目的探讨尿流式细胞术联合基质辅助激光解析电离飞行时间质谱(Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry,MALDI-TOF MS)直接鉴定尿标本病原菌的应用。方法收集2017年1-10月住院及门诊泌尿系统感...目的探讨尿流式细胞术联合基质辅助激光解析电离飞行时间质谱(Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry,MALDI-TOF MS)直接鉴定尿标本病原菌的应用。方法收集2017年1-10月住院及门诊泌尿系统感染患者送检的清洁中段尿阳性标本234份。所有样本均通过尿流式细胞仪(UF-1000i)进行菌量计数;根据主要病原菌不同浓度的菌量,由MALDI-TOF MS判断分值来判定结果的可靠性。MALDI-TOF MS技术直接鉴定中段尿标本中大肠埃希菌(UF-1000i细菌计数>10~5个/ml)与Biotyper数据库中的大肠埃希菌最佳匹配图谱进行比较。MALDI-TOF MS技术鉴定血琼脂平板上与中段尿不同菌量计数的大肠埃希菌的光谱比较。结果 MALDI-TOF MS直接法鉴定大肠埃希菌为可靠鉴定的最低菌量浓度为6×10~4个/ml,铜绿假单胞菌最低菌量浓度为1×10~5个/ml,金黄色葡萄球菌最低菌量浓度为3×10~5个/ml,粪肠球菌最低菌量浓度为5×10~5个/ml。MALDI-TOF MS技术直接鉴定中段尿标本中大肠埃希菌(UF-1000i细菌计数>10~5个/ml),鉴定分值为2.245。利用MALDI-TOF MS直接鉴定与Vitek2-Compact全自动细菌鉴定进行对比,鉴定结果一致率为90.39%(207/229);中段尿培养为2种菌时,MALDI-TOF MS直接鉴定法鉴定结果为不可靠。MALDI-TOF MS直接法鉴定结果中鉴定到种水平207例占90.39%(207/229),鉴定到属水平216例94.32%(216/229),5.68%(13/229)MALDI-TOF MS未提供可靠的鉴定结果。结论尿流式细胞术与MALDITOF MS技术联合直接鉴定尿液中病原菌,是一种可靠细菌鉴定的新方法,其快速准确的鉴定,可为临床治疗提供病原学依据,具有一定的临床价值。展开更多
Granulocytic sarcoma or chloroma is a rare tumour derived from myeloid cell precursors. It is generally seen before or after or together with the onset of myelocytic leukaemia. Immunohistochemical staining of myeloper...Granulocytic sarcoma or chloroma is a rare tumour derived from myeloid cell precursors. It is generally seen before or after or together with the onset of myelocytic leukaemia. Immunohistochemical staining of myeloperoxidase is necessary for a definite diagnosis of granulocytic sarcoma. Recognition of this entity ensures an early aggressive chemotherapy that causes regression of the tumour.1-3 We present an unusual case of a 40-year-old woman who presented with back pain, numbness in the legs, and fatigue for 2 weeks. She was diagnosed as having synchronous granulocytic sarcomas of the breast and spine, confirmed surgically and histopathologically. After a subsequent systemic chemotherapy the patient was completely asymptomatic during a 20-month follow-up. We also reviewed the literature about the clinical manifestations, diagnosis, treatment, and prognosis of this condition.展开更多
文摘Granulocytic sarcoma or chloroma is a rare tumour derived from myeloid cell precursors. It is generally seen before or after or together with the onset of myelocytic leukaemia. Immunohistochemical staining of myeloperoxidase is necessary for a definite diagnosis of granulocytic sarcoma. Recognition of this entity ensures an early aggressive chemotherapy that causes regression of the tumour.1-3 We present an unusual case of a 40-year-old woman who presented with back pain, numbness in the legs, and fatigue for 2 weeks. She was diagnosed as having synchronous granulocytic sarcomas of the breast and spine, confirmed surgically and histopathologically. After a subsequent systemic chemotherapy the patient was completely asymptomatic during a 20-month follow-up. We also reviewed the literature about the clinical manifestations, diagnosis, treatment, and prognosis of this condition.
