International Standard for Medical Laboratories Accreditation demanded monitoring the quality of the total testing process (TFP).Recently, the errors in the analysis phase had been effectively controlled, while the errors in pre-and post-analytical phases still remained comparably high, and became the major factors influencing the TTP quality.Thus, monitoring and improving the quality of the extraanalytical phases became the major challenge.Monitoring the TTP quality required the laboratory staff to extend the quality management to the influential elements outside the laboratory.In addition, it also prompted the organizers of external quality assessment (EQA) in China to provide a quality assurance program for extra-analytical phases.The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) had developed a model of quality indicators.The Q-Probes and Q-Tracks programs of the College of American Pathologists provided a good practice of monitoring and improving quality for the extraanalytical phases.Based on the related international guidelines, the QIs system was established for quality management and control in clinical laboratory, so as to manage EQA of extra-analytical phases.

In type 2 diabetes mellitus,the levels of leptin were higher in female and obese subjects compared with male and non-obese subjects.There was negative relationship in female between leptin and HbA_1c,and negative relationship between leptin and HDL-C in male.Gender and obesity had no effect on TNF-? and NP Y.

Objective To investigate the relationship between the leptin level and neonatal weight and the expression of leptin in placenta. Methods The concentrations of leptin in 100 maternal blood and umbilical blood of the term pregnant women were examined by radioimmunoassay (RIA). According to the neonatal weight to divide into the large for gestational age (LGA) group 19 cases, the appropriate for gestational age (AGA) group 65 cases, the small for gestational age (SGA) 16 cases. The level of leptin mRNA in 41 placental tissue was examined by Reverse transcription polymerase chain reaction (RT PCR). Results (1) The expression level of leptin mRNA in placenta was 0 97?0 04, which was positively related to the neonatal weight significantly ( r =0 43, P 0 05).(3)The concentration of leptin in umbilical blood was (7 58? 5 15) ?g/L, which was positively related to the neonatal weight ( r =0 57, P

Objective To investigate endoscropic assist in rat orotracheal intubation.Methods 40 rats were randomly divided into two groups.The procedure time, total time, intubation frequency,the success rate of the first intubation and the survival rate in 24h were compared between the conventional group and the endoscropic group.Results The total time in two groups were nearly the same.But the procedure time and frequency of intubation were significantly less in the endoscropic group than those in the conventional group.The success rate of the first intubation in the endoscropic group was obviously higher than that of the conventional group.There was no obviously difference between the survival rate after extubation in 24h between groups.Conclusion Endoscropic assist is superior to the conventional method and worth promoting.

Objective To observe the impact of DPP4 inhibitor Saxagliptin on body weight of type 2 diabetes patients. Methods In this randomized and parallel study,50 patients were given either Saxagliptin(n=25)or Glimepiride(n=24). The changes of body weight, HbA1c and hypoglycemic events were observated in 12 weeks. Results There were no significant difference in gender,age and body weight between 2 groups(P>0. 05). After 12 weeks treatment,body weight has significant changed in both group,and the weight changes were sig-nificant differet in two groups:an average of 0. 4 kg weight was increased in Glimepiride group and 0. 4 kg weight was decreased in Saxagliptin group (P<0. 05). The change of HbA1c level has no statistical difference in two groups (P>0. 05). Hypoglycemia event was happened four times in Glimepiride group,while no hypoglycemia event was happened in Saxagliptin group. Conclusion Compared with Glimepiride,Saxa-gliptin provides similar hypoglycemic action with less hypoglycemia,at the same time,Saxagliptin yields better results in lowering weight.

BACKGROUND: Cigarette smoking has been recognized as one of the high risk factors in carcinogenesis of lung cancer. Early diagnosis of lung cancer may be of clinical therapy value.OBJECTIVE: To explore the mutation of K-ras oncogene in bronchoalveolar lavage fluid(BALF) in order to reveal its relationship with cigarette smoking in lung cancer patients.DESIGN: Randomized controlled trial based on the patients.SETTING: Department of Toxicology, College of Radiology and Public Health of a university, and Department of Respiratory Medicine of a university hospital.PARTICIPANTS: The out-patients and inpatients in the Second Affiliated Hospital of Soochow University between June 1999 and September 2001 were included. The patients were confirmed to have lung cancer or innocuous diseases by fiber bronchoscopy through bronchoalveolar lavage(BAL) and cytological or pathological examination.METHODS: BALF samples were obtained from 37 smoking patients with lung cancer and 25 nonsmoking patients with lung cancer, and 20 with benign pulmonary diseases in the Second Affiliated Hospital of Soochow University. They were detected for K-ras codon 12 mutations using polymerase chain reaction with restriction fragment length polymorphism(PCR-RFLP).MAIN OUTCOME MEASURES: Codon 12 mutations of K-ras gene.RESULTS: K-ras mutation in patients with lung cancer was found to have an average frequency of 36% (22/62)but no K-ras gene mutation was detected in patients with benign pulmonary diseases. The mutation frequency in heavy smokers(69% ) was higher than that in moderate smokers(31%), mild smokers (25%) and nonsmokers (20%). The mutation was related to age and history of smoking, but not to sex and TNM classification.CONCLUSION: Cigarette smoking may be correlated with the mutation of K-ras gene. Early detection of K-ras mutation in BALF may be of clinical value, which helps the identification and diagnosis of smoking-related lung cancer.

Objective To evaluate the effect of maternal separation stress on the behavior of neonatal rd mice.Methods Neonatal rd mice were divided into maternal separation (MS) group (n=9) and control group (n=9).MS-stress was induced in the MS group by 4-hour-separation per day for 28 days.Open field test,elevated plus maze test,forced swim test and tail suspension test were used to evaluate the anxiety-like and depression-like behavior of the neonatal rd mice.Results The stay time and distance travelled of MS group in the central zone were 0.88％ and 28.17±5.65 cm,respectively,significantly shorter than that of the control group (2.61％,109.9±9.79 cm.P =0.04,P =0.001).Compared with the control group,the stay time in open arms of the MS group was significantly decreased (P<0.01),while the immobility time in forced swim test and tail suspension test of the MS group were 126.5±10.22 s and 21.56±6.83 s,significantly longer than that of the control group (77.75±16.83 s,P =0.02,7.37±3.22 s,P =0.03).Conclutions The 28-day maternal separation stress can significantly increase the anxiety-like and depression-like behavior in neonatal rd mice.

Objective To establish a rat model of liver metabolism profile in chronic heart failure (CHF), to explore the dynamics of liver metabolism in CHF from the point of view of metabolism, and to find the characteristic metabolites valuable for the molecular mechanism and management of CHF.Methods Twenty male Wistar rats were assigned to the CHF group to receive aortic coarctation or to the control group to receive sham surgery, and were bred for 24 weeks following surgery.The metabolic profiling of the rat liver tissues was analyzed on a metabonomics research platform. Orthogonal partial least squares-discriminant analysis ( OPLS-DA) model and principal component analysis ( PCA) model were established for liver tissues of the CHF rats, and the characteristic metabolites were finally derived by data processing with SPSS 19.0 software.Results The PAC and OPLS-DA models were established successfully.Ten characteristic metabolites with significant differences between the CHF and control groups, including lysophosphatidyl choline, lysophosphatidyl ethanolamine, oleic acid, glycocholic acid, and dehydroepiandrosterone sulfate, were screened and identified from the models.Conclusions The metabolic disorders in CHF rats are well fitted to the established metabolic profile models, and these identified characteristic metabolites may provide reference for the pathophysiological molecular mechanism and management, etc., of chronic heart failure.

A 880 bp cDNA localized to the putative NS5 region of HGV genome was expressed in E.coli BL21(DE3). The cDNA fragment was inserted into a plasmid pGEX-5X-1,at the downstream of the DNA sequence encoding Schistosoma japonicum glutathione S- transferase(GST),in the same reading frame with the gene of GST. A 60KD GST-NS53 fusion protein was expressed at 37℃ in a form of inclusion bodies amounting to 30 percent of total host protein whereas at 20℃ mainly in a form of soluble protein . The fusion protein was extracted and purified to homologue. The purified GST-NS53 fusion protein could be specifically recognized with either the sera from the patient infected by HGV or the antisera directed against GST.

OBJECTIVE To study the in vitro activity of cefepime combined with sulbactam against carbapenem-resistant strains of Acinetobacter spp clinically isolated. METHODS The activity of each drug alone was determined against 24 isolates. Chequerborad synergy testing was then performed against all the isolates. RESULTS The percentage of the FIC index showed 33.3% synergism, 62.5% additive, 4.2% (1/24) indifference, and no antagonism tively. CONCLUSIONS Testing of cefepime and sulbactam combinations revealed synergism and additivity activity against some carbapenem-resistant strains(23/24) of Acinetobacter spp which could be likely to prove beneficial effect for the treatment of infections due to multidrug-resistant strains of Acinetobacter spp.