Objective　To explore the factors related to local recurrence after resection of rectal carcinoma and the significance of reoperation. Methods　A retrospective analysis was made on the clinical date of 25 cases who had local recurrence after resection of rectal carcinoma. Results　The primary operation revealed that 19 cases were in Dukes stage B,15 in stage C.8 cases were low-differentiated adenocarcinoma,2 adenocarcinoma and 3 malignant chang of villous adenoma. The distal incision margin from the tunor was <3 cm in 16 cases, >3cm in 9. Radical operation was performed in 12 cases, palliative opration in 9; and non-resection procedure was made in 4. The median survival time in radical operation group was 30 months, in palliative opration group 12 months, and in non-resection group 2.3 months. 5-year survival rate in reopration patients was 21.7%. Conclusions　Local recurrence after resection of rectal carcinoma is closely related to the Duckes' classification, histological type of tumor, and selection of operation.Active surgical intervention is indicated for local recurrence after resection of rectal carcinoma which can prolong the patient's survival time.

Objective To establish a new method for rapid detection of electrolytes based on micro spectrometer and dry reagent.Methods The liquid electrolyte reagent was lyophilized for the preparation of reagentin powder form,which was then sealed into a detector cup of micro spectrometer for later experiment.During determination,the detector cup,in which the specimens and diluents were added to the dry reagent,was put into the detector slot of micro spectrometer,the contents in the detector cup were then well mixed by the magnetic stirring system of micro spectrometer and incubated for 6min with the heating system.Afterwards,the A values of potassium ion,sodium ion and chloride ion were detected respectively at 620nm,405nm and 456nm following the reaction principles of turbidimetry,enzymatic method and chemical method.Based on the findings of those detections mentioned above,the performance of the electrolytic dry reagent was evaluated,and the results were then statistically analyzed.Results The linear range of each parameter could meet the demand for clinical analysis,and the dry reagents had good reaction stability for 90 days after being lyophilized,with the intra-assay coefficient variation(CV) less than 4%,inter-assay CV less than 5%,and the recovery rate from 95% to 105%.No obvious interference was observed in the determination results under the circumstance that the serum TB was less than 290.40?mol/L and the TG was less than 11.20mmol/L.The detection results by this method were well correlated with that of dry chemical analysator VITRO S-250(R≥0.98).Conclusion The method is accurate and reliable in determining the serum electrolytes,and its process is simple process and convenient to carry out.Therefore,it can satisfy the condition for field aid as well as primary care.

ObjectiveTo evaluate the performance of antinuclear antibody (ANA) detection in clinical laboratories.Methods There were 2 external quality assessments (EQA) scheme for nuclear antibody detection.The panel consisting of 5 samples was distributed.Each participant laborotory of the EQA program was required to report the ANA qualitative results,patterns,titers and anti-double strain DNA (dsDNA) antibody,anti-extractable nuclear antigen(ENA) antibody,the percent agreements of which were calculated respectively.ResultsThe number of laboratories performing ANA test with IIF increased from 77.6％ ( 149/192 )in 2006 to 82.2％ (342/416) in 2011,while the number of laboratories performing ANA test with ELISA was in the range of 14.5％ ( 53/365 ) and 16.0％ ( 52/326 ).The positive percent agreements of IIF was over 98％.The positive percent agreement of ELISA were all over 90％.IIF showed more satisfying positive percent agreements than ELISA every year.Over 90％ of the laboratories reported correct results for samples with granular ANA pattern except 0613 and 0624.Over 95％ of the laboratories reported correct results for samples with homogeneous ANA pattern.Two samples with centromere pattern were correctly detected by 88.5％ ( 161/182 ),79.0％ ( 147/186 ) of the laboratories in 2007,while the sample with centromere pattern was correctly detected by 98.4％ (299/304), which indicated an improvement in the detection of centromere pattern.In ANA positive results,the lowest percentage of the laboratories reporting the median result was 36％ (94/261),while the highest percentage was only 85.5％(224/262).The satisfied results of anti-ENA antibody were over 90％.And those of anti-dsDNA antibody was over 85％.ConclusionsIIF is the most common method for ANA screening in clinical laboratories.ELISA is also used in some laboratories.The two methods reported satisfying results in ANA test.The detection of anticentromere antibodies is improved.But the results of ANA titer reported are unsatisfactory. ANA detection in routine practice needs to be improved by standardization.

Objective Anti-RNase virus-like particles containing HCV RNA 5'-UTR were used as positive samples in national external quality assessment ( EQA ) to evaluate the competency of clinical Laboratories for the quantification of HCV RNA and analyze the possible problems of domestic kits. Methods The quality control samples with target values in EQA panels were distributed nationally twice by National Center of Clinical Laboratory (NCCL) to participating laboratories for the quantification of HCV RNA in 2008 and 2009. Each panel consisted of 5 samples. All participants were required to carry out the detection and to return results in expected time. Positive samples were virus-like particles which had been calibrated against the WHO HCV International Standard (NIBSC96/798)and the results of positive samples from participants should be in the range of target value of logarithm ± 0. 5. The 2nd panel in 2008 contained the common HCV genotypes and the 2nd panel in 2009 contained serial diluted samples of genotype 1b. The results of positive samples detected with 3 different lots reagent (21001,21078 and 21097) from the 2nd EQA in 2009 were statistically analyzed using the analysis of variance, then Dunnett'S T3 and Tamhane'S T2 were used if heterogeneity of variance was found. Results There was 390 participating laboratories in 2008 and 428/426 in 2009. The percentages of laboratories within the range of target value of logarithm ± 0. 5 for varied genotypes were different. The percentages of laboratories for 1b were more than 91%, for 2a were 93.7% and 74. 2% ,for6 were 83.3% and 80. 3%. The CVfor the low-level sample was higher than that for the high-level sample in the same year. The numbers of laboratories reporting false-negative samples in 2008and the 2nd in 2009 were 5, 1 and 10 respectively. Statistical differences were found among the results of four quality control serum samples using 3 different reagents( F = 288.23, 324. 79, 291.98 and 261.16,P ＜0. 01 ). Conclusion The competency for detecting low concentration samples and samples with genotype 2a or 6 needs to be improved.

Objective To investigate the application and needs' survey of mobile App health software in the patients with respiratory chronic disease. To make mobile App health software development more targeted and practical in the near future. To provide the foundation for continuous nursing service. Methods A survey research method was adopted in which self-designed questionnaires were administered to 163 patients with respiratory chronic disease from respiratory ward and outpatient clinic. Results Totally 119(73.0%) patients used smartphone, the mean score of experience in using mobile phones was (32.4 ± 14.1), which was in the medium range. There were 80 patients had ever installed and used this kind of App. The frequency of use of mobile App health software was Breathing Exercises App, Healthy Exercise App, Healthy Diet App and Medicine Remind App. The major reason for using of these App was disease prevention, self health care, disease and health monitoring and rehabilitation exercises. There were 120 patients would like to install App health software specific to respiratory chronic disease. They hope the characters of these App were simple operated, practical and without product placement. These App health software should include following function:timely feedback and guidance, providing practical method and help to register. Conclusion Most patients with respiratory chronic disease had the hardware basis and experience basis of using mobile App health software. More targeted and practical mobile App health software for the patients with respiratory chronic diseases should be developed to provide the foundation for continuous nursing service and patient′s self-management.

Objective To evaluate the performance of HCV RNA detection in the first EQA program in 2012 and analyze possible problems in clinical laboratories.Methods The panel consisting of 5 samples was distributed to 927 laboratories.Each panel contains one negative sample and 4 positive samples,which were virus-like particles calibrated by international standard.The pere ent agreements of all the laboratories for qualitative and quantitative results were calculated.Genomic means (GM) and standard deviations (s) of all laboratories and each reagent were calculated.The overall GM and the GM of each reagent were compared with expected results and correlation curves were calculated.Results The percent agreements of sample 1211,1212,1213,1214 for qualitative results wcrc 99.5％ (403/405),98.5％ (400/406),100.0％ (405/405),100.0％ (406/406),respectively.The percent agreement of the negative sample was 99％ (401/405).The percent agreements of sample 1211,1212 and 1213 for quantitive results were similar,which were 93.8％ (549/585),92.3 ％ (541/586) and 94.5％ (554/586).However,the agreement of sample 1214 was only 87.7％ (514/586)and the agreement of sample 1214 for reagent A was 67.2％ (92/137).The overall GM agreed with expected results,while GMs of reagent C,E and G deviated from expected results.GMs of sample 1211,1212,1213 and 1214 reported by labs using reagent C were 4.22,3.56,5.16 and 5.90,respectively.GMs of sample 1211,1212,1213 and 1214 reported by labs using reagent E were 4.52,3.78,5.55 and 6.29,respectively.GMs of sample 1211,1212,1213 and 1214 reported by labs using reagent G were 4.83,4.36,5.72 and 6.56,respectively.Conclusions The overall results of HCV RNA qualitative and quantitative detection are satisfactory.However,some problems still exist,such as deviation of GM of some reagents,the interassay variability,systematic deviation and accidental deviation,which show that the quality of reagents should be improved.

Objective To evaluate the agreement of antinuclear antibody (ANA) titer reported in clinical laboratories and analyze possible problems in clinical laboratories.Methods Experiment survey.The panel consisting of 5 samples was distributed to 533 laboratories.Each panel contains one negative sample and 4 positive samples,which were from individuals of autoimmune disease.ANA titer system was divided into traditional titer system with two-fold dilution and titer system with 3.2 times dilution.Clinical laboratories were required to report the ANA titers and initial screening dilution according to the standard used in routine work.Results were expressed as median titers and range for acceptable performance.As to titer system with two-fold dilution,acceptable performance on proficiency testing was defined by a result equal to median titer ± two two-fold dilutions.While as to titer system with 3.2 times dilution,acceptable performance on proficiency testing was defined by a result equal to median titer ± 3.2 times dilutions.The laboratories percentages with acceptable performance were calculated to evaluate their agreements.Results 412 laboratories reported ANA titer results,of which 11.9％ (49/412)reported results with two-fold dilution titer system,88.1％ (363/412)reported results with 3.2 times dilution titer system.The median titers of sample 1211,1212,1213 and 1215 reported with two-fold titer system were 1 ∶ 640,1∶ 320,＞ 1 ∶ 1280 and1∶ 160,respectively.The agreement within the median ANA titer reported with two-fold dilution titer system ranged from 24.5％ (12/49) to 57.1％ (28/49) and the lowest percentage of the results within the acceptable limits was 87.8％ (43/49).The median titers of sample 1211,1212,1213 and 1215 reported with 3.2 times dilution titer system were 1 ∶ 1000,1∶ 1000,＞ 1 ∶ 3200 and 1 ∶ 320,respectively.The agreement within the median ANA titer reported with 3.2 times dilution titer system ranged from 63.3％ (31/49)to 83.7％ (41/49).The lowest percentage of the results within the acceptable limits was 98.0％ (48/49).Conclusions The results of ANA titer reported are unsatisfactory.Standardization for reagent,microscopy,procedure and result interpretation is necessary to improve the agreement of ANA titer report in different laboratories.

Objective To investigate the potential role of human cytomegalovirus lower matrix phosphoprotein 65 (HCMV pp65) in murine systemic lupus erythematosus (SLE).Methods The prokaryotic vector pET-28b and eukaryotic vector pcDNA 3.0 were constructed to express the HCMV pp65 protein.All the C57BL/6 mice were inoculated with pp65 eukaryotic vector intramuscularly five times at 2-week intervals and then were bled via the retro-orbital vein.Subsequently,indirect ELISA was used to evaluate the concentration of anti-pp65 IgG,anti-dsDNA and ANA.At the same time,IL-1 b,IL-6,and TNF-α were determined by competitive ELISA.Results The early onset of autoantibodies and an overexpression of IL-6 were observed in immunized male C57BL/6 mice.Conclusion HCMV pp65 triggers the deregulation of humoral immunity in C57BL/6 mice,which indicates that the immune responses induced by HCMV pp65 may be involved in the development of SLE.

Objective To evaluate the clinical value of the combination of S-shaped urethral dilator and nephro-scope for the treatment of male urethral stricture disease. Methods Guidewires were inserted into bladder through the nephroscope under direct vision. The urethral dilation with S-shaped urethral dilator was carried out by nephroscope in 41 male patients. All catheters were located across the strictures and remained for 4-6 weeks. The regular follow-up was done on all cases to assess the clinical effect on urine flow. Results All surgeries were successful without serious complications. The mean operative time was (40.16 ± 5.78) min. The voiding symptoms were significantly improved after catheter removal compared with those of preoperation in all cases. Patients were followed up after surgery and were regularly urethral dilation at least 6 weeks. The mean follow-up time was (34.75±6.42) weeks.There were incontinence, diminished sexual function and other complications after operation in all cases. Conclusion Nephroscope combined with S-shaped urethral dilator for the treatment of male urethral stricture disease is feasible, minimally invasive and safe, which is worthy of recommendation.

【Objective】The chemical constituents of Viscum liquidambaricolum Hayata.were studied to screen the constituents with antitumor activity.【Methods】Chromatography was used for the isolation and purification of chemical constituents of Viscum liquidambaricolum Hayata..And their structures were identified on the basis of spectroscopic evidences and physiochemical properties.Meanwhile,the in-vitro antitumor activities of two kinds of triterpenoids and one kind of sitosterol were investigated.【Results】Four compounds were isolated from Viscum liquidambaricolum Hayata.and their structures were identified as genkwanin(1),?-amyrin acetate(2),erythrodiol(3) and ?-sitosterol(4).Compounds 2 and 3 had an inhibitory effect on mice sarcoma 180(S180),Ehrlich ascites carcinoma(EAC) and ascties hepatoma(HeAP),and compound 4 had an inhibitory effect on mice S180 and EAC,their half-inhibitory concentrations being less than 400??g/mL.【Conclusion】Compounds 1～4 are isolated from Viscum liquidambaricolum Hayata.for the first time,and compound 1 is isolated from Loranthaceae for the first time.Triterpenoids and steroids from Viscum liquidambaricolum Hayata.exert certain antitumor activity.