagent according to the salfle intervals and tested finally,by abbott CLIA method.Results The pattern of addition of serum sample and anti-HBe-HRP affected the real results significantly.Furthermore,the longer intervals between the two additions led to more false-positive results.Whereas,simultaneous addition of serum and anti-HBe-HRP had no effects on the real results. In group C,the results of 73.1 percentage of positive samples were consistent with group A. Twenty positive samples in group A showed negative reactions by abbott CLIA method.Conclusion The interval between the addition of serum sample and anti-HBe-HRP could lead to false positive result, which,can be avoided maximumly with simultaneous addition.