Objective To investigate the serum lactate dehydrogenase (LDH),total bilirubin (TBIL)and indirect bilirubin (IBIL)and homocysteine (Hcy)levels change in megaloblastic anemia (MA)and myelodysplastic syndrome (MDS)in the differential diagnosis of the clinical application value.Methods Hitachi 7 600 automatic biochemical analyzer was applied to the determination of 40 patients with MA,30 with MDS patients and 40 healthy physical examination (normal control group)of serum LDH,TBIL,IBIL and Hcy levels,and application SPSS16.0 statistical software for data processing were retrospectively analyzed.Results Ma group of LDH,TBIL,IBIL and Hcy four biochemical index level was significantly higher than that of MDS group and normal control group (P<0.01).MDS group of LDH levels higher than normal control group (P<0.01).MDS group of TBIL,IBIL and Hcy,there was no statistically significant difference compared with normal control group (P>0.05).MA group of LDH,TBIL,IBIL,Hcy higher positive rate higher than that of MDS group,LDH and Hcy was most significant,four biochemical indexes between the two groups compared to increase the positive rate of difference was statistically significant (P<0.01).Conclusion Joint detection of LDH,TBIL,IBIL and Hcy four biochemical index level of the differential diagnosis of MA and MDS has certain clinical value.

Objective To investigate the relationship between red blood cell distribution width (RDW) and prognosis in patients with multiple myeloma (MM).Methods The population that studied consisted of 27 patients with multiple myeloma and 30 healthy controls.The RDW was calculated according to the results of blood routine examination and compared between patients and healthy controls.Then,compared the difference between the two groups of RDW.MM patients were treated with international standard staging (ISS),and the differences of RDW in different stages were analyzed.ISS staging was used to draw the receiver operating curve (receiver operating characteristic curve,ROC curve),then take RDW14.65 ％ as the best cut-off point,the MM patients were divided into low RDW group (RDW=14.65 ％) and high RDW group (RDW ＞14.65％).Overall survival (OS) condition were compared between the above two groups.The impacts of RDW on OS were analyzed by Kaplan-Meier and Log-rank test.Results The average RDW value in experimental and controlled were 15.60 ％ ± 2.35 ％ vs 12.72 ％ ±0.61 ％ separately (t=6.201,P＜0.001),with statistical differences.The average RDW value in low ISS(Ⅰ + Ⅱ stage) and high ISS (Ⅲ stage) were 13.99 ％ ± 1.08％ vs 16.55 ％±2.39％ separately (t=3.800,P=0.001).The median survival time of low RDW and high RDW group was 13 months and 8 months respectively,and the difference was statistically significant (x2=6.481,P =0.011).Conclusion RDW increased in patients with MM,the risk stratification higher prognosis is worse.