Objective To explore the diagnostic value of urine retinol binding protein (RBP) ,beta‐N‐acetyl amino glycosidase enzymes(NAG) combined with serum cystatin C (CysC) detection in early kidney damage of type 2 diabetes mellitus (T2DM ) . Methods Totally 58 cases of T2DM complicating in our hospital were selected as the group A ,54 cases of simple T2DM (group B) and 52 individuals undergoing the physical examination(group C) .The urine RBP ,NAG and serum CysC were detected in three groups ,their differences were compared .The positive rates for detecting early diabetic renal damage were compared between the single index detection and combined detection .Results The levels of urine RBP ,NAG and serum CysC level in the group A were significantly higher than those in the group B and C ,the differences were statistically significant (P< 0 .05);the levels of urine RBP ,NAG and serum CysC level in the group B were significantly higher than those in the group C ,the differences were statistical‐ly significant(P<0 .05);The positive rates of single detection of RBP ,NAG and CysC were 87 .93% ,86 .21% and 84 .48% respec‐tively ,the positive rate of 3‐index combined detection was 94 .83% ,which was significantly higher than that of single index detec‐tion ,the difference was statistically significant (P<0 .05) .Conclusion Urine RBP ,NAG and serum CysC are the sensitive indexes in early diabetic renal damage .The 3‐index combined detection has better comprehensive sensitivity and possesses higher clinical ap‐plication value .

目的 探讨脑梗死患者溶栓治疗前后血脂水平和凝血功能参数的变化,为临床治疗脑梗死提供科学依据.方法 (1)对81脑梗死患者根据头部CT或MRI病灶大小,梗死体积按Pullicino公式(长×宽×层数/2)计算进行分组:大梗死组(病灶体积＞ 10cm3)10例,中梗死组(病灶体积4～ 10cm3)22例,小梗死组(病灶体积＜ 4cm3)49例,设健康对照组50例.(2)分别在溶栓治疗前24小时内、溶栓治疗后24h内、第3天和第7天采集脑梗死组血标本,进行血脂指标:甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白AI(APOAI)、载脂蛋白B(APOB)和脂蛋白(a)[Lp(a)];凝血功能指标:凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和血浆D二聚体(D-D)检测及统计学分析.结果 (1)大、中、小梗死组溶栓治疗前24h内TG、TC、LDL-C、APOAI、APOB和Lp (a)高于对照组(P＜0.01),HDL-C低于对照组(P＜0.05);大梗死组溶栓治疗前24h内TG、TC、LDL-C、APOAI、APOB和Lp (a)高于小梗死组(P＜0.05).(2)大梗死组溶栓治疗前24h内TG、TC、HDL-C、LDL-C、APOAI、APOB和Lp (a)与溶栓治疗后24h内、第3天和第7天比较差异无统计学意义(P＞ 0.05).(3)大、中、小梗死组溶栓治疗前24h内FIB和D-D高于对照组(P＜ 0.01),PT和APTT低于对照组(P＜0.05),TT无统计学差异(P＞0.05).(4)大梗死组溶栓治疗前24h内FIB和D-D高于小梗死组(P＜0.05),PT、APTT和TT较小梗死组无统计学差异(P＞0.05).(5)大梗死组溶栓治疗后24h内、第3天和第7天D-D、PT和APTT明显高于溶栓治疗前24h内水平(P＜0.01).结论 脑梗死患者溶栓治疗前后血脂水平和凝血功能指标有明显变化,其水平变化可作为脑梗死治疗及预后的判断指标.

目的 探讨检测血浆D-二聚体(D-D)对预防产后出血的临床价值及分娩前、后凝血功能参数的变化.方法 对547例临产孕妇,根据产后是否发生出血分成产后出血组(16例)和产后未出血组(531例),分别进行产前24 h、产后4h内和产后4～24 h内血浆D-D、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)检测,分析D-D水平变化与产后出血的相关性,对分娩前、后凝血功能参数变化进行统计学分析.结果 (1)产后出血组产后4h内和产后4～24 h内D-D、PT和APTT明显高于产前24h,差异有统计学意义(P＜0.05);(2)产后出血组产后4h内和产后4～24 h内TT与产前24h比较差异无统计学意义(P＞0.05);(3)产后出血组产后4h内和产后4～24 h内FIB明显低于产前24 h,差异有统计学意义(P＜0.05);(4)产后出血组产后4h内和产后4～24 h内D-D、PT和APTT高于未出血组,差异有统计学意义(P＜0.05);(5)产后出血组产后4h内和产后4～24 h内FIB低于未出血组,差异有统计学意义(P＜0.05).结论 临产前、后检测D-D及密切关注分娩前、后凝血功能参数变化对预防产后出血有一定的临床参考价值.

Objective To explore the correlation between Antithrombin Ⅲ (AT-Ⅲ ) ,D-Dmier(D-D) ,platelet count(PLT) ,platelet distribution width(PDW) ,mean platelet volume(MPV) ,platelet hematocrit(PCT)with post-partum hemorrhage .Methods 35 cases of postpartum hemorrhage women and 106 cases of normal delivery women (control group) were tested for AT-Ⅲ ,D-D ,PLT ,PCT ,MPV ,PDW before delivery within 24 hours ,to analyze the results of the test .Results (1)The concentration of AT-Ⅲ [(7 .65 ± 3 .11)U/L]in postpartum hemorrhage women was lower than control group[(8 .77 ± 2 .79)U/L] ,(P<0 .05);D-D[(801 .1 ± 522 .1)μg/L] was obvious higher than control group [(357 .6 ± 230 .3)μg/L] ,(P<0 .01) .(2)Compared with control group ,PLT[(104 .7 ± 54 .8)× 109/L] and PCT[(0 .12 ± 0 .04)% ] in postpartum hemorrhage women was obvious lower than control group [(201 .6 ± 76.7)×109/L];[(0.18±0.06)% ],(P< 0.01),therewerestatisticaldifferences;MPV[(12.49±1.57)fL]and PDW[(17 .36±1 .01)% ] were no differences as control group [(12 .70 ± 1 .55)fL],[(17 .38 ± 1 .86)% ],(P>0 .05) .Conclusion Prenatal monitoring of AT-Ⅲ ,D-D and platelet parameters have important clinical significance for the prevention and treatment of postpartum hemorrhage .

目的:探讨凝血因子Ⅶ(FⅦ)浓度和凝血功能参数与产后出血的关系.方法:根据产后出血量对35例产后出血患者进行分组:产后出血量500～800ml 25例为1组,产后出血＞800 ml 10例为2组,在产前24 h,对产后出血患者及110例正常生产孕妇进行FⅦ、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(Fbg)检测和分析.结果:①产后出血患者1组和2组FⅦ浓度均低于对照组,差异有统计学意义(P＜0.05).②1组和2组PT、APTT明显高于对照组(P＜0.01),1组Fbg低于对照组(P＜0.05),2组Fbg明显低于对照组(P＜0.01),TT与对照组比较差异无统计学意义(P＞0.05).③与1组比较,2组Fbg降低(P＜0.05),FⅦ、PT、APTT和TT差异无统计学意义(P＞0.05).结论:产前检测临产孕妇FⅦ水平和凝血功能参数对预防及治疗产后出血有重要的临床参考价值.

目的 了解甲钴胺、叶酸对2型糖尿病(T2DM)肾病(DN)患者的干预效果.方法 将T2DM肾病患者随机分为三组,分别给予叶酸、甲钴胺和叶酸+甲钴胺治疗,对照组为健康人.对比观察各组的血Hcy、尿蛋白、叶酸和VitB12水平.结果 干预前血浆Hcy与VitB12、叶酸均呈负相关.叶酸组、甲钴胺组和叶酸+甲钴胺组的Hcy、尿蛋白水平干预后低于干预前及对照组(P＜0.05).结论 叶酸与甲钴胺治疗可降低DN患者血中Hcy水平及尿蛋白(UAER及24H U-Pro)水平.

Objective To explore the changes of plasma fibrinogen ,plasminogen and D-dimmer before and after thrombolytic therapy in patients with acute myocardial infarction (AMI) ,to provide the evidence for treatment and prognosis AMI .Methods 93 cases of patients with AMI were divided into twe groups ,reperfusion group of 77 cases ,obstract group of 16 cases .At the same pe-riod ,30 cases myocardial infarction of patients with non thrombolytic therapy were selected as control group .The levels of plasma Fib ,Plg and D-dimer in each group were detected at different times .Results The levels of Fib and D-D in AMI patients were higher than those in the control group before thrombolysis therapy (P<0 .05) .Compared with before thrombolysis therapy ,the Fib and Plg levels of AMI patients were decreased significantly after thrombolytic therapy 6 h(P<0 .01) ,and returned to the normal level after 48 h .The D-dimmer level of AMI patients was increased significantly after thrombolytic therapy 6 h(P<0 .01) ,and returned to the normal level after 7 d .After thrombolytic therapy 6 h ,the levels of Fib and Plg of reperfusion group were decreased signifi-cantly(P<0 .05) ,the level of D-dimmer was increased significantly (P<0 .05) .Conclusion The levels of plasma fibrinogen ,plas-minogen and D-dimmer have important reference value for monitor the thrombolytic therapy effect in patients with AMI .

目的：探讨血小板计数（PLT）、血小板分布宽度（PDW）、血小板平均体积（MPV）、血小板比容（PCT）、网织血小板比率（IPF）、D-二聚体（D-D）和脂蛋白a（Lp-a）与急性脑梗死的关系。方法对231例急性脑梗死患者（急性脑梗死组）PLT、PDW、MPV、PCT、IPF、血浆D-D和血清Lp-a进行检测及分析，选择健康人群50名作为对照组。结果与对照组比较，急性脑梗死组PLT、PCT明显减少（P＜0．01）；PDW、MPV、IPF、D-D和Lp-a明显升高（P＜0．01）。结论血小板参数、D-D和Lp-a 水平的变化与急性脑梗死的发生发展密切相关，监测它们的变化对预防和治疗急性脑梗死具有重要的临床意义。

Objective To explore the causes and treatment strategies for pseudo - reduction of platelet count by blood cell analyzer. Methods A total of 351 blood samples for platelet count less than 100 × 109 / L measured by Beckman LH780 automatic blood cell analyzer were re - examined by handmade dilute count and smear staining for microscopy. They were divided into 5 groups according to platelet histogram,297 specimens with normal platelet histogram were allocated in group A;13 specimens with small platelet histogram in group B:11 specimens with large platelet histogram in group C:19 specimens with platelet aggregation histogram in group D,and 11 specimens with red cell fragments histo-gram in group E. The platelet count by blood cell analyzer and handmade dilute count were compared with smear staining examination under mi-croscopy for degree of coincidence. Results ① In comparison with handmade dilute count,the difference between group A and group B was not statistically significant( P ﹥ 0. 05),the difference between group C and group D was statistically significant( P < 0. 01),and the platelet count with blood cell analyzer was higher in group E,and the difference between group E and other groups was statistically significant( P < 0. 01). ②There was high degree of coincidence in results between handmade dilution count and smear staining examination under microscopy . Conclusion Platelet count by blood cell analyzer may be pseudo - reduced. In order to raise the accuracy of platelet count,the samples with abnormal platelet histogram need to be checked by handmade dilute count and smear staining examination under microscopy.

Objective:To discuss the correlation and prognosis on the levels of plasma coagulation factorⅩⅢ(FⅩⅢ)and IL-17in patients with cerebral infarction.Method:①According to the infarction size of CT or MRI of head,50patients with cerebral infarction were divided into three groups:great dimension infarction group(infarction size>10cm3),middle dimension infarction group(infarction size 4to 10cm3)and small dimension infarction group(infarction size<4cm3).Healthy control group included 20cases.Damage degree of nerve function was evaluated according to NIHSS score.Anticoagulant specimens of cerebral infarction group were collected within 24h,at 3rd day,7th day and 14th day respectively.The levels of FⅩⅢ and IL-17were measured by enzyme linked immune double antibody sandwich assay.②According to NIHSS scores within 24hand 14th day of cerebral infarction group,recent prognosis was compared.Result:①The levels of FⅩⅢ and IL-17of great dimension infarction group within 24hwere obviously higher than those of control group(P<0.01),the levels of FⅩⅢand IL-17of middle dimension infarction group and small dimension infarction group within 24hwere higher than those of control group(P<0.05).②Compared with small dimension infarction group,the levels of FⅩⅢ and IL-17of great dimension infarction group were different(P<0.05).③Along with the state of illness improved,the levels of FⅩⅢand IL-17had decline tendency(P>0.05).④The level of FⅩⅢ was positively correlated with the recent prognosis in patients with cerebral infarction groups(r=0.33),the level of IL-17was positively correlated(r=0.31).Conclusion:The levels of FⅩ Ⅲ and IL-17in patients with cerebral infarction would have positive correlation with course and prognosis,and their changes could be used as diagnose indexes of treatment and prognosis.

目的：探讨血浆凝血因子XⅢ（FXⅢ）、IL-17水平与脑梗死患者病程进展及预后的相关性。方法：①对50例脑梗死患者根据头部CT或MRI病灶大小，梗死体积按Pullicino公式（长×宽×层数／2）计算进行分组：大梗死组（病灶体积〉10cm3），中梗死组（病灶体积4～10cm3），小梗死组（病灶体积〈4cm3）；健康对照组20例，神经功能受损程度按照NIHSS进行评分。分别在24h内、第3天、第7天、第14天采集脑梗死组抗凝血标本。采用酶联免疫双抗体夹心法检测FXⅢ、IL-17含量。②根据脑梗死组发病24h内和第14天的NIHSS评分进行近期预后分型比较。结果：①大梗死组发病24h内FXⅢ、IL-17水平明显高于对照组（P〈0．01），中、小梗死组发病24h内FXⅢ、IL-17水平高于对照组（P〈0．05）。②大梗死组FXⅢ、IL-17水平与小梗死组比较差异有统计学意义（P〈0．05）。③随着梗死病情好转，FXⅢ、IL=17水平有下降趋势（P〉0．05）。④脑梗死组患者近期预后与FXⅢ水平下降呈正相关（r=0．33），与IL-17水平下降呈正相关（r=0．31）。结论：脑梗死患者血浆FXⅢ、IL-17水平与病程及预后呈正相关，其水平变化可作为脑梗死治疗及预后的判断指标。

This study was aimed to explore the correlation of mean platelet volume (MPV), fibrinogen (FIB) and blood rheology with the youth patients with cerebral infarction, so as to provide the basis for the clinical early diagnosis and treatment. The 109 patients with cerebral infarction aged between 18 - 45 were divided into three group: the large (> 10 cm(3)), middle (4 - 10 cm(3)) and small (< 4 cm(3)) area infarction; 30 healthy persons were served as control group. All the four groups were subjected to 16 examinations, such as MPV, FIB, and rheology (Lηb, Mηb, Hηb, ηp, Lηr, Mηr, Hηr, KVE, EAI, ERI, EDI, EEI, HCT, ESR). The results showed that all the MPV, FIB and rheology indexes of the different infarction groups were higher than those of healthy control group (P < 0.05). The MPV, FIB and rheology indexes in the large area infarction group were all higher than those in the small area infarction group (P < 0.05). The indexes of MPV, FIB and rheology in the various cerebral infarction area groups obviously decreased, but those did not reach to the level in the healthy control group (P < 0.05). The MPV, FIB content and rheology level correlated with infarction areas (r = 0.36, 0.29 and 0.48, respectively). It is concluded that the serious intensity of youth patients with cerebral infarction positively correlated with the levels of MPV, FIB and rheology indexes. Regular examination of above mentioned index may be useful to prevent youth patients from cerebral infraction.

Objective To explore the correlation of FIB,IL-17 with the patients with cerebral infarction.Methods According to the infarction size of CT or MRI of head,the 50 patients with cerebral infarction were divided into three group: the large(10 cm3),middle(4~10 cm3)and small(4 cm3) area infarction;According to the damage degree of nerve function,were divided into three type: the serious(30~42 scores),moderate(15~29 scores) and mild(0~14 scores) NIHSS scores,20 healthy persons were served as control group.To collect anticoagulant specimens within 24 h,IL-17 were measured by two-layer antibody sandwith enzyme linked immunosorbent assay.FIB were measured by blood coagulation function full-automatic analyser.Results The levels of FIB,IL-17 of the large group obviously higher than control group(P 0.01),the levels of FIB,IL-17 of middle and small group higher than control group(P 0.05);the levels of FIB,IL-17 of the serious type obviously higher than control group(P 0.01),the levels of FIB,IL-17 of moderate and mild type group higher than control group(P 0.05);the levels of FIB,IL-17 of the large group compared with small group were difference(P 0.05);the levels of FIB,IL-17 of the serious type compared with mild type group were difference(P 0.05).Conclusion It is closely relevant that serious intensity of cerebral infarction and the levels of plasma FIB,IL-17.There is great value to regular test FIB,IL-17 to prevent from cerebral infarction.

Objective To analyze the relationship between Ureaplasma urealyticum(UU),Chlamydia trachomatis(CT),Neisseria gonorrhoeae(NG) infection and seminal morphology parameters and the influence of pathogen infection on the male infertility.Methods Semen samples from 261 cases of male infertility patients were detected for UU,CT,NG,liquefaction time and sperm morphology.Results The positive rates of UU,CT and NG were 24.90%(65/261),4.98%(13/261) and 3.83%(10/261).There were statistical difference of liquefaction time,sperm density,activity rate,sperm motility and sperm morphology between patients with pathogen infection and others without pathogen infection(P<0.05).Conclusion UU,CT,NG infection might affect semen quality and male infertility.

Objective:To discuss the blood coagulation function in premature infants with different gestational age,analysis the effect of treatment after cryoprecipitate transfusion in low fibrinogen of premature infants.Method:①The 126 cases were divided into three groups according to gestational age:32 weeks group,≥32-35 weeks group and ≥35-37 weeks group.Pprothrombin time(PT),part-time activation thromboplastin(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(D-D) and platelet account(PLT) within after born 24 hours of the three groups and 50 full term infants(control group) were detected,and the condition of blood coagulation function were analyzed.②55 premature infants with low fibrinogen(0.8 g/L) were received cryoprecipitate transfusion,and FIB,PT,APTT,TT,D-D within after transfusion 2 hours were detected,and the changes of blood coagulation function were analyzed compared with before transfusion。Result:①Compared with control group,PT,APTT and TT in premature infants group were significantly increased(P0.01),FIB was significantly decreased(P0.01),D-D was increased(P0.05),and PLT was no significantly difference(P0.05).②Compared with 35-37 weeks group,PT,APTT,TT and D-D of 32 weeks group were increased(P0.05),FIB was decreased(P0.05),PLT was no significantly difference(P0.05).③Compared with before cryoprecipitate transfusion,the blood coagulation function in 55 premature infants after transfusion,FIB was significantly increased(P0.01),PT and APTT decreased(P0.05),TT and D-D were no significantly differences(P0.05).Conclusion:The blood coagulation function in premature infants was lower than that of full term infants,lower gestational age of the infant was more serious,therefore,clinician should attach importance to blood coagulation function as soon as possible.For premature infants with low fibrinogen(0.8 g/L),it should be received cryoprecipitate transfusion as possible as early,which would be of positive clinical significance in improving prognosis and raising survival rate.

Objective To investigate the change of blood coagulation function indexes and blood cell parameters in parturient pregnant women and its clinical significance.Methods 425 cases of parturient pregnant women(parturient woman group) and 139 cases of non-pregnant women (control group) were detected for blood coagulation function indexes:prothrombin time(PT),activated partial thromboplastin time(aPTT),thrombin time(TT),fibrinogen(Fbg),D-Dmier(D-D);blood cell parameters:hemoglobin (HGB),hematocrit (HCT),red blood cell count (RBC),red blood cell distribution width(RDW),White blood cell count (WBC),platelet count (PLT),platelet distribution width (PDW),to analyzer after detected.Results (1)There were statistical differences of the levels of Fbg,D-D,RDW,WBC,PLT,PDW in parturient women were higher compared with the non-parturient women ( P <0.01);(2)There were statistical differences of the levels of PT,HGB,HCT,RBC in parturient women were lower compared with the non-parturient women ( P <0.01);(3)There were no statistical differences of the levels of aPTT,TT in parturient women were no obviously change compared with the non-parturient women ( P > 0.05 ).Conclusions Hypercoagulabale state and different degree of iron deficiency anemia occur in parturient pregnant women.The detection of blood coagulation function indexes and blood cell parameters plays an important role in preventing from complications.