Objective To investigate the expression of inflanmatory cytokines such as interlukin-1β (IL-1 β),interlukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and intercelluar adhesion molecule-1 (ICAM-1),and explore their relationships with neuronal function score after fluid percussion brain injury in rats.Methods The experimental models were established in 48 adult rats.The water content of edematous brain and the expression of IL-Iβ,IL-6,TNF-α and ICAM-1 were measured with dry-wet measure,immunohistochemistry at 6 h,12 h,24 h,3 d,7 d after operation respectively.Results Compared with animals of shame operation (SO) group,neuronal function score decreased in TBI group from 6h (3.78±0.84),reached to the lowest level at 24h (2.65±0.32),and gradually increased at 3d (4.75±0.71).IL-6,IL-1β,TNF-α and ICAM-limmunoreactive expression increased from 6h,reached its maxmum at 24h,lasted to 3th day,and began to decrease at 7d.The linear regression analysis indicated that expression of IL-1β,IL-6,TNF-α and ICAM-1 had negative correlations with change of neuronal function score(r=-0.912,r=-0.892,r=-0.794,r=-0.887 respectively,P＜0.05).Conclusion IL-6,IL-1β,TNF-α and ICAM-1 expression is upregulated following fluid percussion injury in rats,and shows negative correlations with neuronal function score.The possible mechanisms is that inflammatory cytokines are involved in nerve function impairment by inducing secondary brain injury.

Objective To investigate the curative effect of microsurgical treatment of anterior communicating aneurysm via the moeifiee pterional approach uneer combinee neuroelectrophysiological monitoring. Methods The clinical eata of 35 cases of anterior communicating aneurysms were analyzee retrospectively. All the cases were treatee by the microsurgical treatment via moeifiee pterional approach uneer combinee neuroelectrophysiological monitoring. Results All the anterior communicating aneurysms were clippee completely by microsurgical treatment uneer combinee neuroelectrophysiological monitoring. The curative effect was assessee at eischarge accoreing to GOS,inclueing gooe in 29 cases(82. 9% ,29 / 35),moeerate eisability in 4 cases(11. 4% ,4 / 35),severe eisability in 1 case(2. 9% ,1 / 35),eiee in 1 case(2. 9% ,1 / 35). Conclusion Microsurgical treatment of anterior communicating aneurysms via moeifiee pterional approach uneer combinee neuroelectrophysiological monitoring is a safe ane effective methoe,which might be helpful to reeuce the ratio of postoperative eisability ane mortality,ane then improve quality of life for patients.

Objective To detect the disinfectant-resistant geneqacA/B in the strains ofStaphylococcous aureus isolated from January 2014 to December 2014.Methods Fifty-one isolates were collected. PCR assay was used to detectmecA gene andqacA/B gene in the isolates followed byStaphylococcus protein A (spa) typing. Antimicrobial-resistant phenotypic typing was conducted to analyze the homology of theseqacA/B positive strains. The clinical information of the patients from whom the strains were isolated was collected to further understand the clinical background ofqacA/B-carryingS. aureus.Results The prevalence ofmecA and qacA/B genes was 21.6% (11/51) and 13.7% (7/51), respectively in the strains. The prevalence ofqacA/B gene in the methicillin-resistantS. aureus strains (54.5%, 6/11) was signiifcantly higher than that in the methicillin-sensitiveS. aureus strains (2.50%, 1/40). The prevalence ofmecA gene inqacA/B gene positive strains (6/7) was signiifcantly higher than that inqacA/B gene negative strains (1/7). TheseqacA/B positive strains were classiifed into 4 spa types (t037, t091, t932 and t895). The main type was t037 (4/7), which was from the pediatric ward.Conclusions The prevalence ofqacA/B gene is low in theS. aureus strains. However, the prevalence of this gene in methicillin-resistantS. aureus strains is far higher than that in methicillin-sensitiveS. aureus. spa type t037 may be a prevalent clone in pediatric ward.

Objective To develop a candidate reference method for the determination of sodium in serum by inductively coupled plasma mass spectrometry method (ICP-MS). Methods Aluminum, as internal standard of sodium, was added into serum samples and sodium standard solutions by gravimetric analysis. The samples were digested by HNO3 and diluted, and its 23Na/27Al isotope ratios were obtained by ICP-MS. The sodium concentrations were calculated with the standard curve method in serum. Results The analytical recoveries of sodium were 100.67% and 100.15% respectively, and the precisions were 0.08% and 0.04% respectively for 2 different serum samples. The results of measuring sodium in serum of Standard Reference Material (SRM) gave the coefficients of variation (CVs) of 0.18% and 0.22% for 2 levels of standard reference material(SRM) 909b and 0.41%, 0.41% and 0.66% for 3 levels of SRM 956b. The relative deviations between the results and median of the certified value were 0.17% and 0.14% for 909b and -0.09%, -1.05%, -0.48% for 956b respectively. Conclusions The ICP-MS and aluminum internal standard method is proved to be not only precise and accurate, but also quick and convenient for measuring sodium in serum. It is promising to be a candidate reference method for determination of sodium in serum.

Objective To investigate the clinical effects of surgical treatment of lower lumbar fracture with mini-incision via retroperitoneal anterior approach. Methods The data of 21 cases with serious lower lumbar burst fracture were analyzed retrospectively. There were 15 males and 6 females with an average age of 35.9 years (ranged, 19-65 years). The lesion was located in L3 in 10 cases, L4 in 8 and L5 in 3cases. According to Magerl classification, there was type A (burst in 12 cases, type B (distraction) in 2 and type C (retortion) in 7 cases. All the 21 cases were treated with anterior decompression, bone graft fusion and internal fixation with mini-incision via retroperitoneal anterior approach. The changes of radiograph and neurologic status were recorded respectively. Results All the cases had been followed up for an average of 41.9 months (12-86 months). The radiograph showed obvious improvement on the injured body height (from 42.62％ preoperatively to 94.33％ postoperatively, P＜0.01) and the canal encroachment index (from 2.67 preoperatively to 0.14 postoperatively, P＜0.01). Significant improvement in neurological function were achieved in all patients with the improvement of one grade except for 1 case with L3, T11 fracture and complete paraplegia. No failure of implants was found during the follow-up period. Conclusion Anterior decompression and internal fixation with mini-incision via retroperitoneal anterior approach are successful in treating serious lower lumbar burst fractures.

Objective To assess system deviation of HbA1c measurement in clinical laboratories in China by the national trueness verification project.Methods Bias assessing research.Two lots samples of human whole blood pools with different HbA1c concentration levels were prepared and sent to laboratories by dry ice package.Laboratories were asked to measure these samples in 5 repeats per set in three consecutive Wednesday separately,results were reported through Web-based software.Meanwhile the IFCC reference measurement procedure was applied to assign HbA1c reference values for the two lots samples.The following information or data were analyzed:measurement systems,intra-lab CVs and inter-lab robust CVs of all laboratories,inter-lab robust CVs and bias based on peer groups,et.al.The criterion of bias was set at ± 4.5％.Results 106 of 120 laboratories submitted results,including 88 using high performance liquid chromatography method,13 using immune turbidimetry method and 5 using enzymatic methods the intra-lab CVs of lot 201311 ranged from 0 to 4.6％,with median of 1.1％,while for lot 201312 the intra-lab precision ranged from CV0 to CV4.5％,with median of CV0.9％.The inter-lab robust CVs of 201311 and 201312 with single determinations were 5.6％ and 6.1％ and inter-lab robust CVs of 201311 and 201312 of each lab's average results were 5.9％ and 5.6％ respectively.The inter-lab CVs of group BIO-RAD,TOSOH,ARKRAY and PRIMUS at two level were less than 5％.For all laboratories,the percents of pass of 201311 and 201312 were 61/106(57.5％) and 56/106(52.8％) respectively.The pass ratio of each group on two lots were as follows:of group BIO-RAD were both 19/45 (42.2％),of group TOSOH were 85％ (17/20) and 75％ (15/20),of group ARKRAY were 71.4％ (10/14) and 50％ (7/14),of group PRIMUS were 6/8,5/8; of group immune turbidimetric method were both 46.2％ (6/13) and of group enzymatic were both 3/5.Conclusions There were improvement for the performance of trueness of HbA1c measurement in domestic laboratories,while some of them should be addressed.Academic,research institutions,EQA organizer,manufacturers and clinical laboratories should work together to achieve the standardization of HbA1c measurement.

In order to investigate EV71 antibody levels among general population from Fujian Province after the 2008‐2009 HFMD epidemics ,390 sera‐specimens were collected from 390 participants in 2010 .EV71‐specific antibody was detected by neutralization test ,indicating 186 (47 .69% ) sera of 390 were EV71‐seropositive .Although the difference by gender was not statistically significant on positive rates and antibody titers ,significant differences were observed in positive rates and antibody titers among age groups .The positive rate was increasing with age ,while the 0 age‐group yielded the lowest positive rate of 16 .67% .Subsequently ,significant difference was detected among positive rates and antibody titers between age groups of 0 to 4 years‐old and 5‐years‐old ,with the positive rate of 25 .33% and 61 .67% ,respectively .Therefore ,the EV71 antibody levels among general population from Fujian Province after the 2008‐2009 HFMD epidemics was still in the low level ,especially the age groups of 0 to 4 years‐old .The epidemic of HFMD mainly caused by EV71 will still occur in the future ,and children under 5 years old are major susceptible population ,continuously intensive surveillance ,prevention and control are required .

Objective To evaluate the trueness of 13 routine measurements for serum uric acid and the role of reference method in improving harmonization and trueness among routine measurement systems. Methods The research is related to the reagent evaluation.Usingisotope dilution liquid chromatography tandem mass spectrometry ( ID-LC/MS/MS) method as the comparison method, Wako, Sekisui, DiaSys, Maker,Dirui,Leadman,BSBE,Biosina,Mindray,MedicalSystem,LongMarch,and Kehua 13 kinds of uric acid kits were chosen as the evaluation methods with Hitachi 7170A as the analyzer.serum uric acid in 40 fresh frozen serawere collected from clinical laboratory of Beijing hospital in 2014,coveringboth physiological and pathological status ( 80 -940 μmol/L ) .19 kinds of prepared materials and the 40 fronzen sera were measuredby comparison method and evaluation methods and linear regression analysis was made for the results.The performance of evaluation methods was revealed and recalibration was performed on every evaluation methodby the linear regression equation.The variation of percent bias(%) of the uric acid values in 19 preparation materials was compared.Results All test methods demonstrated good precision ( CV<1.75) and good correlation (R2 >0.998, P<0.01) with the comparison method when measuring uric acid values in 40 fresh frozen sera The meanpercent bias was 0.17% ( -3.06% -7.31%).After recalibration, 4 of 19 samples with no matrix effect values percent bias reduced and met the demands of quality ( <4.8%) induced from biological variation.Conclusion All test methods demonstrated good trueness and their calibration traceability was verified.Recalibration using reference method or standard reference materials contributes to harmonization among methods.

Objective Preparation of aqueous reference materials for cholesterol and glycerol.Methods Study on reference materials.The certified reference materials GBW09203b and GBW09149 were weighed accurately and dissolved into 20% of methyl cyclodextrin aqueous solution to prepare six kinds of candidate reference materials of cholesterol and glycerol according to the concentration.The materials were tested for homogeneity and stability using routine methods.The reference methods of isotope dilution liquid chromatography tandem mass spectrometry (ID-LC/MS/MS) were used to determine the concentration of cholesterol and glycerol to evaluate the accuracy of the certified values.Meanwhile, the blank verification test was carried out.The expanded uncertainty was the combination of standard uncertainty of measurement, unhomogeneity and instability.Results It showed that the six candidate reference materials were homogeneous and stable for at least 1 year at-70 ℃ and-20 ℃.The certified values (reference value ± expanded uncertainty,mmol/L) were as follows,for cholesterol:0.65±0.01,1.31 ±0.01,2.57±0.02,5.21±0.06,7.71±0.08,10.24±0.06;for glycerol:0.29±0.01,0.58±0.01,1.22±0.02,2.24±0.02,3.46±0.04,4.52 ±0.04.The results of reference methods were consistent with the certified values.Blank validation tests showed that the concentration of the analytes would not be affected by the reagent and the blank matrix.Conclusions Certified reference materials for cholesterol and glycerol in aqueous solution have been prepared successfully.These materials are homogeneous and stable, and the certified values are reliable.Therefore the materials have been approved to be the Certificate Reference Materials of GBW 09823, GBW 09824, GBW 09825, GBW09826, GBW09827 and GBW 09828.

The pediatric reference intervals in clinical laboratory play an important role in diagnosis of illness,therapeutic monitoring,prediction of prognosis and health evaluation.Compared with establishing reference interval for adults,there are more challenges to establish pediatric reference intervals.Therefore,the procedure and key technologies of direct method and indirect method are stated based on the characteristics of children population and pediatric,by which to define,transfer and validate pediatric reference intervals.This study will provide systematically methodological ideas for clinical laboratories to establish pediatric reference intervals.