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ObjectivesInvestigate the characteristics and rules of hematology changes in patients with COVID-19, and explore the possibility to identify moderate and severe patients using conventional hematology parameters or combined parameters. MethodsThe clinical data of 45 moderate and severe type patients with SARS-CoV-2 infections in Jingzhou Central Hospital from January 23 to February 13, 2020 were collected. The epidemiological indexes, clinical symptoms and laboratory test results of the patients were retrospectively analyzed. Those parameters with significant differences between the two groups were analyzed, and the combination parameters with best diagnostic performance were selected using the LDA method. ResultsOf the 45 patients with COVID-19 (35 moderate and 10 severe cases), 23 were male and 22 female, aged 16-62 years. The most common clinical symptoms were fever (89%) and dry cough (60%). As the disease progressed, WBC, Neu#, NLR, PLR, RDW-CV and RDW-SD parameters in the severe group were significantly higher than that in the moderate group (P<0.05); meanwhile, Lym#, Eos#, HFC%, RBC, HGB and HCT parameters in the severe group were significantly lower than that in the moderate group (P<0.05). For NLR, the AUC, the best cut-off value, the sensitivity and the specificity were 0.890, 13.39, 83.3% and 82.4% respectively, and for PLR, the AUC, the best cut-off, the sensitivity and the specificity were 0.842, 267.03, 83.3% and 74.0% respectively. The combined parameter NLR&RDW-SD had the best diagnostic efficiency (AUC was 0.938) and when the cut-off value was 1.046, the sensitivity and the specificity were 90.0% and 84.7% respectively, followed by the fitting parameter NLR&RDW-CV (AUC = 0.923). When the cut-off value was 0.62, the sensitivity and the specificity for distinguishing severe type from moderate cases of COVID-19 were 90.0% and 82.4% respectively. ConclusionsThe combined parameter NLR&RDW-SD is the best hematology index and can help clinicians to predict the severity of COVID-19 patients, and it can be used as a useful indicator to help prevent and control the epidemic.
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Objective To investigate the relationship between the rs6682925T / C gene polymorphism of interleukin (IL)-23 receptor (IL-23R) gene and susceptibility to acute coronary syndrome (ACS). Methods A case-control study. 180 ACS patients (the disease group) and 90 patients with normal coronary angiography(control group) were selected from January 2017 to April 2018 in jingzhou central hospital. The disease group included 109 males and 71 females,aged (59.95±9.29) years old and the control group included 49 males and 41 females, aged (58.39 ± 9.43) years old. The gene polymorphism of IL-23R gene rs6682925T/C was detected by Sanger sequencing,and serum IL-23R concentration in peripheral blood was detected by ELISA. The statistical analysis methods used include normal distribution test,t test,analysis of variance and chi-square (χ2) test. Unconditional logistic regression analysis of the relationship between IL-23R gene rs6682925T/C polymorphism and susceptibility to ACS. Results There were no significant differences in gender, age, body mass index, apolipoprotein b, total cholesterol and low-density lipoprotein cholesterol between the ACS group and the control group(χ2=0.923, P>0.05;t=1.294, P>0.05;t=-0.574, P>0.05; t=- 0.417, P>0.05). However, the differences in triglyceride, fasting blood glucose, high-density lipoprotein cholesterol,smoking rate,diabetes and hypertension were statistically significant(t=5.411,P<0.05;t=5.828, P<0.05;t=-6.655, P<0.05;χ2=7.738, P<0.05;χ2=13.201, P<0.05;χ2=8.359, P<0.05). Compared with the control group, the IL-23R rs6682925 polymorphic site in ACS group had significant differences in the distribution of TT, CT, CC genotype and C allele frequency (χ2=9.858, P<0.05;χ2=10.833, P<0.05) and the frequency of C allele in the acute coronary syndrome group was significantly higher than that of the control group. In addition, the risk of rs6682925 CC genotype carriers suffer from acute coronary syndrome was 3.261 times that of TT genotype (95％CI:1.553-6.847,P=0.002). Compared with the control group,the serum IL-23R concentration in the peripheral blood of the ACS group was significantly increased [(353.20±140.79) pg/ml vs (187.41±123.36) pg/ml,t=9.495,P<0.01]. Conclusions IL-23R rs6682925 gene polymorphism is associated with genetic susceptibility to ACS, and the rs6682925 CC genotype might act as a risk factor for ACS.
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Objective To explore the relationship between gene polymorphisms of triggering receptor expressed on myeloid cells-1 ( TREM-1 ) rs2234237A/T, rs9471535A/G and susceptibility to coronary atherosclerotic heart disease ( coronary heart disease for short , CHD).Methods A case-control study.120 patients with CHD ( CHD group) and 90 healthy people (Normal control group ) were selected from November 2016 to April 2017 in Jingzhou Central Hospital.The single nucleotide polymorphisms (SNPs) of TREM-1gene (rs2234237 and rs9471535)were analyzed using Sanger method in all subjects. Comparing baseline clinical data and the distribution of genotype frequencies in the two groups .Non conditional logistic regression was used to analyze the relationship between TREM -1 gene ( rs2234237 and rs9471535) polymorphisms and susceptibility to CHD .Results The proportion of gender as well as level of age, body mass index, total cholesterol, triglyceride and low density lipoprotein cholesterol were not statistically significant between the two groups ( χ2＝0.575, P＞0.05; t＝-1.670, P＞0.05; t＝-1.719, P＞0.05; t＝1.011, P＞0.05; t＝-1.834, P＞0.05; t＝0.474, P＞0.05, respectively), while the proportion of smoking, hypertension and diabetes as well as level of high density lipoprotein cholesterol and fasting plasma glucose were statistically significant between the two groups (χ2＝4.321, P＜0.05; χ2＝39.213, P＜0.01; χ2＝24.184, P＜0.01; t＝5.476, P＜0.01; t＝-5.106, P＜0.01, respectively).The distribution of rs2234237, rs9471535 genotypes and alleles was statistically significant in the two groups (rs2234237: χ2＝6.893, P＜0.05; χ2＝7.159,P＜0.05, respectively; rs9471535: χ2＝8.284, P＜0.05; χ2＝8.314, P＜0.05, respectively).The genotype frequency of rs2234237(AT+TT)in CHD group was significantly lower than in the control group (38.3% vs 53.3%,χ2＝4.680, P＝0.031), and the genotype frequency of rs9471535 ( AG +GG) in CHD group was significantly lower than in the control group (37.5% vs 53.3%, χ2＝5.225, P＝0.022) .In addition, the T allele frequency of rs2234237 in CHD group was significantly lower than in the control group (21.7%vs 33.3%, χ2＝7.159, P＝0.007) , and the G allele frequency of rs9471535 in CHD group was significantly lower than in the control group(20.8%vs 33.3%, χ2＝8.314, P＝0.004).The CHD risk of people carrying rs2234237 TT was 0.173 times of AA (95% CI: 0.048 -0.629, P＝0.008), and the CHD risk of people carrying rs9471535 GG was 0.108 times of AA(95% CI: 0.026-0.450, P＝0.002).However, carriers with T allele of rs2234237(AT+TT) or with G allele of rs9471535(AG+GG)were not significantly associated with the CHD risk(P＞0.05).Conclusions TREM-1 gene rs2234237 A/T and rs9471535 A/G polymorphisms are significantly associated with susceptibility to CHD .rs2234237 TT genotype and rs9471535 GG genotype might act as protective factors of CHD.
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OBJECTIVE To improve the level of HBV-DNA quantity dection.METHODS The necessity and feasibility of quality control improvement on the basis of external quality assessment results were analyzed.The source of error were songht through analyzing the whole experiment process,to improv the experiment protocol.RESULTS Four main sources of error were improved,and two of them existed in reality.Through improvements in handling protocol,coefficient of variability(CV) of internal quality control has decreased to 3.3% from 9.3% before improvement in protocol.External quality control results were also increased in large-scale.CONCLUSIONS Through the improvement in experiment process,quality assurance of HBV-DNA quantity analysis has been upgraded in essence.
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Objective To analyze the levels of serum total bilirubin in patients and healthy con-trols, eatablish a method of using the mean of total bilirubin in serum of patients to control internal quality, and validate the reference range. Methods Frequencies mode of SPSS13.0 statistic software package was applied to performing analysis of all data, and then the analytic interval was determined based on the frequencies of the data. The daily data mean in the analytic interval was calculated. With the daily data mean as the testing data, the quality control was carried out by the same way of quality control for quality control sample. At the end of each month, the means of various analyzers were compared. Based on the results of healthy controls, the formula mean±1.96s was used to validate the current reference range. Results With the daily data mean as the testing data for quality control, its coefficient variation was within the accepatable limit, and the 95% distribition range was the same as the current reference interval. Conclusion It is necessary to establish suitable interval in which the da-ta mean was used for internal quality control. The current reference range in our hospital is proper.
