Application of Westgard internal quality control frequency on-line calculator in general chemistry internal quality control / 中华检验医学杂志

Objective:An on-line calculator for calculating the frequency of internal quality control is recommended to select quality control procedures and appropriate run lengths for general chemistry in Beijing Tongren Hospital.Methods:The cumulative controlled coefficient of variations of 10 general chemical tests in the laboratory department of Beijing Tongren Hospital for 19 consecutive months were used as the imprecision. The mean value of absolute percentage difference between the quality control results and the target value of 15 batches of 10 tests in the external quality assessment (EQA) general chemistry in 2018 was used to estimate the Bias of each test. Use the allowable range of EQA target value of the National Center for Clinical Laboratories in 2018 to estimate the total allowable error (TEa) of each test. The data were input into the Westgard internal quality control frequency calculator, and 10 different candidate statistical quality control (SQC) procedures and corresponding run lengths were calculated online, including single rule and multiple rule, number of quality control concentration levels (or test projects) ranging from 1 to 4. The SQC program with relatively simple quality control rules and long run length was selected according to the actual situation of the laboratory.Results:The 1 3s, N=3 or 1 3s, N=2 rule could be adopted for ALP and CR, and the corresponding run length was 1000. TBIL and ALT projects can adopt 1 3s, N=3 or 1 3s, N=2 rule and its corresponding run length; UA can use multiple rules 1 3S/2 2S/R 4s/4 1s, N=4 (run length 395) or 1 3S/(2of3) 2S/R 4s/3 1s N=3 (run length 259); CHO, AST and AMY can adopt two multiple rules 1 3S/2 2S/R 4s/4 1s, N=4 or 1 3S/(2of3) 2S/R 4s/3 1s, N=3 and their corresponding run length. GGT project can adopt 1 3S/2 2S/R 4s/4 1S, N=4 rule (run length 50); The run length of 10 candidate quality control rules calculated by LDH was too short, the detection performance should be improved preferentially, and the quality control rules and corresponding run length were not recommended for the time being. Conclusion:The Westgard internal quality control frequency online calculator is easy to operate. Clinical laboratories can use this calculator to select SQC program and appropriate run length. It is recommended that laboratories adjust SQC program according to the current actual situation.

Design of internal quality control program for specific protein testing based on patient risk / 中华检验医学杂志

Objective:Patient risk-based statistical quality control (SQC) program was designed for 9 specific protein projects using Westgard sigma rules with run length.Methods:The cumulative coefficient of variation of immunoglobulin (Ig)G, IgA, IgM, C3, C4, rheumatoid factor (RF), antistreptolysin O (ASO), transferrin (TRF) and prealbumin (PA) from the laboratory department of Beijing Tongren Hospital between December 2018 to May 2019 were used as the estimated value of imprecision. The mean of the absolute value of the percentage difference of 10 batches in the laboratory, which was derived from the results of participating the external quality assessment (EQA), was used as the estimated value of bias. The National Center for Clinical Laboratories EQA evaluation criteria was used as an allowable total error (TEa), and the sigma value of each project (σ) was calculated. Westgard Sigma rule with run length was used to design appropriate SQC program for each project, including quality control rules, number of control measurements (N) and frequency of quality control.Results:The sigma value was larger than 6 for SQC procedure of IgG, IgA, IgM, C4 and TRF. SQC could be established with the use of 1 3s rule, number of control measurements (N)=2, number of runs (R)=1, and a run length of 1 000 patient samples. Combined with the average daily workload, internal quality control could be conducted once every 10 days for IgG, IgA, IgM and C4, every 50 days for TRF. The σ was 5.86 for C3, SQC program could be established with run length of 450 using 1 3S/2 2S/R 4s rule (N=2, R=1), combined with average daily workload, internal quality control could be conducted every 4.5 days. σ was between 3 and 4 for RF, ASO and PA. With the use of 1 3S/2 2S/R 4s/4 1s/6 X rule (N=6, R=1), SQC program with a run length of 45 and higher frequency internal quality control activities. Conclusion:It is feasible to use Westgard sigma rules with run length for the laboratories design of personalized risk-based SQC procedures, the method is very simple and intuitive. This tool is valued to be recommended to be actively applied by all clinical laboratories.

Establishment and performance evaluation of a domestic chemiluminescence immunoassay of serum HE4 / 中华检验医学杂志

Objective@#To establish and evaluate a domestic Chemiluminescence immunoassay(CLIA) for detecting serum human epididymis protein4(HE4).@*Methods@#To establish a double antibody sandwich CLIA for the determination of serum HE4. Fluorescein isothiocyanate (FITC) and alkaline phosphatase (ALP) were used to label two different monoclonal antibodies of HE4. The separation could be realized by the magnetic particles coated with anti-FITC antibodies. Measure the relative light unit (RLU) after adding substrate solution, the RLU is proportional to the concentration of HE4. After evaluating the analytical performance including sensitivity, precision, accuracy, linearity, specificity under the optimized condition, this study compared the method with the commerical HE4 kits as well.@*Results@#The precision of with-in lot , and with-out lot are less than 4.0% and 5.0% respectively; Recovery is within 90.0%-110.0%; LoB is 5.0 pmol/L; functional sensitivity is 15.0 pmol/L; measure range is 15.0-1 500.0 pmol/L; the Correlation coefficient is bigger than 0.99 comparing with commercial kits. The AUC(area under curve) of three methods is 0.895, 0.900 and 0.896 respectively.@*Conclusions@#This study established a sensitive CLIA method with high repeatability and wide measure range; it has good correlation with commercial HE4 test kits.(Chin J Lab Med, 2018, 41: 615-620)

Realization of Rehabilitation Needs and its Influential Factors of Adults with Physical Disability in Shanghai, China / 中国康复理论与实践

@#Objective To explore the rehabilitation needs and its influential factors of adults with physical disability in Shanghai, and to provide evidence for decision-making of the precise rehabilitation service. Methods From November to December, 2016, the rehabilitation demands, utilization rate and its influential factors of 390 registered people with physical disability were investigated with a questionnaire. Results The service of occupational rehabilitation met 62.34%and educational rehabilitation met 52.00%of the needs of adults with physi-cal disability at the age of 18 to 40 years. The service of occupational rehabilitation met 38.71%and educational rehabilitation met 35.29%of the needs of adults with physical disability of grade two. The main obstacle to the service utilization wasDo not know(67.34%). As a part ofotherreason, the cumulative frequency oftemporarily not neededaccounted for 16.41%in all reasons. Conclusion The rehabili-tation service should focus unmet needs to complete the community rehabilitation and health governance, and optimize the service system.

Association between single nucleotide polymorphism of BARD1 gene and BRCA1 gene mutation in epithelial ovarian cancer / 中华妇产科杂志

Objective To investigate the relationship between single nucleotide polymorphism (SNP) of BARD 1 gene and BRCA1 gene in epithelial ovarian cancer (EOC).Methods Nineteen EOC patients with BRCA1 gene mutation and 50 EOC cases without BRCA1 gene mutation between January 2016 and October 2016 were collected,and all EOC were diagnosed by pathological method.BARD1 gene variants were detected by next generation sequencing (NGS).The SNP of BARD1 gene was analyzed by Pearson linear correlation.Logistic regression analysis was used to research the clinicopathologic features and BRCA1 gene mutation associated with BARD1 gene SNP.Pearson's chi-square test was used to analyze the association between BARD1 gene Val507Met,Arg378Ser and Pro24Ser with different clinicopathologic features and BRCA1 gene mutation risk.Results (1) Eight BARD1 gene variants were found in 69 ovarian cancer patients,in which Val507Met,Arg378Ser and Pro24Ser were common variants,and the rate of mutation were all 54％ (37/69).(2) There was a significant linear correlation among Val507Met,Arg378Ser and Pro24Ser (all P＜0.01).(3) Obvious differences were found in Val507Met,Arg378Ser and Pro24Ser of BARD1 gene between BRCA1+ and BRCA1 (all P＜0.05).(4) No differences were found between BARD1 gene Val507Met,Arg378Ser and Pro24Ser and the clinicopathologic features (all P＞0.05),while obvious differences were found in BRCA1 gene mutation compared to the controls group.The risk of BRCA1 mutation in Val507Met and Arg378Ser were more evident in subjects with negative family history,positive menopause history,negative tubal ligation,onset age (≤60 years old) and sensitivity to platinum-based chemotherapy in EOC (all P＜0.05),while Pro24Ser was only more evident in positive menopause history of EOC (P＜0.05).Conclusions BARD1 Val507Met,Arg378Ser and Pro24Ser are the common genotypes,which are associated with BRCA1 mutation in EOC.The family history,menopause history,tubal ligation,onset age and sensitivity to platinum-based chemotherapy have effects on BARD1 SNP in the risk of BRCA1 gene mutation.

Clinical Research Progress of Scalp Acupuncture Therapy Based on Evoked Potentials / 世界科学技术-中医药现代化

This paper reviewed recent advances in clinical and basic researches of scalp acupuncture based on evoked potentials (EPs).The role and significance of various EPs in scalp acupuncture were analyzed and compared.Eventrelated potentials (ERPs) which occupied leading position in EPs application nowadays and the latest advances in the related components of its action were combined to make a prospect of the scientific research methods of scalp acupuncture in the treatment of cerebral apoplexy and other diseases.

Study on Mechanism of Scalp Acupuncture in Immediate Effects of Stroke Hemiplegia Based on ERP / 世界科学技术-中医药现代化

This study was aimed to explore the immediate effect mechanism of the middle 2/5 of the vertex-temporal anterior oblique line in the treatment of stroke by scalp acupuncture using event-related brain potential (ERP).A total of 30 stroke cases who met the inclusion criteria and 25 healthy subjects were selected.Patients in both groups were treated by scalp acupuncture,with stimulation on the middle 2/5 of the vertex-temporal anterior oblique line on the right side.ERP was detected before acupuncture and 10 min after acupuncture in both groups.The muscle strength and neurological deficit score of the stroke group were also detected.At the end of the experiment,the movement-related cortical potentials (MRCPs) of both the left and right hand were extracted from the ERP.The results showed that after 10 min scalp acupuncture stimulation,the neurological deficit score of the stroke group was lower than that of the pretreatment (P ＜ 0.05);the muscle strength rating was higher than before (P ＜ 0.05).Before and after acupuncture,the amplitude of MRCPs on the diseased side of the stroke group was significantly decreased compared to before (P ＜ 0.05).It was concluded that the immediate effect of scalp acupuncture treatment of hemiplegia patients with stroke was definite.Its mechanism may be that acupuncture stimulates the motor cortex through the vertex-temporal anterior oblique line,reduces the energy loss of brain motion planning,activates the damaged brain movement related area cortex neurons,improves the processing efficiency of movement in the brain,so as to promote the improvement of hemiplegic limb motor function immediately.And we also observed that the healthy side brain has a compensatory effect,which suggested that in our clinical scalp acupuncture,bilateral stimulation may be more effective.

Relationship between expression of PD-L1 and microsatellite instability of colorectal cancer and its significance / 中国肿瘤临床

Objective:To investigate the expression and clinical significance of PD-L1 in colorectal cancer (CRC). Methods:A total of 210 CRC patients who accepted radical surgery in our hospital from January 2015 to January 2016 were divided into three groups, namely, high-frequency microsatellite instability (MSI-H), low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS). The expression of PD-L1 was detected by immunohistochemistry, and the expression characteristics of PD-L1 in different types of CRC were analyzed. Results:CRC cases with low differentiation had a higher expression of PD-L1 than CRC patients with high differ-entiation (P<0.05). PD-L1 had a positive rate of 75.8%in the MSI-H group and a rate of 9.3%in the MSI-L and MSS groups, wherein the difference between the two groups was statistically significant (P<0.05). Conclusion:PD-L1 was positively expressed in some CRC tu-mor tissues, and its positive rate was significantly higher in MSI-H than in MSI-L and MSS. The therapeutic effect of a PD-L1 blocker for patients with MSI-H CRC might be preferable.

Clinical significance and distribution of BRCA genes mutation in sporadic high grade serous ovarian cancer / 中华妇产科杂志

Objective To investigate the mutations of BRCA genes in sporadic high grade serous ovarian cancer (HGSOC) and study its clinical significance. Methods Sixty-eight patients between January 2015 and January 2016 from the Affiliated Cancer Hospital of Zhengzhou University were collected who were based on pathological diagnosis of ovarian cancer and had no reported family history, and all patients firstly hospitalized were untreated in other hospitals before. (1)The BRCA genes were detected by next-generation sequencing (NGS) method. (2)The serum tumor markers included carcinoembryonic antigen (CEA), CA125, CA199, and human epididymis protein 4 (HE4) were detected by the chemiluminescence methods, and their correlation was analyzed by Pearson linear correlation. Descriptive statistics and comparisons were performed using two-tailed t-tests, Pearson′s chi square test, Fisher′s exact tests or logistic regression analysis as appropriate to research the clinicopathologic features associated with BRCA mutations, including age, International Federation of Gynecology and Obstetrics(FIGO)stage, platinum-based chemotherapy sensitivity, distant metastases, serum tumor markers (STM). Results (1) Fifteen cases (22%, 15/68) BRCA mutations were identified (BRCA1: 11 cases; BRCA2: 4 cases), and four novel mutations were observed. (2) The levels of CEA, CA199, and HE4 were lower in BRCA mutations compared to that in control group, while no significant differences were found (P>0.05), but the level of CA125 was much higher in BRCA mutation group than that in controls (t=-3.536,P=0.003). Further linear regression analysis found that there was a significant linear correlation between CA125 and HE4 group (r=0.494,P0.05), while significant differences were found in CA125 and sensitivity to platinum-based chemotherapy between the patients with BRCA mutation and wild type (P<0.05). The multiple factors analysis showed that the high level of CA125 was a independent risk factor of BRCA mutations in sporadic HGSOC (P=0.007). Conclusion The combination of CA125 with BRCA have great clinical significance, the mutation of BRCA gene could guild the clinical chemotherapy regiments.

The correlation of TCF7L2 genetic polymorphisms with intimal -medial thickness and stiffness in the hypertension and type 2 diabetic patients / 中国基层医药

Objective To explore the relationship between TCF7L2 genetic polymorphisms with intimal -medial thickness (IMT),carotid arterial stiffness in patients of type 2 diabetes mellitus(T2DM)with hypertension. Methods 872 patients of hypertension and T2DM were enrolled into this study,and they were divided into two groups according to IMT,carotid arterial stiffness and cPWV:the observation group(n =432,IMT >1.0mm,cPWV >12m/s),the control group(n =440,IMT≤1.0mm,cPWV≤12m/s).Meanwhile,400 healthy subjects(normal fasting gluose,blood pressure,without diabetes and hypertension family history)were selected as the healthy group.Typed gene polymorphisms of TCF7L2 by RT -PCR,the body mass index(BMI),waist -hip ratio,systolic blood pressure, diastolic blood pressure,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL -Ch), low -density lipoprotein cholesterol(LDL -Ch),insulin sensitivity index(ISI),glycated hemoglobin A1C(HbA1c) between groups were compared.Calculated each allele and genotype frequencies and implemented Hardy -Weinberg equivalent test.The distributional differences of alleles frequencies between groups were analyzed by χ2 test and geno-type frequencies through dominant model.Results Distributional differences of rs290487 genotype frequencies had statistically significant differences in the observation group vs the control group(χ2 =33.296,P 0.05 ).Conclusion rs290487 involved in the development of T2DM with hypertension,C and T alleles might be the risk factors of increasing the IMT and carotid arterial stiffness levels in patients of T2DMwith hypertension.Logistic regression analysis revealed that the increase of SBP,DBP,TC,TG,LDL-Ch and decrease of HDL -Ch may be the risk factors of hypertension and diabetic patients.Meanwhile,it dedicated that the increase of those biochemical indexes might be the important elements which would lead to the gene variations of C and T alleles.

Effect of difluoromethylorithine proliferation, apoptosis and cell cycle in different breast cell lines with different ODC G316A / 肿瘤研究与临床

Objective To investigate the proliferation,apoptosis and cell cycle and possible mechanisms of different breast cell lines by difluoromethylorithine (DMFO).Methods The growth of breast cancer MDA-435 (ODC GG) cell lines and SK-br3 (ODC AA) cell lines treated with DFMO were observed.The apoptosis and cell cycle were detected by flow cytometry.PCR was applied to detect the changes of A and G alleles of ODC G316A in MCF-7 cells treated with DFMO.Results The growth inhibition rates of MDA-435 and SK-br3 cells treated with 10 mmol/L and 20 mmol/L DFMO after 48 h were 24.1％ and 33.6 ％,46.3 ％ and 53.5 ％,respectively,and there was statistical significance (t =2.134,P =0.021,t =2.213,P =0.019).The growth inhibition rates of MDA-435 and SK-br3 treated with 10 mmol/L and 20 mmol/L DFMO after 72 h were 28.9 ％ and 35.7 ％,54.3 ％ and 65.4 ％,respectively,and there was statistical significance (t =2.434,P =0.015,t =2.489,P =0.013).The apoptosis rates of MDA-435 (ODC GG) and SK-br3 (ODC AA) cells both dealt with 20 mmol/L of DFMO after 24 h,48 h and 72 h were (7.58± 2.06) ％ and (13.88±3.45) ％ (t =2.047,P =0.041),(43.28±14.28) ％ and (59.96±16.42) ％ (t =3.680,P =0.000),(77.87±30.25) ％ and (93.08±32.15) ％ (t =3.293,P =0.000 1),respectively.The proportions of S stage cells MDA-435 (ODC GG) and SK-br3 (ODC AA) cells under the same condition after 24 h,48 h and 72 h were (13.25±2.38) ％ and (12.89±2.21) ％ (P ＞ 0.05),(21.43±3.12) ％ and (12.24±3.55) ％ (t =2.638,P =0.012),(16.32±3.23) ％ and (15.24±3.01) ％ (P ＞ 0.05),respectively.After the treatment by DFMO,the expression of ODC G316A allele A in breast cancer cell line MCF-7 (ODC AG) was reduced (t =3.708,P =0.000),and the expression of G had no significant changes.Conclusion The proliferation inhibition and apoptosis in breast cancer cells treated by DFMO is different in breast cancer cells with different genetic type of ODC G316A.DFMO can inhibit the activity of ODC,and the mechanism may be that DFMO could selectively bind to ODC G316A allele A.

Clinical observation of levosimendan in the treatment of refractory congestive heart failure / 药学实践杂志

Objective To evaluate the efficacy of loading or non loading administration of levosimendan in the treatment of pa -tients with refractory congestive heart failure (RCHF).Methods A randomized, open, control clinical trial was conducted in 40 pa-tients with RCHF.Besides regular treatment , patients in test group ( n=20) were given levosimendan injection with initial loading dose of 6-12 μg/kg for 10 min,followed by a continuous infusion of 0.1 μg/(kg· min).While in control group (n=20), patients were given Levosimendan injection with a continuous infusion of 8.7μg/min for 24 h.Dyspnea, eject fraction(EF),BNP level, blood pressure, heart rate, rhythm of the heart, the function of liver and kidney before and after drug administration were examined .All ad-verse events during the process were recorded .Results The base line showed there was no significant difference between the 2 groups. Dyspnea degree , general clinical condition , BNP, EF values were all improved , compared with those in patients before treatment .Af-ter 30 min of administration, in test group improved dyspnea , decreased systolic and diastolic blood pressure were more greatly than those in control group (P=0.04 and 0.01, respectively).However there were no significant differences of dyspnea degree , decreased BNP, between the 2 groups after administration of 6 h, 24 h, and 72 h.In addition, there was no significant difference in enhanced EF value at 24 h, 72 h between the 2 groups.Conclusion Levosimendan was effective in treating RCHF and could improve hemodynam-ic, degree of dyspnea and decrease BNP , increase EF value.Compared with loading group, non loading administration of levosimendan in the treatment of RCHF was equivalent , safe, and more convenient .

Numerical assessment of impeller features of centrifugal blood pump based on fast hemolysis approximation model / 生物医学工程学杂志

The impeller profile, which is one of the most important factors, determines the creation of shear stress which leads to blood hemolysis in the internal flow of centrifugal blood pump. The investigation of the internal flow field in centrifugal blood pump and the estimation of the hemolysis within different impeller profiles will provide information to improve the performance of centrifugal blood pump. The SST kappa-omega with low Reynolds correction was used in our laboratory to study the internal flow fields for four kinds of impellers of centrifugal blood pump. The flow fields included distributions of pressure field, velocity field and shear stress field. In addition, a fast numerical hemolysis approximation was adopted to calculate the normalized index of hemolysis (NIH). The results indicated that the pressure field distribution in all kinds of blood pump were reasonable, but for the log spiral impeller pump, the vortex and backflow were much lower than those of the other pumps, and the high shear stress zone was just about 0.004%, and the NIH was 0.0089.

Short-term and long-term effect of mask bi-level positive airway pressure combined with recombinant human brain natriuretic peptide on acute heart failure / 中国医师进修杂志

Objective To observe the short-term and long-term effect of mask bi-level positive airway pressure (BiPAP) combined with recombinant human brain natriuretic peptide (rhBNP) on acute heart failure.Methods One hundred cases of acute heart failure patients were divided into BiPAP combined with rhBNP group (51 cases) and conventional treatment group (49 cases) by random digits table.Conventional treatment group was given routine drug for heart failure treatment,and BiPAP combined with rhBNP group on the basis of routine treatment,was given BiPAP combined therapy with rhBNP.Arterial blood oxygen partial pressure (PaO2),arterial blood oxygen saturation (SaO2),and the change of clinical symptoms were recorded before and 30 min,2 h after treatment.All patients were followed up for 3 months,and cardiovascular events,related parameters of echocardiography and 6 min walking distance test were compared between two groups.Results Clinical symptoms (respiratory frequency and heart rate) and blood gas analysis index (PaO2,SaO2) were significantly improved after treatment in two groups,and BiPAP combined with rhBNP group improved more significantly.There was significant difference (P ＜ 0.05).After 3 months' follow-up,the incidence of cardiovascular events in BiPAP combined with rhBNP group was lower than that in conventional treatment group [17.6％ (9/51) vs.38.8％ (19/49),P ＜ 0.05].The left ventricular end-diastolic diameter (LVEDd),left ventricular ejection fraction (LVEF) in BiPAP combined with rhBNP group was better than that in conventional treatment group [(55.0 ± 6.1) mm vs.(63.3 ± 6.5) mm,(52.5 ±7.2)％ vs.(44.7 ± 6.8)％] (P ＜ 0.05).The 6 min walking distance test in BiPAP combined with rhBNP group was higher than that in conventional treatment group [(325.6 ± 36.4) m vs.(210.2 ± 34.1) m] (P ＜0.05).Conclusion BiPAP combined with rhBNP in short-term treatment of acute heart failure is effective and safe,and can improve the long-term prognosis of patients.

Evaluation of measurement uncertainty in clinical chemistry assays based on the data of internal quality control and external quality assessment / 中华检验医学杂志

ObjectiveTo evaluate the suitability of Nordtest guideline in estimating measurement uncertainty of routine tests in clinical laboratory.MethodsData of clinical laboratory of Beijing Tongren Hospital were collected,which came from 176 days of Internal Quality Control ( IQC ) from July 2010 to December 2010 and 6 times of External Quality Assesment ( EQA ) of NCCL from 2009 to 2010.The combined and expanded uncertainties of 21meaurements (sodium, potassium, chlorine,calcium,phosphrous,glucose,urea nitrogen,creatinine,uric acid,total protein,albumin,total bilirubin,direct bilirubin, alanineaminotransferase, aspartateaminotransferase, alkalinephosphatase, lactate dehydrogenase,glutamyl transpeptidase,creatine kinase,triglyceride and total cholesterol) were evaluated according to Nordtest guideline.ResultsOf all the measurements,expanded uncertainty of direct bilirubin ( 17.69％ ) was the highest.For some enzymes such as ALT,AST,ALP and LDH,expanded uncertainties were all over 10％ markedly influenced by the calibrator uncertainty.Expanded uncertainty of triglyceride was 12.7％,also largely influenced by calibrator uncertainty,while that of total cholesterol was 6.96％.ConclusionsNordtest guideline is suitable to evaluate the measurement uncertainty of routine assays in clinical laboratory.However,calibrator uncertainty should be taken into account in the process of evaluation.

An initial investigation of the serum thyroid hormone reference range in the apparently healthy individuals of Beijing and Shanghai area of China / 中华检验医学杂志

ObjectiveTo establish the reference intervals of serum triiodothyronine (TT3),the thyroxine ( TT4 ),free triiodothyronine ( FT3 ),free thyroxine ( FT4 ) and thyroid-stimulating hormone (TSH)in the apparently healthy individuals of Beijing and Shanghai.Methods According to the requirement for laboratory support for the diagnosis and monitoring of thyroid diseases in the National Academy ofClinicalBiochemistry(NACB)laboratorymedicinepracticeguidelines, therewere 390 apparently healthy individuals tested (221 male,169 female,18 -65 years old) from Beijing and Shanghai for serum TT3,TT4,FT3,FT4 and TSH on American Beckman UniCel DXI 800 Automatic Chemiluminescent Analyzer.All markers were analyzed between gender,region,age group using t test and ANOVA.The reference intervals of all markers were determined by P2.5 - P97.5.ResultsTT3,TT4,FT3,FT4,TSH levels in the male group were ( 1.90 ± 0.32) nmol/L,( 116.77 ± 18.02) nmol/L,( 5.28 ±0.67) pmol/L,( 11.54 ± 1.97) pmol/L,( 1.92 ± 1.12 ) mIU/L,respectively,while the above indicators in the female group were ( 1.82 ± 0.32) nmol/L,( 115.73 ± 14.39 ) nmol/L,(5.04 ± 0.59 ) pmol/L,( 10.94 ± 1.45) pmol/L,( 2.37 ± 1.86 ) mIU/L,respectively.When comparing the results in genders,statistical significance was shown in TF3,FT3,FT4 and TSH of two gender groups( t =2.377,3.642,3.471,2.520,all P ＜ 0.05 ).When comparing different regions,statistical significance was only shown in FT3 ( t =6.410,P ＜ 0.05 ),in which Beijing group was (5.01 ± 0.63) pmol/L,and Shanghai group was (5.41 ±0.61 ) pmol/L,and no significant difference were shown in other four markers.Correlation analysis showed that TT4 was positively correlated with age (r =0.22,P ＜ 0.001 ) while TSH was negatively correlated with age ( r =- 0.12,P ＜ 0.05 ).TT3,TT4,FT3,FT4,TSH reference intervals were ( 1.22 - 2.50 ) nmol/L,(83.37 - 149.37 ) nmol/L,( 3.88 - 6.48 ) pmol/L,( 7.70 - 14.86) pmol/L,( 0.38 - 5.58 ) mIU/L,respectively.ConclusionDifferences of serum thyroid hormones were observed in different areas of China,It is important to establish reference intervals of the serum thyroid hormones in Chinese population.

Relationship between interleukin-18 levels and characterization of atherosclerotic plaque and percutaneous coronary intervention / 老年心脏病学杂志（英文版）

Background lnterleuldn-18(IL- 18) plays a key role in the development,progression and outcome of coronary artery disease and its complications.However,its variability relation to the characterization of atherosclerotic plaque and percutaneous coronary intervention are still unknown.Methods Fifty four patients with coronary artery disease [22 patients with stable angina (SA) and 32 patients with acute coronary syndrome (ACS)] were enrolled in this study.All patients underwent percutaneous coronary intervention (PCI).The stability of the plaques at the criminal vessels was assessed with analogical IVUS.Serum IL-18 levels were measured at the time points of 5 rain before PCI,and Oh,6h,24h and lmonth after PCI in all patients.Results ACS group consisted mainly of lipidic unstable plaques while SA group of fibrous stable plaques.Moreover,compared with those in SA group,eccentricity index (EI) and remodeling index (RI) were significantly higher in ACS group.Positive remodeling was seen in ACS group while negative or no remodeling in SA group.Further,serum IL-18 levels were significantly elevated in patients with ACS than those in SA group before PCI,increased at Oh,6h,24h after PCI (P＜0.05)and were not significant different at 1 month after PCI from those before PCI.Conclusions There is significant difference in the composition and structural characteristics of atherosclerotic plaques between ACS and UA groups.PCI triggersd and enhances the inflammatory response in a short time.Serum levels of IL- 18 are the predictors of progression of unstable plaque in atherosclerosis.Post-operative complications of PCI might be reduced by inhibiting IL- 18.(J Geriatr Cardiol 2008;5:21-24)