1.Establishment of FMEA risk management procedures for blood coagulation tests in clinical laboratories
Guanghua NIU ; Yujie GAO ; Baihui CUI
Chinese Journal of Laboratory Medicine 2016;(1):13-17
Definiting the workflow and key link of the risk management in medical laboratory by FMEA.Identifying risk factors of the workflow and key link of blood coagulation test by the criteria for laboratory accreditation , such as ISO15189 recognition criteria and CAP laboratory accreditation inspection . Through the evaluation of the blood coagulation test , effective corrective actions and examining performance data periodically , the quality of the blood coagulation test can be improved continuously.
2.A scoring research on application of kinetic house tree person test on college students
Kaixuan GONG ; Baihui GAO ; Hao LIU ; Xumei WANG
Chinese Journal of Behavioral Medicine and Brain Science 2015;24(1):80-83
Objective The kinetic house tree person test has many advantages compare to traditional psychometrics,but also some limits such as scoring subjectively and ambiguous.This research attempted to develop a reliable scoring system.That can distinguish college students with emotional disorder from normal college students by employing kinetic house tree person (KHTP) drawings.Methods 143 College students were invited to partake in the research KHTP drawings,the Beck Depression Inventory Ⅱ (BDI-Ⅱ),the Beck Anxiety Inventory (BAI) were administered to the subjects.Undergraduates with a BDI score of ≥ 14 or a BAI score of ≥8 were classified as the clinical group,while those with a BDI-Ⅱ and a BAI score are minimal were classified as the controis.The researcher and an expert studied and analyzed the KHTP drawings Manual,filtrate 35 indicators correlate to emotional disorder,and then researcher make standard for evaluation of every indicator.The standard for evaluation were then revised by the researcher and another rater then finalized by the expert.Results The results showed that 35 indicators correlate to emotional disorder were found,and there were significant differences in facial expressions (x2 =19.109,P<0.01) and actions (x2 =13.341,P< 0.01) between clinical group and normal group.The Pearson coefficient of concordance showed that the inter-rater reliability and inner-rater reliability was consistent(r=0.932,r=0.913,P<0.01).The t-test was employed to verify the discriminant validity between the clinical and control groups.The result showed that a significant discriminant validity was found with the scoring system developed in this research(t=14.890,P<0.01).Conclusion The scoring system developed from this study has good inter-rater reliability,inner-rater reliability and discriminant validity.
3.Diagnostic value of serum anti-phospholipase A2 receptor antibodies (PLA2R) in idiopathic membranous nephropathy
Guanghua NIU ; Yujie GAO ; Baishan WANG ; Lina WU ; Hongyang GUO ; Baihui CUI ; Cheng ZHANG ; He GUO
Chinese Journal of Laboratory Medicine 2015;(9):595-599
Objective To investigate the diagnostic value and monitoring application of anti-phospholipase A2 receptor antibodies ( PLA2R ) in patients with idiopathic membranous nephropathy ( IMN) .Methods A retrospective study was used .48 patients were diagnosed as idiopathic membranous nephropathy by puncturing kidney from January of 2013 to June of 2014 in the Hospital of Liaoning Traditional Chinese Medical University and Shengjing Hospital of China Medical University were included. 43 patients were diagnosed as non-idiopathic membranous nephropathy ( NIMN ).35 healthy volunteers were selected as control groups.Serum PLA2R were detected by indirect immunofluorescence.The intensity of antibodies fluorescence and the level of urine protein in 24 hours(24 h PRO) ,serum UREA ,serum CYSC, serum UA,GFR were compared in each groups.Measurement data was shown as mean ±standard deviation;Count data was shown as frequency or composition, t test andχ2 test were used as statistical method.Results (1) Among 48 cases with IMN,37 cases showed positive PLA2R (positive rate 77.08%).All of cases were negative in NIMN group.The sensitivity and the specificity of serum PLA2R were 77.08%and 100%.(2) Compared with control groups, the levels of UREA, CYSC and UA were found statistically significant differences in patients with IMN ( P <0.05 ) .( The levels of UREA in control groups and IMN groups respectively:4.12 ±1.25,6.02 ±2.28, t =4.446,P=0.00;UA:262 ±49,331 ±112,t =2.577,P =0.017;CYSC:0.78 ±0.21,1.16 ±0.27,t=4.63,P=0.00.) Compared with control groups, the levels of main items in patients with NIMN had statistically significant differences (P<0.05).(The levels of UREA in control groups and Allergic purpura nephropathy subgroups respectively:4.12 ±1.25,5.43 ±1.84,t=3.606,P=0.000 2;UA:262 ±49, 299 ±51, t=1.050,P=0.03;CYSC:0.78 ±0.21, 1.06 ±0.31, t=1.672,P=0.02.The levels of UREA in control groups and lupus nephropathy subgroups respectively:4.12 ±1.25, 5.90 ±2.20,t=4.225,P=0.00;UA:262 ±49, 342 ±92,t=2.409,P=0.026;CYSC:0.78 ± 0.21,0.92 ±0.24, t =1.674, P =0.00.The levels of UREA in control groups and IgA nephropathy subgroups respectively:4.12 ±1.25,6.69 ±2.87,t=4.756,P=0.00;UA:262 ±49,361 ±52,t=4.598, P=0.00;CYSC:0.78 ±0.21, 1.30 ±0.36,t=4.752,P=0.00.The levels of UREA in control groups and tumor associated nephropathy subgroups respectively: 4.12 ±1.25, 5.02 ±1.70, t =3.626, P =0.002;UA:262 ±49, 289 ±92,t=0.05,P=0.01;CYSC:0.78 ±0.21, 0.98 ±0.20,t=1.1,P=0.01.) There was no statistically significant differences between IMN group and NIMN ( P >0.05 ) . ( 3 ) Positive correlation were found between 24 h PRO(r=0.877,P=0.00),serum UA (r=0.766,P=0.00 ) with the level of PLA2R antibodies fluorescence intensity.( 4 ) There were no correlation between serum PLA2R antibody with IMN pathology aging (r=0.087,0.194,0.182;P=0.598,0.399,0.667).PLA2R positive rate(Ⅰstage:37.50%,Ⅱstage:84.85%, Ⅲstage 85.71%) may increases with the increasing of illness severity.Conclusion Serum PLA2R antibody would be a new laboratory diagnosis standard in patients with IMN.(Chin J Lab Med, 2015, 38:595-599 ) Objective To investigate the diagnostic value and monitoring application of anti-phospholipase A2 receptor antibodies ( PLA2R ) in patients with idiopathic membranous nephropathy ( IMN) .Methods A retrospective study was used .48 patients were diagnosed as idiopathic membranous nephropathy by puncturing kidney from January of 2013 to June of 2014 in the Hospital of Liaoning Traditional Chinese Medical University and Shengjing Hospital of China Medical University were included. 43 patients were diagnosed as non-idiopathic membranous nephropathy ( NIMN ).35 healthy volunteers were selected as control groups.Serum PLA2R were detected by indirect immunofluorescence.The intensity of antibodies fluorescence and the level of urine protein in 24 hours(24 h PRO) ,serum UREA ,serum CYSC, serum UA,GFR were compared in each groups.Measurement data was shown as mean ±standard deviation;Count data was shown as frequency or composition, t test andχ2 test were used as statistical method.Results (1) Among 48 cases with IMN,37 cases showed positive PLA2R (positive rate 77.08%).All of cases were negative in NIMN group.The sensitivity and the specificity of serum PLA2R were 77.08%and 100%.(2) Compared with control groups, the levels of UREA, CYSC and UA were found statistically significant differences in patients with IMN ( P <0.05 ) .( The levels of UREA in control groups and IMN groups respectively:4.12 ±1.25,6.02 ±2.28, t =4.446,P=0.00;UA:262 ±49,331 ±112,t =2.577,P =0.017;CYSC:0.78 ±0.21,1.16 ±0.27,t=4.63,P=0.00.) Compared with control groups, the levels of main items in patients with NIMN had statistically significant differences (P<0.05).(The levels of UREA in control groups and Allergic purpura nephropathy subgroups respectively:4.12 ±1.25,5.43 ±1.84,t=3.606,P=0.000 2;UA:262 ±49, 299 ±51, t=1.050,P=0.03;CYSC:0.78 ±0.21, 1.06 ±0.31, t=1.672,P=0.02.The levels of UREA in control groups and lupus nephropathy subgroups respectively:4.12 ±1.25, 5.90 ±2.20,t=4.225,P=0.00;UA:262 ±49, 342 ±92,t=2.409,P=0.026;CYSC:0.78 ± 0.21,0.92 ±0.24, t =1.674, P =0.00.The levels of UREA in control groups and IgA nephropathy subgroups respectively:4.12 ±1.25,6.69 ±2.87,t=4.756,P=0.00;UA:262 ±49,361 ±52,t=4.598, P=0.00;CYSC:0.78 ±0.21, 1.30 ±0.36,t=4.752,P=0.00.The levels of UREA in control groups and tumor associated nephropathy subgroups respectively: 4.12 ±1.25, 5.02 ±1.70, t =3.626, P =0.002;UA:262 ±49, 289 ±92,t=0.05,P=0.01;CYSC:0.78 ±0.21, 0.98 ±0.20,t=1.1,P=0.01.) There was no statistically significant differences between IMN group and NIMN ( P >0.05 ) . ( 3 ) Positive correlation were found between 24 h PRO(r=0.877,P=0.00),serum UA (r=0.766,P=0.00 ) with the level of PLA2R antibodies fluorescence intensity.( 4 ) There were no correlation between serum PLA2R antibody with IMN pathology aging (r=0.087,0.194,0.182;P=0.598,0.399,0.667).PLA2R positive rate(Ⅰstage:37.50%,Ⅱstage:84.85%, Ⅲstage 85.71%) may increases with the increasing of illness severity.Conclusion Serum PLA2R antibody would be a new laboratory diagnosis standard in patients with IMN.