Monitoring the changes in plasm C-reactive protein,fibrinogen and blood white cell in patients with primary hypertension combined with acute cerebral infarction

BACKGROUND： Inflammatory reaction and the increased level of its accompanying active protein play an important role in the occurrence and development of cerebral infarction. C-reactive protein, fibrinogen and white blood cell, as the monitoring index of inflammatory reaction, are very important in the occurrence and development of acute cerebral infarction. OBJECTIVE： To make a comparison between patients with primary hypertension accompanied with acute cerebral infarction and with simple primary hypertension by observing the changes in plasma C-reactive protein and fibrinogen levels as well as white blood cell and differential counts and analyzing their significances. DESIGN ： Controlled observation SETTING ： Ward Building for VIP, Shenzhen Hospital, Peking University. PARTICIPANTS： Totally 133 patients with primary hypertension were selected from Ward Building for VIP, Shenzhen Hospital, Peking University during September 2003 to September 2005, The diagnostic criteria were based on the hypertension diagnosis criteria formulated by the 7^th World Health Organization-International Society of Hypertension Guidelines （WHO-ISH） in 1998. The informed consents were obtained from all the participants. The involved patients were assigned into two groups： primary hypertension group, in which, there were 65 patients with primary hypertension （ degree 2）, including 42 males and 23 females, with mean age of （61 ±14）years and mean blood pressure of （162.7±6.8）/（94.2±8.4） mm Hg （1 mm Hg =0.133 kPa）, and primary hypertension combined with cerebral infarction group, in which, there were 68 patients with primary hypertension combined with cerebral infarction （ meeting the diagnostic criteria formulated in the 4^th National Cerebrovascular Diseases Meeting in 1995 and diagnosed by skull CT or MRI to exclude the patients with lacunar infarction）, including 42 males and 26 females, with mean age of （56±15） years and mean blood pressure of （176.4±9.2）/（96.3±9.7） mm Hg. METHODS： Plasm C-reactive protein and fibrinogen levels, and white blood cell and differential counts of patients in the two groups were examined 24 hours after stroke. The above indexes were re-examined in the primary hypertension combined with cerebral infarction group 72 hours after stroke. White blood cell and differential counts were performed with laser method （East Asia FE-95001 RAM-1, Japan）. The level of C-reactive protein was measured with turbidimetry （BNII Automatic Systems For Analysis, USA）. The level of fibrinogen was measured with algorithm method when prothrombin time was normal and with Clauss method when prothrombin time was abnormal （ACL Automatic Coagulation Analyzer, USA）. MAIN OUTCOME MEASURES： The plasm C-reactive protein and flbrinogen levels, and white blood cell and differential counts 24 hours after stroke in two groups and 72 hours after stroke in primary hypertension combined with cerebral infarction group. RESULTS： All the 133 involved patients participated in the result analysis. The plasm C-reactive protein and fibrinogen levels, and white blood cell and neutrophil counts in patients with primary hypertension were all within the normal range. The plasm C-reactive protein and fibrinogen levels, and white blood cell and neu- trophil counts in patients with primary hypertension combined with cerebral infarction were significantly higher than those in patients with primary hypertension 24 hours after stroke and 72 hours after stroke respectively[24 hours after stroke：（32.12±11.76） mg/L vs. （5.02±3.21 ） mg/L;（4.64±0.75） g/L vs. （3.12±0.49） g/L; （9.32±81）×10^9 L^- 1 vs. （5.78±1.32）×10^9L^- 1 （7.85±2.38）×10^9 L^- 1 vs.（3.49±1.28）×10^9 L^-1,t =7.094, 5.759,4.106,5.491, respectively,all P〈 0.01; 72 hours after stroke： （47.62±18.43） mg/L vs. （32.12±11.76） mg/L; （5.08±0.82） g/L vs. （4.64±0.75） g/L, t =2.864,2.220, respectively, both P 〈 0.05]. CONCLUSION： The increase in fibrinogen level and white blood cell count are the important index in monitoring primary hypertension combined with acute cerebral infarction. The increase in plasm C-reactive protein and fibrinogen levels 72 hours after stroke indicates that plasma C-reactive protein and fibrinogen are very important in the development of disease.

INVESTIGATION OF PARAMETERS OF NONWOVEN FILTER USED IN WHITE CELLS REMOVING

This paper is concerned with the relation between the parameters of nonwoven filter and removing of white cells. Melt-blown polypropylene nonwovens are used as filtration materials of white cells filter. According to the combination of different fiber diameter, different product density and different weight, optimized combination of parameters of nonwoven filter with more effective removing of white cells is obtained. The result is that removing of white cells is 96.90 percent; recovery of red cells is 92.27 percent.

Synovial White Cell Count in the Diagnosis of Septic Arthritis: Are Current Diagnostic Practices Appropriate?

Introduction & aims: Septic arthritis is an emergency, potentially causing irreversible joint destruction and disability. Synovial WCC and polymorphonuclear cell percentage are the best predictors of septic arthritis likelihood. Yet, synovial white cell and differential count are not routinely assessed. We aim to investigate the incidence of failure to perform these tests, and to develop correct synovial fluid analysis practices. Method: This is a retrospective analysis of native joints having undergone arthrocentesis for suspicion of septic arthritis at Box Hill Hospital (BHH) during September 2011 and September 2013 inclusive. Recruitment was from the Eastern Health Decision Support Service (DSS), a database compiled from all systems within Eastern Health, of which BHH is a member. The study was limited to large joints, including hip, knee and shoulder. All prosthetic joints were excluded from the patient population. All patient histories were examined for suspicion of septic arthritis and subsequent arthrocentesis. Pathology records were accessed to determine incidence of cell count and differential. Results: One hundred and thirty-six cases of joint aspirations were identified within the time frame, of which sixty-seven fitted our criteria for evaluation. All but two cases were delivered using the DSS, which was limited to data compiled only until June 2013. The two remaining cases were identified with a manual search of the radiology and pathology databases from June to September 2013. 22 of the 67 joint aspirates studied did not have a cell count carried out. Four of these 22 cases had a diagnosis of septic arthritis. In five aspirates, there was a failure to confirm a definite diagnosis and they were thus conservatively treated as a septic joint. The remaining acute joints in which no cell count was done were gout (7 cases), pseudogout (5 cases) and rheumatoid arthritis (1 case). Cell counts were not routinely detected for a variety of reasons. Eleven aspirates were deemed too viscous, and in eight cases the sample had clotted prior to pathologist assessment. Two cases had insufficient volume, and one sample was too bloodstained to calculate a cell count and differential;likely due to traumatic aspiration. Conclusions: 33% of acute monoarthritis’ evaluated over the study period failed to have a synovial fluid WCC and differential. This may be due to inadequate samples, or lack of appropriate collection tube. Better education is required for appropriate collection and test requesting wherein a diagnosis of septic arthritis is in question.

Automated White Blood Cell Disease Recognition Using Lightweight Deep Learning

White blood cells(WBC)are immune system cells,which is why they are also known as immune cells.They protect the human body from a variety of dangerous diseases and outside invaders.The majority of WBCs come from red bone marrow,although some come from other important organs in the body.Because manual diagnosis of blood disorders is difficult,it is necessary to design a computerized technique.Researchers have introduced various automated strategies in recent years,but they still face several obstacles,such as imbalanced datasets,incorrect feature selection,and incorrect deep model selection.We proposed an automated deep learning approach for classifying white blood disorders in this paper.The data augmentation approach is initially used to increase the size of a dataset.Then,a Darknet-53 pre-trained deep learning model is used and finetuned according to the nature of the chosen dataset.On the fine-tuned model,transfer learning is used,and features engineering is done on the global average pooling layer.The retrieved characteristics are subsequently improved with a specified number of iterations using a hybrid reformed binary grey wolf optimization technique.Following that,machine learning classifiers are used to classify the selected best features for final classification.The experiment was carried out using a dataset of increased blood diseases imaging and resulted in an improved accuracy of over 99%.

White Blood Cells Detection Using Spectral Tresholding

The study of the morphology of White Blood Cells (WBCs) further contributes to the clinical diagnosis of blood diseases. In this research paper, we come up with an image segmentation enhancement by combining Fourier Fast Transform on smear blood capture and classical thresholding. The Fast Fourier Transform (FFT) is a very powerful tool in image processing and it was used to segment and extract the WBCs. Our image processing method uses a Fast Fourier Transform combined with filtering and an Inverse Fast Fourier Transform for the extraction and visualization of the high frequency region of the image. In order to remove residual Red Blood Cells acting as noise in the expected result, a final thresholding step is added at the end of the processing. The results presented in this article report the tests performed using our mathematical implementation. Moreover, we were able to detect and differentiate the sub-families of WBCs.

Automated Artificial Intelligence Empowered White Blood Cells Classification Model

White blood cells (WBC) or leukocytes are a vital component ofthe blood which forms the immune system, which is accountable to fightforeign elements. The WBC images can be exposed to different data analysisapproaches which categorize different kinds of WBC. Conventionally, laboratorytests are carried out to determine the kind of WBC which is erroneousand time consuming. Recently, deep learning (DL) models can be employedfor automated investigation of WBC images in short duration. Therefore,this paper introduces an Aquila Optimizer with Transfer Learning basedAutomated White Blood Cells Classification (AOTL-WBCC) technique. Thepresented AOTL-WBCC model executes data normalization and data augmentationprocess (rotation and zooming) at the initial stage. In addition,the residual network (ResNet) approach was used for feature extraction inwhich the initial hyperparameter values of the ResNet model are tuned by theuse of AO algorithm. Finally, Bayesian neural network (BNN) classificationtechnique has been implied for the identification of WBC images into distinctclasses. The experimental validation of the AOTL-WBCC methodology isperformed with the help of Kaggle dataset. The experimental results foundthat the AOTL-WBCC model has outperformed other techniques which arebased on image processing and manual feature engineering approaches underdifferent dimensions.

A Novel Meta-Heuristic Optimization Algorithm in White Blood Cells Classification

Some human diseases are recognized through of each type of White Blood Cell(WBC)count,so detecting and classifying each type is important for human healthcare.The main aim of this paper is to propose a computer-aided WBCs utility analysis tool designed,developed,and evaluated to classify WBCs into five types namely neutrophils,eosinophils,lymphocytes,monocytes,and basophils.Using a computer-artificial model reduces resource and time consumption.Various pre-trained deep learning models have been used to extract features,including AlexNet,Visual Geometry Group(VGG),Residual Network(ResNet),which belong to different taxonomy types of deep learning architectures.Also,Binary Border Collie Optimization(BBCO)is introduced as an updated version of Border Collie Optimization(BCO)for feature reduction based on maximizing classification accuracy.The proposed computer aid diagnosis tool merges transfer deep learning ResNet101,BBCO feature reduction,and Support Vector Machine(SVM)classifier to forma hybridmodelResNet101-BBCO-SVM an accurate and fast model for classifying WBCs.As a result,the ResNet101-BBCO-SVM scores the best accuracy at 99.21%,compared to recent studies in the benchmark.The model showed that the addition of the BBCO algorithm increased the detection accuracy,and at the same time,decreased the classification time consumption.The effectiveness of the ResNet101-BBCO-SVM model has been demonstrated and beaten in reasonable ratios in recent literary studies and end-to-end transfer learning of pre-trained models.

Admission white blood cell count predicts short-term clinical outcomes in patients with uncomplicated Stanford type B acute aortic dissection

sInflammation 被显示了与尖锐大动脉的解剖(AAD ) 相关。现在的学习试图与不复杂的斯坦福类型 B AAD.MethodsFrom 2008 在病人与在里面医院和长期的所有原因死亡在承认上评估白血房间计数(WBCc ) 的协会到 2010，有不复杂的类型 B AAD 的 377 个连续病人的一个总数被注册然后列在后面起来。承认上的临床的数据和 WBCc 是镇定的。主要结束点是在里面医院死亡，长期的所有原因 death.ResultsThe 在里面医院死亡率是 4.2% ，并且长期的所有原因死亡率在 18.9 个月的中部的后续期间是 6.9% 。承认上的 WBCc 被 univariate 考克斯回归分析作为一个连续变量和一个范畴的变量为在里面医院死亡作为一个风险因素识别用一 11.0 敢椠 ? 割掉 ? 潣摬猠敷吗？

Elevated White Blood Cell Count Is Associated with an Increased Risk of Insulin Resistance among Non-Diabetic Taxi-Motorbike Drivers Working in Cotonou, Benin

High white blood cell count (WBC) and insulin resistance (IR) are interrelated events that contribute to non-communicable diseases (NCDs), including type-2 diabetes (T2D). However, associations between IR and hematological parameters have never been explored in populations of Benin. The aims of this study were to determine the prevalence of IR and associated hematological parameters in taxi-motorbike drivers (TMDs) working in Cotonou. A total of 133 participants were analyzed in this cross-sectional study. Complete blood count, including WBC and platelet, as well as fasting plasma glucose and insulin, were performed by standard procedures. IR was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Factors associated with IR, their odds ratios (ORs) and 95% confidence intervals (CIs) were determined by logistic regression analysis. The mean age of the study participants was 39.3 years. The HOMA-IR cut-off (75th percentile) for IR was 5.9. The overall prevalence of IR was 24.1%. IR increased with the increase of exposure duration and WBC levels. Logistic regression analysis revealed that the risk of IR increased significantly with higher total WBC, with adjusted ORs (95% CI) for the second and third tertiles of 3.56 (1.10 - 11.58) and 4.01 (1.21 - 13.31), respectively. Similar patterns of associations were observed in an analysis restricted to non-drinkers, although these estimates lacked statistical significance. BMI > 24.2 kg/m2 was independently associated with an increased risk of IR (OR = 3.82, 95% CI: 1.33 - 11.03, P = 0.013). In conclusion, the prevalence of IR in TMDs was 24.1%. IR was significantly associated with elevated WBC count and BMI. WBC may serve as a biomarker to identify individuals at the greatest IR risk.

Evaluation of Total White Blood Cells and Cluster of Differentiation 4 Cells among Post-Menopausal Women in Elele, Nigeria

This study investigated some immune system related parameters among post-menopausal women in Elele, River state, Nigeria. Forty-two individuals participated in this study and forty control subjects were established as well. Blood was collected from the participants, and CD4 cells and total white blood cells count were analyzed using standard procedures. Result showed that test subjects and control values were 5.46 ± 1.64 × 109/L and 7.24 ± 1.47 × 109/L, respectively for total white blood cell and 1265.19 ± 458.56 cells/μl and 2159.53 ± 400.02 cells/μl respectively, for CD4 cells. There was significant difference (P < 0.001) among the test subject and control for both parameters. The results in the test subjects for both parameters were significantly lower compared to the control. The decline in immune system related parameters among the test subjects may predispose them at risk of multiple infections and other associated health conditions.

The Anti-Proliferative Effect of 5-Fluorouracil on Tumor Is Highly Associated with the Renewal of Peripheral White Blood Cells

The efficacy of chemotherapy is thought to be direct killing of tumor cells, but documented studies have been shown that immunity plays a role in its effectiveness. In a pilot study to observe the bone marrow suppression and regeneration in tumor bearing mice induced by single dose injection of 5-fluorouracil (5-FU), we unexpectedly found that tumors grew fast as bone marrow mononuclear cells (BMC) and peripheral white blood cells (PWBC) were decreased quickly during myelosuppression meanwhile significantly slow as repopulating of BMC and PWBC during bone marrow regeneration after 5-FU treatment, no matter whether in low or high dose administration, but the higher the dose was, the lower of the nadir of BMC and PWBC were reached to, as well as the much more powerful duration and strength of the repopulated BMC and PWBC, suggested that the immunity might be a predominant drive in 5-FU chemotherapy. Due to the fact that BMC is the source of PWBC which is its final maturational and functional form, it could be proposed that the anti-proliferative effect of 5-FU on tumor is highly associated with the renewal of PWBC.

Selection of Reference Genes in Equine White Blood Cells for Real Time PCR Normalization Following Extracorporeal Shock Wave Therapy

Selection of proper reference genes (RGs) is an essential step needed for accurate normalization of results from genomic studies. Expression of RGs is regulated by many factors such as species, age, gender, type of tissue, the presence of disease, and the administration of therapeutic treatment. The aim of the present study was to identify optimal RGs in a set of blood samples collected at different time points (0, 24, 48, 72 h) from horses following administration of extracorporeal shock wave therapy (ESWT). The mRNA expression of twelve RGs: HPRT1, ACTB, HSP90A, SDHA, GUSB, B2M, UBC, NONO, TBP, H6PD, RPL32, GAPDH was determined using real time quantitative polymerase chain reaction (qPCR). An SAS program developed on the algorithm of geNorm, SASqPCR, was used to determine stability of the expression and the number of optimal RGs. The results showed that the range of quantification cycle (Cq) values of the evaluated genes varied between 17 and 26 cycles, and that one optimal RG, ACTB, was sufficient for normalization of gene expression. Results of stability of expression demonstrated that ACTB was the optimal choice for all the samples studied. Notably, in samples collected at 72 h post ESWT, TBP showed a significant change in the expression level, and was not suitable for use as a RG. These results substantiate the importance of validating and selecting an appropriate RG.

Does East Meet West?—The Association between Oriental Tongue Inspection and Western Clinical Assays of White Blood Cell Subsets

The autonomic nervous system (ANS) controls white blood cell (WBC) subsets;therefore, the status of ANS can be assessed by assaying WBCs. However, this requires invasive blood sampling, time, cost, and training. Therefore, this study focused on a traditional technique, tongue inspection, which is a simpler method. The purpose of this study was to investigate whether there is an association between the traditional method of tongue inspection and clinical assay of WBC subsets. Twenty-one female alopecia areata patients were divided into two age-matched groups: 1) alopecia areata totalis (AT);and 2) alopecia areata multiplex (AM). Images of patient tongues were captured by a digital camera and categorized before blood sampling. Finally, patients were divided into five groups (normal, Yin+, Yang–, Yin– and Yang+) based on the Eight Principles of traditional Chinese medicine (TCM). Concurrently, venous blood was obtained for WBC subsets. The absolute numbers of WBCs and granulocytes of the AT group were higher than those of the AM group. The AT group was Yin+ but not Yang+, whereas the AM group was Yang+ but not Yin+. Thus, the AT group showed more elements of “cold” (Yin > Yang) compared with the AM group with elements of “hot” (Yin < Yang). Tongue inspection suggested a possibility of consistence with those of WBCs although statistical significance was not obtained. Moreover, some Yin+ and Yang+ subjects showed some trend in similarities between tongue inspection and WBC subsets although this was not statistically significant. Therefore, traditional techniques (such as tongue inspection) acupuncture must be studied further to detect whether subtle effects are induced by acupuncture treatment. As this study is underpowered, a larger scale study including males is required in the future.

The Influence of Apple-or Red-Grape Pomace Enriched Piglet Diet on Blood Parameters,Bacterial Colonisation,and Marker Gene Expression in Piglet White Blood Cells

Proanthocyanidins and flavanoids, both subfamilies of the polyphenols, are highly concentrated in different fruits and berries as well as in fruit pomace. They have shown to exhibit anti-cancer, anti-microbial, anti-oxidative, and im- mune-modulatory effects in vertebrates. Herein the effect of additional apple pomace or red-grape pomace in conven- tional piglet starter feeds were investigated in 36 young growing piglets. Immunological marker gene expression was quantified by quantitative real-time RT-PCR in white blood cells, and intestinal bacterial flora was investigated from weaning to three weeks post weaning. Polyphenol content in red-grape pomace, gut content and tissues were analyzed with HPLC. Flavan-3-ols (epicatechin and catechin) and proanthocyanidins (B1, B2 and C1) were identified in the gas- tro-intestinal tract content, whereas only traces could be detected in various piglet organs. The blood parameters, he- moglobin and hematocrit, were affected and down-regulated in all groups over testing period. In both pomace treated groups more thrombocytes were present compared to the standard feeding group. It turns out, that the pomace diets had greatest impact on the bacterial content in the colon. Results demonstrate that feeding apple pomace and red- grape pomace tended to increase the number of total colonic bacteria. Steptococci/Enterococci increased in the red- grape pomace. C. perfringens was not detectable at the second time point. The number of lactobacilli increased in both applied diets. The number of Clostridium perfringens decreased with the age of the piglets. Trends of mRNA expression changes were found in white blood cell (WBC) between different feeding regimens, since the expression variability in the groups was very high. Between the different time points there were significant differences within the apple pomace group, where TNF? (p = 0.033), NF?B (p = 0.024) and Caspase 3 (p = 0.019) mRNA expression increased signifi- cantly during treatment. We conclude that both polyphenol rich feedings have the potential to positively influence the intestinal flora, blood parameters, and WBC mRNA gene expression pattern of immunological marker genes.

Distinction of white,beige and brown adipocytes derived from mesenchymal stem cells

Adipose tissue is a major metabolic organ, and it has been traditionally classified as either white adipose tissue(WAT) or brown adipose tissue(BAT). WAT and BAT are characterized by different anatomical locations, morphological structures, functions, and regulations. WAT and BAT are both involved in energy balance. WAT is mainly involved in the storage and mobilization of energy in the form of triglycerides, whereas BAT specializes in dissipating energy as heat during cold- or diet-induced thermogenesis. Recently, brownlike adipocytes were discovered in WAT. These brownlike adipocytes that appear in WAT are called beige or brite adipocytes. Interestingly, these beige/brite cells resemble white fat cells in the basal state, but they respond to thermogenic stimuli with increased levels of thermogenic genes and increased respiration rates. In addition, beige/brite cells have a gene expressionpattern distinct from that of either white or brown fat cells. The current epidemic of obesity has increased the interest in studying adipocyte formation(adipogenesis), especially in beige/brite cells. This review summarizes the developmental process of adipose tissues that originate from the mesenchymal stem cells and the features of these three different types of adipocytes.

Enhancing The Efficiency of White Organic Light-emitting Diode Using Energy Recyclable Photovoltaic Cells

We demonstrate that power recycling is feasible by using a semi-transparent stripped Al electrode as interconnecting layer to merge a white organic light-emitting devices(WOLED) and an organic photovoltaic(OPV) cell.The device is called a PVOLED.It has a glass / ITO / CuPc / m-MTDATA ∶ V 2 O 5 / NPB / CBP ∶ FIrpic ∶ DCJTB / BPhen / LiF / Al / P3HT∶ PCBM / V 2 O 5 / Al structure.The power recycling efficiency of 10.133% is achieved under the WOLED of PVOLED operated at 9 V and at a brightness of 2 110 cd / m 2,when the conversion efficiency of OPV is 2.3%.We have found that the power recycling efficiency is decreased under high brightness and high applied voltage due to an increase input power of WOLED.High efficiency(18.3 cd / A) and high contrast ratio(9.3) were obtained at the device operated at 2 500 cd / m 2 under an ambient illumination of 24 000 lx.Reasonable white light emission with Commission Internationale De L'Eclairage(CIE) color coordinates of(0.32,0.44) at 20 mA / cm 2 and slight color shift occurred in spite of a high current density of 50 mA / cm 2.The proposed PVOLED is highly promising for use in outdoors display applications.

Human induced pluripotent stem cells: A new source for brown and white adipocytes

Mesenchymal stem cells(MSCs) derived from human induced pluripotent stem cells(hiPSCs) provide a novel source for generating adipocytes, thus opening new avenues for fundamental research and clinical medicine. We present the adipogenic potential of hiPSCs and the various methods to derive hiPSC-MSCs. We discuss the main characteristic of hiPSC-MSCs, which is their low adipogenic capacity as compared to adult-MSCs. Finally, we propose several hypotheses to explanation this feature, underlying a potential critical role of the micro-environment. We favour the hypothesis that the range of factors or culture conditions required to induce adipocyte differentiation of MSCs derived from adult tissues and from embryonic-like cells could differ.

显微镜视场数对血涂片细胞计数影响的研究

目的通过研究显微镜的光学技术参数视场数对显微镜下手工计数血涂片内白细胞计数和血小板计数的影响,规范显微镜用于细胞计数的参数和方法。方法分别使用全自动血细胞分析仪法、改良牛鲍计数板法和血涂片法3种方法对300例外周血标本进行白细胞和血小板计数,其中血涂片法分别使用视场数为20和26.5的显微镜进行计数,对结果进行比较分析和细胞估算。结果对视场数为20的显微镜每油镜视野下血小板计数和白细胞计数均低于视场数为26.5的显微镜,差异有统计学意义(P<0.05)。视场数为20的显微镜估算的白细胞计数正常值和高值均低于全自动血液分析仪和改良牛鲍计数板,视场数为26.5的显微镜估算的白细胞计数正常值、低值和高值均低于全自动血液分析仪和改良牛鲍计数板,差异有统计学意义(P<0.05)。R=10时,视场数为20的显微镜估算的血小板计数正常值和高值均低于全自动血液分析仪和改良牛鲍计数板,视场数为26.5的显微镜估算的血小板计数正常值、低值和高值均低于全自动血液分析仪和改良牛鲍计数板,差异有统计学意义(P<0.05)。R=15时,视场数为20和视场数为26.5的显微镜估算的血小板计数正常值、低值和高值均高于全自动血液分析仪法及改良牛鲍计数板,差异有统计学意义(P<0.05)。视场数为20和26.5的显微镜使用血小板估算公式时,与全自动血液分析仪及改良牛鲍计数板比较,3种浓度标本差异均无统计学意义(P>0.05)。结论不同视场数的显微镜对计数白细胞和血小板有影响;视场数为20的显微镜在R=10、视场数为26.5的显微镜在R=7.33时对低值标本的血小板计数具有参考意义;视场数为20的显微镜在低值标本的白细胞计数时具有参考意义;对于两种视场数的显微镜来说,血小板估算公式适用于低值、正常值、高值标本的血小板计数。

外周血和尿常规炎性指标评估PD-1抑制剂治疗晚期尿路上皮癌预后的价值

目的:探讨血小板与白细胞比值(platelet and white blood cells ratio, PWR)、血小板与淋巴细胞比值(platelet and lymphocyte ratio, PLR)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)以及尿白细胞计数(urinary leucocyte count, ULEU)与接受PD-1抑制剂治疗晚期尿路上皮癌(urothelial carcinoma, UC)患者预后的关系。方法:收集78例接受PD-1抑制剂治疗晚期UC患者的临床资料,利用Kaplan-Meier法计算生存率和Log-rank检验比较不同组间的生存差异,同时采用COX回归分析预后影响因素。结果:低PLR组与高PLR组的1年生存率分别为71.98%和47.63%,差异有统计学意义(P<0.05);低NLR组与高NLR组的1年生存率分别为71.36%和48.15%,差异有统计学意义(P<0.05);PWR高低两组和ULEU状态预测UC患者生存率无显著性差异(P>0.05)。单因素回归分析结果显示,N分期、M分期、TNM分期、远处转移个数、PLR、NLR是影响晚期UC患者生存情况的危险因素(P<0.05)。多因素回归分析显示,PLR是影响接受PD-1抑制剂治疗的UC患者预后的独立因素。结论:PLR、NLR为影响接受PD-1抑制剂治疗晚期UC患者预后的独立因素,PLR高值组和NLR高值组患者的预后较PLR低值组和NLR低值组的患者差。

肝素结合蛋白、总胆红素和白细胞计数联合预测严重创伤合并脓毒症的效能评价

目的:评价肝素结合蛋白(HBP)联合脏器功能指标对严重创伤合并脓毒症患者预警诊断和预后预测效能评价研究。方法:回顾性分析2019年1月~2020年9月期间入住浙江大学医学院附属第二医院急诊医学科的多发伤并完成HBP检测患者184例,根据SEPSIS 3.0诊断标准将患者分为脓毒症组(n=89)和非脓毒症组(n=95),追踪患者临床结局分为死亡组(n=43)和非死亡组(n=141)。连续测定患者HBP水平,比较两组HBP峰值差异,评估其诊断脓毒症的效力,以HBP峰值的中位数为界值进一步分析其与临床预后相关性,评估HBP单独及联合总胆红素(TBil)及白细胞(WBC)评估预后的效力。结果:(1)脓毒症组(n=89)与非脓毒症组(n=95)HBP的峰值(71.7±68.6 vs 52.5±56.1)无显著差异(P=0.051)。(2)184例患者中HBP峰值与WBC计数呈正相关(r=0.244,P<0.01),与TBil水平呈正相关(r=0.241,P<0.01)。(3)TBil水平、WBC计数及PCT水平独立诊断脓毒症曲线下面积(AUC)分别是:0.618、0.631和0.718,三者联合AUC为0.684,诊断敏感度为60.7%,特异度为71.6%(P<0.05)。(4)死亡预后相关分析显示:高HBP水平组患者死亡率要显著高于低水平组(30.4%vs 16.3%,P<0.05);WBC计数值也是死亡组显著高于非死亡组(17.5±6.9 vs 12.8±4.7,P<0.01),尤其合并脓毒症者,该值有显著差异(P<0.01)。HBP峰值、TBil水平、WBC计数、SOFA评分及APACHE-II评分对预测脓毒症死亡预后的AUC分别是:0.618、0.603、0.719、0.823及0.811,HBP联合TBil及WBC评估脓毒症预后的AUC为0.750,评估的敏感度为74.4%,特异度为74.5%(P<0.05)。(5)三者联合评估在预测脓毒症预后效力上与人工评分差异无统计学意义(P>0.05)。结论:HBP、TBil及WBC三者联合用于评估多发伤患者发生脓毒症风险的预测效力较高,对于合并脓毒症的外伤患者死亡风险预测具有较高的临床指导价值。