2015年 · 第38卷第02期

coagulation factor VIII (FVIII), von willebrand factor (vWF), tissue factor pathway inhibitor (TFPI), tissue factor (TF) and thrombomodulin (TM) were synthesized extrahepatically. Plasma levels were normal or extremely low under physiological conditions, but often increased under some pathological conditions. In order to observe the changes of the above substances in liver diseases, this study selected patients with chronic hepatitis B, liver cirrhosis and liver failure as the research objects, and observed and analyzed the changes of different liver diseases, different stages of the same liver disease and compared with normal controls.

Burn ward is a key area where nosocomial infection occurs and various drug-resistant bacteria are produced. Because of the destruction of skin barrier and serious impairment of immune function, burn patients are prone to bacterial infection and colonization. Bacterial infection has become the most serious complication of burn patients^[1,2]。 The changes of pathogenic bacteria distribution and drug resistance in patients with burn infection directly affect the therapeutic effect of burn patients. The results showed that the pathogenic bacteria of Burn Family were different in different regions and at different periods in the same region^[3,4]。 The kinds and composition of bacteria, such as the medical staff, the environment and the surface of medical devices, are important factors leading to the infection of patients in burn department^[5]。

Intrahepatic and extrahepatic bile duct stones are common diseases in hepatobiliary surgery, and there are many types of surgical treatments at present, including bile duct and intrahepatic bile duct exploration, hepatic lobe and segment resection, correction of hepatic duct stenosis, biliary enterostomy and management of complications, etc. Because of the complexity of the disease and the widespread distribution of stones, it is difficult to achieve the goal of treatment by a single surgical method. It is often used in combination according to the nature of the disease. On the same patient, these operations often need to be performed at the same time^[1,2]。 Because of the complexity of surgery, especially those who undergo lobectomy and segmentectomy are more likely to bleed. The recurrence rate of intrahepatic and extrahepatic bile duct stones is high after surgery, and some patients also need blood transfusion or blood preparations for supportive treatment before surgery due to long-term consumption. Therefore, blood transfusion therapy is one of the important means of preoperative support, intraoperative and postoperative hemorrhage for intrahepatic and extrahepatic bile duct calculi, and may also cause a series of blood transfusion reactions. Nowadays, the transfusion technology is maturing, and the transfusion reaction caused by ABO blood group incompatibility is almost impossible, which is mainly caused by irregular antibodies outside the ABO blood group system. Normally, there are no irregular antibodies in the blood. People can produce irregular antibodies through blood transfusion, injection, pregnancy with maternal and infant blood type incompatibility or immune stimulation of blood products and some unaware stimulation^[3]。 In order to understand the distribution of irregular antibodies in patients with intrahepatic and extrahepatic bile duct stones, the screening results of irregular antibodies in 2 741 patients with intrahepatic and extrahepatic bile duct stones who applied for blood transfusion from May 1, 2013 to April 30, 2014 in Dongfang Hepatobiliary Surgery Hospital of the Second Military Medical University are analyzed and reported as follows.

multiple myeloma (MM) is an immune dysfunction caused by the malignant proliferation of cloned lymphocytes. A large number of small molecule light chain fragments are the main pathogenic factors of the disease. These light chain fragments or fragments thereof can be deposited in multiple organs through blood circulation, causing dysfunction. Light chain MM tumor cells only synthesize and secrete monoclonal light chains, but not corresponding heavy chains^[1]。 The characteristics of laboratory examination are analyzed to strengthen the understanding of light chain MM.

Mycoplasma pneumoniae (Mycoplasma pneumonia, MP) is a common clinical pathogenic microorganism, and it is an important pathogen of respiratory tract infection in children, adolescents and the elderly. Its clinical infection shows a periodic epidemic trend^[1,2,3]Due to the emergence of drug-resistant strains, it has brought great difficulties to clinical prevention and treatment. In 2011, CLSI launched the CLSI M43-A guideline on in vitro drug susceptibility testing for Mycoplasma humana^[4]This guideline provides a reference basis for the standardization and standardization of clinical in vitro drug susceptibility test of Mycoplasma pneumoniae. In this study, 185 strains of Mycoplasma pneumoniae were collected from clinic for in vitro drug susceptibility test according to the guideline, and their drug resistance results were judged in combination with the interpretation criteria in the guideline, so as to investigate the clinical significance of this guideline, provide a reference basis for clinical prevention and treatment of Mycoplasma pneumoniae, and guide the rational use of antibacterial drugs in clinic.

Zygomycosis is an invasive fungal infectious disease, and primary cutaneous zygomycos (PCZ) is a rare zygomycosis, which is susceptible to infection of immunocompromised patients such as neutropenia, diabetes or transplant patients. PCZ is often a locally invasive disease with relatively rapid progression. It can be observed by histopathology that it usually invades the skin and surrounding vascular tissues. Because the culture is easy to neglect and the identification is difficult, there are few reports of infection cases caused by this kind of fungus in China. The author recently found a case of incision infection of Mucor irregular in a patient with pheochromocytoma after surgery, which is reported as follows.

Due to the defects of traditional vacuum test tubes such as slow separation speed and poor serum quality, in order to ensure the quality of test and improve the accuracy of test results, serum separation gel blood collection test tubes have been widely used in clinical practice. The Provincial Hospital Affiliated to Shandong University introduced BD separation gel blood collection tube in 2009. After blood centrifugation, the separation gel is between serum and blood cells, which can effectively protect serum components. However, when the blood samples of patients with multiple myeloma were prepared by using the separation gel blood collection tube, it was found that the serum would be distributed under the separation gel.

glycated hemoglobin (HbA_1c) is a biological indicator to evaluate long-term glycemic control and complication risk in diabetic patients^[1]。 However, many factors can interfere with HbA_1cAccuracy of test results (e.g. hemoglobin variants^[2]Chronic liver disease, renal failure and hemolytic anemia, etc^[3])。 HbA measured by different detection methods when hemoglobin variants are present_1cResults may vary. For Hb E, HbA was detected by Tosoh A1c 2.2 Plus and Bio – Rad Variant ⅡTurbo glycosylated hemoglobin analyzer, respectively_1cLow and high test results^[4]。