Effect of storage temperature and time on erythrocyte sedimentation rate.

OBJECTIVE: This paper explores the effect of blood sample storage temperature and time on the erythrocyte sedimentation rate (ESR) by using the Weiss method. METHODS: Whole blood samples were collected from 80 patients and diluted 1:9 with sodium citrate solution. Each sample was split into two tubes. Using the Weiss method, ESR was tested within 1 h of collection, and one sample was placed at 4 °C and the other at room temperature (23 ± 2 °C). ESR was then measured at 2, 4, 6, 8, 12, and 24 h. The data were statistically analyzed with consideration for temperature and time. RESULTS: ESR decreased gradually over 6 h at room temperature, but the results were not statistically significant. Similarly, there was no significant difference in the decline of ESR within 8 h at 4 °C. However, ESR results decreased significantly after the samples were stored at room temperature for more than 6 h or at 4 °C for more than 8 h. ESR reduction was lower in the samples stored at 4 °C than in those stored at room temperature over the same time period. CONCLUSION: Blood sample storage temperature and duration can affect the measurement of ESR using the Weiss method. ESR testing should be completed within 4 h of sample collection in clinical work.

Using information technology to optimize the identification process for outpatients having blood drawn and improve patient satisfaction.

BACKGROUND: This study explored the application effect of information technology in optimizing the patient identification process. METHODS: The method for optimizing the identification process involved in drawing blood among outpatients using information technology was executed from July 2020. In this paper, 959 patients who had blood drawn from January to June 2020 were included as the pre-optimization group, and 1011 patients who had blood drawn from July to December 2019 were included as the post-optimization group. The correct rate of patient identification, waiting time, and patient satisfaction before and after the optimization were statistically analyzed. The changes in these three indexes before and after the optimization implementation, as well as the application effects, were compared. RESULTS: The correct rate of patient identification after optimization (99.80%) was higher than before optimization (98.02%) (X2 = 13.120; P < 0.001), and the waiting time for having blood drawn was also significantly shortened (t = 8.046; P < 0.001). The satisfaction of patients was also significantly improved (X2 = 20.973; P < 0.001). CONCLUSIONS: By combining information technology with the characteristics of blood collection in our hospital, using the call system to obtain patient information, then scan the QR code of the guide sheet for automatic verification, and finally manually reconfirm patient information, which can significantly reduce the occurrence of identification errors, improve work efficiency and improve patients' satisfaction.

Preliminary Study on Reference Interval of Serum Pepsinogen in Healthy Subjects.

OBJECTIVE: This study determined the reference interval of pepsinogen (PG) of healthy people in the local region to provide a basis for early screening of gastric cancer. METHODS: Among the healthy people who underwent a physical examination in our hospital from January 2020 to December 2020, 2568 subjects were selected based on the relevant screening criteria. Their serum PG I and II levels and PG I:PG II ratio were determined by chemiluminescent microparticle immunoassay (CIMA), and the results were statistically analyzed. Finally, according to document CLSI-C28-A3, the PG reference interval of the local region was determined. RESULTS: The PG I and II levels of the males in all age groups were higher than those of the females in the corresponding age groups, and the differences were statistically significant (P < 0.05). However, the differences in the PG I:PG II ratio between the genders in the different age groups were not statistically significant (P > 0.05). The PG I and II levels increased with age in both men and women, while the PG I:PG II ratio was not correlated with age in either gender. CONCLUSION: The PG reference interval of the local region was initially determined as providing a reliable reference basis for clinical treatment.

The Value of Combined Serum Amyloid A Protein and Neutrophil-to-Lymphocyte Ratio Testing in the Diagnosis and Treatment of Influenza A in Children.

OBJECTIVE: The aim of this study was to explore the value of serum amyloid A protein (SAA) and neutrophil-to-lymphocyte ratio (NLR) testing in the diagnosis and treatment of children with influenza A. METHODS: Specimens were collected from 85 children with influenza A, 85 children with a bacterial infection, and 86 healthy children. The levels of SAA and C-reactive protein (CRP) were measured, and routine blood tests were performed. RESULTS: The levels of SAA and CRP in the bacterial infection group were significantly higher than those in the influenza A group, and the levels in the influenza A group were higher than those in the healthy children. The NLR level in the influenza A group was not different from that in the bacterial infection group, but the NLR levels in the influenza A group and the bacterial infection group were higher than that in the healthy controls. The number of white blood cell (WBC) in the influenza A group was not different from that in healthy children, while the WBC counts in the control and bacterial infection groups were higher than that in the influenza A group. The distribution width of red blood cells in the bacterial infection group was higher than that in healthy controls. The receiver operating characteristic curve analysis showed that the area under the curve for the diagnoses of influenza A for SAA, NLR, and CRP was 0.806, 0.768, and 0.699, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SAA/NLR (SAA and NLR in the series) were 68.24%/76.47% (57.65%), 84.88%/72.09% (96.76%), 81.69%/73.03% (96.08%), 73.00%/75.61% (70.00%), and 76.61%/74.27% (77.78%), respectively. CONCLUSION: In the early diagnosis of children with influenza A, the values of SAA and NLR are high. Thus, they could be used for monitoring and efficacy evaluation during the course of the disease.

Service Quality Improvement of Outpatient Blood Collection by Lean Management.

OBJECTIVE: To explore the application effect of lean management in improving the quality of outpatient blood collection services. METHODS: For this study, a total of 146,907 patients whose blood was sampled by outpatient services between April 2020 and September 2020 were selected. We analyzed the influence of various factors on the waiting time and satisfaction levels of the patients for blood collection and eliminated confounders based on the results of the analysis. Lean management for the outpatient blood collection service was implemented in July 2020. Thus, the 38,275 cases sampled on weekday mornings between April and June 2020 were selected as the ordinary management group, while the 39,473 cases sampled on weekday mornings between July and September 2020 belonged to the lean management group. Finally, the changes in waiting time and the satisfaction levels of the patients were evaluated. RESULTS: The age and gender of the patients and the length of service of the staff, who administered blood collection had a negligible effect on the waiting time (Z=-1.243, P=0.418; Z=-1.569, P=0.389; Z = -1.062, P= 0.563), while there was a statistical difference in the waiting time between different days and different sessions (Z = -2.581, P = 0.013 and Z = -4.672, P < 0.001). We also found that the length of service of blood collection staff, day, session, and age and gender of patients did not have a meaningful effect on patient satisfaction (P > 0.05). Overall, the median waiting time of outpatients decreased from 22 min to 13 min after the implementation of lean management (Z =10.522, P < 0.001), while the satisfaction level of outpatients increased from 95.37% to 98.33% (χ 2 = 559.580, P < 0.001). CONCLUSION: The application of lean management can significantly shorten outpatient waiting time for blood collection, improve patients satisfaction levels, and enhance the overall patient experience. Thus, lean management can significantly improve the service quality of outpatient blood collection.

The Diagnostic and Therapeutic Value of the Detection of Serum Amyloid A and C-Reactive Protein in Infants with Rotavirus Diarrhea.

OBJECTIVE: This study explores the significance of serum amyloid A (SAA), C-reactive protein (CRP), and white blood cell (WBC) in the diagnosis and treatment of diarrhea in infants. METHODS: Specimens were collected from 126 children with diarrhea and 66 healthy children undergoing health examination. According to the results of stool culture and rotavirus (RV) antigen, these children were divided into three groups: rotavirus group (70 cases), bacterial infection (56 cases), and control groups (66 cases). On the fourth day of admission, children in the RV group underwent stool culture again. Based on the subsequent results, they were further divided into two groups, ie, no secondary bacterial infection and secondary bacterial infection groups. The levels of RV antigen, bacterial antigen, SAA, CRP, and WBC were detected in all children. Then, ROC curve analysis was performed to determine the diagnostic efficacy of SAA, CRP and WBC. RESULTS: The levels of SAA, CRP, and WBC for the RV group were lower than those of the bacterial infection group, but higher compared with the control group (P<0.05). The diagnostic efficacy of SAA was higher than that of CRP and WBC, with the area under the curve of 0.876, 0.803, and 0.765, respectively. The positive and negative predictive values, specificity, and sensitivity of SAA were slightly better compared with CRP and WBC. The SAA, CRP, and WBC levels of children with a bacterial infection in the RV group on the fourth and seventh days after admission were also significantly higher compared with children without bacterial infection. CONCLUSION: Serum amyloid A, CRP, and WBC levels had a high value in the differential diagnosis of infantile diarrhea. As such, they can be used in the early diagnosis and curative efficacy assessment of children with diarrhea.

The Value of Serum Amyloid A in the Diagnosis and Management of Ankylosing Spondylitis.

OBJECTIVE: The present study aimed to explore the clinical value of serum amyloid A (SAA) in the diagnosis, treatment, and assessment of ankylosing spondylitis (AS). METHODS: Seventy-eight patients with AS were enrolled as the case group, while the control group consisted of 80 healthy individuals enrolled during the same time period. According to the criteria of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), patients in the case group were divided into those in the remission phase (36 patients) and those in the active phase (42 patients). Levels of SAA, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured in all enrolled subjects and analyzed. RESULTS: SAA levels were significantly higher in the AS group (39.65 ± 12.32 ng/mL) than in the control group (7.64 ± 1.32 ng/mL) (p =0.011) and in patients in the active phase (56.18 ± 17.25 ng/mL) compared with those in the remission phase (20.36 ± 5.36 ng/mL) (p =0.015). The sensitivity and specificity of SAA were 79.49% and 77.50%, respectively. There was a positive correlation between SAA level and the BASDAI grade (r = 0.77, p =0.005), CRP level (r = 0.68, p =0.011), and ESR (r = 0.62, p =0.012). CONCLUSION: Not only is SAA a reliable indicator for the presence of AS, it may also be useful for monitoring the activity of this disease.

The Application of the EP9-A Protocol in the Analysis of the Performance of the Immunofluorescence Assay for HCG Detection.

OBJECTIVE: The present study aims to evaluate the comparability of the results of two methodologies for detecting human chorionic gonadotropin (HCG) to assess whether the immunofluorescence method for detecting HCG is adequate for clinical applications. METHODS: Referring to the protocol requirements of the American Clinical Laboratory Standards Institute (CLSI) EP9-A2 (methodological matching and bias assessment with patient samples), we collected 40 fresh serum specimens from our outpatients and inpatients, including 20 specimens with abnormal HCG concentrations (eight samples with different concentration ranges were selected daily and HCG was measured simultaneously with the two testing systems for five consecutive days). The assays were performed on a Dxl 800 fully automated immunoassay analyzer from Beckman Coulter Inc., USA, as a comparative method and on a Jet-iStar 3000 immunoassay analyzer from Zhonghan Shengtai Inc. as an experimental method. Methodological comparison and bias assessment of the results of the two methods for HCG detection were performed. The OLR regression model was used for calculating bias and regression analysis, and Spearman's rank correlation coefficient was used for correlation analysis. The correlation and comparability of the two systems were calculated based on the results of the analysis. RESULTS: A good correlation in HCG results in the range of 5-50,000 U/mL was obtained from the two assay systems (r = 0.998) with the regression equation of y = 1.020x + 12.96. The estimated deviation was within the permissible deviation and acceptable. CONCLUSION: The results of HCG measurement by the two different assay systems were well correlated and comparable.

Carnosic acid alleviates depression-like behaviors on chronic mild stressed mice via PPAR-γ-dependent regulation of ADPN/FGF9 pathway.

RATIONALE: The pathway of adiponectin (ADPN)/fibroblast growth factor 9 (FGF9) was recently thought as a key role in the development of depression. ADPN is crucially regulated by peroxisome proliferator-activated receptor-gamma (PPAR-γ). Natural material carnosic acid (CA) has been applied for therapeutics of mental disorders. OBJECTIVES: To evaluate the antidepressive effect of CA in stress-treated mice and define whether its effects is involved in the regulation of ADPN/FGF9 pathway. METHODS: In vivo study, the levels of ADPN and FGF9 in both serum and hippocampus tissues, the expressions of ADPN receptor 2 (AdipoR2) in hippocampus and PPAR-γ in abdominal adipose, as well as the pathological changes of hippocampus were determined in 28-day period of chronic unpredictable mild stress (CUMS)-induced depression model of male ICR (Institute of Cancer Research) mice or adipo-/- mice. In vitro study, the level of ADPN and the mRNA expressions of both ADPN and PPAR-γ were determined in mouse 3T3-L1 preadipocytes. RESULTS: In vivo study, treatment with CA (50 or 100 mg/kg per day) for 21 days markedly suppressed depressive-like behaviors, the elevating levels of FGF9 and decreasing levels of ADPN in both serum and hippocampus tissues, the downregulating protein and mRNA expressions of AdipoR2 in hippocampus and PPAR-γ in abdominal adipose, as well as the pathological injury of hippocampus induced by CUMS in male ICR mice. The antidepressive effects of CA were markedly attenuated in male CUMS-treated adipo-/- mice. In vitro study, incubation with CA (3-30 µmol/L) for 24 h could concentration-dependently upregulate the mRNA expressions of both PPAR-γ and ADPN as well as increase the level of ADPN. The experiments using PPAR-γ-specific inhibitor GW9662 and transient transfection with mutated PPAR-γ-binding site promotor constructs showed that the activation of PPAR-γ mediated CA-induced ADPN expression in adipocytes. CONCLUSIONS: CA could significantly improve stress-induced depressive disorder, which may be related to regulating the dysfunction of ADPN-FGF9 pathway via activating PPAR-γ in adipocytes.

The correlation between adiponectin and FGF9 in depression disorder.

Adiponectin (ADPN) and fibroblast growth factor 9 (FGF9) has been reported as anti-depressive and pro-depressive factor, respectively. However, it is unknown whether there is directly interaction between ADPN and FGF9 in depression. The present study aims to investigate the correlation between ADPN and FGF9 in depression disorder. Firstly, the decreased level of ADPN and the increased level of FGF9 in plasma of depressive patients compared with non-depressive subjects were observed. Furthermore, these is a significant negative correlation between the ratio of ADPN to FGF9 and the total score of Hamilton Depression Scale in total investigated subjects. The similar changes of ADPN and FGF9 were also observed in elder adiponectin gene knockout (Adipo-/-) mice with an increasing trend to depressive-like behaviors. Secondly, the decreasing level of ADPN and increasing level of FGF9 in plasma and hippocampus tissues were observed in chronic unpredictable mild stress (CUMS)-induced depression in ICR mice with significant depressive-like behaviors and hippocampus damage, which attenuated by injection of recombinant ADPN or FGF9 antibody into lateral ventricle. In Adipo-/- mice, injection of FGF9 antibody into lateral ventricle also attenuated CUMS-induced depressivelike behaviors. The protein expression of FGF receptor 3 (FGFR3), the main receptor of FGF9, was significantly down-regulated in hippocampus tissues of CUMS-treated mice, which could be attenuated by treatment with either recombinant ADPN or anti-FGF9. In summary, the present results suggest that ADPN maybe a key negative regulator of FGF9/FGFR3 in depressive disorder and the dysfunction of ADPN-FGF9 pathway plays a key role in stress-induced depression.

[Association between androgenetic alopecia and metabolic syndrome: a meta-analysis].

OBJECTIVE: To investigate the association between androgenetic alopecia (AGA) and metabolic syndrome (MS). METHODS: Literature on association between AGA and MS up to December 26, 2013 was searched from PubMed, Web of Knowledge, Scopus, Cochrance library, SinoMed, CNKI, Wanfang and VIP databases, and the studies met the eligibility criteria were selected. Meta-analysis was performed by using StataSE 12.0 software to determine the association between AGA and MS. RESULTS: Four case-control studies and 2 cross-sectional studies met the eligibility criteria, including 950 AGA subjects and 3056 control subjects were entered the analysis. Meta-analysis showed that AGA was significantly correlated with MS (OR=2.70, 95%CI: 1.67-4.37, P<0.01). Stratification analysis showed that AGA was significantly correlated with MS in male (OR=2.30, 95%CI: 1.33-3.98, P<0.01) and female subjects (OR=4.61, 95%CI: 1.26-16.94, P<0.05); and AGA was significantly correlated with MS in European (OR=5.29, 95%CI: 2.86-9.80, P<0.01) and Asian subjects (OR=1.92, 95%CI: 1.18-3.10, P<0.01). CONCLUSION: Based on the available data, AGA may be a risk factor for MS, indicating that AGA patients would be a targeting population for screening of metabolic syndrome.

A non-intrusive method for monitoring the degradation of MOSFETs.

Highly reliable embedded systems have been widely applied in the fields of aerospace, nuclear power, high-speed rail, etc., which are related to security and economic development. The reliability of the power supply directly influences the security of the embedded system, and has been the research focus of numerous electronic information and energy studies. The degradation of power modules occupies a dominant position among the key factors affecting the power supply reliability. How to dynamically determine the degradation state and forecast the remaining useful life of working power modules is critical. Therefore, an online non-intrusive method of obtaining the degradation state of MOSFETs based on the Volterra series is proposed. It uses the self-driving signal of MOSFETs as a non-intrusive incentive, and extracts the degradation characteristics of MOSFETs by the frequency-domain kernel of the Volterra series. Experimental results show that the identification achieved by the method agrees well with the theoretical analysis.

Design and implementation of a digital angular rate sensor.

With the aim of detecting the attitude of a rotating carrier, the paper presents a novel, digital angular rate sensor. The sensor consists of micro-sensing elements (gyroscope and accelerometer), signal processing circuit and micro-processor (DSP2812). The sensor has the feature of detecting three angular rates of a rotating carrier at the same time. The key techniques of the sensor, including sensing construction, sensing principles, and signal processing circuit design are presented. The test results show that the sensor can sense rolling, pitch and yaw angular rate at the same time and the measurement error of yaw (or pitch) angular rate and rolling rate of the rotating carrier is less than 0.5%.

[The therapeutic effects of fluid resuscitation in severe sepsis and septic shock].

OBJECTIVE: To evaluate the therapeutic effect of fluid resuscitation on severe sepsis and septic shock. METHODS: Twenty patients with severe sepsis and septic shock were given fluid resuscitation and got the following parameters in the ranges as follow: central venous pressure (CVP) 8 - 12 mm Hg (for ventilation patient: 12 - 15 mm Hg), mean artery pressure (MAP) 65 - 90 mm Hg, mixed venous oxygen saturation (SmvO(2)) > 70%. Hemodynamics, tissue perfusion and vascular endothelial cell function were measured and compared before and after fluid resuscitation. RESULTS: Pulmonary arterial wedge pressure (PAWP), cardiac index (CI), left ventricular stroke work index (LVSWI) and systemic vascular resistance index (SVRI) increased significantly after reached the goal of fluid resuscitation (P < 0.01) whereas pulmonary vascular resistance index (PVRI), lactate level in arterial blood and gastric-to-arterial carbon dioxide partial pressure gap (Pg-aCO(2)) decreased significantly (P < 0.01), and the serum levels of endothelin (ET) and von Willebrand factor (vWF) were also decreased significantly after fluid resuscitation (P < 0.05). CONCLUSIONS: Early goal-directed fluid resuscitation can improve hemodynamics, tissue perfusion and alleviate vascular endothelial cell injury in patients with severe sepsis and septic shock, it is an effective therapy for these patients.