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Objective:To establish a candidate reference procedure for the enumeration of cell particles in urine and applied to the multi-center performance evaluation of an automated urine formed elements analyzer.Methods:According to the standardized mannual microscopic examination of fresh non-centrifuged urine samples and the recommended reference method for enumeration of cell particles in urine published by ISLH, we established a candidate reference procedure for the enumeration of cell particles in urine. From four class A tertiary hospitals′ clinical laboratories, three rigorous trained technicians per hospital tested the same specimen respectively using the reference procedure. Each specimen was repeatedly counted 5 times, obtaining the quantitative results of cell particles were obtained in urine. Four hospitals used the established candidate reference measurement procedure and the automated urine formed elements analyzer to detect 40 to 60 urine specimens from September 2020 to January 2021, and evaluate the established reference method, meanwhile evaluate the accuracy and consistency of the each count from automated urinalysis analyzer.Results:Using the candidate reference measurement procedures, the coefficient of variation of results derived from three trained technicians per hospital was less than 6.98% (red blood cells), 6.99% (white blood cells), 13.94% (epithelial cells) and met the quality requirements. The performance evaluation results of automated urine formed elements analyzer showed that the accuracy of red blood cells, white blood cells and epithelial cells met the requirements (bias≤4.98%) and was well consistent with the reference measurement procedure ( R2≥0.989). Conclusions:A candidate reference measurement procedure for the enumeration of urine cell particles was successfully established with satisfactory precision and accuracy. This procedure was applied to multicenter performance evaluation of an automated urine formed elements analyzer with good accuracy and consistency.
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Objective@#To investigate the potential improvement of sample quality by automatic pre-analysis sample checking system, comparing to visual inspection for coagulation tests routinely.@*Methods@#Thirty samples with hemolysis, Icteric and lipemia in different levels were prepared and issued to 13 technicians for visual check, to evaluate the consistency individually. 2 949 blood samples with order for coagulation test were collected in Beijing Chaoyang Hospital in April and May 2018, the quality of all samples was evaluated by both visual check and automatic sample quality checking system before analysis, performance of two measurements detecting hemolysis, lipid, icteric or clot was compared.@*Results@#Significant differences were found in visual check among operators. The Kappa coefficients in three randomly selected groups were 0.32, 0.26 and 0.38 respectively, indicating that the consistency of visual check was poor. Among all investigated samples, 3 samples with unacceptable interference were detected visually, including 2 samples with hemolysis and another one with lipemia. On the other hand, 19 unqualified samples were identified by automatic checking system. Five types of interference of unqualified samples were detected as icteric (26.32%,5/19), clot (21.05%,4/19) hemolysis (5.26%,1/19),lipemia (36.84%, 7/19), and hemolysis with lipemia (10.53%,2/19) respectively by automatic checking system. But one case of hemolysis sample rejected by visual check was not rejected by automatic sample quality checking system.7 samples were merely affected on D-dimer by lipemia, which level did not influence the results of prothrombin time(PT) and activated partial thromboplastin time (APTT). Notably, other two samples were interfered with not only tests of PT, APTT and fibrinogen by hemolysis, but also D-dimer by the considerable level of lipemia, which showed the superiority of test-specific quality checking features.@*Conclusions@#The automatic pre-analysis sample quality checking system can improve the detection rate of unqualified samples and improve the efficiency of routine, helping realization of total quality management.
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The theories of pathophysiology come from experimental research,and experimental teaching is an important part of pathophysiology course.Experimental teaching can cultivate the abilities of independent thinking and comprehensive analysis in students,improve their practical skills,and enhance their understanding and application of theoretical knowledge.However,teaching reform should be carried out due to the drawbacks of current pathophysiological experimental teaching.With the teaching idea centered on learning,the quality of pathophysiological experimental teaching can be enhanced by rational arrangement of experimental courses,optimization of teaching contents,and comprehensive application of various teaching models,so as to effectively improve the level of theoretical knowledge and comprehensive practical ability among students.
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Pathophysiology is a subject that studies the occurrence,development and mechanism of diseases.It plays important roles in medical education and is an important and difficult point in medical education.Based on our teaching experience and the characteristics of pathophysiology,this paper puts forward the idea of “Focus on learning”,aiming to resolve the problems of insufficient communication,unsound teaching design and single teaching method,etc.existed in teaching process.The active communication with students,a good job of teaching design and the reasonable application of various teaching methods and techniques should be carried out to improve the teaching effect of pathophysiology.
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Objective To compare and study the two kinds of quality control methodologies related to intelligent quality management system ( iQM) and traditional quality control , and the quality control performance of iQM equivalent to traditional quality control were evaluated , ensuring the accuracy of the results of blood gas testing.Methods Beijing Chaoyang Hospital of Capital Medical University , Beijing Tiantan Hospital of Capital Medical University , Shanghai Longhua Hospital of Shanghai University of Chinese Medicine, and Sichuan Provincial People′s Hospital, these 4 medical institutions were selected to implement this study.During the period from June 2016 to December 2016, in the routine detection of total 3 712 specimen, the iQM and traditional quality control modes were used simultaneously to calculate the mean values of all blood gas parameters quality controls , SD, CV (%) and Sigma values, to evaluate the quality control performance and difference of the two quality control modes .Results During the process of testing blood gas samples from 3 712 specimen in 4 hospitals, iQM process control solution ( PCS) A, B, C ran 1 089, 7 678 and 154 quality control samples respectively , and 732 external quality control samples were run by traditional quality control mode .Considering the most sensitive parameters of blood gas testing pO 2, iQM PCS A, B, C′s Sigma value are higher than 8, however, the traditional quality control′s Sigma value are less than 6; For parameters pCO2, pO2and Na+, there exists significant difference between two quality control methods (P＝0.004 8,P＝0.000 1,P＝0.004 4,P＜0.01), other parameters pH, K+, Ca ++, Glu, Lac and Hct, there exists no significant difference between two quality control methods (P＝0.250 6, P＝0.062 3,P＝0.034 0,P＝0.346 9,P＝0.186 3,P＝0.823 1,P＞0.01).Totally 22 errors detected by iQM, includes 14 micro-clots and 8 interferences samples, which were not detected by traditional quality control .Conclusions The error in blood gas analysis mainly comes from the pre-analytical phase.iQM enhanced specimen inspection capabilities and make up for the inability of traditional quality control to monitor the quality of specimens , enabling full-scale, real-time, and dynamic monitoring of each specimen , powerful error detection capabilities , and automatic error correction capabilities . Besides, automatic documentation saves staff much time.The system can effectively ensure the accuracy of blood gas test results, meet the quality requirements of related laws and regulations and related industry standards , and also can meet the clinical intended use , providing new ideas for POCT quality management and improvement.
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Objective To evaluated the association between the NAGL and the chronic kidney disease (CKD) patients with iron status,which was occurred iron scarcity for CKD patient in clinical.Methods 154 CKD patients were included in this study.Serum neutrophil gelatinase-related lipid transport protein(NGAL) were detected in anemia group and non-anemia group of chronic kidney disease.The NGAL,univariate correlation and multivariate regression analysis,as well as ROC curve analysis,were used to assess and compared the diagnostic potential of NGAL,ferritin,EPO and Tfr (transferrin receptor) in CKD patients after analyzing the patient's iron status.Results NGAL levels were markedly higher in CKD patients with anemia than CKD patients without anemia.In the analysis,NGAL was inverse correlated with hemoglobin,hematocrit,MCV,MCH,serum iron and TSAT(correlation relation was-0.36,-0.32,-0.26,-0.31,-0.38,-0.3,respectively).ROC analysis was employed to assess and compare the diagnostic potentials of the NGAL,ferritin,EPO,and Tfr (transferritin receptor) in identifying this condition among CKD patients.The NGAL showed that the area under the curve of iron deficiency in CKD patients (AUC) was 0.713,with good sensitivity and specificity (58.6％ vs 74.7 ％).Conclusion NGAL might be proposed as a new tool in the assessment of iron deficiency and in the management of iron therapy for CKD patients.
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Objective To establish a new traceability pathway of point-of-care testing ( POCT ) of HBA1c by using commutable quality controls, in order to improve the accuracy of POCT HBA1c and the harmonization of testing results with those of central laboratories.Methods The study was about measurement traceability. Human frozen whole blood samples with IFCC assigned values were used to calibrate the G8 HBA1c Variant in June, 2013.According to the CLSI EP9-A2-IR guideline, 50 patient samples and 2-level commercial QC samples were then analyzed by G8 system and DCA Ventage system.The best fitting curves for fresh patient samples and the commercial QC materials were established separately. The patient results tested on the DCA Ventage were modified and verified.Paired t-test and Passing Bablok linear regression were used.Results The linear equation of DCA/G8 before calibration was Y=0.899 5X+0.389 1(R2 =0.991 0).Calibration by fresh patient samples reduced the mean bias of DCA/G8 from -0.40%±0.34%to 0.00%±0.29%.Calibration by QCs reduced the mean bias to 0.15%±0.29%.The linear correlation established by quality controls was stable, which made the bias was lower between DCA and G8 in the consequent six runs.Conclusions The accuracy and the traceability of POC testing could be realized by using commutable QC materials traceable to IFCC assigned values.Through this method, POC testing can become more comparable to the results of clinical laboratory HBA1c instruments.
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A spore is another life cycle form of Bacillus anthracis for resisting starvation.When conditions are favorable for growth, the dormant spore will germinate,go through outgrowth, and are ultimately converted back into a growing cell. As the first step back to vegetative growth, germination could be induced by nutrients and a variety of non-nutrient agents. Nutrient germinants trigger cation release and water absorption by binding to receptors in the spore′s inner membrane.Then the spore′s peptidoglycan cortex is hydrolyzed and the spore core rehydrates, which allows the resumption of spore metabo-lism and macromolecular synthesis.This paper reviews the nutrient germinant receptor and cortex lytic enzymes in the spore germination process of B.anthracis.