Objective To explore the feasibility of preheating in 41 ℃ water bath for 30 minutes to correct the red blood cell parameters in the specimens containing high-titer cold agglutinins(CAs). Methods Two specimens containing high-titer CAs were selected during work,and the parameters of complete blood count at room temperature or after preheating in 37 ℃ or 41 ℃ water bath were compared.The smears were stained,and the distribution of red blood cells was observed with a microscope.Further,74 specimens without CAs were collected for complete blood count,and then the test results at room temperature and after preheating at 41 ℃ were compared. Results At room temperature,the specimens containing high-titer CAs showed significantly reduced red blood cell count(RBC)and hematocrit(HCT),abnormally increased mean corpuscular hemoglobin(MCH)and mean cell hemoglobin concentration(MCHC),abnormal percents of hemoglobin(HGB)and RBC,and aggregation of a large number of red blood cells.After being preheated at 37 ℃ for a certain time,the specimens demonstrated obviously improved parameters while still aggregation of a small number of red blood cells.After being preheated at 41 ℃ for 30 minutes,the specimens showed significantly increased RBC,normal HCT,MCH,and MCHC,and evenly distributed red blood cells.The 74 specimens without CAs showed the comparability was ≥80% between room temperature and preheating at 41 ℃ for 30 minutes or 60 minutes. Conclusion We can preheat the specimens containing high-titer CAs in a water bath at 41 ℃ to obtain accurate red blood cell parameters.

目的 对1例食管癌术后放化疗患者口腔感染的霍乱弧菌进行菌株鉴定和病原特征分析.方法 取患者口腔分泌物进行分离培养并观察细菌形态特征,用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)进行蛋白质水平鉴定,并进行血清群检测;用K-B纸片扩散法进行药敏试验;提取细菌基因组DNA构建文库并进行细菌基因组重测序,通过核糖体多位点序列分型(rMLST)、平均核苷酸相似度(ANI)分析和非冗余蛋白质库(NR)比对,对菌株进行分子生物学鉴定,并进一步对其MLST分子分型和毒力基因进行分析.结果 MALDI-TOF MS鉴定分值为2.151,rMLST分析显示该菌株与霍乱弧菌吻合度为100％,ANI分析显示ANIb值为96.05％,ANIm值为96.56％,NR数据库基因注释得到霍乱弧菌相关的基因2981个,血清群检测为非O1/O139群霍乱弧菌.药敏试验结果显示该菌对哌拉西林/他唑巴坦、氨曲南、头孢哌酮/舒巴坦、头孢他啶、头孢吡肟、庆大霉素、阿米卡星、左氧氟沙星、环丙沙星、亚胺培南、美罗培南均敏感.MLST显示该菌株为新的ST型(ST-986),且携带toxR、hlyA、nanH、hapA、mshA、ompU、rtxC以及T6SS等毒力基因,而未检出ctxAB、tcpA、zot、ace及st等5种毒力基因.结论 检出ST-986新型非O1/O139群霍乱弧菌.临床医生应警惕免疫力低下人群中口腔感染这种病原体的可能性.