Comparison of patient-centered doctor-patient communication skills in anesthesiologists with different working experience and genders / 中华麻醉学杂志

Objective:To compare the patient-centered doctor-patient communication skills in anesthesiologists with different working experience and genders.Methods:The second and third year residents who had been trained as residents in the Department of Anesthesiology in our hospital from September 2017 and September 2018 and senior physicians who had worked for 10-15 yr in our hospital, were recruited to perform a preoperative interview in a standardized patient counter.Consultation and Relational Empathy (CARE) measure was used to assess the communication skills among senior physicians, residents, and anesthesiologists of different genders.The residents also took the objective structured clinical examination (OSCE) and theory examination.Results:Thirty-six residents and 20 senior physicians were included.There was no significant difference in the CARE measure score between residents and senior physicians and in the total CARE measure score between residents who received doctor-patient communication training at the stage of medical students and those who did not ( P>0.05). Compared with the residents in the second year, the listening ability score and decision-making ability score were significantly decreased ( P<0.05), and no significant change was found in the scores for the other items in the residents in the third year ( P>0.05). Compared with residents, the listening ability scores were significantly increased, and the caring ability scores were decreased ( P<0.05), and no significant change was found in the scores for the other items in senior physicians ( P>0.05). There was no difference in CARE measure scores between the male and female anesthesiologists.The resident′s CARE measure score was positively correlated with the annual OSCE score ( r=0.486, P<0.05), and there was no correlation between the resident′s CARE measure score and annual theoretical examination grade ( r=0.308, P>0.05). Conclusion:Senior anesthesiologists with more clinical experience are not superior to the junior residents in patient-centered communication skills, and the doctor-patient communication skills of residents are not related to their medical theoretical grade.Moreover, there is no significant difference between male and female anesthesiologists in terms of doctor-patient communication skills before surgery.Therefore, training of patient-centered doctor-patient communication skills should be strengthened at all levels of anesthesiologists.

Multiple measures to improve the pre-examination quality of laboratory medicine: practice and experience / 中华医院管理杂志

The hospital improved its pre-examination quality of laboratory medicine by means of setting up pre-examination quality management committee, full-course supervision of pre-examination process, and clarified responsibility system. Informationization means play multiple roles for the pre-examination quality, including full-course management, early warning and interception of unqualified sample. The coordinated application of multi-departments, multi-links and multi-measures can improve the pre-examination quality of laboratory medicine and ensure the quality of test results and the medical safety of patients.

Effect of double heterozygous hemoglobin on the results of different glycosylated hemoglobin detection systems / 临床检验杂志

Objective@#To investigate the effects of glycosylated hemoglobin A1c (HbA1c) from the patients with double heterozygotes Hb Q-H and Hb J-Bangkok combined with β-thalassemia on the results of different HbA1c detection systems. @*Methods@#Blood samples from 20 healthy adults and 20 patients with type 2 diabetes mellitus (T2DM) were collected to assess the results of five glycosylated hemoglobin detection systems. Blood samples from one Hb Q-H patient and one Hb J-Bangkok patient with β-thalassemia were also collected, and they were performed hemoglobin capillary electrophoresis with Capillarys2 and globin gene analysis by gap-PCR, PCR-RDB and DNA sequencing. The levels of HbA1c in all samples were detected by BioRad VARIANT Ⅱ (VⅡ), BioRad VARIANT ⅡTurbo2.0 (V Ⅱ-T2.0), Capillarys 2 Flex Piercing (C2FP), Primus Ultra2 (Ultra2) and Roche PPI 800 (PPI 800) glycosy lated hemoglobin detection instruments, respectively. For the samples with double heterozygotes, the levels of HbA1c were detected for 3 times each sample, and the results were preserved and analyzed. @*Results@#The genotype of the Hb Q-H sample was --α QT /--SEA;β N /β N , and HbA1 CD74 G＞C mutation occurred in globin α1 chain, forming Hb Q-Thailand hemoglobin variant without normal α-globin peptide chain. The genotype of Hb J-Bangkok combined with β-thalassemia was αα/αα;βCD56/βCD41-42, and the point mutation of GGC＞GAC occurred at codon 56 of globin β-chain, forming Hb J-Bangkok hemoglobin variant without normal β-globin peptide chain. For the Hb Q-H sample, HbA1c results were reported by 3 of 5 HbA1c detection systems. The chromatograms of VⅡ and VⅡ-T2.0 detection systems were obviously different from normal chromatograms, and HbA1c results were not reported. However, the chromatograms of the C2FP system were similar to normal chromatograms, and the result of HbA1c was 3.7%. The Ultra2 system and PPI system reported the HbA1c results, 5.3% and 5.7%, respectively, without abnormal alarm. For the Hb J-Bangkok with β-thalassemia sample, HbA1c results were also reported by 3 of 5 HbA1c detection systems. The chromatograms of VⅡ and Sebia detection systems were obviously different from normal chromatograms, and HbA1c results were not reported. However, the chromatograms of VⅡ-T2.0 system were different from normal chromatograms, and a P4 peak (84.9%) was found. The HbA1c result was reported as 4.7%. The Ultra2 system and PPI system reported the HbA1c results, 4.7% and 3.8%, respectively, without abnormal alarm. @*Conclusion@#The samples from the Hb Q-H patient and the Hb J-Bangkok patient with β-thalassemia do not contain normal HbA, and there should be no HbA1c results. The chromatograms of VⅡ and VⅡ-T systems are obviously abnormal, indicating that the results can not be reported. The C2FP system is interfered obviously by Hb Q-H, but reports the HbA1c results, while it does not report the HbA1c results of Hb J-Bangkok combined with β-thalassemia. Both of Hb Q-H and Hb J-Bangkok have obvious interference to PPI and Ultra2 detection systems.

Diagnostic value of different detecting technologies in antinuclear antibody in autoimmune disease / 国际检验医学杂志

Objective To evaluate the diagnostic value of different detecting technologies in antinuclear an-tibody(ANA)in autoimmune diseases(AID).Methods A total of 52 cases of patients with systemic lupus er-ythematosus(SLE),97cases of patients with AID but without SLE,92 cases of patients without immune disea-ses were collected in this study.ANA was detected by enzyme-linked immunosorbent assay(ELISA),indirect immunofluorescence(IIFA)method and linear western blot method(LIA).Results Average coincidence rate between ELISA and IIFA method to detect the ANA was 78.8% in the three groups of participants.The re-sult of ANA detected by ELISA method was positively correlated with that of IIFA method(r=0.598,P<0.05).They found that patients with AID and without AID groups both existed the phenomenon of IIFA ANA+LIA ANA -,their fluorescence titers were given priority to with 1:100.Their fluorescence modes were given priority to with granularity in both AID group(67.44%)and without AID group(54.69%),there was no difference between the two groups(P>0.05),but they were significantly higher than that of other flu-orescence modes.At the same time,the study found that patients with IIFA ANA -LIA ANA+were mostly AID patients(73.3%),the ratio was higher than without AID group,among these patients,AID patients were with SSA/Ro60,SSA/Ro52,SSB/La as the main positive autoantibodies,rather than without AID patients with anti-Sm,SSA/Ro52,SSB/La,CenpB as the main positive antibodies.Conclusion It should pay attention to multi-index joint and multi-tests detection when we diagnose autoimmune diseases.

Application of two different out-of-plane ultrasound-guided needling techniques / 临床麻醉学杂志

Objective To compare simulated training of "45° tilting insertion" and the "dynamic scan" needling under B ultrasound.Methods Fifty volunteer residents and visiting physicians worked in the anesthesiology department in Peking Union Medical College Hospital were recruited to attend the simulated needling training.The insertion time,insertion attempts until success,numbers of success while advancing the needle and numbers of needle tip visible upon success were re corded.The degree of difficulty and safety of the techniques,the confidence of performing the techniques,the clinical usefulness of the techniques and the training effect were evaluated among the volunteers.Results There were no differences in the insertion time,numbers of successful insertion while advancing the needle and numbers of needle tip visible upon success between the two techniques.Compared with "45° tilting insertion" technique,"dynamic scan" resulted in less needle redirection times and a higher first-attempt successful rate,and got higher scores in terms of difficulty and safety (P＜0.05 or P＜0.01).The confidence scores of performing the two technique were similar.20 (40％) volunteers chose to use "dynamic scan",8 (16％) chose to use "45° tilting insertion" and 22 (440％) chose to use both technique in their clinical work.100％ of them considered the training was greatly helpful or helpful.Conclusion The technique of "dynamic scan" produced a higher first-attempt successful rate and was easier and safer than "45° angle insertion".The combination of the two techniques might be a new technique that is worth trying.

Correlation analysis between the expression of 5-hydroxymethyl-cytosine and invasion, metastasis and prognosis of melanoma / 中华皮肤科杂志

Objective To detect the level of 5-hydroxymethyl-cytosine (5-hmc)in melanoma tissues,and to analyze the correlation between 5-hmc and the invasion,metastasis and prognosis of melanoma.Methods A streptavidin-peroxidase immunohistochemical method was used to detect the level of 5-hmc in 67 melanoma tissues and 20 pigmented nevi tissues.Univariate and multivariate analyses were performed with the Cox's proportional hazards regression model to analyze the correlation between the expression of 5-hmc and the prognosis of melanoma.Results The expression rate of 5-hmc was significantly lower in melanoma tissues than in pigmented nevus tissues (40.30％ [27/67] vs.75％ [15/20],22 =7.428,P =0.006).According to American Joint Committee on Cancer (AJCC) TNM staging system,the expression level of 5-hmc was significantly lower in the stage Ⅳ melanoma tissues than in the stage Ⅱ and stage Ⅲ melanoma tissues (x2 =4.416,P =0.036).Patients with lymph node metastasis showed significantly lower expression of 5-hmc compared with those without lymph node metastasis (x2 =5.902,P =0.015),and the level of 5-hmc expression significantly decreased along with the increase of Clark grade (x2 =4.828,P =0.028).There were no significant differences in the level of 5-hmc expression between patients of different ages,genders or nationalities (P ＞ 0.05).Multivariate Cox regression analysis showed that distant lymph node metastasis (HR:2.67,95％ CI:1.22-5.84),not receiving surgical resection (HR:0.41,95％ CI:0.18-0.95),and low expression of 5-hmc (HR:3.54,95％ CI:1.09-11.43)were independent risk factors for poor prognosis of melanoma.Conclusion 5-Hmc may participate in the invasion and metastasis of melanoma,and be associated with the prognosis of melanoma.

Establishment and application of the autoverification system in laboratory clinical chemistry and immunology laboratory / 中华检验医学杂志

Objective To improve the efficiency of result reporting and ensure the accuracy of the results by establishing autoverification system in Clinical Chemistry and Immunology Laboratory.Methods The study followed the requirements of the Clinical Laboratory Standards Institute(CLSI)AUTO-10A and ISO 15189:2012.In addition,seven categories of verification rules were encoded using the autoverification function of the CentraLink?Data Management System on the Aptio?Automation platform.These rules included Clinical Diagnostic Standard(CS), Sample Status(SS), Quality Control Severity(QS), Instrument Error Flags Severity(IS), Normal Severity(NS), Delta Check Severity(DS), and Logical Assessment Standard(LS).Various modules of Aptio Automation,laboratory information system(LIS)and hospital information system(HIS)were integrated using the CentraLink system to establish the autoverification system.Results The autoverification system was set up and tested from August 2015 to April 2016.In total, the system ran 4 496 425 tests on 366 180 chemistry specimens.The overall autoverification rate for tests performed increased from 53.4% to 87.0%.Glucose had the highest rate (98.3%)while CKMB had the lowest rate(63.6%).Average TAT for result verification decreased by 97.7%,from 46.3 minutes to 3.7 minutes.The system ran 410,040 tests on 160 119 chemiluminescence specimens.The autoverification rate for tests performed increased from 40.2%to 89%.C-P had the highest rate(98.4%)while A-TPO had the lowest rate(58.7%).Average TAT for result verification decreased by 77.4%,from 14.6 minutes to 3.3 minutes.From May 2016 to January 2017(when autoverification was employed),compared with the same period in 2014(when manual verification was employed),the following changes were observed with no increase in staff capacity:a)Volume of routine chemistry tests increased by 46.4%,and median TAT for tests decreased by 41.9%, from 118 minutes to 83 minutes; b)Volume of chemiluminescence tests increased by 24.5%and median median TAT for tests decreased by 52.4%, from 131 minutes to 86 minutes;c)Median TAT for critical values decreased by 50.5%; d)Rates of tests that did not go through autoverification were 88.2% for NS,6.05% for SS, 2.40% for DS,2.00% for LS, 0.97%for IS,and 0.43% for CS; e)Rates of abnormal specimen status identified by Aptio Automation were 7.13‰for jaundice,5.39‰ for blood lipids,2.20‰ for hemolysis,0.17‰ for barcode error, and 0.15‰ for insufficiency;f)Error rate decreased to 0.00%;and g)staff satisfaction increased from 85%to 100%.Conclusion Autoverification of results by using the CentraLink Data Management System can achieve quality control over the entire process of clinical laboratory testing, ensure accuracy of test results, improve work efficiency, decrease TAT, minimize the error rate, avoid skill variation of staff, reduce the pressure of performing manual verification,and improve medical security.

Expression and mechanism of Twist2 in glioma / 中华病理学杂志

Objective@#To investigate the significance of Twist2 in glioma and whether it is involved in the malignant transformation of glioma by epithelial-mesenchymal transition (EMT).@*Methods@#Using immunohistochemical method detected the expression level of Twist2 in 60 cases of gliomas (including WHO grades Ⅱ, Ⅲ and Ⅳ, each for 20 cases) and 20 cases of non-tumor brain tissues. Real-time fluorescence quantitative PCR and Western blot were used to detect the expression level of Twist2 mRNA and protein in 61 cases of fresh glioma tissue (WHO grade Ⅱ 16 cases, Ⅲ 21 cases, Ⅳ 24 cases) and 12 cases of adjacent tissues, and the expression levels of E-cadherin, N-cadherin and vimentin were also investigated in fresh glioma tissue.@*Results@#Immunohistochemistry results showed that the percentages of Twist2 expression in glioma was 90%(54/60) compared with 30%(6/20) in non-tumor brain tissues(P<0.01). The percentages of Twist2 expression were 75% (15/20), 95% (19/20), and 100% (20/20) in the WHO gradesⅡ, Ⅲ and Ⅳ gliomas, respectively. WHO grades Ⅳ and Ⅲ were significantly higher than that of WHO grade Ⅱ (P<0.01). There was no significant difference between WHO grade Ⅳand WHO Ⅲ glioma (P>0.05). Real-time fluorescence quantitative PCR and Western blot showed that the expression level of Twist 2 in gliomas was significantly higher than that in para-cancerous tissues (P<0.01), and those in WHO grades Ⅳ and Ⅲ gliomas were significantly higher than that in WHO grade Ⅱ glioma (P<0.01). There was no significant difference between WHO grade Ⅳand grade Ⅲ glioma (P>0.05). Detection of key protein expression in EMT by Western blot displayed that the expression of E-cadherin was negatively associated with Twist2 in glioma (r=-0.972, P<0.01). The expression of N-cadherin and vimentin was positively associated with Twist2 in glioma(r=0.971, P<0.01; r=0.968, P<0.01).@*Conclusions@#The expression of Twist2 in human glioma is positively correlated with the malignant grade of glioma, which may be involved in the malignant progression of glioma by EMT.

Effects of ICAT silencing in Wnt signaling pathway and NSC67657 induced cell differentiation of HL-60 cells / 中华血液学杂志

Objectives@#To investigate the effect of β-catenin interacting protein 1 (ICAT) silence in Wnt signaling pathway and sterol drug NSC67657 induced cell differentiation of HL60 cell.@*Methods@#HL-60 cells were treated with NSC67657, the cell surface antigen CD14 expression was detected by flow cytometry. Lentivirus LV-ICAT-RNAi vector was constructed and infected HL-60 cells. Then the ICAT gene and protein expression were analyzed using real-time qPCR and Western blot technique. Furthermore, Co-immunoprecipitation assay was used to confirm the interaction of β-catenin/ICAT proteins, and Western blot was employed to compare the expressions of Wnt signaling pathway downstream targets Cyclin D1, TCF-1 and c-Jun between Lentivirus LV-ICAT-RNAi vector infected HL-60 (HL-60i) cells and un-infected HL-60 (HL-60v) cells. The cellular differentiation of HL-60i and HL-60v cells treated with NSC67657 for 24 h was evaluated by Wright’s staining, transmission electron microscopy and flow cytometry analysis.@*Results@#HL-60 cells could be induced to differentiate into monocytes by 10 μmol/L NSC67657. The CD14 positive cells could reach to (92.30±5.14) % after NSC67657 treatment for 5d. The co- immunoprecipitation assay demonstrated that ICAT protein did interact with β-catenin protein, and the absorbance of protein electrophoresis bands increased in differentiated cells. The expressions of Wnt signaling pathway downstream target proteins in HL-60i cells were higher than that in HL-60v cells when they were treated by 10 μmol/L NSC67657, but lower than NSC67657 untreated cells. CD14 positive HL-60i cells were significantly lower than that of HL-60v cells[ (8.33±3.14) % vs (19.08±4.73) %]when treated with NSC67657, but still higher than that of uninfected and untreated HL60 cells[ (0.60±0.03) %] (F=119.24, P=0.010) . The results of cellular morphology and ultrastructure observation were also in accord with that of cell surface antigen analysis.@*Conclusions@#ICAT does participate in HL-60 cells monocytic differentiation induced by NSC67657, and Wnt/β-catenin signaling pathway might play a bridge role.

Establishment and application of a real-time monitoring system for temperature-humidity in clinical laboratory based on the Internet of things / 临床检验杂志

Objective To research the establishment and application of real-time monitoring system of temperature-humidity in clinical laboratories.Methods The collection net for temperature-humidity data was set up using wireless temperature-humidity recorders and repeaters,and a management software which connected to LIS seamlessly was developed according to the management standard for temperature-humidity in clinical laboratories and the requirements for real-time monitoring.Results The real-time monitoring system sent the collected data of temperature-humidity as needed to repeaters by wireless signal and then transferred to host computer.As long as the data was out of the allowable range,the monitoring system could trigger alarm by sending message or E-mail to administrator who accessed the host through web browser to view the status of system,save attendance records,export data and generated reports.Conclusion The automatically monitoring for temperature-humidity of circumstances and instruments in the laboratories was achieved for 24-hours of every day by the developed system and met with the relevant requirements of real-time monitoring for temperature-humidity in clinical laboratories.

Development and application of management system for personnel information of clinical laboratory / 临床检验杂志

Objective To develop an efficient and all-round management system of personnel information based on the standards of quality management in clinical laboratory.Methods ASP.NET and database technology were used to construct a web platform and develop the management modules of personnel information.Results The developed system consisted of 4 modules.The module of onestop management for personnel archives was realized,which could be viewed and self-maintained by individuals and auto-retrieved by the system.The module of job post for staff attendance record was realized by continuous,dynamic management and permanent retrievability of registered responsibilities.The module of training and examination could publish the information for staff to complete self-training within deadline and evaluated the training effects and competence by online tests,and granted appropriate authority to staff.The module of performance assessment could evaluate the performances of staff statically and dynamically by using objective indicators and review mechanism.After the application of the system,staff archives were updated in real time instead of once for year.The time for reviewing archives of staff reduced from fifteen minutes to one minute,the error incidents of staff reduced by 20％,workload for staff training and examination reduced by 60％,and the satisfaction degree of customers for staff increased from 93％ to 96.5％.Conclusion The developed management system could realize all-round standard management with high efficiency,so it should be more effective and cost-saving than traditional manners.The staffs would be willing to accept and cooperate with it.

Diagnostic Value of Detecting the Serum and Urine Procalcitonin(PCT) for the Urinary System Infection / 现代检验医学杂志

Objective To explore diagnostic value of the serum and urine procalcitonin (PCT) detecting in the urinary system infection.Methods The serum and urine PCT levels in 45 urinary system infection patients with clear pathological diagnosis (exclude other system infections) who were outpatiented or hospitalized in the People's Hospital of Zhongshan between March and November 2016 (including 21 cases of upper urinary tract infection and 24 cases of lower urinary tract infection) and 35 healthy adults who went through physical examinations at the hospital during the same period,were measured using electrochemiluminescence immunoassay (ECLIA) on Cobase 601 Immunoassay Analyzer and analyzed to compare the differences of PCT levels in the three groups.Results The urine PCT level in upper urinary tract infection group was 0.243± 0.123 ng/ml.It was significantly lower than lower urinary tract infection group (0.486±0.232 ng/ml,t=4.11,P=0.000) and control group (0.454± 0.253 ng/ml,t=3.96,P=0.000).The serum PCT level in upper urinary tract infection group was 0.062±0.014 ng/ml.It was obviously higher than that in lower urinary tract infection group (0.043±0.020 ng/ml,t=3.56,P=0.01) and control group (0.032±0.013 ng/ml,t=7.38,P=0.000).In all groups,the urine PCT levels were significantly higher than their serum PCT levels (t =9.48,9.12,6.79,P＜ 0.01),and significant differences were observed in them.The sensitivity,specificity,positive predictive value and negative predictive value of serum PCT for diagnosing upper urinary tract infections were 81.5％,84.2％,80.6％ and 85.6％ respectively,and the urine PCT were 86.4％,80.7％,88.4 ％ and 83.1 ％ respectively.Conclusion Detection of serum and urine PCT has important accessory diagnostic value for identifying upper and lower urinary tract infections.

Status and training of preoperative anesthetist visit in anesthesia residents / 基础医学与临床

Objective To investigate the resident performance on preoperative anesthetist visit in Beijing hospitals,thereby providing introduction for further training.Methods A self-designed questionnaire was distributed among the anesthesia residents who were receiving anesthesia residency training in Beijing through WeChat.The questionnaire covers geographic data of the residents,information on preoperative visit and existing training program.Results160 questionnaires were reclaimed.History-taking and physical examination were not comprehensive in many residents,the nature of surgery was not evaluated by most residents.The capacity of risk assessment and risk informing were not competent in many residents.The most desired training methods for preoperative visit were scenario simulation and bedside observation.Conclusions Scenario simulation with standard patient may have a promising prospect in preoperative anesthetist visit training.

Mutation analysis of the ATP2A2 gene in a Kazakh family with Darier's disease / 中华皮肤科杂志

Objective To analyze mutations in the ATP2A2 gene in a Kazakh family with Darier's disease.Methods Clinical data were collected from 49 members from a family with Darier's disease,and peripheral blood samples were obtained from 44 family members and 100 unrelated healthy people.Genomic DNA was extracted from these blood samples.PCR and DNA sequencing were performed to detect mutations in the ATP2A2 gene.Results Darier's disease was inherited in an autosomal dominant manner in this family.A G→A heterozygous mutation (1288-1G→A) was identified at position 1288-1 at the splice site in exon 12 of the ATP2A2 gene in 11 patients in this family,but not in 33 healthy members or 100 healthy controls.Conclusion Darier's disease in this family may be caused by the heterozygous mutation (1288-1G→A)at the splice site in exon 12 of the ATP2A2 gene.

Diagnostic value of anti-nucleosome antibody for juvenile systemic lupus erythematosus / 临床检验杂志

Objective To evaluate the diagnostic value of anti-nucleosome antibody for juvenile systemic lupus erythematosus (JSLE).Methods Fifty-four patients with JSLE,28 patients with non-JSLE and 26 healthy children were chosen in this study.antinuclear antibody(ANA),anti-nucleosome antibody (AnuA),anti-dsDNA antibody,anti-histone antibody (AHA) and anti-Sm antibody were detected by ELISA or western-blot method.The relevant clinical data were collected and analyzed.Results For diagnosis of JSLE,the sensitivity and specificity of AnuA was 77.78％ and 96.30％.The sensitivity of AnuA combined with ANA,anti-dsDNA and antiSm was higher than that of single detection.AnuA usually associated with fever,oral/nasal pharyngeal ulcer,lung damage,lymphocyte absolute value,urine protein and C3 level.Conclusion AnuA can be used as a serum marker for JSLE diagnosis.The detection of AnuA combined with anti-dsDNA and anti-Sm should be more helpful for diagnosis of JSLE.

Interference of glucose-6-phosphate dehydrogenase deficiency on measurements of glycated hemoglobin by three detection systems / 临床检验杂志

Objective To observe the interference of glucose-6-phosphate dehydrogenase (G6PD) deficiency on glycated hemoglobin (HbA1c) detected by three measurement systems.Methods A total of 286 cases of blood and serum samples were collected at Zhongshan Hospital of Sun Yat-Sun University from August 2012 to April 2016.The blood samples were divided into healthy control group (122 cases),diabetes group (82 cases),glucose-6-phosphate dehydrogenase deficiency group (61 cases) and diabetes with G6PD deficiency group (21 cases).The levels of HbA1 c were detected by three measurement systems,including Primus Ultra2,Variant lⅡ Turbo 2.0 and Modular P.The results of HbA1c were converted into the estimated average blood glucose concentration (eAG).The values of A eAG-FPG in different groups were calculated and statistical analysis was performed for evaluation of the differences from the three measurement systems.Results The HbA1c results measured by the three systems and AeAG-FPG values in G6PD deficiency group were all lower than healthy control group(all P ＜0.05).The measured results were similar in both diabetes group and diabetes with G6PD deficiency group.Conclusion G6PD deficiency may cause false H-bA1c results detected by three measurement systems.In the case of HbA1c for evaluating blood glucose control,the interference of G6PD deficiency should be noticed.

Relevant factors analysis on the survival of gastric cancer patients with lung metastasis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the factors affecting survival rate in gastric cancer patients with lung metastasis.</p><p><b>METHODS</b>Clinicopathological and follow-up data of 64 gastric cancer patients with lung metastasis treated at the Cancer Hospital of Tianjin Medical University from January 1995 to December 2011, were retrospectively analyzed. The survival rate was calculated. Univariate and multivariate analysis were performed to find the factors affecting survival rate using Log-rank test and Cox proportional hazards model, respectively.</p><p><b>RESULTS</b>The median survival time was 7 months. The 1-, 2- and 3-year survival rates were 32.8%, 18.8% and 7.8% respectively. Univariate analysis showed that primary tumor location, type of lung metastasis, lung metastasis combined with other distant metastasis and chemotherapy were significant factors for prognosis (P<0.05). Multivariate analysis revealed that bilateral lung metastasis(HR=2.093, 95% CI: 1.092-4.014, P=0.026) and lung metastasis combined with other distant metastasis (HR=2.433, 95% CI: 1.359-4.358, P=0.003) were independent risk prognostic factors, while chemotherapy was independent protective factor(HR=0.387, 95% CI: 0.211-0.710, P=0.002).</p><p><b>CONCLUSIONS</b>Prognosis of gastric cancer patients with lung metastasis is quite poor, especially those with bilateral lung involvement and extra-pulmonary metastasis. Systemic chemotherapy may improve the prognosis of these patients.</p>

Expression and significance of human telomerase reverse transcriptase mRNA in different subtypes of melanoma / 肿瘤研究与临床

Objective To detect the expression of human telomerase reverse transcriptase (hTERT) mRNA in the melanoma, and to analyze the relationship between the expression and subtypes and clinicopathological features of melanoma. Methods Expression of hTERT mRNA was detected by real-time quantitative PCR in 64 cases of melanoma and 30 cases of nevus. SPSS 17.0 software was used to analyze the relationship between hTERT mRNA expression and clinical pathological features of melanoma. Results The relative expression of hTERT mRNA in melanoma tissues was higher than that in nevus tissues [(52.43±5.42) vs (21.38±3.73), t= 4.72, P= 0.000]. The expression of hTERT mRNA in melanoma had no significant correlation with age, gender, ethnicity (all P> 0.05), but had relationship with subtypes, lymph node metastasis, Clark classification (all P 0.05). Conclusions The expression of hTERT mRNA in melanoma is high, especially in mucosal melanoma. hTERT may play an important role in the occurrence and development of melanoma.

Analysis of NRAS gene mutations and prognostic factors in patients with acral melanoma / 中华皮肤科杂志

Objective To detect NRAS gene mutations in patients with acral melanoma, and to analyze their relationship with the prognosis of acral melanoma. Methods Clinical and pathological data were collected from 55 patients with pathologically diagnosed acral melanoma. DNA was extracted from paraffin?embedded specimens from lesions of the 55 patients and 15 patients with nevus. PCR and direct DNA sequencing were performed to detect NRAS gene mutations. Univariate and multivariate analyses were performed using the Cox′s proportional hazards regression model. Results Of the 55 patients, 6(10.9%)carried the Q61R mutation in codon 61 of the NRAS gene. No mutations were found in exon 1 or 2 of the NRAS gene in any of these paraffin?embedded specimens, and none of the pigmented nevus specimens harbored NRAS gene mutations. Of the 6 patients carrying NRAS gene mutations, 4 had lymph node metastasis. Multivariate Cox regression analysis showed that independent factors of poor prognosis included advanced clinical stage(RR = 2.54, 95% CI: 1.062- 6.066, P < 0.05), not receiving surgical resection(RR = 2.98, 95% CI:1.316- 3.525, P < 0.05), and carrying NRAS gene mutations (RR = 2.73, 95% CI: 0.932- 3.257, P < 0.05). Conclusions NRAS gene mutations may be associated with lymph node metastasis in patients with acral melanoma. The prognosis of acral melanoma may be associated with clinical staging, treatment strategies and NRAS gene mutations. Additionally, NRAS gene mutations may serve as a new index for predicting prognosis of acral melanoma.

Construction of ICAT interference lentivirus expression vector and establishment of stable HL 60 cell lin / 国际检验医学杂志

Objective To construct the ICAT gene interference lentivirus expression vector targeting and to establish stable transfected cell line HL60 .Methods The interference sequence targeted at human ICAT gene was designed and synthesized ,after annealing ,which was connected to PGLV3 interference vector and with PG‐p1‐VSVG ,PG‐p1‐REV ,PG‐p1‐RRE were co‐transfected into 293T cells The lentivirus particles were packaged and generated .The virus titer was detected .HL60 cells were transfected for establishing the stable cell line ;RT‐PCR and Western Blot techniques were used to detect ICAT gene and protein expression in sta‐ble HL60 cells ,then the results were compared with those in the control group .Results The lentivirus expression vector targeted at ICAT was successfully constructed and the virus titer was 2 × 108 U/mL .Stable transfected HL60 cell line was established .The effective interference verification revealed that shICAT could significantly reduce the mRNA and protein level of ICAT ( P<0 .001) .Conclusion The shRNA lentiviral expression vector of ICAT gene is successfully constructed and the HL 60 cell line stably interfering ICAT expression is established .