目的 分析降钙素原监测在指导慢性阻塞性肺疾病急性加重期(AECOPD)使用抗菌药物的临床价值.方法 选取2018年3月至2019年11月在湘潭市第一人民医院呼吸内科进行治疗的AECOPD患者52例,随机分为试验组和对照组各26例,试验组依据降钙素原(PCT)水平使用抗菌药物治疗,对照组根据患者的临床症状和既往使用抗菌药物的种类给予抗菌药物治疗,观察两组患者的抗菌药物治疗时间、抗菌药物使用强度、治疗效果、二重感染发生率及PCT水平情况并进行比较.结果 治疗后3、7 d时,两组的PCT水平均较治疗前降低(P<0.05);治疗后3、7 d时,试验组的PCT水平低于对照组(P<0.05).试验组的治疗时间明显短于对照组(P<0.05),抗菌药物使用强度明显低于对照组(P<0.05).试验组治疗效果优于对照组(P<0.05),二重感染发生率低于对照组(P<0.05).结论 依据PCT监测指导抗菌药物使用,有利于缩短抗菌药物治疗时间,降低使用强度,减少并发症,降低医疗费用.

This article reports the diagnosis and treatment of twin girls who were diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Hunan Province, China. The twin girls, aged 1 year and 2 months, were admitted on January 29, 2020 due to fever for one day and cough and sneezing for two days respectively. Both recovered after symptomatic treatment. The two girls had mild symptoms and rapid recovery, suggesting that children with SARS-CoV-2 infection may be mild and have a good prognosis. There were differences in the clinical symptoms and imaging findings between the twin girls, suggesting that SARS-CoV-2 infection has diverse clinical features in children.

【目的】探讨孕妇体质量、降钙素原（PCT）与孕期血糖的相关性。【方法】375例孕妇按体质量指数（BMI）分为正常组238例、超重组105例和肥胖组32例；按PCT浓度分为低浓度组360例、中浓度组88例和高浓度组18例，对三组孕妇进行血糖检测并比较分析。【结果】空腹血糖（FPG）异常、PCT异常、葡萄糖耐量试验（OGTT）异常和妊娠期糖尿病（GDM）的发生率均随孕妇体重升高、PCT浓度升高呈增加趋势，不同组间比较差异均有高度显著性（均P＜0．01）；孕前 BMI与 PCT呈正相关（r＝0．66，P＜0．01）。【结论】孕妇体重、PCT与孕期血糖密切相关，孕妇体重与PCT呈明显正相关。

目的探讨快速诊断阴道念珠菌感染的方法。方法研制一种新的外阴阴道念珠菌快速培养液,并与普通细菌培养法对照,观察两种方法检测外阴阴道念珠菌快速培养液的准确度、精密度和培养时间。结果快速培养液和普通细菌培养液结果比较,其准确度一致（P＞0.05）,精密度相等（0.0%）,培养时间缩短为2.0～2.5 h。结论快速培养法操作简单,准确度高,精密度好,检测时间短,使用快速培养液培养外阴阴道念珠菌能为临床明确早期诊断,及时开展治疗提供有力的实验室支持,值得推广应用。

<正>外阴阴道念珠菌病(vulvovagina1candidiasis,VVC)包括无症状的阴道寄居及有症状的阴道炎。念珠菌外阴阴道炎一般以阴道为主,可同时合并外阴炎,但偶尔可见到念珠菌外阴炎单独存在。大多数念珠菌外阴阴道炎的症状、体征典型,容易作出诊断;对症状及体征不典型者,要根据有无诱发因素及

Objective To explore the differences of the detection results of electrolyte by blood-gas analysis and biochemistry method,and to compare the clinical significance of the two methods in reference of their laboratory turn around time(TAT).Methods Artery blood and venous blood were collected from 86 inpatients in the First Hospital of Xiangtan.The artery blood was tested for electrolyte by ABL80 Blood-gas Analyzer,and the venous blood was centrifuged and the venous sera were determined for electrolyte by the Abbott Architect C8000 Automatic Biochemistry Analyzer.The laboratory TAT of the two methods from the reception of the specimens to the delivery of the reports was collected and analyzed.Results The potassium concentration in the artery blood determined by the blood-gas analyzer was significantly lower than that in the venous serum detected by the automatic biochemistry analyzer(P<0.01),but the correlation between them was good(r=0.889).The concentrations of sodium,chlorine and calcium measured by the two methods were not statistically different(P>0.05).The TAT of artery blood by blood-gas analysis was sharply shorter than that of venous serum by biochemistry analyzer(P<0.01).Conclusions The potassium concentration in the artery blood determined by the blood-gas analyzer is significantly lower than that in the venous serum detected by the automatic biochemistry analyzer,despite a good correlation between them.The laboratory TAT of artery blood samples by blood-gas analysis is markedly shorter than that of venous serum by biochemistry analyzer.The electrolyte in artery blood determined by blood-gas analysis is helpful to the early diagnosis of emergency or critical conditions.

目的 探讨超敏C反应蛋白(H-CRP)、肌红蛋白(MYO)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)联合检测诊断急性冠状动脉综合征(ACS)的临床价值.方法 检测61例(UAP)患者、54例稳定性心绞痛(SAP)患者、48例急性心肌梗死(AMI)患者、32例健康对照组作为研究对象,共计163例.血清中H-CRP、cTnI、MYO、CK-MB的含量水平,并动态分析其在AMI患者血清中的含量变化.结果 在患者发病2hAMI组患者血清H-CRP和MYO、cTnI的含量明显高于其它各组,具有显著性差异;CK-MB的含量在患者发病6hAMI组明显高于其它各组,具有显著性差异;UAP组患者血清H-CRP的含量明显高于SAP组和健康对照组,具有显著性差异;SAP组患者血清H-CRP和MYO、cTnI、CK-MB的含量略高于健康组患者,无显著性差异;H-CRP于AMI发病后2h开始显著升高,24h达到峰值,72h仍维持高水平,168h后达到基线水平;TnI于AMI发病后2h开始明显升高,24h达到峰值,72h仍维持较高水平,168h后达到基线水平;MYO于2h水平显著升高,12h到达峰值,24h出现明显下降,48h到达基线水平,72h后恢复到正常水平;CK-MB于6h水平开始明显升高,24h达到峰值,48h水平明显下降,72h达到基线水平,168h后恢复到正常水平.结论 H-CRP和cTnI、MYO、CKMB的联合检测在ACS的诊断及预后评估中具有更重要的临床意义.

Objective To explore the dynamic changes of white blood cell(WBC),platelet(PLT),reticulocyte(RET)% which can reflect the bone marrow hematopoietic function suppression or recovery after different chemotherapy courses for various digestive tract malignancies.Methods We collected the WBC,PLT,RET% values using 18°×4 fan-shaped peep-plate and sysmex XT-2000i before and 7 days,14 days and 21 days after six chemotherapy courses(from the first to the sixth).Results The parameters in first course had significant differences from the third,fourth,fifth and sixth course(P<0.05).Significant differences were seen in the third course from the fifth and sixth courses(P<0.05).These parameters were significant different between the fourth and the sixth course(P<0.05).Conclusion WBC,PLT and RET% are sensitive indexes and can be chosen to evaluate the bone marrow hematopoietic function suppression or recovery in digestive tract malignancies patients after chemotherapy,which can make treatments much more scientific,reasonable and effective,thus is worthy of promotion in clinical practice.

目的了解乳腺癌患者放疗导致骨髓造血功能抑制和恢复过程中白细胞（WBC）、血小板（PLT）、网织红细胞百分率（RET%）、高荧光强度网织红细胞百分率（HFR%）、中荧光强度网织红细胞百分率（MFR%）的动态变化情况。方法选择乳腺癌患者68例为放疗组,选择健康体检者36例为对照组,采用Sysmex全自动血细胞分析仪XT-2000i检测放疗前和放疗后第7、14、21、28、35、42天外周血WBC、PLT、RET%、HFR%、MFR%,对照组与放疗前比较及放疗组放疗前后各项指标的变化。结果放疗前组网织红细胞参数与正常对照组的RET%和HFR%比较,与放疗前的差异有统计学意义（P＜0.05）。放疗组放疗前后组网织红细胞参数比较差异均有统计学意义（P＜0.05）,第7天,WBC、RET%、HFR%和MFR%已开始下降,差异有统计学意义（P＜0.05）;第14、21、28天,WBC、PLT、RET%、HFR%和MFR%持续下降,显著低于放疗前,差异有统计学意义（P＜0.05）;第35天,WBC和PLT持续低于放疗前,差异有统计学意义（P＜0.05）;第42天,WBC和PLT恢复到正常水平,低于放疗前水平,HFR%和MFR%持续增高,显著高于放疗前水平,差异有统计学意义（P＜0.05）。结论 WBC、PLT、RET%、HFR%和MFR%5项参数可作为评价乳腺癌患者放疗后骨髓造血功能受抑和开始恢复的敏感指标,帮助临床医师及时调整治疗方案,不失时机地给予各种支持疗法及化疗时机的选择,具有重要的临床意义。

目的比较3种检验方法对阴道分泌物中念珠菌的检出率。方法 1 510例阴道分泌物标本采用直接涂片法、细菌培养法和快速培养法同时检测。结果快速培养法的阳性率为23.2%,其灵敏度为94.8%,特异度为99.2%;直接涂片法阳性率为12.6%,细菌培养法阳性率为23.6%。直接涂片法阳性率较低,快速培养法的阳性率高。结论外阴阴道念珠菌快速培养法是一种方便、快速、准确的阴道分泌物念珠菌的检测方法。

Objective To determine the clinical distribution and drug resistance of 252 strains of Escherichia coli in our hospital in 2010 to guide the reasonable use of antibacterials.Methods The clinical specimens were isolated and cultured with general method,and identified with CS TDR 2010 identification system.The antibacterial sensitivity was detected with the broth microdilution test.Results The 252 strains of Escherichia coli were detected from sputum(34.9%),urine(30.2%),secretion(10.7%),pus(9.1%),blood(4.4%),bile(4.0%),nasopharyngeal swab(3.6%),ascites(1.6%),and other specimens(1.6%).The highest susceptibility rate of Escherichia coli to 19 antimicrobials was meropenem(100%),followed by piperacillin-tazobactam(98.0%).The highest resistant rate of Escherichia coli was ampicillin(92.1%),and the second was cefazolin(79.8%).There were 121 strains of Escherichia coli producing ESBLs,and the rate of ESBLs was 48.0%.Conclusion The clinical distribution of Escherichia coli is wide in the respiratory tract and the urinary tract.The resistant rate of Escherichia coli that is above 50% amounts to 10 antibacterials.The use of antibacterials should be controlled strictly.

Objective To evaluate a kind of modified reticulocyte(Ret) staining solution.Methods The observation test of the modified Ret staining solution was performed under the microscope,counted the staining time,analyzed the effective life and tested its accuracy and precision.Results The modified Ret staining samples had a lot of characters,such as not easily fade,few residues,clear visual field and bright background,etc.Compared with the routine staining solution-brilliant cresyl blue,the staining time was short(5 min) and the effective life was long(30 months).The accuracy of the modified staining solution was consistent with that of the brilliant cresyl blue(P 0.05),but the precision of the modified staining solution was better than that of the brilliant cresyl blue.Conclusion The modified Ret staining solution is an excellent staining.It is worthy to be spreaded in practice.

[目的]比较心脂肪酸结合蛋白(H-FABP)与肌红蛋白、CK-MB和肌钙蛋白I(cTnI)在诊断急性心肌梗死(AMI)早期的诊断价值.[方法]因胸痛1～2 h急诊入院的患者(AMI 21例,其他疾病引起胸痛44例)分别于胸痛症状发作1～2、3和6 h采集血标本,20名年龄相匹配的正常对照于8 am,10 am和1 pm采集血标本,采用酶联免疫吸附法(ELIA)检测H-FABP、肌红蛋白、CK-MB和cTnI.[结果]AMI组1～2和3 h内采集的血标本H-FABP和肌红蛋白显著高于(P＜0.05)非AMI组和对照组.3 h血标本cTnI在AMI组较非AMI组和对照组增高(P＜0.05),CK-MB在3 h血标本中,AMI组高于对照组(P＜0.05),而与非AMI组差异无显著性(P＞0.05).[结论]H-FABP在诊断AMI超急性期有重要的价值.

Objective To explore the dynamic change of the reference range of normal newborn reticulocyte count and relationship to the day age of newborn by 18° × 4 fan-shaped peep-plate method.Methods Counted of reticulocyte of 415 normal newborns from age of 1 day to 10 days with 18° × 4 fan-shaped peep-plate method,and compared the result counted with Miller peep-plate method recommended by International Committee for Standardisation in Hematology(ICSH).Divided the values into groups by the newborn day age and different detecting method,then deal with the results with SPSS 12.0 software.Results Compared the reference range of newborn reticulocyte by the 18° × 4 fan-shaped peep-plate method of 1 d age(3.09 %-6.81 %)with those of 2 d(3.00 %-6.34 %),7 d(0.27 %-1.15 %)with those of 8 d(0.32 %-1.28 %),8 d with those of 9 d(0.34 %-1.38 %),9 d with those of 10 d(0.35 %-1.53 %),and all the differences had no statistical significance(P > 0.05).Compared the reference range of newborn reticulocyte counted by the 18° × 4 fan-shaped peep-plate method of 2 d age with those of 3 d(1.93 %-4.03 %),3 d with those of 4 d(1.35 %-3.13 %),4 d with those of 5 d(1.26 %-1.98 %),5 d with those of 6 d(0.72 %-1.45 %),6 d with those of 7 d,and the statistical significant difference were found among these groups(P < 0.01).Furthermore,the difference results in newborn reticulocyte values counted by the 18° × 4 fan-shaped peep-plate method had no statistical significance with the results of that counted by the Miller peep-plate method(P > 0.05).Conclusion There is a variation along with the reference range of newborn reticulocyte and their day age,and existing a low value period.Therefore the 18° × 4 fan-shaped reticulocyte enumerative peep-plate method can take the place of the Miller peep-plate to determine the reticulocyte value of the newborn.Thus the definite reference range of the newborn reticulocyte establishes the foundation to laboratory performing and clinical application.

Objective To study and make a new 18° × 4 fan-shaped reticulocyte enumericative peep-plate. Methods A new type 18° × 4 peep-plate was made by cutting with ampoule knife on the slide,and then compare it in reticulocyte counting with the Miller peep-plate recommended by ICSH. Results The accuracy of the new reticulocyte enumericative peep-plate was consistent with that of the Miller peep-plate recommend by ICSH,but the precision of the new reticulocyte enumericative peep-plate was prior to that of the Miller peep-plate. The reference range was also consistent with other published reports. Conclusion The process of making the new type reticulocyte enumericative peep-plate is simple and easy. It needn't special equipments. Thus it is worth to spread in practice.

本文探讨了五项血清学指标(LN、HA、Ⅳ-C、PE、PCⅢ)对肝纤维化早期诊断的应用.本文中的实验采用放射免疫法检测(LN、PCⅢ、Ⅳ-C、HA);采用酶法测定PE活性;并以室内质控保证试验的可靠性.其结果为各项指标测定值均显示随肝脏的受损程度而依次升高;统计学显示除慢性肝炎重型与肝硬化部分项目无显著性差异外,其余各组慢性肝炎间均有显著性差异(P＜0.05).并得出联合检测上述五项血清学指标是判断慢性肝病有无纤维组织增生的敏感而可靠指标的结论,为观察抗纤维化药物的有效性提供简便而有效的证据.