A multicenter study on the establishment and validation of autoverification rules for coagulation tests / 中华检验医学杂志

Objective:To establish autoverification rules for coagulation tests in multicenter cooperative units, in order to reduce workload for manual review of suspected results and shorten turnaround time (TAT) of test reports, while ensure the accuracy of results.Methods:A total of 14 394 blood samples were collected from fourteen hospitals during December 2019 to March 2020. These samples included: Rules Establishment Group 11 230 cases, including 1 182 cases for Delta check rules; Rules Validation Group 3 164 cases, including 487cases for Delta check; Clinical Application Trial Group 77 269 cases. Samples were analyzed for coagulation tests using Sysmex CS series automatic coagulation analyzers, and the clinical information, instrument parameters, test results, clinical diagnosis, medication history of anticoagulant and other relative results such as HCT, TG, TBIL, DBIL were summarized; on the basis of historical data, the 2.5 and 97.5 percentile of all data arranged from low to high were initially accumulated; on the basis of clinical suggestions, critical values and specific drug use as well as relative guidelines, autoverification rules and limits were established.The rules were then input into middleware, in which Stage I/Stage II validation was done. Positive coincidence, negative coincidence, false negative, false positive, autoverification pass rate, passing accuracy (coincidence of autoverification and manual verification) were calculated. Autoverification rules underwent trial application in coagulation results reports.Results:(1) The autoverification algorisms involve 33 rules regarding PT/INR, APTT, FBG, D-dimer, FDP,Delta check, reaction curve and sample abnormalities; (2)Autoverification Establishment Group showed autoverification pass rate was 68.42% (7 684/11 230), the false negative rate was 0%(0/11230), coincidence of autoverification and manual verification was 98.51%(11 063/11 230), in which positive coincidence and negative coincidence were respectively 30.09% (3 379/11 230) and 68.42%(7 684/11 230); Autoverification Validation Group showed autoverification pass rate was 60.37%(1 910/3 164), the false negative rate was 0%(0/11 230), coincidence of autoverification and manual verification was 97.79%(3 094/3 164), in which positive coincidence and negative coincidence were respectively 37.42%(1 184/3 164) and 60.37%(1 910/3 164); (3) Trialed implementation of these autoverification rules on 77 269 coagulation samples showed that the average TAT shortened by 8.5 min-83.1 min.Conclusions:This study established 33 autoverification rules in coagulation tests. Validation showedthese rules could ensure test quality while shortening TAT and lighten manual workload.

Establishing and Verifing Detection Limit for the Eight Items before Blood Transfusion with Enzyme-Linked Immunosorbent Assay by the WS/T 514-2017 Industry Standard Documents / 现代检验医学杂志

Objective To evaluate the limit of detection of eight enzyme-linked immunosorbent assay (ELISA) according to hospital grade assessment and ISO15189:2012.Methods According to the new health industry standard WS/T 514-2017:"Establishment and verification of detection capability for clinical laboratory measurement procedures",the limit of detection (LoD) was established,in the sameset of detection system,using two reagent lot,each lot for 5 consecutive days 4 consecutive days to assess the value of the concentration of five specimens were detected repeatedly,calculated the corresponding hit rate,then transform into probability units,and the corresponding concentration value production regression model,the hit rate of 95 ％ corresponds to the probability unit 1.645 substituted into the equation,the resulting concentration value was LoD estimates.The detection limit values were tested for 3 consecutive days of detection of two LoD concentrations near the declared concentration of the sample (diluted by the standard material) was detected 4 times repeatedly to calculate the positive result was greater than or equal to the percentage of LoD statement,greater than or equal to the critical value of 87％,then verified success.Results HBsAg:0.100 IU/ml,HBsAb:9.642 mIU/ml,HBeAg:0.666 NCU/ml,HBeAb:3.700 NCU/ml,HBcAb:0.786 IU /ml,HCV:0.506 NCU/ml,TP:2.236 mIU/ml and HIV:0.135 NCU/ml.The detection limit estimates were passed.Conclusion The verification limit of the verification project in the testing method and detection system of the laboratory meet the requirements Objective.

Formation rules of baicalin-berberine complex / 中成药

AIM To study the formation rules of baicalin-berberine complex.METHODS Under the conditions of different ratios of baicalin to berberine,heating methods and media (pH,ionic strength),the yield and composition of mixed decoction precipitation were determined by HPLC.RESULTS 0.5 g Baicalin and 1 g berberine produced the highest amount of precipitation.Higher heating temperature,nearly neutral pH (6.8) and glucose addition were beneficial to precipitate generation,in sharp contrast to NaCl addition.CONCLUSION The yield and composition of baicalin-berberine complex are mainly influenced by heating temperature and additives.

Treatment of multiple cancer with apatinib:A case report / 实用肿瘤学杂志

Multiple primary carcinomas(MPC),also known as multiple cancer,refers to single or multi-ple organ tissues occur more than two primary cancer in the same patient.In this case,it has been found multiple simultaneous cancers within 6 months.It is called metachronous cancer,which multiple cancers come from differ-ent original cancers more than 6 months.It is reported that there is a low incidence rate of multiple primary carci-nomas,which is largely influenced by radiotherapy and chemotherapy.Multiple primary cancers are easy to be confused with metastatic tumors in clinical practice,both of them are quite different in terms of treatment and prognosis.Therefore,it is helpful to improve the survival of patients by timely diagnosis and treatment.This article reported a case of multiple primary carcinomas.

Treatment of multiple cancer with apatinib:A case report / 实用肿瘤学杂志

Multiple primary carcinomas(MPC),also known as multiple cancer,refers to single or multi-ple organ tissues occur more than two primary cancer in the same patient.In this case,it has been found multiple simultaneous cancers within 6 months.It is called metachronous cancer,which multiple cancers come from differ-ent original cancers more than 6 months.It is reported that there is a low incidence rate of multiple primary carci-nomas,which is largely influenced by radiotherapy and chemotherapy.Multiple primary cancers are easy to be confused with metastatic tumors in clinical practice,both of them are quite different in terms of treatment and prognosis.Therefore,it is helpful to improve the survival of patients by timely diagnosis and treatment.This article reported a case of multiple primary carcinomas.

Analysis on CYP2C19 polymorphism among patients with cardiovascular diseases in Dongguan area / 国际检验医学杂志

Objective To investigate the distribution status of cytochrome CYP2C19 polymorphisms among patients with cardio-vascular diseases in Dongguan area .Methods A total of 1662 patients with cardiovascular diseases (CVD) in our hospital were se-lected .The peripheral blood was collected for extracting genomic DNA .The CYP2C19 genotype was detected by the polymerase chain reaction (PCR) combined with gene chip technology .The allele frequency and metabolic phenotype of CYP2C19 were com-pared between the CVD patients aged lower than 45 years and aged higher than 45 years old .Results Among 1662 cases ,713 cases (42 .90% ) were CYP2C19 extensive metabolizer ,740 cases(44 .52% ) were moderate metabolizer and 209 cases (12 .58% ) were poor metabolizer .The allele frequencies of CYP2C19﹡1 ,CYP2C19﹡2 and CYP2C19﹡3 were 65 .16% ,30 .08% and 4 .75% re-spectively .One hundred and four cases (40 .00% ) of extensive metabolisms were detected in the lower than 45 years old group ,104 cases(45 .38% ) of moderate metabolisms and 38 cases (14 .62% ) were detected .In the higher than 45 years old group ,609 cases (43 .44% ) of extensive metabolisms ,622 cases of moderate metabolisms and 171 cases(12 .20% ) of poor metabolism were detec-ted .The proportion of various genotypes had no statistical difference between the lower than 45 year old group and higher than 45 year old group(P>0 .05) .Conclusion Detecting CYP2C19 genotype for determining the genetic characteristics can evaluate the clopidogrel resistance risk and formulate the personalized anti-platelet therapeutic scheme .

Correlation between ApoE gene polymorphisms and chronic cardiovascular disease and blood lipid levels of patients / 国际检验医学杂志

Objective To analyze the correlation between apolipoprotein E(ApoE) gene polymorphisms and the incidence rate of chronic cardiovascular disease as well as the blood lipid levels of patients.Methods ApoE gene polymorphism and lipid levels were measured by suing gene chip analysis system and biochemical analyze in 1 414 cases of chronic cardiovascular disease patients(experimental groups) and 374 cases of healthy subjects(control group).Results Compared with control group,E3/4 genotype frequency was increased in experimental group,while E2/E3 genotype frequency decreased(P<0.05).Compared with control group,the levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein-cholesterol(LDL-C) were obviously increased and the level of HDL-C was decreased in experimental group(P<0.05).Compared with patients with E2/E3 genotype,the level of HDL-C in patients with E3/E4 genotype was decreased and the levels of TC,LDL-C were increased significantly(P<0.05).Proportions of different ApoE genotypes in patients with cerebral infarction,cerebral hemorrhage,hypertension,coronary heart disease,type-2 diabete and fatty liver were different.Compared with the E2/E3 genotype,the proportion of the E3/E4 genotype in patients with cerebral infarction,cerebral hemorrhage,hypertension,coronary heart disease,type-2 diabete and fatty liver were increased(P<0.05).Conclusion ApoE gene polymorphism might be important cause of the individual difference of lipid levels and a risk factor for the occurrence and development of chronic cardiovascular diseases.

Analysis of clinical distribution and resistance of methicillin-resistant Staphylococcus aureus in primary hospital / 中国基层医药

Objective To analyze the distribution and drug resistance rate of methicillin-resisitant Staphylococcus aureus(MRSA) and methicillin-susceptible Staphylococcus aureus(MSSA) isolated from different departments in a certain primary hospital during 2009 to 2012,and to provide scientific evidences for clinical application of antibiotics.Methods Pathogens and bacterial resistance to antibiotics were identified using the VITEK 2 compact equipment.The data were got from WHONTES.5 and analyzed by SPSS 13.0.Results There were 517 Staphylococcus aureus strains were detected(MRSA 135 strains,MSSA 382 strains).The rate of MRSA was 24.5％,27.7％,24.8％,27.0％ during the four years.MRSA was mainly found in the department of oncology,orthopaedicsand ICU.MRSA was mainly isolated from pus,secretion,sputum and blood.The 517 Staphylococcus aureus strains showed high sensitive to vancomycin,linezolid and teicoplanin,the sensitive rate was 100％.Conclusion Establishing a more comprehensive MDRO monitoring and hospital infection control system in the primary hospital,and rational using antibacterial drugs at the based of the antibiotics susceptibility test in the treatment can be effective in preventing MRSA resistance rates increasing and hospital-borne.

Comparative study on health risk behaviors between male and female freshmen among medical universities, scientific and technologic universities / 中华行为医学与脑科学杂志

ObjectiveTo explore the distribution and characteristics of health risk behaviors between the male and female college freshmen in the medicine and science,and to provide evidence for appropriate health intervention measures.MethodsA questionnaire investigation was performed on college students'health risk behaviors among 1019 freshmen from medical and science college in urban area of Harbin.Results (1)There were statistically significant among the different gender in difference of risky behaviors except playing video games,net surfing,considered suicide,drug abuse and a few activities outside the 60 minutes every day (P ＜ 0.01 ).(2)Medical male risk behavior of the frequency(56.4％,19.2％,12.7％ and 47.1％ )higher than that of science and engineering male(35.6％,5.2％,1.6％ and 17.3％ )in trying to smoking,current smoking,sexual behavior and breakfast skipping.Recent medical males drinking rate was 85.3％ higher than male of science and engineering 72.2％.The incidence of female science and engineering students,respectively( 89.3％,50.8％ and 38.5％ ) than female medical students (72.4％,36.9％ and 8.0％ ) in trying to drinking and recent drinking and breakfast skipping.ConclusionThe risk behaviors of college freshmen were prevalent.The frequency of risk behaviors are different among the College Freshmen in different genders and with different major,respectively.Therefore,it is necessary to take measures for intervention.

Association of polymorphisms of transforming growth factor-beta 1 gene with coronary heart disease / 中国基层医药

Objective To explore the association of transforming growth factor-beta 1(TGF-β1) polymorphisms with coronary heart disease(CHD).Methods The 509C/T polymorphisms of TGF-β1 gene were analyzed by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) in 300 patients of CHD and 300 healthy individuals,the levels of serum lipids and hsCRP were also studied.Results The levels of hsCRP、TC 、LDL、ApoB in serum and the frequencies of C、T allele at position-509 of TGF-β1 gene were statistically significant higher than the controls(P＜0.01,P＜0.05).Conclusion The polymorphisms of TGFβ1-509C/T were associated with CHD.C allele should be the susceptibility gene in the occurence of CHD.

Association of TNF-alpha-238G/A and 308 G/A gene polymorphisms with pulmonary tuberculosis among patients with coal worker's pneumoconiosis / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>Tumor necrosis factor-alpha (TNF-alpha) may play an important role in host's immune response to mycobacterium tuberculosis (M. tuberculosis) infection. This study was to investigate the association of TNF-alpha gene polymorphism with pulmonary tuberculosis (TB) among patients with coal worker's pneumoconiosis (CWP).</p><p><b>METHODS</b>A case-control study was conducted in 113 patients with confirmed CWP complicated with pulmonary TB and 113 non-TB controls with CWP. They were matched in gender, age, job, and stage of pneumoconiosis. All participants were interviewed with questionnaires and their blood specimens were collected for genetic determination with informed consent. The TNF-alpha gene polymorphism was determined with polymerase chain reaction of restriction fragment length polymorphism (PCR-RFLP). Frequency of genotypes was assessed for Hardy-Weinberg equilibrium by chi-square test or Fisher's exact probability. Factors influencing the association of individual susceptibility with pulmonary TB were evaluated with logistic regression analysis. Gene-environment interaction was evaluated by a multiplicative model with combined OR. All data were analyzed using SAS version 8.2 software.</p><p><b>RESULTS</b>No significant difference in frequency of the TNF-alpha-308 genotype was found between CWP complicated with pulmonary TB and non-TB controls (chi2 = 5.44, P = 0.07). But difference in frequency of the TNF-alpha-308 A allele was identified between them (chi2 = 5.14, P = 0.02). No significant difference in frequencies of the TNF-alpha-238 genotype and allele (P = 0.23 and P = 0.09, respectively) was found between cases and controls either, with combined (GG and AA) OR of 3.96 (95% confidence interval of 1.30-12.09) at the -308 locus of the TNF-alpha gene, as compared to combination of the TNF-alpha-238 GG and TNF-alpha-308 GG genotypes. Multivariate-adjusted odds ratio of the TNF-alpha-238 GG and TNF-alpha-308 GA genotypes was 1.98 (95% CI of 1.06-3.71) for risk for pulmonary TB in patients with CWP. There was a synergic interaction between the TNF-alpha-308 GG genotype and body mass index (OR = 4.92), as well as an interaction between the TNF-alpha-308 GG genotype and history of BCG immunization or history of TB exposure. And, the interaction of the TNF-alpha-238 GG genotype and history of BCG immunization or TB exposure with risk for pulmonary TB in them was also indicated.</p><p><b>CONCLUSIONS</b>TNF-alpha-308 A allele is associated with an elevated risk for pulmonary TB, whereas TNF-alpha-238 A allele was otherwise.</p>

CA 125 expression in cervical and vaginal secretions in women in normal reproductive period / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the tumor-associated antigen CA125 expression in the serum and cervical and vaginal secretions in women during normal reproductive period, and explore the clinical value of detecting tumor markers in the cervical and vaginal secretions.</p><p><b>METHODS</b>A total of 145 women in reproductive period were divided into 3 age groups (20-29 years, 30-39 years, and over 40 years), and their CA125 levels in cervical secretion, vaginal secretion and serum were detected by automatic electro-chemiluminescent immunoassay.</p><p><b>RESULTS</b>CA125 levels in the cervical secretion, vaginal secretion and serum showed no significant difference between the 3 age groups (P>0.05). In each group, CA125 levels differed significantly between the cervical secretion, vaginal secretion and serum (P<0.001). In the 145 women, the average CA125 level was 497.82 - or + 75.29 U/ml in the cervical secretion, 114.66 - or + 26.40 U/ml in vaginal secretion and 18.06 - or + 3.35 U/ml in serum, showing significant differences between them (P<0.001).</p><p><b>CONCLUSION</b>CA125 expression level is significantly higher in the cervical and vaginal secretions than in the serum in women in normal reproductive period, and its levels in cervical and vaginal secretions can be more sensitive and convenient for early detection of related diseases.</p>

Clinical meanings of serum CA19-9 level in hepatocirrhosis patients / 中国基层医药

Objective To explore the clinical meanings of serum CA19-9 levd in hepatocirrhosis patients. Methods 61 hepatitis B and hepatocirrhosis patients were as treatment group, and 35 normal were as control group. The content of serum CA19-9 was measured by dectrochemistry lighting and the liver function was determined too. According to Child-Pugh liver function integral method,the treatment group was divided into 27 cases of A grade,20 cases of B grade and 14 cases of C grade. Results The serum CA19-9 level in hepatocirrhosis patients was higher than that of normal group significantly(P< 0. 005 ). The serum CA19-9 level decreaed obviously through the treat- ment,thereinto A and B grade fell evidendy in the Child-Pugh liver function integral method( P < 0. 005). C grade was not significantly different(P<0.05 ). The serum CA19-9 levd was positivdy associated with TBiL, ALT and AST of liver function integral method. Conclusion The serum CA19-9 levd of hepatocirrhosis patients is improved in different degrees. And it can be a prognostic target and used to estimate the degree of damage of liver function of hepatocirrhosis patients.

Changes of serum cytokine caused by acute paraquat poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the change of cytokine interleukin IL-1 beta, IL-6, IL-10, tumor necrosis factor-alpha (TNF-alpha) occurred in acute paraquat (PQ) poisoning rats and to investigate the mechanism of acute lung injury caused by paraquat (PQ) poisoning.</p><p><b>METHODS</b>All 72 healthy adult Wistar rats were random assigned into normal control groups, paraquat high dose group (120 mg/kg), paraquat middle dose (60 mg/kg) group, paraquat low dose group (30 mg/kg). Three observing periods of time included 8, 24, 72 h and the standards of TNF-alpha, IL-1 beta, IL-6, IL-10 were determined.</p><p><b>RESULTS</b>Every index of the PQ group was significantly higher than that in the NS group at the same period of time (P<0.05 or P<0.01). In the 72 h group, the high dose group was significantly higher than the middle and low dose group (P<0.05), and there was no significantly difference between the middle and low dose group (P>0.05). For the comparison of index in the same dose group, the group of 72 h was much higher than 8 h group and 24 h group (P<0.05), and there was no difference between the 8h group and 24 h group (P>0.05).</p><p><b>CONCLUSION</b>The cytokine may play an important role in paraquat-induced acute lung tissue injury.</p>

Research and advancement of treating avascular necrosis of the femoral head / 介入放射学杂志

To undertake retrospective analysis of the research and advancement of treating avascular necrosis of the femoral head.After comparing the superiority and inferiority of different treatments and the present therapeutic status many therapeutic methods for avascular necrosis of the femoral head have been performed,commonly according to the staging of necrosis.Conservative therapy is suitable for stage 0 ～Ⅰ,interventional therapy is suitable for stage Ⅱ～Ⅲ,operation is adapted for stage Ⅱ～ Ⅲ and femoral head collapse or degenerative changes.Avascular necrosis of the femoral head is a chronic and dysfunctional illness.Comprehensive treatment according to different stage is now the most popular.Interventional therapy is the study focus of the avascular necrosis of the femoral head meanwhile.(J Intervent Radiol,2006,15: 636-639)

Effects of chronic benzene poisoning on DNA and antioxidase of mice / 中国组织工程研究

BACKGROUND:As an important industrial solvent,benzene can cause DNA damage,chromosome aberrence,formation of DNA adducts and gene mutation. OBJECTIVE:To explore the effects of benzene on DNA and the mechanism,as well as the changes of antioxidase system it caused. DESIGN:Randomized case control study. SETTING:The Department of Clinical Laboratory of First Affiliated Hospital and Public Health College of Harbin Medical University. PARTICIPANTS:The experiment was completed in the Animal Centre in Public Health College,Harbin Medical University.Twenty-four healthy male mice of Kunming species weighed between 18 g to 22 g were chosen.The mice were provided by Experimental Animal Centre of Second Affiliated Hospital,Harbin Medical University. INTERVENTIONS:The mice were divided into control group,low dose benzene group and high dose benzene group.Inhaling benzene smoke method was used 4 hours per day to cause benzene poisoning to mice except those of the control group.The mice were executed two months later to separate marrow cells and peripheral lymphocytes and remove liver,spleen and brain to make homogenate. MAIN OUTCOME MEASURES:Single cell gel electrophoresis (SCGE) was used to assay the DNA damages of marrow cells and peripheral lymphocytes.Meanwhile,the contents of superoxide dismulase(SOD),glutathione peroxidase(GSH-Px) and malondialdehyde(MDA) in liver,spleen and brain tissues were also detected. RESULTS:The comet percentage of marrow cells and peripheral lymphocytes in two benzene poisoning groups were(83.56± 10.28),(92.54± 15.93)% ,and(41.27± 6.03)% ,(65.79± 11.62)% respectively which were much higher than those in control group[(4.13± 0.52)% ,(2.21± 0.31)% ](P< 0.01) and represented dose-response relationship.The SOD activity of liver homogenate and GSH-Px activity of high dose and low dose groups were (11 573.31± 1 938.72),(12 574.68± 1 938.72) nkat/g and (309.40± 82.85),(375.41± 55.18) nkat/g respectively which were much lower than those in control group [(16 668.67± 3 137.96),(588.62± 110.52) nkat/g] (P< 0.05).However, there was no significant difference between different dose groups. The GSH-Px activity in spleen homogenate in two experimental groups was(421.75± 124.02) and(523.10± 45.18) nkat/g respectively which was much lower than that of control group [(618.42± 57.01) nkat/g](P< 0.05) and there was significant difference between two groups (P< 0.05).In the brain homogenate of both benzene groups,the GSH-Px activity was(87.35± 19.84) and(95.02± 14.00) nkat/g respectively which was much lower than that of control group[(118.36± 7.67) nkat/g] (P< 0.05) and without difference between two groups.The MDA content in brain homogenate of high dose group was(3.99± 1.15) μ mol/mg which was much higher than that of control group [(2.58± 0.53) μ mol/g] (P< 0.05). CONCLUSION:Chronic benzene poisoning can cause DNA impairment of marrow cells and peripheral lymphocytes and reduce the activity of antioxidase.

Effect of serotonin on subdiaphragmatic vagus nerve afferent discharge and its mechanism in rats / 第三军医大学学报

Objective To investigate the effect and mechanism of serotonin (5-HT) and secretin(SEC) on afferent discharge of vagus in rats. Methods Spontaneous afferent discharge of subdiaphragmatic vagus nerve was recorded in urethane anesthetized rats. The effects of 5-HT, 5-HT3 receptor antagonist and 5-HT+SEC on the discharge of subdiaphragmatic vagus nerve were investigated by intravenous injection of different dosage of 5-HT(3, 10, 30 ?g/kg), Granisetron (1 mg/kg) and 5-HT+SEC. Results Intravenous 5-HT caused obvious exciting effect on spontaneous afferent discharge of subdiaphragmatic vagus nerve. The 5-HT3 receptor antagonist significantly inhibited the effects of 5-HT. 5-HT+SEC could augment the effect of 5-HT on spontaneous discharge. Conclusion The exciting effect of 5-HT on afferent discharge of subdiaphragmatic vagus nerve is possibly mediated by 5-HT3 receptor related to vagus nerve afference. Secretin can augment the exciting effect of 5-HT on spontaneous discharge of vagus afferent nerve.

A study on the relationship between diabetic retinopathy and the state of diabetes mellitus control / 中国糖尿病杂志

Objective To investigate the relationship between diabetic retinopathy(DR) and the state of diabetes mellitus(DM) control.Methods The factors for the occurrence and development of DR were analyzed by non conditional Logistic regression model.Results 5 significant factors were screened out,which were urinary microalbumin excretion index(ALB/Cr),blood glucose before breakfast,glycosylated hemoglobin(HbAlc),diabetic neuropathy and course of DM.And the sugestible threshold value of blood glucose before breakfast is 7.90mmol/L at which we can prevent the occurrence of DR,and at 7.15mmol/L,occurrence of DR can be strictly controlled.Conclusion The state of controlling blood glucose and other complications in DM patients influences the occurrence and development of DR.