Urinary tract infection (UTI)is a commonly encountered disease during routine clinical care. In the mean time, it is also a commonly encountered hospital acquired infection. UTI possesses various clinical symptoms, and usually the symptoms are atypical. The detection of leukocyturia and bacteriuria is an essential index for screening and confirmatory diagnosis of UTI. This article summarized the pathogenesis of UTI, diagnostic criteria, clinical significance and application evaluation of detection of the WBC and bacteria in urine.

The incidence of α-thalassemia and β-thalassemia is high in Guangxi,Guangdong,Sichuan and other province in China.Because no effective approach to thalassemia treatment could be used clinically now,the most cost-effective strategy to control this disease is to prevent the birth of babies with severe form of thalassemia.It is important to make effective screening and correct diagnosis of thalassemia by laboratory test.Laboratory diagnosis of thalassemia includes routine diagnosis and genetic diagnosis.The laboratory routine tests are some hematology examination,comprising red blood cell indices,erythrocyte osmotic fragility test,hemoglobin analysis,and others.Anyone alone of these laboratory parameters can not be used to diagnose the carrier of thalassemia.It is necessary to combine these tests to make screening diagnosis.The final diagnosis of thalassemia need to perform the gene mutation examination or globin train analysis.Technologies for gene mutation detection have been the main and gold standand method of diagnosing thalassemia now.

As the reference method, microscopic examination is still the most basic method of red cell morphology examination.There are several ways to improve the laboratory personnel's skill and ability on abnormal erythrocyte morphology diagnosis, including deep understanding of pathological mechanisms of abnormal red cell morphology, raising the ability of recognizing abnormal red blood cell that are of great clinical value, following and implementing rules to ensure the accuracy and repeatability of the examinations, standardizing reports of abnormal erythrocyte morphology.

Objective To explore the signification and method of Cut-off verification and gray zone setting in chemiluminescent assay.Methods NCCLS EP-12 A2 document defines that C50 is the analyte concentration of cut off value for immunology qualitative test and C5-C95 interval is the range of analyte concentration that yields 5％ positive results to 95％ positive results for immunology qualitativc test.The C50 and C5-C95 interval of HBeAg in ARCHITECT i2000 were worked out according to the cut off value provided by HBeAg reagent calibrated in ARCHITECT i2000,which were verified to approve the character declaimed by manufactory or not.Gray zone was set and the procedure of cut off verification and gray zone set in chemiluminescent were built; A set of quality control was detected 20 times with two different lot HBeAg reagent kits,S/CO was caculated and compared with t test.Results C50 and C5-C95 interval of reagent (lot 06087L100,96378HN00) were 0.171 PEI U/ml,0.125 PEI U/ml; ＞0.154 PEI U/ml to 0.188 PEI U/ml,0.119 PEI U/ml to ＜0.150 PEI U/ml,respectively.S/CO of negative quality control and positive quality control were (0.550 ±0.038),(2.422 ±0.084) and(0.334 ±0.063),(3.587 ±0.321),respectively.They all approved the character (the sensitivity at cut off was less than 0.5 PEI U/ml)declaimed by manufactory,and the results of S/CO between two lot kits were obvious difference (t =9.944,15.499,P ＜0.01).Conclusion C50 and C5-95 interval can be used to verify cut off value and set gray zone in chemiluminescent assay;They may vary in different lot reagents and they must be verified to approve the character declaimed by manufactory.

Objective To determine the diagnostic value of 8-hour pH monitoring in gastroesophageal refulux disease(GERD)and compare its sentivity and specificity with that of 24-hour monitoring.Methods Patients had been given esophageal manometry and ambulatory 24-hour pH monitoring.The 8-hour datas were analyzed from the standard ambulatory 24-hour pH recording.GERD was confirmed if DeMeester Score was no less than 14.72 according to the routine pH monitoring,then DeMeester score was reanalyzed according to 8-hour period,the same dignosis cirteria was used for 8-hour pH monitoring.Results Totally 221 patients met the entrance criterion.The 8-hour test had a sensitivity of 93.5% when compared to the 24-hour test and a specificity of 95.9%.Kappa test and Mc-nemar test verified the two monitor periods were with considerable consistency.The Pearson coefficient correlation was 0.929 with P value less than 0.001.Conclusion The 8-hour analysis is as sensitive and specific as the routine test for demonstrating GERD.By using this method,patients may suffer less discomfort and appear enhanced compliance.

Objective To study the application and influential factors of urine tissue polypeptide specific antigen(TPS) for early detection and clinical outcome in bladder transitional cell cancers (BTCC). Methods Urine TPS in 76 cases of newly diagnosed BTCC,42 cases of recurrent BTCC,26 cases of postoperative BTCC with normal urine cytology,28 cases of benign bladder diseases,42 normal controls were determined by ELISA.The TPS levels were compared with the cystoscopic results and pathological findings.The relationship between urinary TPS level and the development and prognosis of BTCC was analyzed. Results The urine TPS level was not related to age and sex.The TPS levels in newly diagnosed BTCC group,recurrent BTCC group,postoperative BTCC with normal urine cytology group, bladder benign diseases group and control group were (341?403)U/L,(212?166)U/L,(168?115)U/L,(135?48)U/L and (81?37)U/L,respectively.There was significant difference between each other (all P

Objective To study abnormal defecation in patients with posterior vaginal prolapse combined with anorectal manometry. Methods From Jan. 2008 to Nov. 2009, clinical documents and examination of anorectal manometry of 40 patients with posterior vaginal prolapse were studied retrospectively. Anal physiologic testing was performed for 40 patients. These patients were classified into group A ( stage 0 and [posterior vaginal prolapse, represented normal) and group B ( stage Ⅱ - Ⅳ ).Results of anorectal manometry, constipation and symptoms of defecation were compared. Results The average anal canal resting pressure and squeeze pressure of 40 patients were (40 ±21 ) and (96 ±33) mm Hg (1 mm Hg =0. 133 kPa). In group A, the anal canal resting pressure and squeeze pressure were (37 ±21) and (78 ±43) mm Hg, rectal sensation threshold and rectal maximum volume were (106 ±61 ) and (183 ± 51 ) ml. In group B, the anal canal resting pressure and squeeze pressure were (42 ± 21 ) and (102±30) mm Hg, rectal sensation threshold and rectal maximum volume were (90±44) and (171 ±61) nl.Apart from maximum squeeze pressure ( P = 0. 039 ), the other clinical index did not show statistical difference (P ＞ 0. 05 ). Rectal sensation threshold, intended volume and maximum capacity of (116 ± 69 ),( 170 ± 90), ( 191 ± 75 ) ml in patients with constipation were higher than (84 ± 31 ), ( 121 ± 37 ), ( 169 ±45) ml in patients without constipation. In addition to maximum capacity (P = 0. 281 ), the other clinical index reached statistical difference between patients with and without constipation (P ＜ 0. 05 ). Patients with defecation symptoms have higher rectal sensation threshold, intended volume and maximum capacity than those of patients without defecation symptoms. Conclusions As gradually increased in the degree of prolapse, resting pressure and squeeze pressure tend to be increased, while the rectal sensation threshold and rectal maximum volume tend to be decreased. Patients with defecation symptoms and constipation have increased the initial feeling of volume and maximum tolerated volume.

Objective To discuss clinical efficacy of the modified Stoppa approach in the treatment of acetabular anterior fractures.Methods From January 2011 to December 2014,22 patients with acetabular anterior fracture were treated at our department.They were 14 males and 8 females,with an average age of 36.6 years (range,from 18 to 49 years).By the LetourneI-Judet classification system,there were 9 anterior wall fractures,12 anterior column fractures,and one transverse fracture.The modified Stoppa approach was used for fracture reduction under direct visualization in this cohort.Fixation with reconstruction plate was conducted after satisfactory reduction was confirmed by the X-ray examination.The operative duration,incision length,bleeding volume,fracture reduction quality,function of the affected hip and complications were recorded.Results In this cohort,the incision length ranged from 6 to 15 cm,averaging 9.5 cm;the intraoperative bleeding volume ranged from 100 to 1,000 mL,averaging 550 mL;the operative duration ranged from 40 to 160 minutes,averaging 126.2 min.The 22 patients were followed up for an average of 15.5 months (from 12 to 18 months).According to the Matta imaging evaluation,the fracture reduction was rated as excellent in 18 cases,as good in 3 cases and as poor in one,yielding an excellent to good rate of 95.5％.According to the Harris scoring system,the function of the affected hip was assessed at the final follow-up as excellent in 12 cases,as good in 9 cases,and as poor in one case,giving an excellent to good rate of 95.5％.Traumatic arthritis occurred in one case;there were no such complications as reduction loss or implant failure.Conclusion The modified Stoppa approach is a satisfactory one for the treatment of unstable acetabular anterior fractures,owning to its advantages like minimal invasiveness,simple dissection,excellent visual control of reduction and fixation,and a low rate of complications.

SUMMARY Behcet’sdisease(BD)isachronicvascularinflammatorydiseaseofunknowncauses.Itis called intestinal BD,when digestive tract is involved.To investigate small bowel feature of intestinal BD, we now report 5 intestinal BD cases undergone capsule endoscopy from December,2010 to April,2014 in Peking University People’s Hospital.General information,clinical feature and endoscopic feature were presented,and literatures were reviewed.There were 3 male and 2 female patients.Age range was from 23 to 55 years old (median age 40 years old).Disease course was from 3 days to 28 years (median course 9 years).4 patients were diagnosed as systemic BD,and the rest independent intestinal BD.4 systemic BD patients all presented as recurrent oral aphthous as initial symptom and had history of vulvar ulcer and skin lesion.They all had gastrointestinal symptoms,including retrosternal pain (2 cases),he-matochezia (3 cases),diarrhea (3 cases)and abdominal pain (2 cases).1 patient had a history of fis-tula of ileocecal junction and underwent caecectomy.5 patients all underwent whole digestive tract exami-nation by endoscopy,including gastroscopy,colonoscopy and capsule endoscopy.Except of 1 normal re-sult of colonoscopy,all endoscopy results revealed lesions.Capsule endoscopy results of all patients were abnormal.Types of small intestinal lesion were various,including ulceration,erosion,protrusion and vasculopathy.All digestive tract can be involved in BD patients.Capsule endoscopy can evaluate lesions throughout whole digestive tract,especially in small intestine.As a consequence,it is helpful to explain gastrointestinal symptom,increase early diagnostic rate.Intestinal BD (IBD)mainly involves small bow-el,and ileum is the major involved segment,not only limited in ileocecum.The updated perspective of IBD lesion distribution will contribute to differential diagnosis between IBD and Crohn’s disease.This is the first time to report capsule endoscopic feature of BD patients in China.

Objective To investigate the effects of simethicone on the quality of video capsule endoscopy (VCE) examination.Methods A prospective study was performed in 90 patients received VCE examination from February 2010 to October 2014.The randomized table was set according to different dosage of simethicone the patients received,by which patients were divided into three groups.Group 1 (35 cases) received 15 mL simethicone,group 2 (30 cases) received 30 mL simethicone and control group (25 cases) received no simethicone.The small intestinal visualization quality of VCE was scored by segments.Segment A was proximal small intestine (one hour after VCE passing pylorus).Segment B was distal small intestine (one hour before VCE passing ileocecal valve).Segment A and B were scored according to the air bubbles and degree of cleanliness.Gastric transit time,small bowel transit time and VCE completion rate were recorded.Student's t test,Mann Whitney rank sum test and chi square test were performed for statistical analysis.Results The average scores of segment A of group 1,group 2 and control group were 0.58,0.33 and 1.67,respectively,and the average socres of segment B were 0.25,0.00 and 1.17,respectively.The lesion detection rates of group 1,group 2 and control group were 68.6％ (24/35),80.0％ (24/30) and 52.0％ (13/25),respectively,and the differences was statistically significant (x2 =8.238,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =7.354 and 9.349,P=0.034 and 0.005).The detection rates of small intestinal erosion of group 1,group 2 and control group were 22.9％ (8/35),70.0％ (21/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2=8.714,P=0.013).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =10.600 and 7.380,P=0.005 and 0.025).There was no statistically significant difference in the detection rates of ulcer,vascular malformation and protrusion among the three groups (all P＞0.05).The detection rates of lesions＜0.5 cm of group 1,group 2 and control group were 37.1％ (13/35),66.7％ (20/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2 =8.242,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =9.250 and 7.842,P =0.011 and 0.017).Conclusion Oral adminstration of 30 mL simethicone could obviously decrease air bubbles in small intestine,and increase lesion detection rate of VCE.