浅谈微博在尿沉渣形态学教学改革中的作用

伴随医学检验专业改制(五年学制改为四年制),教学学时也相应缩减,在此形势下,如何保持教学质量尤其是尿沉渣形态学教学质量成为目前教改的焦点。利用微博建立尿沉渣形态学线上教学互动平台就可解决这一问题,教改实践证明:这样不仅保持了教学质量,学生对形态学的学习兴趣也提高了。     

Platelet satellitism in infectious disease?

Background

Platelet satellitism is a phenomenon of unknown etiology of aggregating platelets around polymorphonuclear neutrophils and other blood cells which causes pseudothrombocytopenia, visible by microscopic examination of blood smears. It has been observed so far in about a hundred cases in the world.

Case subject and methods

Our case involves a 73-year-old female patient with a urinary infection. Biochemical serum analysis (CRP, glucose, AST, ALT, ALP, GGT, bilirubin, sodium, potassium, chloride, urea, creatinine) and blood cell count were performed with standard methods on autoanalyzers. Serum protein fractions were examined by electrophoresis and urinalysis with standard methods on autoanalyzer together with microscopic examination of urine sediment. Erythrocyte sedimentation rate, blood culture and urine culture tests were performed with standard methods.

Results

Due to typical pathological values for bacterial urinary infection, the patient was admitted to the hospital. Blood smear examination revealed phenomenon, which has persisted for three weeks after the disease has been cured. Blood smears with EDTA as an anticoagulant had platelet satellitism whereas the phenomenon was not observed in tubes with different anticoagulants (Na, Li-heparin) and capillary blood.

Discussion

We hypothesize that satellitism was induced by some immunological mechanism through formation of antibodies which have mediated platelets binding to neutrophil membranes and vice versa. Unfortunately we were unable to determine the putative trigger for this phenomenon. To our knowledge this is the second case of platelet satellitism ever described in Croatia.Key words: blood platelets, thrombocytopenia, EDTA, urinary infection     

Diagnostic accuracy of UriSed automated urine microscopic sediment analyzer and dipstick parameters in predicting urine culture test results

Introduction

Urinary tract infection (UTI) is one of the most common types of infection. Currently, diagnosis is primarily based on microbiologic culture, which is time- and labor-consuming. The aim of this study was to assess the diagnostic accuracy of urinalysis results from UriSed (77 Electronica, Budapest, Hungary), an automated microscopic image-based sediment analyzer, in predicting positive urine cultures.

Materials and methods:

We examined a total of 384 urine specimens from hospitalized patients and outpatients attending our hospital on the same day for urinalysis, dipstick tests and semi-quantitative urine culture. The urinalysis results were compared with those of conventional semi-quantitative urine culture.

Results:

Of 384 urinary specimens, 68 were positive for bacteriuria by culture, and were thus considered true positives. Comparison of these results with those obtained from the UriSed analyzer indicated that the analyzer had a specificity of 91.1%, a sensitivity of 47.0%, a positive predictive value (PPV) of 53.3% (95% confidence interval (CI) = 40.8–65.3), and a negative predictive value (NPV) of 88.8% (95% Cl = 85.0–91.8%). The accuracy was 83.3% when the urine leukocyte parameter was used, 76.8% when bacteriuria analysis of urinary sediment was used, and 85.1% when the bacteriuria and leukocyturia parameters were combined. The presence of nitrite was the best indicator of culture positivity (99.3% specificity) but had a negative likelihood ratio of 0.7, indicating that it was not a reliable clinical test.

Conclusions:

Although the specificity of the UriSed analyzer was within acceptable limits, the sensitivity value was low. Thus, UriSed urinalysis results do not accurately predict the outcome of culture.     

纳米氧化锌对人肺腺癌细胞A549的毒性

探讨纳米氧化锌（ZnO）对体外培养的人肺腺癌细胞A549的生物学效应。使用原子力显微镜（AFM）、透射电镜（TEM）和X射线衍射仪（XRD）研究纳米ZnO颗粒物的理化性质。然后,使用0mmol/L、0.1mmol/L、0.5mmol/L、1mmol/L、5mmol/L、10mmol/L的纳米ZnO处理体外培养的人肺腺癌A549细胞,MTT 法测定细胞生长活性。并且测定1mmol/L 纳米ZnO染毒24h后细胞培养液上清中,乳酸脱氢酶（LDH）和胞内的超氧化物歧化酶（SOD）、过氧化氢酶（CAT）的活性以及丙二醛（MDA）的含量。使用透射电镜和流式细胞仪检测细胞凋亡的情况。荧光染色检测细胞产生活性氧（ROS）的生成。实验所用的ZnO纳米颗粒为长75 nm、直径20nm的针状纤锌矿晶体。细胞实验结果表明,纳米ZnO颗粒对A549细胞的生长活性具有明显的抑制作用,存在剂量－效应关系。培养液上清中LDH活性显著升高（P < 0.05）,胞内CAT活性显著下降、MDA含量显著升高（P < 0.01）,但SOD活性下降不明显。荧光染色检测发现染毒后A549细胞出现细胞凋亡,而且细胞内ROS的生成与纳米ZnO存在剂量－效应关系。结论是纳米氧化锌诱导人肺腺癌A549细胞产生活性氧,引发细胞凋亡,并产生细胞毒性。     

乳腺癌耐受蛋白介导5-氟脲嘧啶的耐受及机制探讨

AIM To filtrate breast cancer resistance protein(BCRP)-mediated resistance agents and investigate the mechanism,so as to provide valuable datum for optimization clinical chemotherapy scheme to tumor with evaluation marker of BCRP expression. METHODS MTT assay was used to filtrate BCRP-mediated resistance agents with PA317/Tet-on/TRE-BCRP cell of different expression levels of BCRP after treated with different concentration anticancer agents. High performance liquid chromatography(HPLC) was applied to measure relative dose of intracellular retention resistance agents. Nuclear DNA fluorescence dye,Hochest 33258, staining and flow cytometry were adopted to detect apoptotic cells after treated with drugs. RESULTS There were shown increasing durg-resistance to 5-fluorouracil,methotrexate, doxirubicin, pirarubicin,etoposide and mitoxantrone followed with increasing expression of BCRP on PA317/Tet-on/TRE-BCRP cells(P＜0.05, n=3),but shown sensitive to paclitaxel, cisplatin, vincristine, mitomycin and vindesine. There also was shown significant negative correlation between the intracellular retention dose of 5-fluorouracil with different expression of BCRP(r=-0.885, P＜0.05, n=3).There were shown parallel results of that decreasing cellular apoptotic rate with increasing cellular expression of BCRP after treated with 5-fluorouracil by fluorescence dye staining and flow cytometry(P＜0.05, n=3),and also shown significate rise of the apoptotic rate of BCRP expression cells after treated with Ko143 (P＜0.05, n=3). Every group of cells could be different extently blocked in phase of G0/G1 treated with 5-fluorouracil. CONCLUSION Resistance of 5-fluorouracil could be especially mediated by conjugated with BCRP and acted as drug exclude-pump substrate. Cellular ability resistant to 5-fluorouracil-induced apoptosis could be reinforced by BCRP expression.     

Oxidative stress in cases of chronic fluoride intoxication

This study was conducted to find out the level of oxidative stress and effect of supplementation of vitamin C, D and Calcium on levels of SOD, serum and urinary fluoride in children residing in endemic fluorosis area. For this the fluoride belt of Jaipur district was selected. The parameters selected were Super oxide dismutase, serum fluoride and urinary fluoride. The study was conducted on one hundred children, selected from four areas (25 from each area) consuming water containing 1.2, 2.4, 5.6 and 13.6 mg/l of fluoride. Drinking water fluoride, serum and urinary fluoride were measured by Ion selective electrode method. Serum SOD by Xanthine oxidase method using kit of Ransod (kit cat. No. SD125). The post treatment values showed a significant reduction in serum fluoride and SOD. Urinary fluoride levels increased significantly in post treatment stage. The results revealed a normal SOD levels in all groups but an increasing trend was observed with increasing fluoride concentration. Treatment with Calcium, Vitamin D and Vitamin C showed a significant reduction in serum fluoride and SOD and increase in urinary fluoride. A high positive correlation between pretreatment and post treatment group was observed in serum fluoride, SOD and urinary fluoride (P < 0.05). The study indicated an increasing oxidative stress in cases of fluorosis with increasing drinking water fluoride concentration. Treatment with Calcium, Vitamin D and Vitamin C resulted a significant reduction in serum fluoride and SOD and increase in urinary fluoride.     

目标性监测在留置导尿管相关感染中的作用

目的研究留置导尿管相关泌尿系感染(urinary tract infection,UTI)目标性监测是否降低尿路感染发生率,并分析其危险因素,为医院感染管理和控制提供科学的依据。方法采用目标性监测方法,对2011年所有住院患者发生导尿管相关泌尿系感染情况进行调查与分析。结果 769例留置尿管患者,发生泌尿系感染136例,感染率为17.69%,与去年相比感染率明显下降,监测发现感染与基础病、无菌操作、手卫生及导尿管留置时间有关;尿培养病原菌依次排列为:大肠埃希菌、粪肠球菌、金黄色葡球菌、铜绿假单胞菌、克雷柏杆菌、真菌等。结论临床上应严格掌握留置导尿的适应症,病情允许时尽可能缩短留置时间。同时,要严格无菌操作,做好导尿管的护理、定期更换导尿管及尿袋、合理使用抗生素,降低泌尿系感染的发生率。     

氧化型低密度脂蛋白诱导LOX-1 在基因和蛋白水平表达

目的研究氧化型低密度脂蛋白(oxidized LDL, ox-LDL)是否能在基因和蛋白两个水平诱导内皮细胞表达凝集素样氧化低密度脂蛋白受体(lectin-like oxidized LDL receptor, LOX-1),以探讨LOX-1在动脉粥样硬化形成和发展中的作用.方法将不同浓度ox-LDL(20,40,60,80 mg/L)与内皮细胞共孵育24 h及浓度40 mg/L的ox-LDL作用内皮细胞不同时间(0、3、6、12、24 h),反转录聚合酶链反应检测LOX-1 mRNA水平表达,细胞酶联免疫法测定LOX-1蛋白水平表达.结果加入Ox-LDL 20 mg/L使LOX-1 mRNA和蛋白表达量增加(P＜0.01),40 mg/L使其表达量达最高峰,随后逐渐下降.而同一浓度下从0 h～24 h的趋势是LOX-1 mRNA和蛋白逐渐增加(P＜0.01),在12 h增加最明显.结论氧化型低密度脂蛋白呈剂量依赖性和时间依赖性地上调LOX-1 mRNA和蛋白表达,LOX-1可能在动脉粥样硬化形成和发展中起重要作用.     

重金属离子Cd Hg Pb在鳗鱼体内残留规律研究

研究了0.005、0.05、0.10和0.15/mg/L四种不同浓度的Cd与0.10mg/LPb,0.05mg/LHg在日本鳗鱼肝脏、腮、鱼血和鱼肉的残留规律。分别将鳗鱼暴露于上述浓度的重金属35 d后再用清水喂养43 d,考察鳗鱼对该三种重金属的吸收和清除规律。结果显示三种重金属在鳗鱼体内富集能力依次是Hg>Pb>Cd。Cd在鳗鱼组织中蓄积顺序为肝脏>腮>鱼肉>血。鳗鱼体内Cd的吸收量与其暴露浓度呈正相关,停止暴露后Cd由其他组织向肝脏转移,可导致肝脏Cd负担持续增大。0.15mg/L浓度的Cd可使鳗鱼产生急性和亚急性中毒症状。鳗鱼组织中Hg和Pb蓄积顺序为腮>肝脏>鱼肉>血。鱼肉中两种重金属消除速度非常缓慢。     

An in vitro model mimicking the complement system to favor directed phagocytosis of unwanted cells

BackgroundOpsonization, is the molecular mechanism by which target molecules promote interactions with phagocyte cell surface receptors to remove unwanted cells by induced phagocytosis. We designed an in vitro system to demonstrate that this procedure could be driven to eliminate adipocytes, using peptides mimicking regions of the complement protein C3b to promote opsonization and enhance phagocytosis. Two cell lines were used: (1) THP-1 monocytes differentiated to macrophages, expressing the C3b opsonin receptor CR1 in charge of the removal of unwanted coated complexes; (2) 3T3-L1 fibroblasts differentiated to adipocytes, expressing AQP7, to evaluate the potential of peptides to stimulate opsonization. (3) A co-culture of the two cell lines to demonstrate that phagocytosis could be driven to cell withdrawal with high efficiency and specificity.ResultsAn array of peptides were designed and chemically synthesized p3691 and p3931 joined bound to the CR1 receptor activating phagocytosis (p < 0.033) while p3727 joined the AQP7 protein (p < 0.001) suggesting that opsonization of adipocytes could occur. In the co-culture system p3980 and p3981 increased lipid uptake to 91.2% and 89.0%, respectively, as an indicator of potential adipocyte phagocytosis.ConclusionsThis in vitro model could help understand the receptor–ligand interaction in the withdrawal of unwanted macromolecules in vivo. The adipocyte-phagocytosis discussed may help to control obesity, since peptides of C3b stimulated the CR1 receptor, promoting opsonisation and phagocytosis of lipid-containing structures, and recognition of AQP7 in the differentiated adipocytes, favored the phagocytic activity of macrophages, robustly supported by the co-culture strategy.How to cite: Bartsch IM, Perelmuter K, Bollati-Fogolin M, et al. An in vitro model mimicking the complement system to favor directed phagocytosis of unwanted cells. Electron J Biotechnol 2021;49. https://doi.org/10.1016/j.ejbt.2020.09.010.     

前列腺增生症经尿道前列腺电切术并尿失禁原因及预防

目的：探讨良性前列腺增生症经尿道前列腺电切术后并尿失禁的原因。方法翻阅病案资料,随机选取2011年1月-2013年1月广西中医药大学第一附属医院良性前列腺增生症行前列腺电切术病人330例。术后回访6个月-1年,平均回访8个月。结果共出现尿失禁21人,发生比例为6.3%。其中,轻度尿失禁4.5%,压力性尿失禁1.2%,完全性尿失禁0.6%。结论经尿道前列腺电切术较为大多数病人所接受,是治疗良性前列腺增生症的理想方法。术后尿失禁是一种多因素综合作用的结果,部分尿失禁是由于医源性造成,需引起重视,大多数的病人可以在短时间内恢复。     

Survey on reporting of epithelial cells in urine sediment as part of external quality assessment programs in Brazilian laboratories

IntroductionEpithelial cells (ECs) are structures regularly observed during urine microscopy analysis. The correct identification of EC subtypes can be useful since renal tubular epithelial cells (RTECs) are clinically relevant. We investigate the urinary ECs report and the judgement of its clinical importance by Brazilian laboratories.Materials and methodsA survey with four questions was made available to participants of the Urinalysis External Quality Assessment Program (EQAP) from Controllab. Laboratories composed 3 groups: (1) differentiating ECs subtypes: “squamous”, “transitional” and “RTECs”; (2) differentiating ECs subtypes: “squamous” or “non-squamous” cells; (3) without ECs subtype identification. Participants did not necessarily answer to all questions and the answers were evaluated both within the same laboratory’s category and within different categories of laboratories.ResultsA total of 1336 (94%) laboratories answered the survey; Group 1, 119/140 (85%) reported that ECs differentiation is important to the physician and 62% want to be evaluated by EQAP, while in Group 3, 455/1110 (41%) reported it is useful to them, however only 25% want be evaluated by EQAP. Group 2 laboratories 37/51 (73%) reported that the information is important, but only 13/52 (25%) are interested in an EQAP with differentiation of the 3 ECs subtypes.ConclusionMost of the laboratories do not differentiate ECs in the three subtypes, despite the clinical importance of RTECs. Education of laboratory staff about the clinical significance of urinary particles should be considered a key priority.     

东北黑土区小流域侵蚀产沙WaTEM/SEDEM模型模拟

东北黑土区是我国重要的商品粮基地。近年来,受自然因素及人类不合理活动的影响,土壤侵蚀严重。土壤侵蚀模型是预测侵蚀产沙的重要工具,Wa TEM/SEDEM模型是一个分布式模型,本文以黑龙江省拜泉县25个水库控制流域为研究对象,采用Wa TEM/SEDEM模型模拟小流域侵蚀产沙特征,得到如下结论:研究区模型泥沙输移系数KTC最佳组合为0.38和0.55;利用Wa TEM/SEDEM模型模拟得到的产沙量(SY)与实际值相近,相关系数为0.95;产沙模数(SSY)的模拟值与实际值相关系数为0.34,相关程度相对较低,但均比回归方程模拟得到的产沙量和产沙模数相关程度高。流域泥沙输移比平均值为0.32。以齐心水库控制流域为例,模型模拟发现,流域平均侵蚀模数为351.2t/(km2·a),将齐心水库控制流域模拟结果与临近研究区的有关研究进行对比,证实Wa TEM/SEDEM在黑土区模拟流域侵蚀产沙有很好的应用前景。该研究可为黑土区土壤侵蚀与水土保持措施实施提供科学依据。     

流式细胞术分析五味子乙素促进阿霉素内化的实验研究

[目的]建立流式细胞术分析肿瘤细胞内阿霉素分布的方法,并研究低浓度五味子乙素对K562细胞内化阿霉素的影响。[方法]体外培养猪内皮细胞(pEC),以20μmol/L阿霉素处理2、4和6小时;或加入不同浓度阿霉素(0、10、20、40、80和100μmol/L)处理4小时。培养K562细胞,以5μmol/L阿霉素处理2、4和6小时;或加入不同浓度阿霉素(0、2.5、5、10和20μmol/L)处理4小时。采用不同浓度(0、25、50和100μmol/L)五味子乙素(Sch B)与阿霉素联合处理K562细胞4小时。收集细胞,采用流式细胞术分析阿霉素的特异荧光。[结果]固定浓度处理pEC(20μmol/L)和K562(5μmol/L)后检测,发现细胞内荧光强度随时间延长而增加,两种细胞4小时组荧光强度分别达到6小时组的96.93%和95.23%/。在直方图上,阴性和阳性细胞群界限分明。阿霉素(2.5、5和10μmol/L)单独处理细胞的荧光强度分别为26.78±3.34、64.70±6.24和118.35±9.67;添加25μmol/L Sch B实验后荧光强度增加到43.45±4.25、103.74±7.36和146.69±8.32,Sch B显著增加了K562细胞内阿霉素的分布(p<0.05)。[结论]建立的方案可快速测定细胞内的阿霉素分布;低浓度Sch B促进肿瘤细胞内化阿霉素。     

Nychthemeral rhythmicity of urinary copper levels in healthy Indians and renal stone formers

Nychthemeral rhythmicity of urinary copper (Cu) was studied in 40 clinically healthy volunteers and 35 renal stone formers. A marked diurnal rhythm was noticed in urinary Cu levels in healthy subjects with maximum excretion at 0000 to 0600 hr followed by a progressive fall during the rest of the period reaching minimum between 1200 to 1800 hr in males and 0600 to 1200 hr in female volunteers. Similarly, all stone patients exhibited a definite rhythm in urinary Cu with significant amplitude and acrophases at 2145 hr for males and 2141 hr for female stone formers. However, there was no difference in mean 24-hr Cu excretion in male and female stone formers, whereas a significant change was observed in case of healthy subjects. Urinary Cu was found to be significantly increased in renal stone formers in comparison to healthy controls of either sex attributing a significant role of this overlooked trace mineral in the crystallization and/or activation of either of the process of stone formation in the renal tubules.     

Urinary protein thiols in different grades of proteinuria

Total thiol status of plasma, especially thiol groups over protein contributes maximum to the plasma antioxidant status of the body. Serum protein thiols were found to be decreased in various disease conditions including chronic renal failure patients. Only few studies determined the levels of urinary protein thiols in disease conditions. The current study was designed to know the levels of urinary protein thiols in patients with different grades of proteinuria. The study was conducted on urine of 40 healthy controls and 61 cases with proteinuria. Based on proteinuria cases were further divided into two groups; group I - microproteinuria (150–300 mg protein/d), 32 cases, group II - frank proteinuria (>300 mg protein/d), 29 cases. Urinary thiol levels were determined by spectrophotometric method using dithionitrobenzoic acid. A significant decrease (p<0.01) in urinary thiol in group I and group II cases was observed in present study and this decrease was associated with proteinuria.     

Establishment of Reference Interval for Liver Specific Biochemical Parameters in Apparently Healthy North Indian Population

Reference intervals (RI) are the most common decision support tool used for interpretation of numerical laboratory reports. The quality of the RI can play as large a role in result interpretation as the quality of the result itself. As such there is hardly any study examining RI for liver specific biochemical parameters in Indian population especially north Indians having drastically different food habits as compared to rest of the India. So there is a need to establish the RI for north Indian population. Present study was conducted on 2,021 apparently healthy individuals of north Indian origin ranging in age from 15–60 years, were selected randomly using defined criteria. Lipemic, hemolysed, icteric and stored samples were also excluded adopting preanalytical criteria for rejection of sample. Non parametric methodology for determination of RI was adopted as most of the biochemical parameters included revealed non Gaussian distribution. Data were analyzed for middle 95 percentile (2.5th–97.5th percentile), median and 95 % confidence interval using SPSS software package version 10.0. The upper and the lower limit of RI (reported Vs observed) for bilirubin (0–1.2 Vs 0.30–1.30 mg/dL), serum glutamate oxaloacetate transferase (SGOT) (0–41 Vs 13–52.80 IU/L), serum glutamate pyruvate transferase (SGPT) (0–50 Vs 10–68 IU/L) showed wide variation as compared to reported standard RI however Gamma glutamyl transferase (GGT) (0–50 Vs 5.00–50.60 IU/L) remained within the reported standard RI. Further gender wise evaluation revealed higher cutoff in males (AST 14–55, ALT 11–70.35, GGT 6.76–51.09 in IU/L, bilirubin (0.40–1.34 mg/dL) as compared to females (SGOT 13–50.43, SGPT 9–63.43, GGT 3.92–48.70 in IU/L, Bilirubin 0.30–1.20 mg/dL) for both enzymatic and non enzymatic biochemical parameters. The variations may be attributed to dietary pattern smoking and alcoholism.     

Urinary enzymes in nephrotic syndrome

Tubular damage is a complication associated with nephrotic syndrome and increased levels of urinary enzymes are of significant value in detection of the same. The aim of our study was to evaluate the use of urinary lysozyme and trehalase as markers of tubular dysfunction in nephrotic syndrome. This study assessed 35 nephrotic syndrome patients and 30 healthy controls matched for age and sex. Urine samples were examined at pretreatment and post treatment (8 weeks) stages for proteinuria, lysozyme and trehalase. At pretreatmant stage there was significant increase in urinary lysozyme and trehalase as compared to controls (p<0.001). A good correlation was observed between degree of proteinuria and urinary lysozyme (p<0.001;r=0.80) and trehalase (p<0.001; r=0.74). At the end of 8 weeks of treatment, the patients showed significant decrease in their urinary lysozyme and trehalase activity (p<0.001) but no correlation with degree of proteinuria was observed. Our results indicate that enzymes like lysozyme and trehalase can be used as markers of tubular dysfunction.     

基于改进RUSLE模型的皇甫川流域土壤侵蚀产沙模拟研究

采用GIS与RS技术,以RUSLE模型为基础,增加流域输沙能力与淤地坝拦沙效率模块,并在黄土高原粗沙多沙区流域皇甫川进行验证。模型模拟结果显示:率定期1991-1999年皇甫站实测输沙量与模拟值拟合较好,纳什系数(Nash)与相关系数均超过0.7,而验证期2000-2009年的模拟结果相对较差。不同土地利用状况的土壤侵蚀模数表明:皇甫川流域土壤侵蚀模数超过15 000t/(km2·a)的区域主要发生于裸露的砒砂岩与植被覆盖较差的沙地;而土壤侵蚀模数小于2 500t/(km2·a)的区域主要分布在地势较为平坦的河滩地与植被盖度好的高原区。在相同降雨条件下,皇甫川流域不同土地利用类型土壤侵蚀模数的大小顺序为裸砒砂岩沙地耕地草地林地。根据修正RUSLE模型分析皇甫川流域淤地坝的拦沙效益发现,1991-2009年淤地坝平均年拦蓄泥沙约为0.42亿t,几乎与皇甫站(1955-2010年)年均输沙量0.41亿t相当。