1.Evaluation of urine analysis by flow cytometry and strip test in diagnosing urinary tract infection
Fie QI ; Jian PAN ; Jiang HAN ; Shi CHENG ; Quan DONG ; Tingju ZHANG ; Rui MA ; Guijian LIU
Chinese Journal of Laboratory Medicine 2009;32(6):630-634
Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.
2.Survival analysis on AIDS antiretroviral therapy in Henan province during 2003-2009
Ding-Yong SUN ; Qi WANG ; Wen-Fie YANG ; Qian ZHU ; Zhe WANG
Chinese Journal of Epidemiology 2012;33(2):181-184
Objective To study the effect of a government-provided-free highly activeantiretroviral treatment (HAART) program,on the reduction of mortality and relevant risk factorsamong adult (AIDS) patients in Henan province.Methods Data on the survival and deaths of AIDSpatients were collected from the National HAART reporting system between 2003 and 2009.Coxproportional hazards model was applied to analyze those factors that affecting the survival time of thepatients.Results 24 669 cases were enrolled to this study in Henan province,from 2003 to 2009.The overall mortality declined from 20.1/100 person-years in 2003 to 5.1/100 person-years in 2009.There was significant difference between the survival curves of different CD4 + T counts and differentnumbers of opportunistic infection syndromes.Results from the Multivariate Cox proportional hazardsregression analysis indicated that CD4+T cell counts ( >200 cells/μl,50-199 cells/μ l) was a riskfactor to death,with hazard ratio as 4.4 and 2.0 respectively.Hb of the patients that lower than 90,was a risk factor to death with the HR=1.8.Number of opportunistic infection (OIs) episodes was arisk factor to the mortality (HR=1.7).In addition,other risk factors would include age ( ≥60 years,old),being male,unmarried or divorced,ALT>100 μl,and other routes of infection,other thanFormer Plasma Donors (FPDs),with HR as 2.2,1.6,1.5,1.3 and 1.2.However,the protectivefactors would include:(1)the earlier the HAART began,the longer the survival time would last(HR =0.8 ) ; (2) when one spouse had already had the infection of HIV,it seemed helpful for the otherspouse to live longer (HR=0.8).Conclusion The National Free Treatment Program hadsignificantly reduced the AIDS mortality rate.Some effective measures should be further taken tomonitor the CD4 + T and the opportunistic infection of the AIDS patients.Patients who were in need totake the HARRT should be adopted into the ART timely,At the same time,the occurrence ofopportunistic infections should be actively prevented.