Bone marrow granulocyte to nucleated erythrocyte ratio (M/E)

The ratio of myeloid cells to nucleated red blood cells (M/E) is a type of bone marrow cytology. Bone marrow cytology is the most valuable for diagnosing hematopoietic diseases. It is also useful for diagnosing other non-hematopoietic diseases, unexplained fever, cachexia. Unexplained hepatosplenomegaly has differential diagnosis significance. Basic Information Specialist classification: cardiovascular examination classification: microscopy Applicable gender: whether men and women apply fasting: not fasting Tips: Those who are not suitable for examination are hemophilia and diffuse intravascular coagulation. If there is no special need, do not have a bone marrow puncture. Normal value 1.28 ~ 5.951. Clinical significance Increase: 1 cell system hyperplasia infection, granulocyte leukemia, leukemia-like reaction. 2 red blood cell system reduces simple red cell aplastic anemia. Reduced (or inverted): 1 granulocyte system reduces agranulocytosis, radiation sickness, chronic benzene poisoning, etc. 2 red blood cell system hyperplasia A. young red blood cells proliferative anemia, iron deficiency anemia, hemolytic anemia, thalassemia. B. Megaloblastic hyperplasia, megaloblastic anemia (gastrointestinal resection, nutrition, infanthood, pregnancy), lobular echinococcosis. Normal: normal bone marrow, thrombocytopenic purpura, iron deficiency anemia, aplastic anemia, myelosclerosis, polycythemia vera. People to be examined: people with reduced or increased blood cells (white blood cells, red blood cells, and platelets), long-term unexplained fever, malaria, bone marrow bacterial culture, and clear or not tumor cell bone marrow metastasis. Low results may be diseases: pediatric renal anemia, pediatric drug-induced hemolytic anemia results may be high disease: chronic granulocyte monocytic leukemia considerations Preoperative preparation: The patient is placed in accordance with the doctor's instructions. Inspection process Inspection method: bone marrow examination. Inspection process: 1. Select the puncture site. 2. Anesthesia. 3. Fix the length of the needle. 4. The doctor's left thumb and finger are fixed at the puncture site. The right hand-held bone marrow puncture needle is inserted perpendicularly to the bone surface. If the sternum is puncture, it should be inserted at an angle of 30o to 40o with the bone surface. When the needle tip touches the bone, rotate the needle along the long axis of the needle of the needle and push it forward to slowly penetrate the bone. 5. Extract the bone marrow fluid and pull out the needle core, connect the dry syringe (10m1 or 201m1), and use the appropriate force to extract the bone marrow fluid. Bone marrow cytology check steps: 1. Smear: It is required that the smear slide and push piece should be clean, no putty pollution, the smear should be thin and uniform, the number of smears is about 10, and two blood samples are used for comparison. 2. Dyeing: commonly used Wright-Gemsa mixed staining; cytochemical staining is often used together. 3. Low magnification examination: to determine the degree of bone marrow hyperplasia, usually the ratio of mature red blood cells to nucleated cells in bone marrow slices to determine the bone marrow hyperplasia 4. Oil Mirror Inspection: Select the cells to be evenly distributed. Under the oil microscope, classify and count at least 200 nucleated cells, and pay attention to whether there is qualitative change. Not suitable for the crowd Hemophilia and disseminated intravascular coagulation, if there is no special need, do not do bone marrow puncture. Adverse reactions and risks May cause bleeding and infection.