Objective To investigate the relationship between atherogenic index of the plasma (AIP) and gestational diabetes mellitus (GDM).Methods Clinical data of 764 women with 24-28 week gestation receiving prenatal cares in Jiaxing Maternal and Child Health Hospital from July to October of 2014 were retrospectively analyzed.Among 764 cases there were 133 cases of gestational diabetes(GDM group) and 631 healthy pregnant women(control group).Receiver operating curve (ROC) was used to evaluate the CHO,TG,HDL-C,LDL-C,CHO/HDL ratio,TG/HDL-C ratio,LDL/HDL ratio and AIP in distinguishing the two groups.The correlation between TG and HDL-C was analyzed by Spearman correlation analysis.Results The area under the curve (AUC) of AIP in diagnosis of GDM was 0.79 (P＜0.0001).Taking AIP 0.0985 as cut-off value,the sensitivity,specificity and negative predictive value of AIP in diagnosis of GDM were 78.9％,64.2％ and 94.1％,respectively.TG was negatively correlated with HDL-C in study group (r=-0.175,P=0.042),but there no correlation in control group (r=0.008,P=0.851).Conclusion AIP may be used to predict low risk of GDM and as an indicator to reflect atherogenic changes of serum lipid profile in GDM patients.

Objective]Procalcitonin(PCT) was evaluated as a parameter for predicting bacteremia diagnosed by blood cultures . [Methed]Blood cultures and PCT levels from 3343 specimens collected in 2013were analyzed [Result]The PCT concentrations of bacteremia cases(n=331) were significantly higher than those of non-bacteremia(n=2856)(median:3 .2ng/ml vs 0 .4ng/ml ,P<0 .05 ) .The area under the receiver operating characteristic curve (ROC-AUC ) of PCT for discriminating bacteremia from non-bacteremia was 0 .86 ,and sensivityorspecialitywas 0 .76 or 0 .86 .[Conclusion]PCT could be helpful in the accurate diagnosis of bacteremia .

目的：采用网织红细胞血红蛋白含量（CHr）和红细胞平均体积（MCV）鉴别诊断产后贫血中的缺铁性贫血，以减少不必要的铁剂补充。方法将216例产妇分成101例对照组（Hb≥10.5g/dl）和115例贫血组（6.0<Hb<10.5g/dl）。产后贫血组给予4周的补铁治疗，利用Hb、MCV、CHr在基线（T0）和4周后（T4）间水平变化来观察补铁治疗反应。使用MCV、CHr诊断缺铁性贫血的参考值（80fl、28pg）再将产后贫血组分别分成各两小组：MCV低值组和正常值组、CHr低值组和正常值组。结果在贫血组中，MCV和CHr各低值组和正常值组的Hb均相同增加，在MCV和CHr的低值组中相对应的MCV和CHr都显著增加，而MCV和CHr的正常值组中相对应的MCV和CHr未显著变化，推测MCV和CHr的低值组对补铁有治疗反应，存在缺铁现象，反之无。结论产后贫血并非一定是缺铁性贫血，Hb、MCV、CHr的联合检测可有效地鉴别诊断真正的产后缺铁性贫血，减少不必要的铁剂补充。

Objective To build a simple,automatable detection method for diagnosing bacterial peritonitis. Methods Neutrophil gelatinase -associated lipocalin(NGAL),lactate dehydrogenase(LDH),proteins and glucose were assessed in peritoneal fluids from patients with nonmalignant ascites,along with nucleated cell count and differ-entiation.Results One hundred and eleven specimens were analyzed,26 of which with PMN count≥250 ×106 /L, thus compatible with bacterial peritonitis.The median concentration of LDH and NGAL was 3.4 and 3.7 -fold higher in samples with PMN≥250 ×106 /L.The concentration of proteins was also higher in samples with ≥250 ×106 PMN /L, whereas that of glucose was lower.The PMN count significantly correlated with peritoneal fluid values of LDH(r =0.859),NGAL(r =0.774)and proteins(r =0.268),but not with glucose(r =-0.069).The area under ROC curve was 0.88 for LDH,0.89 for NGAL and 0.94 for their combination(both tests positive),whereas that of proteins and glucose was 0.80 and 0.71,respectively.Sensitivities and specificities were 0.81 and 0.87 for LDH≥227U /L, 0.96 and 0.75 for NGAL≥120μg/L,0.77 and 0.95 for their combination.The agreement with PMN count was 0.86 for LDH,0.80 for NGAL,and 0.91 for their combination.Conclusion Assessment of NGAL in peritoneal flu-ids,especially in combination with LDH,may be a reliable approach for screening of bacterial peritonitis in patients with nonmalignant ascites.

目的:评价Coulter LH-750血液分析仪在白细胞分类时单核细胞计数的准确性。方法:选取1 048例病人,按仪器计数单核细胞数高低分成两组,进行手工镜检并与仪器结果进行对比,并统计误分为单核的异常细胞的百分比。结果:低值组与镜检对比无显著性差异(P>0.05),高值组与镜检对比有显著性差异(P<0.01),异常细胞中肿胀变性粒细胞占31.4%,杆状核粒细胞占20%,异淋占24.6%,幼稚细胞占15.4%,有核红占8.6%。结论:LH-750血液分析仪在单核细胞>10%时有一定的假阳性率,为了保证检验质量,必须镜检复查,保证结果的真实性。

目的 探讨采用尿白蛋白渗透压比值(AOR)校正尿液浓度的差异以准确预测24 h尿微量白蛋白(24 h-UMA)的可行性.方法 测定130名糖尿病患者晨尿微量白蛋白、葡萄糖、肌酐、渗透压和24 h尿微量白蛋白,界定微量白蛋白尿的24 h-UMA为30～300 mg/24 h.结果 晨尿AOR与24 h-UMA的相关性(r=0.87;P<0.01)和尿蛋白肌酐比值(ACR)与24h-UMA相关性(r=0.88;P<0.01)相似.AOC检测微量白蛋白尿的cut-off值为18.4 mg/mOsm ×102时,敏感度和特异性分别为82%、86%,AOC的AUC为0.89.ACR检测微量白蛋白尿的cut-off值为15 mg/g,其敏感度和特异性分别为85%、85%,ACR的AUC为0.90.在不同尿糖浓度水平时AOC预测24h-UMA的能力基本不变(尿葡萄糖<5.5 mmol/L,r=0.89;5.5～42 mmol/L,r=0.78;>42 mmol/L,r=0.81).结论 AOR与24h-UMA显著相关,其相关性基本不受尿糖的干扰;AOR是一种可替代ACR检测糖尿病微量自蛋白尿的方法.

目的:初步探讨微量法红细胞沉降率应用于婴幼儿中测定的可行性。方法:以Vesmatict自动血沉仪法为参考方法,比较微量法与Vesmatic血沉仪法分别测定90名婴幼儿未梢血和静脉血红细胞沉降率(ESR)的结果。结果:两方法间的线性关系为y=0.22x+15.1,相关性具有统计学意义(r=0.78,P<0.001)。结论:微量法红细胞沉降率采用末梢血适合婴幼儿ESR的测定,测定结果与标准魏氏法具有可比性。

目的:探讨糖化血红蛋白(HbAlc)在妊娠期糖尿病筛查中的价值。方法:对妊娠期糖尿病(GDM)组38例,正常妊娠组(对照组)40例进行FPG、口服50g葡萄糖筛选实验、HbAlc测定。结果:正常对照组FPG、糖筛查实验及HbAlc检测阳性率分别为7.9%,21.1%,2.6%;GDM组检测阳性率分别为40%,85%,82.5%。结论:HbAlc检验方法快速、简单、实用,不易受其它因素影响,可作为GDM筛查的指标。

目的 探讨尿沉渣分析仪、尿干化学分析仪及涂片显微镜检测的临床应用价值.方法 采用尿沉渣分析法、尿干化学分析法、手工沉渣镜检法对1500份住院患者的尿液标本沉渣进行检测.结果 尿沉渣分析法、尿干化学分析法、手工沉渣镜检法对白细胞的检测阳性率分别为40.3%(605/1500)、40.8%(612/1500)、43.5%(653/1500),红细胞的检测阳性率分别为47.4%(711/1500)、46.5%(698/1500)、46.8%(702/1500),差异无统计学意义(P>0.05).尿干化学分析法无法检测管型.尿沉渣分析法与手工沉渣镜检法对管型的检测阳性率分别为14.7%(220/1500)、7.0%(105/1500),差异有统计学意义(P<0.05).结论 Clinitek-500尿干化学分析仪对尿中管型的检测存在不足,尿沉渣分析法、尿干化学分析法、手工沉渣镜检法检测尿中白细胞和红细胞结果较一致.

随着临床检验技术的发展和学科模式由"医学检验"向"检验医学"转变,使检验项目及临床意义研究不断增加和深化,同一项目呈现多种检测方法.因此,作者认为目前在医院使用的报告方式有时已不能充分发挥其应用价值,建议通过以下四方面建立标准化的报告格式,使其更具完整性和可交流性.