Objective To investigate the clinical value of neutrophil-to-lymphocytc ratio(NLR) in identifying blood stream infection caused by different pathogens and for differentiating coagulase negative staphylococcus(CNS)bloodstream infection and contamination.Methods Medical records of 500 patients who underwent blood culture test and routine blood test at the same time were retrospectively analyzed,blood culture negative group 356 patients,blood culture positive group 144 patients,which included Gram-negative group,Gram positive group,fungi group,CNS bloodstream contamination and mingled group.Collected the results and calculated the NLR at the same time.NLR were applied by t test of each group.ROC curve was used to determine the cut off value of NLR.Results ①Mean values of NLR in negative blood culture,blood stream infection group,CNS bloodstream infection and contamination were 6.12,13.15,10.11 and 6.24.NLR had statistical difference between negative blood culture and blood stream infection group,CNS bloodstream infection group and contamination group (P＜0.05).②Mean values of NLR in and fungi group were 15.33,11.63 and 10.58,respectively.NLR had statistical difference between Gram-positive bacteria group and Gram-negative bacteria group (P＜0.05).NLR had no differences among Gram-positive bacteria (15.33) and Gram negative bacteria (11.63) compared with (10.58) fungi respectively (P＞0.05).③The area under the curve of NLR predicting a positive blood culture,distinguishing Gram-positive bacteria and Gram-negative bacteria,differentiating CNS bloodstream infection and contamination were 0.86,0.60 and 0.75,respectively.The optimal cut off values of NLR for predicting a positive blood culture,distinguishing Gram-positive bacteria and Gramnegative bacteria,differentiating CNS bloodstream infection and contamination were 10.45,7.50 and 8.10 respectively.Conclusion NLR is highly effective in distinguishing blood stream infection and differentiating CNS bloodstream infection and contamination.

Objective To discuss the value of serum thymidine kinase 1 and DNA ploidy for the diagnosis of patients with acute myeloid lecukemia.Methods Determined TK1 and DI in 20 healthy people,6 patients with benign proliferate in hematological system and 66 patients with acute myeloid lecukemia by chemiluminescence detection technique and flow cytometry.Nonparametric comparisons among three group were done by rank sum test.ROC curve was used to determine the AUC and the diagnosis value serum thymidine kinase 1 and DNA.Results As showed by peripheral blood results,the TK1 (x2 =36.877,P＜0.001) and DI (x2=4.040,P＜0.05) had statistically difference among healthy people group,patients with benign proliferate in hematological system group and AML group.The normal control group compared with the AML group,TK1 (Z=-6.073,P＜0.001)and DI (Z=-2.012,P =0.044) had statistically difference;The normal control group compared with the benign proliferate patients,TK1 (Z=-1.234,P =0.169) and DI (Z=-1.084,P =0.278) had no statistically difference.The benign proliferate patients and that with AML patients,TK1 (Z=2.177,P=0.036) had statistically difference,but DI (Z=-1.801,P=0.061) had no statistically difference.The TK1 and DI area under the ROC curve were 0.950 (P＜0.001) and 0.638 (P=0.063),best cut-off were 1.73 pmol/L and 0.98,sensitivity were 0.95,0.78,and specifity were 0.88,0.39.Conclusion Serum TK1 and DI is a important diagnostic marker of early for AML patients,TK1 have a better diagnostic performance than DI significantly.

Objective To evaluate the significance of the level change of urinary conductivity (Cond) on the disease progress in the patients with type 2 diabetic nephropathy(DN) .Methods 138 patients with type 2 diabetes mellitus (T2DM) in our hospital were selected and divided into the normoalbuminuria (NUA) ,microalbuminuria (LUA) and macroalbuminuria (MUA) group;then among them 107 cases were re‐divided into the DN group and the diabetes mild renal injury (DC) group .The levels of urinary Cond were measured by using the Sysmex UF‐1000i urine flow cytometer .The urine specific gravity (SG) was detected by the ARKRAY AUTION MAX AX‐4280 analyzer ,and the urine albumin (U‐Alb) was tested by the Siemens BNⅡ automatic protein analyzer .Re‐sults The Cond level in the MUA group was (14 .1 ± 4 .5)ms/cm ,which was lower than (15 .7 ± 4 .3)ms/cm in LUA group(P<0 .05) ,while the Cond level in the LUA group was significantly lower than (17 .6 ± 5 .7) ms/cm in the NUA group(P<0 .05);the SG levels in the NUA group and the LUA group were 1 .014(1 .010-1 .019) and 1 .015(1 .010 -1 .020) respectively ,both were higher than 1 .011(1 .009-1 .012) in the MUA group SG (P<0 .05) .Cond was positively correlated with SG (r=0 .63 ,P<0 .05) and negatively correlated with 24 h‐UAE (r= -0 .183 ,P<0 .05) .The Cond level in the DN group was(13 .2 ± 4 .3)ms/cm ,which was significantly lower than (15 .0 ± 4 .4) ms/cm in the DC group (P<0 .05) ,there was no statistically significant differences in the SG level between the DN group and DC group (P>0 .05) .The area under curve (AUC) of ROC for Cond was 0 .612 (0 .502-0 .723) .When setting the cut‐off vales of Cond as 11 .85 ms/cm ,then the sensitivity was 43 .8% ,and the specificity was 78 .0% . Conclusion The urine Cond level change can reflect the disease progress of DN in T 2DM ,but can not be used as its early screening indicato r .