Objective To calculate the measurement uncertainty of clinical chemical analytes according to the internal quality control (IQC)and external quality assessment (EQA)data in clinical laboratory.Methods Collected the IQC data from January to June 2013 and EQA data between 2012~2014 of clinical chemistry in clinical laboratory.Calculated the measure-ment uncertainty and extended uncertainty according to the Nordtest criteria.Results It was effective to evaluate the uncer-tainty using IQC and EQA data.ALP ranked the highest extended uncertainty and Na+ ranked the lowest uncertainty.The range of uncertainty varies greatly,electrolyte 4.27~18.16,enzyme 8.12~24.88,small molecular 4.88~12.44,protein and lipids 4.78~13.1.Conclusion The evaluation of clinical chemistry uncertainty by IQC and EQA data is simple and practi-cal,which is beneficial for assurancing the measurement accuracy.

Medical endoscope capsule is described from its construction principle and drive system.The scheme and function of the drive system,especially the driving velocity and the direction control for that based on FPGA,are introduced in detail.Experiments indicate that the micro-drive system,with a linear speed ranging from 0 to 10 mm/s,can move forward and backward,and turn left and right discretionarily.The availability of programmable logic device makes the system reliable and flexible.

Objective To explore the possibility and reliability of mutual recognition of renal indexs among 20 clinical labora-tories entitled with state key clinical laboratory,and to supply reference for future national mutual recognition of laboratory examination results.Methods Determined the concentrations of TP,ALB,TC,TG and Roche multiple calibrators and sub-mitted the results.The results were analyzed for robust Z score,percentage difference after calibration,bias at medical deci-sion level to observe the possibility and reliability.Results The bias of TG was out of the least allowable bias,thus they were not appropriate to mutual recognition.Conclusion It remains immature in the mutual recognition of lipids’determina-tions and much work needs to be done in field of internal quality control of the laboratory.

Objective To evaluate the efficacy of hypofractionated 3DCRT for primary liver cancer(PLC) with portal vein tumor thrombosis(PVTT).Methods Between April 1999 and August 2003,34 PLC patients with PVTT received hypofractionated 3DCRT.The severity of hepatic cirrhosis was 23 in Child-Pugh gradeA and 11 gradeB.The median value of GTV was 773?cm~3(105-2097?cm~3).The radiotherapy regimen consisted of 38-63?Gy in 7-15 fractions with 4-8?Gy per fraction(median value 5?Gy),the treatment was delivered 3 times per week during every other day.Results Having response rate(CR+PR) of 76%(26/34),the overall 1-,2-,and 3-year survival rate at was 36%,19% and 13%,respectively.Conclusion Hypofractionated three-dimensional conformal radiotherapy is effective for primary liver cancer with portal vein tumor thrombosis.

Objective To study 18F-deoxyglueose positron emission tomography computed tomo graphy(18 FDG PET-CT) in the diagnosis of cervical lymph node(LN) metastasis from rabbit nasopharyngeal VX2 carcinoma.Methods Nasopharyngeal VX2 carcinoma model using 30 rabbits was established. 18 FDG PET-CT,MRI and pathological diagnosis were performed and compared.ResultsFifty-three cervi cal LNs were picked up from resected specimens of 30 rabbits with nasopharyngeal VX2 carcinoma.There were 42 pathologically confirmed positive LNs.Positivity rate was significantly correlated with the volume and the shortest diameter of the LNs (r = 9.18,P =0.007 ; r = 2.77,P = 0.008).The diagnostic sensitivity of PET-CT was 96% (24/25) and 29% (5/17) for LNs with volume >0.5 cm3 and ≤0.5 cm3 ,83% (25/30) and 33% (4/12) for LNs with the shortest diameter ≥0.5 cm and < 0.5 cm,respectively.The diagnostic sensitivity,specificity and accuracy of PET-CT was 69% (29/42) ,100% (11/11) and 95% (40/42) ,com paring with 60% (25/42) ,91% (10/11) and 83% (35/42) of MRl,respectively.The volume measured by PET-CT images was not significantly different from the pathologically measured volume (t =-1.23,P = 0.233) ,while the volume measured by MRI was significantly different from the pathologically measured vol ume (t =-3.99,P = 0.001).Conclusions The sensitivity,specificity and accuracy of PET-CT are better than those of MRl,especially for the cervical lymph nodes with volume >0.5 cm3 or the shortest diameter ≤ 0.5 cm.PET-CT also can be used to detect the smaller metastatic lymph nodes,though the false negative rate is higher.

Objective: To understand the incidence and mortality of colorectal cancer in tumor registration areas of Zhejiang Province,and to provide reference for prevention and control strategies for colorectal cancer. Methods: The colorectal cancer data was retrieved from fourteen tumor registries in Zhejiang Province were collected,the incidence rate and mortality rate were calculated and standardized according to the Chinese standard population in 2010 and Segi's world population in 2000. The incidence and mortality of colorectal cancer in different sex,age group and region were analyzed. Results: The crude incidence rate of colorectal cancer from 2010 to 2014 was 35.82/100 000（20 983 cases）. The standardized incidence rate by Chinese and world standard population were 20.80/100 000 and 23.01/100 000. The crude mortality rate of colorectal cancer was 15.25/100 000 （8 934 cases）. The standardized mortality rate by Chinese and world standard population were 8.01/100 000 and 9.39/100 000. The ratio of mortality to incidence was 0.43:1. From 2010 to 2014,the incidence and mortality rates of colorectal cancer were stable（P>0.05）. The incidence rates of colorectal cancer in urban and rural residents were 37.69/100 000 and 31.14/100 000,and the mortality rates were 15.73/100 000 and 14.05/100 000. The incidence rates of colorectal cancer in males and females were 41.53/100 000 and 30.11/100 000,and the mortality rates were 17.74/100 000 and 12.76/100 000. The incidence and mortality rates of colorectal cancer both increased with age. The incidence rate increased significantly in people after 40 years old,and peaked with 187.35/100 000 in people aged 80-84 years. The morbidity rate peaked with 171.27/100 000 in people aged 85 years or over. Conclusion The incidence and mortality of colorectal cancer in Zhejiang Province were stable,but the incidence was higher than the national average level. The incidence of colorectal cancer in people aged over 40 years increased significantly.

Objective To observe the clinical efficacy and its mechanism of Tongluoyuzufang Ⅰ in patients with diabetic foot (DF).Methods A total of 60 cases with DF was randomly divided into experimental group and control group,30 cases in each group.All patients were given insulin and/or hypoglycemic drugs and other Western medicine comprehensive treatment to control blood sugar steadily.The control group received methylcobalamin treatment,and the experimental group received Tongluoyuzufang Ⅰ therapy treatment based on the methylcobalamin treatment.Both groups were treated for 4 weeks for a course of treatment.The clinical efficacy,ankle-brachial index,nerve conduction velocity,hemorheology,blood lipid,serum cytokines and adverse reactions before and after treatment were compared after 3 courses of treatment.Results After treatment,the total effective rate was 90.0 ％ in the observation group,higher than that in the control group(x2 =5.963,P＜0.05).After treatment,the ankle-brachial index,nerve conduction velocity,hemorheology and blood lipid level in both groups were significantly improved(P＜0.05).After treatment,serum levels of tumor necrosis factor-α(TNF-α) and vascular endothelial growth factor(VEGF) in both groups were significantly decreased,while the levels of anti-thrombin Ⅲ (AT-Ⅲ) has increased(P＜0.05).The improvement of the indexes in the observation group was better than that in the control group(P＜0.05).There were no serious adverse events during treatment.Conclusion Tongluoyuzufang Ⅰ can significantly improve limb ischemia and nerve conduction function in patient with DF.

Objective To evaluate the effect of mild hypothermia on inositol-requiring enzyme 1 (IRE1) signaling pathway during myocardial injury after cardiac arrest and resuscitation in swine.Methods Twenty-one healthy male white swine,weighing 33-41 kg,were divided into 3 groups using a random number table method:sham operation group (group S,n =5),cardiac arrest-cardiopulmonary resuscitation group (group CA-CPR,n=8),and mild hypothermia group (group MH,n=8).The model of cardiac arrest and resuscitation was established based on the previously reported method.The catheters placed in the left femoral artery and right internal jugular vein were connected to the PiCCO Monitor system,and another pacing catheter was advanced from the right external jugular vein into the right ventricle.Ventricular fibrillation was induced by using a 1 mA alternating current through the pacing catheter.Once ventricular fibrillation was successfully induced,mechanical ventilation was discontinued for 8 min,and then cardiopulmonary resuscitation was initiated.Epinephrine 20 μg/kg was administered at 2.5 min of resuscitation followed by repetition every 3 min.Defibrillation was delivered at 5 min of resuscitation,and then spontaneous circulation was evaluated.If return of spontaneous circulation was not achieved,cardiopulmonary resuscitation was immediately resumed for 2 min and then defibrillation was delivered again.Mechanical ventilation was continued for 30 h after successful resuscitation.Animals in group S only underwent surgical preparation without experiencing cardiac arrest and resuscitation.At 5 min after successful resuscitation,body temperature was cooled down to 33 ℃ by using a cooling blanket,and then maintained at this level until 24 h after resuscitation,followed by 5 h of re-warming at a rate of 1 ℃/h in group MH.The temperature was maintained at 37.5-38.5 ℃ with the aid of surface cooling blanket in the other two groups.At 1,6,12,24 and 30 h after resuscitation (T1-5),the values of stroke volume (SV) and global ejection fraction (GEF) were recorded,and meanwhile 2 ml of blood samples was obtained via the femoral vein to measure the concentration of serum cardiac troponin Ⅰ (cTnI) (by enzyme-linked immunosorbent assay) and activity of serum creatine kinase-MB (CK-MB) (by immunosuppression).The swine were sacrificed at 30 h after resuscitation,and then myocardial specimens from the left ventricle were obtained for determination of the expression of caspase-3 (by immunohistochemistry),cell apoptosis (by TUNEL),and expression of IRE1 and casepase-12 (by Western blot).Apoptosis index was calculated.Results Compared with group S,SV and GEF were significantly decreased and the serum CK-MB activity was increased at T1-5,the concentration of serum cTnI was increased at T2-5,the expression of IRE1,caspase-12 and caspase-3 in myocardium was up-regulated,and apoptosis index was increased in CA-CPR and MH groups (P＜0.05).Compared with group CA-CPR,the SV and GEF were significantly increased and the concentration of serum cTnI was decreased at T2-5,the activity of serum CK-MB was decreased at T3-5,the expression of IRE1,caspase-12 and caspase-3 in myocardium was down-regulated,and apoptosis index was decreased in group MH (P＜0.05).Conclusion The mechanism by which mild hypothermia mitigates myocardial injury after cardiac arrest and resuscitation may be related to inhibiting IRE1 signaling pathway in swine.