Objective To explore the application value of interferon gamma release assay (IGRAs)in the clinical detection of tuberculosis infected T lymphocytes.Methods Used IGRAs method to detect the 11 968 outpatients and hospitalized pa-tients from 2013 to 2016 with tuberculosis screening.According to the distribution department analysis,also of positive case detection according to age and gender were analysis and comparison and analysis on the uncertainty of results,different methods were compared.Results Among the 11 968 cases,2 048 cases were positive,the positive rate was 17.11%,and the uncertain result was 107 cases,which accounted for 0.89% of the total number.The positive rates from 2013 to 2016 were 19.65%,21.35%,15.82% and 13.56%,respectively.In the detection and screening of pulmonary and pulmonary tuberculo-sis,the positive rates of the department of respiration,the digestive department,the oncology department,the department of neurology and the department of gynecology were 22.07%,20.27%,23.38%,12.84% and 11.86%,respectively.In the positive screening,men accounted for 62.11%,women accounted for 37.89%,men were significantly higher than women.By age group,was less than or equal to 15,16~25,26~45,46~65,was more than orequal to 66 years old,positive rate were 1.96%,18.51%,16.54%,21.25% and 25.73%,respectively.Analysis of uncertain outcome data,department of respira-tion,rheumatism,department of hematology,accounted for 1.99% and 2.35%,respectively.Compared with other laboratory methods,the IGRAs method had obvious advantages.Conclusion Tuberculosis occurs in various body organs,there were differences in gender and age of Mycobacterium tuberculosis infection.IGRAs is a sensitive and specific method for rapid de-tection of Mycobacterium tuberculosis infection,although it can not be used as a diagnostic indicator,but in patients with suspected tuberculosis IGRAs has a larger clinical application value for the further diagnosis of disease.

Objective To investigate the diagnostic value of the single detection and combined detection of Epstein-Barr virus (EBV) VCA-IgM ,aspartate transaminase (AST) and alanine transaminase (ALT) in EBV current infection .Methods The VCA-IgM positive simples tested by chemiluminescence from January to October 2016 were collected .EBV-DNA was detected by RT-PCR .AST and ALT were detected by using the enzyme rate method .Then samples were divided into the EBV-DNA positive group and EBV-DNA negative group .SPSS22 .0 was used for conducting the non-parametric test .Then each indicator was analyzed by the Logistic regression and receiver operating characteristic (ROC) curve .Results The levels of VCA-IgM ,AST and ALT in the EBV-DNA positive group were higher than those in the EBV-DNA negative group ,the difference was statistically significant (P<0 .05) . VCA-IgM ,AST and ALT showed a correlation with EBV-DNA (P<0 .05) .The areas under curve (AUC) of VCA-IgM ,AST and ALT single indicator detection curve were 0 .803(95% CI:0 .735 -0 .872) ,0 .788(95% CI:0 .708 -0 .868) ,and 0 .752(95% CI:0 .671-0 .832) ,respectively ;AUC of 3-indicator combined detection were 0 .830(95% CI:0 .765 -0 .896) ,which was high than AUC of each single indicator detection .Conclusion Among the indicators in EBV current infection ,VCA-IgM is of great diagnostic value ,and is superior to AST or ALT .Furthermore ,the combined detection of these three indicators is better than single indicator detection ,which contributes to the diagnosis and prevention of EBV infection and other complicating infection .

ObjectiveTo observe the activity and safety of a novel combination therapy for patients with recurrent or refractory aggressive non-Hodgkin lymphoma (NHL).MethodsSix consecutive patients with recurrent or refractory aggressive NHL were treated with B-VIP regimen,boanmycin (5 mg/m2 on Days 1,4,8,12 and 15),vincristine (1.4 mg/m2 on Days 1,8 and 15),ifosfamide (1.2 g/m2 on Days 1,2,3 and 15,16,17) and prednisone (50 mg on Days 1 to 10),every 21 days.All the patients had received ≥5 cycles (average 8.3 cycles) of previous chemotherapy.ResultsSix patients (100 ％) were evaluable for response.The overall objective response rate was 66.7 ％ (4 patients),including 1 case complete (CR) and 3 cases partial responses.Myelosuppression was the most frequent serious complication of this regimen.ConclusionIn the current study,B-VIP was a highly active and safe combination therapy for patients with refractory disease with a poor prognosis or for patients with multiply recurrent aggressive NHL.

Objective:To investigate the efficacy of local application of methimazole cream in the patients with hyperthyroidism complicated with liver failure, and to provide reference for its clinical treatment.Methods:Two patients were admitted to hospital with jaundice as the main performance.Liver function and coagulation function supported the diagnosis of liver failure.The thyroid function indicators suggested hyperthyroidism.Combined with other related examination results, liver failure, hyperthyroidism and hepatitis B virus were diagnosed, and the local treatment of methimazole cream and other related treatments were given.Results:After treatment, the liver function of two patients returned to normal and the thyroid function was improved.After follow-up, one patient changed the external use of methimazole cream to oral treatment, and another patient was still treated in a local manner.Conclusion:There is a conflict in the treatment of hyperthyroidism complicated with liver failure.The local application of methimazole cream in the topic of reducing the risk of liver damage caused by drugs has good results in the treatment of hyperthyroidism.This method also provides the new ideas for its clinical treatment.

Objective To investigate the correlation between plasma 25-hydroxyvitamin D(25-OHVD)levels and the CD4+/CD8+ ratio in elderly men in different states of glucose metabolism.Methods Clinical data of 206 elderly male patients at the geriatrics department of our hospital from April 2011 to August 2017 were collected and retrospectively analyzed.There were 85 patients with type 2 diabetes mellitus(T2DM),39 patients with impaired glucose tolerance(IGT) and 82 patients with normal glucose tolerance(NGT).Locally weighted regression and multivariate generalized linear regression models were used to analyze the correlation between plasma 25-OHVD levels and the CD4+/CD8+ ratio.Results There were significant differences in two-hour postprandial blood glucose and homeostasis model assessment of insulin resistance(HOMA-IR) between the NGT,IGT and T2DM groups (6.5 mmol/L,9.2 mmol/L vs.11.0 mmol/L,11.92 ± 10.57,16.46 ± 10.89 vs.32.67±7.39,respectively,P ＜0.01).Fasting plasma glucose and 2-hour postprandial insulin levels were higher in the IGT and T2DM groups than in the NGT group(5.1 mmol/L,6.3 mmol/L vs.4.9 mmol/L,440.5 nmol/L,367.8 nmol/L vs.255.4 nmol/L,P＜0.05).The haemoglobin A1c(HbA1c)level was higher in the T2DM group than in the NGT and IGT groups(7.1％ vs.5.5％ and 5.8％,P＜0.05).The 25-OHVD and CD4+ levels in the T2DM group were lower than those in the NGT and IGTgroups[11.6 μg/L vs.18.3 μg/L and 17.4 μg/L,(34.0±11.8)％ vs.(40.7±10.5)％ and (40.7±10.2)％,P＜0.01],but were not significantly different between the NGT and IGT groups(P ＞0.05).The CD4+/CD8+ ratios in the T2DM and IGT groups were not significantly different from each other(1.4 vs.1.6,P＞0.05),but were lower than that in the NGT group(2.7,P＜0.01).After adjusting for the influence of related confounders,CD4+/CD8+ increased by 0.4 on average with each standard deviation(7.62 μg/L)increase of 25-OHVD.Compared with 25-OHVD patients in the first quartile,CD4+/CD8+ in the second,third and fourth quartile increased by 0.7,0.9 and 1.1 respectively on average,showing a significant positive correlation and a significant linear trend in the level of 25-OHVD and the CD4+/CD8+ ratio(P＜0.01).Conclusions With the aggravation of glucose tolerance,plasma 25-OHVD levels and the CD4+/CD8+ ratio decrease by varying degrees in elderly men.The deficiency of plasma 25-OHVD may be an independent risk factor for a low CD4+ /CD8+ ratio.

Objective To verify the performance of LIAISON chemiluminescence immunoassay analyzer in the prenatal screening for TORCH .Methods Reference to the US Institute of Clinical and Laboratory Stand-ards(NCCLS) series of documents and literature and combining with actual work ,we designed the verification program ,and tested and evaluated the LIAISON chemiluminescent immunoassay systems for the measurement precision ,accuracy ,linearity analysis ,clinical reportable range and biological reference intervals of Tox IgG , Tox IgM ,Rub IgG ,Rub IgM ,CMV IgG ,CMV IgM ,HSV IgG ,HSV IgM .We also compared the results with analysis performance provided by manufacturers (Italy LIAISON ) or recognized quality indicators .Results Intra-assay imprecision CV values were between 3 .58％ -7 .03％ ,which were less than the predetermined range;inter-assay imprecision CV values were between 3 .13％ -10 .73％ .Linear range validation regression coefficients a values were between 0 .97 -1 .03 and r2 >0 .95 .The linear relationship met the requirements . Both biological reference interval and reportable range meet the requirements .Conclusion The performance of LIAISON chemiluminescence immunoassay detection system satisfied the clinical requirements ,and the meas-urement results had advantages of high sensitivity ,specificity ,stability ,wide detection range ,good accuracy and repeatability ,which was suitable for clinical application .

OBJECTIVE To compare the effectiveness，safety and economy of bovine pulmonary surfactant （PS） and porcine PS in the treatment of preterm neonates with respiratory distress syndrome （RDS）. METHODS Retrieved from PubMed，Embase， Cochrane Library，CNKI，SinoMed，Wanfang and health technology assessment （HTA） organization websites and relevant database， HTA report，systematic review/meta-analysis and pharmacoeconomic study about bovine PS versus porcine PS in the treatment of preterm neonates with RDS were included from the inception to Feb 2022. Data extraction and quality evaluation were carried out for the included literature，and then research results were summarized and analyzed descriptively. RESULTS A total of 1 HTA report，6 systematic reviews/meta-analyses，and 6 pharmacoeconomic studies were included. There appeared to be no significant differences between bovine PS and porcine PS in terms of time staying in neonatal intensive care unit and extra-pulmonary outcomes. In terms of PS re-treatment，blood gas index，total effective rate and the incidence of patent ductus arteriosus，porcine PS was superior to bovine PS. Results from other indicators，such as mortality， the incidence of bronchopulmonary dysplasia，air leakage syndrome，pulmonary hemorrhage，were still controversial. In terms of economy，there was no statistical difference in average hospital charges and administration cost per dose between two groups （P＞0.05）； compared with porcine PS，mean wastage cost per dose of bovine PS was higher （P＜0.001），and 24 h treatment cost of bovine PS was lower （P＜0.05）； the results of average medication cost were controversial. CONCLUSIONS The effectiveness， safety and economy of bovine PS are found to be similar or inferior to porcine PS. It is not certain whether the inferiority has clinical significance.