Objective To evaluate the clinical outcomes of the reformed microlumbar discectomy preserving partial ligamentum flavum to prevent lumbar spinal instability and .scar tissue oppression and adhesion after operation. Methods A prospective, randomized, controlled clinical study was conducted.The patients with unilateral lumbar disc herniation were randomly divided into two groups. The control group (41 cases) underwent classic mien)lumbar disceetomy,.and the test group (44 cases) underwent the same procedure but with a curved incision on the lumbo-dorsa fascia and with partial preservation of the ligamentum flavum. Visual analog scale (VAS) scores and Oswestry scale scores were used to appraise the outcomes. Results Chnieal parameters were significantly improved after the operation in two groups. In the test group the postoperative VAS scores showed a less intensity of pain after the operation than that in the control group, and this superiority disappeared 1 year after the operation. After the operation, the VAS scores in the test group and contnd group were (1.8±0.6) and (3.8±1.3) scores at 3 days (P <0.05), (1.3±0.6) and (3.5±2.1) scores at 12 weeks (P<0.05), and (1.9±0.6) and (2.8±1.7) scores at 1 year (P>0.05) respectively. After the operation, the Oswestry scale scores in the test group and control group were (18.2±6.6) and (34.4±11.8) scores at 12 weeks (P <0.05), (12.0±9.2) and (22.6±10.0) scores at 1 year (P<0.05) respectively. In both groups, there was no patient who had recurrence of intervertebral disc hernia and reoperation. Conclusions Minimally invasive discectomy has satisfactory clinical outcomes,however, with partial preserved ligamentum flavum shows a less intensity pain and a better lumbar function state. Preserving the ligamentum flavum is helpful to prevent the fibrosis-related complication and to preserve the stabihty of the spine.

In recent years , fungal biofilms related infection have become an increasingly important clinical problem .Many clinically important fungi can form biofilms , including:Candida albicans , Cryptococcus neoformans , Rhodotorula species , Aspergillus fumigatus, Malassezia pachydermatis, Histoplasma capsulatum.Many chronic persistent infections are associated with the fungal bio-film formation.The developmental phases of fungal biofilms are complicated , including adhesion, colonisation, maturation and dispers-al, which are governed by many genes .This review discusses clinical impact of biofilm formation of the common human pathogenic fun -gi, biofilm structure and the molecular mechanisms during the biofilm formation process .

Objective To analyze laboratory turnaround time (TAT) and find effective ways to shorten TAT.Methods Data associated with cardiac panel (CK,cTnI and Mb) were collected in 2011 including 19 906 outpatient data and 22 973 inpatient data.The medians and the average medians of the quality indicators on TAT were calculated and the results were transformed to the Six Sigma scale to estimate the degree of control over related process.Processes were considered well controlled when σ ≥4.Based on the results of data analysis,an improvement plan was decided by laboratory quality management meeting and clinical communication meeting.The effect of the improvement plan was evaluated through 2011-2012 satisfaction surveys of outpatients and clinicians.Results The average median of overtime reports for outpatient from specimen collection to reception was 2.78％ (3.5σ),and 17.82％ (2.5σ) for inpatients.The average median of overtime reports for outpatient from specimen reception to result reporting was 3.39％ (3.4σ),and 2.96％ (3.4σ) for inpatients.The average median of overtime reports for outpatient from specimen collection to result reporting was 3.93％ (3.3σ),and 12.18％ (2.7σ) for inpatient.The results of TAT satisfaction surveys for outpatients from 2011 to 2012 were similar,which were 78％ in 2011 and 79％ in 2012; the results for clinicians showed an increase from 80％ in 2011 to 90％ in 2012,including an increase from 75％ to 79％ for very satisfaction choice.Conclusions Outside the laboratory TAT is a key step in sickroom patients delay TAT.The implementation for ten improvement suggestions enabled to shorten TAT effectively.

Mesenchymal stem cells (MSCs) are a population of multipotent cells that can proliferate and differentiate into marrow and non-marrow cell types, such as adipocytes, chondrocytes, myocytes, and so on. In recent years, many researchers have studied whether MSCs are capable of differentiation into neurons in vivo and ex vivo. The result that MSCs-derived neurons express NSE and NF, but don't express GFAP suggests MSCs can differentiate into neurons, some researchers have achieved success in promoting functional recovery in Pakinsons and transactional spinal cord injury rat models by use of MSCs-derived neurons. Therefore, MSCs-derived neurons will play an important role in the therapy for a variety of diseases of the nervous system. [

Objective To construct quality control materials for chlamydia trachomatis (CT) polymerase chain reaction detection and evaluate the stability of the material.Methods The reference regarding the target sequence for CT PCR detection has been reviewed.The ovedap extension technique and molecular cloning techniques were used to construct a recombinant lasmid.Then the recombinant plasmid pTARGETTM-CT was transfected into a HTB-SiHa cells.The cuhured epithelia cells,vere collected as quality control material.Then we evaluated the stability of this material with domestic kits for CT PCR detection.The stability in different conditions were summarized and evaluated.The EQA samples for CT test survey ere prepared from the above prepared cells and distributed to the EQA participants nationwidely.Results Five fragments from CT(178-610),(1219-1993),(2471-3260),(5239-5864),(6722-7499) were cloned into pTARGET TM.The recombinant plasmid was transfected into mammalian cells as a final form for the quality control materials.Real-time PCR analysis howed the original material was positive with domestic chlamydia trachomatis kit(3.21×108 copies/ml).A Series of dilution resulted in the decreased result .The stability testing indicated the quality control materials were stable at least for one month when stored at 4℃,room temperate or 37℃.Conclusions We used several kinds of molecular iology methods such as ovedap PCR and enzyrnatie digest to construct a recombinant plasmid which contained several fragments.The quality control materials for chlamydia trachomatis PCR detection was developed successfully.

The laboratory accreditation plan is an effective way to realize the standardization of medical laboratories.The test method validation is required by ISO 15189 guideline and CAP checklists.However,after CBC analyzers and coagulation analyzers are repaired,no solution for the validation is put forward.

Objective To assess the levels of glucose-6-phosphate isomerase(GPI) mRNA in peripheral blood monocytes and serum GPI levels in patients with rheumatoid arthritis, and analyze the association of serum GPI with MCV antibody, CCP antibody and RF of RA. Methods Fluorogenic quantitative real-time polymerase chain reaction (FQ-RT-PCR) was used to examine mRNA expression on peripheral blood monocytes in 60 RA patients (28 case in active stage,32 cases in stable stage) ,30 patients with other rheumatic diseases, and 30 healthy controls. ELISA was used to detect the levels of serum GPI, anti-MCV antibodies, anti-CCP antibodies and RF in each group. Results The levels of GPI mRNA in RA group [△Ct=4.21 (3.04-7.23)] were significantly higher than those in patients with other rheumatic diseases [△Ct=8.42 (5.16-9.98),P<0.01] and healthy controls [△Ct=8.66 (4.90-10.01), P<0.01]. There were statistically significant differences of GPI mRNA levels between active RA [△Ct=3.78 (1.28-6.09)] and inactive RA[△Ct =5.88(3.23-8.94),H=11.760,P<0.01)]. The RA group serum GPI levels [3.02 (2.02-8.39) mg/L] were higher than those of other rheumatic diseases [0.20 (0.11-0.32) mg/L] and healthy controls [0.18(0.08-0.30) mg/L]. There were significant differences of serum GPI levels between active RA group [4.84(2.81-10.38) mg/L] and inactive RA group[2.12 (1.26-4.34) mg/L] (H=9.830, P<0.01). The sensitivities of GPI, anti-MCV and anti-CCP were 68% (41/60) ,57% (34/60),58% (35/60), respectively and specificities were 95% (57/60), 92% (55/60) and 93% (56/60), respectively. Conclusions The high expression of GPI mRNA in RA patients shows that it may play a pathological role in the development of RA, and it may be correlated with the activity of RA. It may be a valuable diagnostic parameter for RA, because of its high sensitivity and specificity.

Objective Candidas rank as the second factor of deep fungal infection .This study aimed to investigate the rela-tionship between Candidas and melanin by screening clinically isolated melanin -producing Candidas . Methods We incubated 360 strains of clinically isolated Candidas with caffeic acid , DOPA agar , and minimal medium at a temperature of 35℃, with Cryptococcus neoformans as the positive control .We observed the changes in the culture media using transmission electron microscopy (TEM) and electron spin resonance ( ESR) spectroscopy . Results Cryptococcus neoforman produced pigmentation in all the three types of medi -um.At 5 days, a standard strain of Candida albicans SC 5314 turned dark brown in the DOPA agar and minimal medium and , at 10 days, 12 and 15 of the 360 Candida strains turned dark brown in the DOPA agar and minimal medium , respectively, which were not shown to be melanin by TEM and ESR spectroscopy . Conclusion Culture media are not reliable enough for the identification of mel-anin-producing Candidas , and the observations need to be further verified by TEM and ESR spectroscopy .

Objective To establish a method for the determination of serum potassium using isotope dilution inductively coupled plasma mass spectrometry.Methods Frozen human serum pools of different potassium concentrations were prepared from healthy donors of Chao-yang Hospital laboratory in 2010 Serum samples were diluted with 1％ HNO3 supplemented with 41K spike and isotope ratio was measured after selection and optimization of ICP-MS analysis conditions.Serum 39K concentrations were calculated by interpolation method.3 different serum samples were used to evaluate the precision of the method.Standard Reference Material 909b Ⅰ and Ⅱ of National Institute of Standards and Technology were used to evaluate the accuracy.The recovery was evaluated through 2 serum samples added standard material for potassium,uncertainty was calculated.Results The analytical precision of serum potassium measurement was 0.14％ to 0.11％.The results of SRM909b Ⅰ and Ⅱ gave the coefficients of variation (CVs) of 0.39％ to 0.32％.Data was consistent with the certified value and the CV was + 0.12％ and + 0.49％ respectively.The recovery was 99.68％ to 100.12％ for 2 different serum samples.Conclusions ID-ICP-MS method was successfully established to measure the serum potassium concerntration precisely and accurately,it is an ideal method for the accurate determination of inorganic elements.

Risk management is derived from industry.In recent years,risk management is introduced by many medical laboratories their process management abroad.However,the concept of risk management is still very new for laboratories in China.Therefore,the establishment of the project for risk detection,classification,correction,prevention and supervision could help medical laboratories improve their service quality.