2015年 · 第95卷第40期

Clinical hematology is the medical science that mainly studies diseases of the blood and hematopoietic tissues. Clinical hematology research in China started late. In the old China, only a few big cities had some specialized clinical hematologists, even fewer blood experimental technicians, few published papers, and most of them were clinical case reports. After the founding of the People's Republic of China, clinical hematology in China has made continuous progress, especially in recent years, it has made world-renowned achievements. Some fields have reached the international leading level and occupied a place in the world^[1]。 2015 marks the 100th anniversary of the founding of Chinese Medical Journal. As a pioneer of medical journals in China, Chinese Medical Journal has provided a good communication platform for the development of clinical hematology in China and played a promoting role. This article reviews the progress and some outstanding contributions of clinical hematology research in China since the founding of the People's Republic of China.

Pathogenic diagnosis is the gold standard for the diagnosis of infectious diseases. Only by understanding the etiology and drug susceptibility results can we truly choose the correct antibacterial drugs and use them rationally, and at the same time avoid the occurrence of bacterial drug resistance. In the end, it can save medical expenses, reduce hospital stay, and reduce case mortality^[1]。 The key to the correctness of etiological diagnosis lies in specimen management, which directly affects the treatment strategy and efficacy, laboratory cost and efficiency. Therefore, clinical healthcare staff should be aware of the requirements of the microbiology laboratory for specimen collection and transportation, and the laboratory should also meet the needs of doctors and provide accurate and clinically meaningful results^[2]。

Staphylococcus aureus is a common bacterium isolated in clinic, and the results of bacterial resistance surveillance in China show that^[1], which occupies the first place among gram-positive cocci, among which methicillin-resistant Staphylococcus aureus (MRSA) is a common multidrug-resistant bacterium^[2]This drug-resistant bacterium increases the difficulty of anti-infection treatment and costs a lot of medical expenses. Therefore, the United States clearly listed MRSA in the government decree "National Strategy to Fight Drug-resistant Bacteria in the United States" issued on September 18, 2014. It is one of the four types of bacteria of main concern, and many European countries have promulgated regulations on compulsory screening of MRSA. In recent years, surgical site infections caused by methicillin-sensitive Staphylococcus aureus (MSSA) have also received clinical attention^[3]。 Therefore, how to control the infection of Staphylococcus aureus from its colonization is a problem that clinical medical personnel should pay attention to.

Pneumonia is a common infectious disease. There are many types of pathogens, and so are many types of specimens for microbiological examination. The best specimens are bronchoalveolar lavage fluid (BALF) and lung tissue, but because they are invasive methods, they are rarely used in China. This article only discusses coughing or aspirating sputum specimens. Sputum is the most common specimen for the diagnosis of pneumonia in China and in most clinical bacteriology laboratories. Pathogenic diagnosis of pneumonia with sputum specimens – this is a highly controversial topic. There are two common extreme views, or laboratory isolates are directly regarded as pathogens, and all of them are treated with antibacterial therapy; Or the sputum-coughing isolate is considered to be completely meaningless and does not require any analysis and disposal^[1]。 The former is definitely wrong, because the oropharyngeal colonization is contaminated, and common sense judgment can deny it. Is the latter wrong? Have sputum specimens been discarded internationally? According to a recent survey in the United States, in the case of common pneumonia, when respiratory tract specimens are required for etiological examination according to the guidelines, 23% of patients have sputum specimens, and 18% of the results have an impact on treatment^[2]。 It follows that neither of the above-mentioned extreme views is desirable. The author believes that sputum bacterial culture is valuable for the etiological diagnosis of pneumonia-the value is clear but limited.

Vascular calcification is a common pathological feature of atherosclerosis, diabetes, chronic kidney disease and other diseases. It is an active, preventable and reversible highly regulated biological process in which calcium salts are deposited in vascular tissues mediated by various cytokines^[1]。 With the increase of age, vascular calcification will gradually aggravate, usually manifested as decreased vascular compliance and increased cardiac load, which is easy to lead to thrombosis, plaque rupture, myocardial ischemia, left ventricular hypertrophy and heart failure. Vascular calcification is one of the important causes of high morbidity and mortality of cardiovascular and cerebrovascular diseases. According to statistics, about 85% of vascular calcified plaques will be secondary to thrombosis, thus leading to the occurrence of acute cardiovascular events^[2]。 At the same time, vascular calcification is also an important predictor of cardiovascular acute events, stroke and peripheral vascular disease^[3]。 Therefore, it is of great significance to deeply understand the basic research of vascular calcification and actively carry out its clinical application for preventing the harm of vascular calcification, predicting the occurrence of acute cardiovascular events, and reducing the incidence and mortality of cardiovascular and cerebrovascular diseases^[4]。 Therefore, this article now summarizes the basic and clinical progress of vascular calcification as follows.