目的 探讨乙肝病毒(HBV)感染者在不同病程下,吲哚胺-2,3双加氧酶(IDO)表达水平及其与调节性T细胞(Treg)的相关性.方法 对142例HBV感染者及28例正常对照者分别采用流式细胞术、实时荧光定量PCR技术和全自动生化分析仪检测受检者外周静脉血IDO mRNA、调节性T细胞及丙氨酸氨基转移酶(ALT)活性;进行各组间检测结果比较及相关性分析.结果 IDO mRNA从高到低依次为肝癌组(HCC)、急性乙型肝炎组(AHB)、慢性乙型肝炎组(CHB)、肝硬化组(LC)、对照组.LC组与对照组均明显低于其余3组(P＜0.01),其他各组间两两比较,差异无统计学意义(P＞0.05).Treg计数从高到低依次为HCC组、AHB组、LC组、CHB组和对照组.除CHB组外,各组Treg细胞与对照组比较差异均有统计学意义(均P＜ 0.05),其中HCC组明显高于其他3组(F=10.764,P=0.002).ALT检测,总体组间比较,除LC组外,各组ALT活性与对照组比较差异均有统计学意义(均P＜0.05).Treg细胞、ALT、IDO mRNA相关性分析显示ALT活性与IDO mRNA表达无相关性(r=0.196,P=0.026),Treg细胞与IDO mRNA表达呈正相关(r=0.912,P＜0.01).结论 HBV感染者IDO表达明显增强,与Treg细胞正相关,即IDO高表达伴随着外周血Treg细胞比例增高,共同影响HBV的免疫耐受.

Objective To investigate the clinical significance of the level of regulatory T(Treg)cells and indoleamine 2,3-dioxygenase(IDO)in HBV-induced hepatocellar cancinoma.Methods 51 cases of HBV-DNA positive primary liver cancer(HCC),44 cases of chronic hepatitis B(CHB),29 cases of cirrhosis and 28 cases of healthy volunteers(control group)were used RT-PCR and flow cytometry to detect the expression of Treg cells and IDO in peripheral blood of each group.Results The expression of IDO mRNA from high to low were HCC group,CHB group,liver cirrhosis group and control group.The control group and the liver cirrho-sis group were lower than the other 2 groups(P<0.01),and the difference between the other groups was sta-tistically significant(P<0.05).Treg counts from high to low were HCC group,cirrhosis group,CHB group and control group.HCC group was significantly higher than that of control group(P<0.05),except for CHB group,Treg cells in each group were statistically significant compared with control group(P<0.05).The cor-relation analysis of expression of IDO mRNA and Treg:r=0.912,P=0.000,indicating that the expression of IDO in peripheral blood was positively correlated with the Treg cells.Conclusion IDO is over expressed in HCC with the high Treg cell level.Treg cells and IDO may associated with hepatocellular carcinoma immune escape mechanisms.

学制“五改四”后,如何在新形势下培养出能够满足社会需要,具有创新精神和较强实践能力的医学检验技术本科应用型人才,成为检验教育工作者必须解决的问题.我校紧紧围绕“培养具有地方特色,适应我国医药卫生事业和社会现代化发展需要,具有创新精神和实践能力的应用型人才”的定位,以广西高等学校特色专业及课程一体化建设为契机,注重对学生创新能力和实践技能的培养,提出了构建医学检验技术本科一体化多层次的实践教学新体系,并在具体实施过程中取得了不错的效果.

甲状旁腺激素(PTH)的主要功能是调节体内钙和磷的代谢.甲状旁腺腺瘤、增生、腺癌等均可引起PTH分泌异常增加,从而导致机体高血钙和低血磷等代谢紊乱.监测及控制PTH水平,可为甲状旁腺手术及慢性肾病患者持续临床管理提供重要指导.现就PTH检测在临床上的应用作一综述.

目的:探讨数字化采血检验咨询服务在门诊急诊血液标本采集中的应用效果.方法:培训护士熟练掌握采血检验咨询服务及计算机采血检验咨询服务模块的应用.患者在采血期间,采血护士向其讲解血液标本采集相关知识、注意事项等,必要时打印采血检验咨询服务健康教育宣传单等.结果:应用采血检验咨询服务模块进行健康教育后,门诊急诊血液标本采集患者对检验知识和采血知识的健康教育满意度显著高于实施前(P＜0.01).结论:护士利用数字技术实施采血检验咨询服务能提高门诊急诊血液标本采集患者对健康教育的满意度.

目的 对新的检测系统罗氏Cobas 6000 E602全自动电化学发光分析仪的分析性能做规范验证.方法 依据美国临床实验室标准化协会(CLSI)指南文件EP-15A3、EP-9A2、EP-6A的要求,对罗氏Cobas 6000 E602全自动电化学发光分析仪开展的总共15个项目的精密度、准确度、线性范围等3个性能进行验证,并与厂商声明的性能或公认的质量标准进行比较.结果 该全自动电化学发光分析仪检测的15个项目批内精密度分布为(1.66±1.10)％,批间精密度分布为(2.50±1.51)％,均小于厂家声明的不精密度;所有项目对卫计委20份室间质控品检测结果与靶值进行比对,结果全部满分,显示准确度良好;所有15个项目实测相关系数r 2在0.9892～0.9998,证明在厂商声明的线性范围之内的实测值线性良好.结论 罗氏Cobas 6000 E602全自动电化学发光分析仪检测系统参与验证的15个项目精密度、准确度及线性范围等主要性能在本实验室均达到了相关标准的要求.

Objective To investigate the levels of serumβ-C-terminal telopeptide of typeⅠcollagen(β-CTX),procollagen ⅠN-terminal peptide (PINP )and N-MID osteocalcin in the patients with multiple myeloma (MM)and their clinical significance. Methods The electrochemiluminescence immunoassay method was employed to measure the serumβ-CTX,PINP and N-MID levels in 100 MM patients and 40 healthy controls and a comparative analysis on the changes ofβ-CTX,PINP and N-MID levels in differ-ent clinical stages were performed.Results The serumβ-CTX,PINP and N-MID had statistical difference between the MM group and control group (P<0.05).The detection results in the patients with different stages of MM indicated that the later the stage was,the lower the serum N-MID and PINP levels,but the higher the serumβ-CTX level.Conclusion Measuring serumβ-CTX, PINP and N-MID levels can be used for evaluating the bone damage degree in the patients with MM and the bone metabolic marker may serve as an indicator of prognostic evaluation of MM.

目的：比较不同类型高泌乳素血症（H PRL ）的激素水平及临床表现，探讨筛查巨泌乳素在 H PRL诊断中的意义。方法将2011年5月至2013年5月就诊的 H PRL女性患者124例纳入H PRL组，另选取同期体检健康的育龄妇女45例纳入健康对照组；使用罗氏E170全自动电化学发光免疫分析仪测定124例 H PRL患者血浆卵泡刺激素（FS H ）、黄体生成素（L H ）、雌二醇（E2）及经聚乙二醇（PEG ）6000沉淀前后的泌乳素水平，并根据泌乳素回收率分成巨泌乳素、单泌乳素及可疑泌乳素型，记录相关临床症状；同时检测健康对照组的泌乳素水平。结果H PRL患者巨泌乳素检出率（33．1％）高于健康对照组，组间比较差异有统计学意义（ P＜0．05）；经 PEG沉淀前后，巨泌乳素型 HPRL血浆泌乳素水平比较差异有统计学意义（P＜0．05）；经 PEG沉淀前，不同类型 HPRL 血浆FSH、LH、E2水平及LH／FSH比值比较，差异均无统计学意义（P＞0．05）；巨泌乳素型 HPRL常见临床症状的发生率为44％，单体泌乳素型为81％，组间比较差异有统计学意义（ P＜0．05）。结论通过巨泌乳素筛查可区分H PRL的类型，指导H PRL临床用药并避免不必要的检查和误诊。

【Objective】To detect the levels of serum retinol binding protein 4(RBP4) and pregnancy-induced hypertension(PIH).【Methods】60 cases of PIH group(mild PIH group 35 cases and severe PIH group 25 cases),35 cases of normal pregnancy group, RBP4 in serum were determined by immune turbidimetry, and simultaneous determination of fasting blood glucose(FBG) and fasting insulin(FINS), insulin resistance index(HOMA-IR) was calculated. 【Results】Serum RBP4, HOMA-IR in mild and severe PIH group were significantly higher than that of normal pregnancy group, the difference was statistically significant difference(P 0.05); severe PIH group RBP4,HOMA-IR were higher than those of mild PIH group, the difference was statistically significant difference(P 0.05).【Conclusions】The higher serum level of RBP4 can be used as indicators of clinical observation in patients with pregnancy-induced hypertension syndrome.

Objective To investigate prolactin(PRL)levels in patient with hyperprolactinemia in different period of time. Methods Used electrochemical luminescence method,Roche E170 automatic immune analyzer determination of detect 124 cases female patients of hyperprolactinemia (PRL>880 uIU/ml)at 7:30AM,10:00AM and 4:00PM respectivelye of plas-ma PRL level,and in accordance with the polyethylene glycol (PEG)6000 precipitate PRL after A PRL recovery rate of into macroprolactin (MPRL)group (A PRL recovery rate of≤40%),single PRL group (A PRL recovery rate of> 60%),sus-picious PRL group (40%<A PRL recovery rate of≤60%),and simultaneous detect PRL levels in 45 cases of normal con-trol group.Results MPRL positive rate (33.1%)of high PRL group and MPRL positive rate (0%)of normal control group comparison,showed significant differences (χ2=17.886 7,P<0.05).MPRL group and single PRL group untreated by PEG at 10:00AM the PRL levels (1 160±714 uIU/ml,885±801 uIU/ml)and at 7:30AM the PRL levels (1 521±914 uIU/ml,1 497±845 uIU/ml)showed significantdifferences (t巨=1.993,t单=4.46,P<0.05).MPRL group and single PRL group treated by PEG at 10:00AM of the PRL levels (316±231 uIU/ml,766±611 uIU/ml)and at 7:30AM of the PRL levels (488±394 uIU/ml,1 235±912 uIU/ml)showed significant differences (t巨=2.411 4,t单=3.625 2,P<0.05).Single PRL group untreated by PEG at 4:00PM PRL levels (1 033±911 uIU/ml)and at 7:30AM PRL levels (1 497±845 uIU/ml)also showed significant differences (t=3.168 6,P<0.05).Conclusion PRL levels was changed in different time.De-termining the sampling time correct,conduce to the diagnosis of hyperprolactinemia clinical.

能力培养为核心的医学检验人才培养,从改革课程体系,优化教学内容、教学方法和教学手段,改革考试方法,加强师资队伍建设等方面进行,效果良好.

检验结果回报的及时性是衡量一个实验室服务质量、服务水平的重要指标,甚至是一个医院综合实力的体现[1]。随着实验室自动化分析仪的广泛应用,实验室信息系统的不断完善,检验结果回报时间（turn around time,TAT）已有明显改善,但检验结果延迟问题仍然存在[2]。日常工作中影响TAT的因素较多,包括医嘱开具、标本采集运送、标本检测、结果审核签发等环节,涉及医院多个部门。国内外均将加强信息

文章调查了867名医学检验专业本科生对专业状况的认知,让我们听到了学生心声,理解了他们的梦想,这些心声与梦想,承载着我国医学检验的过去、现在与将来.针对不利于实现学生理想的现状,着眼未来,我国医学检验高等教育不能脱离国情与学生关切.教育与医疗主管部门应该携手起来,共同探讨与完善医学检验人才培养方式,以促进建立我国检验医师的职称制度,进而保障医学检验教育事业的健康发展.

Objective To investigate the macroprolactin(MPRL) levels in patients with hyperprolactinemia(HPRL) at different times of the day.Methods To collect the blood samples of 126 cases HPRL patients at 8AM,11AM and 4PM respectively.Plasma prolactin(PRL) and PRL after precipitation of MPRL with polyethylene glycol 6000(PEG 6000) were measured by E170 electrochemiluminescence analyzer.The critical value was not greater than 40% to judge the MPRL with recovery.Results The PRL levels of HPRL patients in different time periods were significantly different.The recoveries of PRL in MPRL group with PEG treatment were significantly different.Conclusion To determine blood collection time will be beneficial to detect MPRL accurately.

Objective To analyze the application of anti-mullerian hormone(AMH) serum in perimenopausal women so as to discuss the significance of anti-mullerian hormone serum in assessing the ovarian functions.Methods A total of 60 patients with menstrual disorder were selected and they were divided into two observation groups: the perimenopausal group and the premature ovarian failure group(POF group),30 in each group.Meanwhile,30 healthy women aged from 35 to 45 with the normal menstrual cycle(28 to 35d) and no endocrine diseases were selected as the control group.The serum ovarian hormone FSH,LH,E2 and AMH of the patients were tested in the visiting month or the 2nd to 3rd day of the next month(any date for amenorrhoea women).The above items of the patients in the perimenopausal group may be retested after six months or one year.Results Compared with the control group,the levels of AMH and E2 in the POF group decreased(P0.05),whereas the levels of FSH and LH increased(P0.05);compared with the control group,AMH in the perimenopausal group was lower(P0.05),FSH was higher,and no obvious changes in LH and E2(P0.05).The level of AMH in the POF group was lower than that in the perimenopausal group(P0.05).After 6 months,the above hormones were retested in the perimenopausal group,the level of AMH was lower than the preliminary test(P0.05),whereas no obvious changes in FSH,LH and E2(P0.05).To compare the above hormones retested after 12 months in the perimenopausal group,AMH decreased obviously,FSH and LH increased greatly and E2 decreased(P0.05).Conclusion The serum AMH can reflect the decreased ovarian functions earlier than FSH,LH and E2,thus it can predict the decline of the ovarian functions of perimenopausal women earlier.

Objective:To investigate the macroprolactin(MPRL) levels and sex hormone levels in patients with hyperprolactinemia(HPRL) at different times of the day.Methods:Plasma prolactin(PRL),luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E2) and PRL after precipitation of MPRL with polyethylene glycol 6000 were measured by E170 electrochemiluminescence analyzer.A PRL recovery rate of ≤ 40% was an critical value of macroprolactinemia.Results:The FSH、LH and E2 levels were the same between patients with M-PRL and patients with true hyperprolactinemia.The PRL levels of HPRL patients in different periods of time were significantly different.The recovey rate of PRL in MPRL group with PEG treatment were significantly different.Conclusion:The proper blood collection time will be beneficial to detecting MPRL value accurately and evaluating the effect of MPRL on PRL determination.

Objective To explore the clinical feature of hospital acquired infection(HAI) caused by Flavobacterium meningosepticum in patients of ICU and analyze the drug resistance.Methods Patients of ICU were divided into observation group and control group according to with or without HAI caused by Flavobacterium meningosepticum. The risk factors for infection were analyzed and strain identification and drug sensitive test were performed.Results At least 55 years old, diabetic, malignant tumor, using of antibiotics and invasive operation were risk factors of this infection disease. The drug resistance rates of pathogenic bacteria to piperacillin/methimazole, cefoperazone/sulbactam, ticarcillin/clavulanate, cotrimoxazole and ciprofloxacin were 16.85%, 19.1%,46.07%,60.67% and 38.20%,and those to other antibacterials were all above 95%. Conclusion Flavobacterium meningosepticum might be resistant to multiple antibacterials, and piperacillin/methimazole and cefoperazone/sulbactam should be the first choice for clinical therapy.

OBJECTIVE To investigate the relationship of serum adiponection level with the intima-media thickness(IMT)in type 2 diabetes mellitus with periodontitis.METHODS The serum samples were taken from 60 cases with T2DM and periodontitis,50 cases with T2DM,fasting plasma glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and Adiponectin were measured.The intima-media thickness(IMT)was detected.Body mass index(BMI)and homeostasis model assessment of insulin resistance(HOMA-IR)were calculated.RESULTS The patients with type 2 diabetes mellitus and periodontitis had significantly higher levels of FPG,FINS,TG,IMT,and HOMA-IR than type 2 diabetes mellitus.The levels of HDL-C and adiponectin were significantly lower in The patients with type 2 diabetes mellitus and periodontitis.CONCLUSION The level of Adiponectin in type 2 diabetes mellitus with periodontitis were significantly lower than those type 2 diabetes mellitus.Adiponectin may be intimately related to the intima-media thickness.

Objective To study the expression and significance of the serum levels of PC Ⅲ and C-Ⅳ in patients with HBV infection during different immune status.Methods The patients of HBV infection were divided into three groups with immune tolerance,immune clearance,immunodeficiency.Serum samples were collected from 20 cases of immune tolerance,20 cases of immune clearance,20 cases of immunodeficiency and 20 cases of normal control.Serum levels of PCⅢ and C-Ⅳ were measured by the electrochemical luminescence method.Results The serum levels of PC Ⅲ in the immune clearance and immunodeficiency group were higher than those of the normal control group(z=-5.041,-4.095,all P0.05).And the serum expression levels of PCⅢ of immune clearance group and immunodeficiency group were higher than those of immune tolerance group respectively(z=-5.356,-4.599,all P0.05).The serum levels of C-Ⅳ in immune clearance group and immunodeficiency group had significant difference with normal control group respectively(z=-3.273,-4.166,all P0.05).The serum expression levels of C-Ⅳ in immune clearance and immunodeficiency group were higher than those in immune tolerance group respectively(z=-2.570,-2.732,all P0.05).Conclusion Serum levels of PCⅢ,C-Ⅳ are closely related with the immune status in patients with chronic HBV infection.The expression levels of PCⅢ,C-Ⅳ have important clinical significance to the diagnosis of hepatic fibrosis.

Objective To establish the reference range of healthy adults’plasma homocysteine(Hcy)in Guilin Region.Methods The plasma Hcy concentration of 960people who underwent physical examination were detected by automatic biochemical analyzer.Results The plasma Hcy level of males was obviously higher than that of females.And the plasma Hcy level increased with age.Conclusion There is significant difference in Hcy levels between different genders and different ages among healthy adults.And the reference range of plasma Hcy of healthy adults in Guilin region was established by our laboratory.