The relationship of CPS-I, OCT and hepatic encephalopathy / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the role of carbamyl phosphate I (CPS-I)and ornithine transcarbamoylase (OCT) levels in cirrhosis patients with and without hepatic encephalopathy, and to analyze the correlations between CPS-Iand OCT with the development of hepatic encephalopathy.</p><p><b>METHODS</b>CPS-I, OCT, plasma ammonia and liver function of 95 cirrhosis patients with hepatic encephalopathy and 25 cirrhosis patients without hepatic encephalopathy in our hospital from January 2008 to December 2009 were analyzed. 60 healthy controls were recruited in the control group. The differences of serum CPS-I, OCT levels among the cirrhosis patients with and without hepatic encephalopathy and the healthy controls were analyzed; the correlations of CPS-I, OCT levels with plasma ammonia and total protein in cirrhosis patients,and the correlations of CPS-I, OCT levels with Child-Pugh classification of cirrhosis symptom severity in cirrhosis were analyzed. the clinical characteristics between patients who had HE and no HE with chi-square tests were compared. Comparisons of CPS-I, OCT levels across patients based on the Child-Pugh classification were performed with One-Way ANOVA and Student-Newman-Keuls, correlation of CPS-I, OCT with other indicators were performed with Pearson correlation analysis.</p><p><b>RESULTS</b>Serum CPS-I and OCT levels in cirrhosis patients with hepatic encephalopathy were (143.3+/-48.5) U/L, (297.0+/-102.6) is multiplied by 10 U/L, which were lower than that in cirrhosis patients without hepatic encephalopathy (180.3+/-51.5) U/L, (351.8+/-109.0) is multiplied by 10 U/L (t = 2.53, t = 2.78, P < 0.01). Compared with healthy controls, serum CPS-I and OCT levels in cirrhosis patients with and without hepatic encephalopathy were all lower (t = 3.21, t = 4.16, t = 2.12, t = 3.15, P < 0.05). CPS-I was correlated with OCT, (r = 0.946, P < 0.05); CPS-I and OCT were negatively correlated with ALT and AST (r = -0.284, r = -0.239, r = -0.303, r = -0.322, P < 0.05). Additionally, CPS-I and OCT levels were negatively correlated with the Child-Pugh classification in Cirrhosis (F = 10.13, F = 20.28, P < 0.01).</p><p><b>CONCLUSION</b>The serum CPS-I and COT levels were important factors affecting plasma ammonia in patients with cirrhosis and played an important role in the development of hepatic encephalopathy.</p>

Application of six sigma quality management strategy to assess total quality performance and design quality control rules in clinical laboratory / 中华检验医学杂志

Objective To apply sigma metrics to assess key indicators designed in the laboratory improvement plan to find problems and promote quality improvement.Methods Sigma metrics were calculated to reflect the performance of analytic phase including imprecision,inaccuracy and Turn around time(TAT).The quality control strategy was designed accordingly.Quality goal index(QGI)was calculated to find the cause of any error for the items exceeding 6 sigma.Quality of pre-,post-analytic and total analytic phase,such as quality of specimen,TAT,panic value notification and satisfaction of physicians and patients were measured in sigma metrics too.Results The average sigma metric of analytic phase was 4.44,while sigma metric for 8 of 27 test items were above 6?.The main cause of performance under 6o" was poor precision.The sigma metrics of quality of specimen,panic value notification,satisfaction of customer and emergent/routine TAT were 4.9,2.9,5.6,2.8,and 2.9 respectively.Conclusion Sigma metrics provide the objective marker for the evaluation of performance in each stage of analytic process.