Newborn screening plays an important role in the 3-tiered system of prevention and control for birth defects in China.With the rapid development of newborn screening and diagnosis,quality control system including internal quality control and external quality assessment should be optimized and improved,and attention should be paid to pre-experimental quality control and management of positive patients as well.Widespread application of tandem mass spectrometry in newborn screening and diagnosis for inherited metabolic diseases greatly enhanced the detection capability and efficiency.The rapid development of molecular diagnosis techniques will confront new challenges and troubles.

Objective To evaluate clinical feasibility of using a modified bio-material of femoral arterial and bi-caval femoral venous cannulae for children by investigating the blood compatibility and toxicological characteristics of the bio-material of the cannula.Methods The evaluation tests including hemolysis test,skin irritative test were performed in rabbits,and systemic acute toxic test was performed in mice.First,the haemolysis rate of this modified cannula bio-material was calculated by determination of absorptance conducted in vitro;second,the extracts of this material were prepared according to the national evaluation standards of medical bio-materials,and then the extracts were injected subcutaneously in rabbits to observe the histological responses of skin 72h after injection;finally the prepared extracts were injected intravenously into mice to observe the systemic responses 72h after injection.Results Hemolysis test showed that the hemolysis rate of the novel cannula bio-material was 1.58%,which was much lower than the international standard(5%).The blood compatibility of this material was also satisfactory.Primary skin test in rabbits showed no erythema,necrosis or edema in skin.Furthermore,acute systemic toxic test in mice showed no death and no loss of body weight,and no obvious abnormal response was observed 72h after injection.Conclusion The novel bio-material for femoral arterial venous cannulae for children meets the requirements of medical material property,and it can be clinically used.

bjective:To study and establish the fingerprint of Pollen Typhae.Methods:Hypersil BDS C18(5?m,4.6mm?250mm) chromatographic column mobile phase acetonitrile-0.1 % phosphoric acid solution(10:90)with fiow rate of 1.0 ml/min and UV detector at 254 nm.ResultsTaking Isorhamnetin-3-O-neohesperidoside as the reference peak,11 common peaks were selected as the fingerprint peaks of Pollen Typhae,Technology investigation indicated that the analytical method this study established has desirable precision,reproducibility,and stability.The similarity of Pollen Typhae fingerprints from different batches is better.Conclusion HPLC fingerprint analysis can be a method for quality control of medical material of Pollen Typhae.

Newborn screening of inherited metabolic diseases by tandem mass spectrometry is flourishing in our country.With expansion of the coverage and spectrum of diseases, it is important to strengthen the quality management, optimize the performance and reduce the false rate currently, such as quality assurance of the specimens, quality control of the process, quality verification of the test procedure, quality evaluation of the laboratory and quality optimization of the interpretation method. Along with development of the equipment, software and project, promotion of regional collaboration by data and experience sharing will be more critical in the future, and national neonatal screening by tandem mass spectrometry will step into a new stage.

Object To study the condition of Wenpi Decoction (WPD) with being decocted first and later added medicinal materials. Methods Contents of aconitine and free anthraquinone in WPD were determined by HPCE. Results Aconitine could reach the safe limit after Radix Aconiti Preparata being decocted 30 min first and the content of free anthraquinone was the highest after Radix et Rhizomea Rhei being decocted 10 min later. Conclusion Radix Aconiti Preparata should be decocted first and Radix et Rhizomea Rhei should be decocted later in WPD.

Objective To assess the diagnostic value of combining aortic dissection detection risk score (ADDRS)with D-dimer in patients with suspected acute aortic dissection(AAD). Methods We retrospectively identified 525 patients with chest pain and with calculated ADDRS and available D-dimer on admission between January 2015 and December 2016. ADDRS ≤1 was defined as ′low probability′ and that >1 as ′high probability′. Results AAD were diagnosed in 106(20.2%)patients. In patients with ADDRS of 0,1 case of AAD was identi-fied and in those with ADDRS of 1,40 were identified while in 76 patients with ADDRS of 2 and 3,71 cases of AAD were identified. D-dimer with threshold of 0.5 mg/L had a negative predictive value of 100%and a specificity of 76.6% in patients with ADDRS of 0. In patients with ADDRS of 1,D-dimer had a negative predictive value of 98.6%. D-dimer showed a negative predictive value of 99.6% and a positive predictive value of 22.3% in patients with low probability. Conclusions High ADDRS benefits confirming AAD. Low ADDRS combined with negative D-dimer is safe and efficient for ruling out AAD ,while low ADDRS with positive D-dimer needs further aortic imaging.

Objective To evaluate the therapeutic effect and toxicities of low dose Gemcitabine combined with Oxaliplatin in the treatment of advanced or metastatic uroedthelial carcinoma.Methods A total of 42 patients pathologically confirmed advanced or metastatic urothelial carcinoma (23 bladder cancer cases,11 ureteral carcinoma cases,and 8 renal pelvic carcinoma cases) were reviewed.Karnofsky score for each patient before treatment was more than 60.Combined treatment with Gemcitabine and Oxaliplatin regimen was as follows:Gemcitabine 700 mg/m2,iv infusion at day 1,8 and day 15,Oxaliplatin 100 mg/m2,iv infusion at day 2.The regimen was administered for more than 2 cycles (every 4 weeks) and the response rate was evaluated.The regimen was used in palliative chemotherapy and adjuvant chemotherapy,respectively.Results According to WHO evaluation criteria on therapeutic effectiveness,7 patients (16.7％) had complete response,13 patients (30.9％) had partial response,14 cases (33.3％) remained stable status,and 8 cases (19.1％) had progression.The overall response rate was 47.6％.The main side effects included thrombocytopenia,leucopenia,nausea,vomiting and alopecia,which were mild to moderate and disappeared when the chemotherapy was ceased.No chemotherapy related death occurred.Conclusions Combined treatment with low dose Gemcitabine and Oxaliplatin is effective for advanced or metastatic urothelial carcinoma,with mild and tolerable toxicities.

Objective To study the etiology,diagnosis,treatment and prophylaxis strategy of the urogenital fistula caused by gynecological and obstetrical surgery.Methods Data of 64 cases with urogenital fistula,who were admitted into second hospital of Tianjin medical university and Tianjin first central hospital from January 1992 to December 2012,were analyzed retrospectively.In Tianjin first central hospital,those cases include vesicovaginal fistula in 10,ureterovaginal fistula in 7 and urethro-vaginal fistula in one case.In second hospital of Tianjin medical university,those cases include vesicovaginal fistula in 26,ureterovaginal fistula in 18,urethro-vaginal fistula in 1 and ureterouterine fistula in one case.The median age was 42 years old (range 21-53).The history of diseased ranged from 16 days to 30 years.All patients were diagnosed by methylene blue test,cystoscopy,ureteroscopy,intravenous urography,ultrasound,computed tomography (CT) and magnetic resonance urography (MRU).The primary fistula was diagnosed in 50 cases and the recurrence was found in 14 cases.Single fistula existed in 56 cases and multiple fistulas were found in 8 cases.In 36 patients with vesicovaginal fistula,transabdominal repair of vesicovaginal fistula (n =20),transpubic surgery (n=10) and transvaginal surgery (n=6) were chosen.In 25 patients with ureterovaginal fistula,ureterocystostomy (n =10),ureterotomy with holmium laser (n =8),ureteral stent placement (n =6) and ureteral stricture excision and bladder-psoas suspension (n=1) were used.Two patients with urethro-vaginal fistulae were cured by the Latzko technique.One patient had uretero-uterine fistula and cured by ureteral stricture excision,ureterocystostomy and bladder-psoas suspension.Results Fifty-five(86％) cases were cured by single-stage surgical treatment and nine patients experienced more than two times of surgical treatment.The incipient patients have a higher success rate of first surgery than recurrent patients (92％ vs.64％,P＜0.05).Single and multiple fistulas have no significant difference about the surgical successive rate (88％ vs.75％,P＞0.05).In cases with vesicovaginal fistula,the success rate of vaginal and abdominal approaches are the same 85％ (P＞0.05).In cases with ureterovaginal fistula,abdominal and endoscopic approaches were 100％ and 85％,respectively (P＞0.05).The mean duration of follow was 20 months (range 3-48).There was no recurrence during follow-up.Conclusions Urogenital fistula caused by gynecological and obstetrical operation can be cured by surgery.Recurrent fistula is a challenge for diagnose and treatment,preoperative need reasonable operation mode to improve the success rate of operation.Both open surgery and endourology approaches are effective treatment options in management the urogenital fistula.

Objective To analyze the incidence and clinical features of urothelial tumors in renal allograft recipients.Methods A retrospective analysis of 1042 patients received renal allografts who had taken immunosuppression for at least six months between 2006 and 2011 in The First Centre Hospital of Tianjin was performed.Results Eleven cases of uroepithelial tumors were diagnosed in the 1042 cases of renal transplantation ( 1.06％ ),of whom 9 cases were noticed by hematuria ( 81.8 ％ ),2 cases ( 18.2％ ) by medical examination.Six patients were diagnosed with multifocal urothelial carcinomas.Surgery was performed on all the patients with renal tumors and followed by chemotherapy or radiotherapy.Conclusion Malignancies in urinary tract after renal transplantation should be bore in mind.Early diagnosis is very important.The treatment options include reducing immunosuppressive agents and removing tumor lesions completely.

Objective Cystic nephroma ( CN ) is an unusual benign neoplasm with high misdiagnosis rate , and at present there is no general method on its treatment .This study aimed to analyze the diagnosis and treatment of CN based on clinical data of CN patients. Methods We retrospectively analyzed the clinical data on 25 patients (including 2 cases of male pediatric patients , aged 14 and 16 years old, and the remaining 23 cases were adults, 11 males and 12 females, aged 14-69[45.1 ±19.6]years) treated in our department of the First Hospital of Shijiazhuang from January 2003 to July 2015 .All patients underwent ultrasound , CT and MRI examination , as well as surgical resection . Results Among these 25 CN patients , there were 15 cases of partial nephrectomy , 5 ca-ses of nephrectomy , 2 cases of retroperitoneal laparoscopic cyst unroofing , 1 case of laparoscopic enucleation of the tumors with nephron-sparing surgery , 1 case of laparoscopic radical nephroureterectomy , and 1 case of retroperitoneal laparoscopic radical nephrectomy .All the patients were successfully followed up for 6 months to 132 months, 1 patient recurred 6 months after retroperitoneal laparoscopic cyst unroo-fing and underwent open partial nephrectomy .No recurrence and me-tastasis were found in the remaining patients . Conclusion Imaging examination is an important measurement for CN , and intraoperative frozen pathology contributes to pathological diagnosis .Since most CN cases are benign , CN patients with no symptom or small cysts can take follow up survey .The principle of the operation is complete resection of the tumor , and nephron-sparing surgery is the first choice . In addition , regular follow-up is necessary in case of recurrence and malignant potential .