In present,clinical laboratory is required to continuously improve the quality management system for providing almost perfect reports and services.The new conception and methodology of quality management in clinical laboratory should be constantly updated in order to ensure the patient safety.The article focuses on the integration of risk management and six sigma,into the quality management system for clinical laboratory.

Objective To study the serum procalcitonin (PCT)in patients with sepsis clinical application value,for the hospi-tal,infection control,to provide a scientific basis for reasonable Shaanxi General of antibiotics.Methods Retrospective anal-ysis of Shaanxi General hospital of CARF in 2011 May~2013 May 201 cases of patients with ICU,According to the severi-ty of infection were divided into 4 groups(SIRS)63 cases,(Sepsis)40 cases,(Severe sepsis)70 cases,(Septic shock)19 ca-ses,Dynamic analysis of ICU monitoring in 1,3,5,7,10,14,17 days each in the blood in patients with PCT,hs-CRP and WBC levels and blood culture,and PCT on the sensitivity,sepsis diagnostic specificity,positive predictive value,and negative predictive value,diagnostic accordance rate.Results PCT levels of SIRS and Sepsis (1.92 ng/ml)(10.8 ng/ml)group,the Severe Sepsis (24.0 ng/ml),and Septic shock compared (34.0 ng/ml)group,the difference was statistically significant (q1=13.8,q2=15.6,q3=17.9,P<0.05).Four groups of hs-CRP and WBC count,and there was no statistically significant difference (F=5.10,P>0.05),PCT levels and the severity of sepsis in positive correlation (r=0.781).The positive rate of blood culture in 26.6%,and PCT the on diagnosis of sepsis sensitivity,specificity,positive predictive value (PP),negative predictive value (NPV)were 87.2%,85.4%,78.9% and 89.3%,respectively,for sepsis diagnosis coincidence rate 85%, the increase of PCT level(≥ 1 ng/ml)was anindependent index 28 natural deposit rate.Conclusion Compared with PCT hs-CRP and WBC could better evaluate the severity of sepsis,and dynamic j udgment of sepsis disease prognosis was more sensitive.Joint detection with blood culture could improve the of accuracy differential diagnosis of sepsis,and to guide clinical rational application of antibiotics.The change of concentration of PCT daily can help predict mortality risk in patients with sepsis in ICU of the hospital,reduce complications and reduce mortality.

Objective To investigate the effect of Salidroside in inducing apoptosis of rat hepatic stellate cells (HSC) stimulated by acetaldehyde and to observe the changes of c- Jnk N- terminal kinase (JNK) activity.Methods HSC stimulated by acetaldehyde were cultured in vitro and were treated with different concentrations of Salidroside.Apoptotic rate was analyzed by flow cytometry and the activity of phosphorylating JNK was measured by Western blot method.Results Salidroside in different concentrations (1.0,1.5,2.0 mg/mL) suppressed the activity of JNK in a dose- effect manner.Average light density was 35.8? 3.4,24.9? 2.7 and 3.4? 0.9 in Salidroside groups, which differed from that in acetaldehyde group( 48.6? 4.8; P

Objective To know student nurses′ knowledge, attitude and practice status related to occupational protection, so as to provide scientific basis for the education and training of occupational safety. Methods A total of 203 student nurses from 4 tertiary general hospitals were surveyed by the “knowledge, attitude and practice” questionnaire designed from October 2014 to January 2015. SPSS 17.0 statistical software was used to analyze the data. Results The knowledge score, attitude score and practice score of occupational protection among 203 student nurses were (18.68±2.98), (25.51±2.98) and (51.67±6.34), and they were all at a medium level. There were significant differences in the knowledge score of occupational protection in student nurses with different internship time and different education background ( F = 8. 299, 3. 088;P<0. 05 ) . Conclusions Schools and training hospitals should provide systematized and regular occupational protection education, in order to improve the consciousness of occupational protection from injury among student nurses and scientifically and effectively avoid the the occupational risks in nursing.

Nuclear magnetic resonance spectroscopy is one of the main analytical techniques for detecting metabolomics, which has the advantages of simple operation, rapid detection and non-invasive feature. By monitoring the changes of metabolites in the body, it is helpful to deeply understand the mechanism of disease and play a role in the diagnosis and treatment of diseases, but its clinical application has not yet been popularized. In recent years, the application of metabolomics in tumors has increasingly become a research hotspot. Therefore, in order to provide a reference for the research and clinical application of tumor metabolomics, the nuclear magnetic resonance spectroscopy and tumor metabolomics were introduced in this paper, and the application progress of metabolomics analysis based on this technique in early tumor screening, clinical diagnosis and prognosis evaluation were reviewed in this paper.

Objective:To explore the application value of patient data-based real-time quality control (PBRTQC) in enhancing the effectiveness of internal quality control (IQC) management.Methods:From the PBRTQC real-time quality control intelligent monitoring platform integrated with the laboratory information system (LIS), a total of 35,631 test results of red blood cell (RBC) count, white blood cell (WBC) count, and dehydroepiandrosterone sulfate (DHEA-S) were collected from patients of the Department of General Xi'an Area Medical Laboratory Center from August 1, 2023, to April 1, 2024. The platform was used in patient data distribution characteristics test, EWMA real-time quality control chart procedure establishment, performance validation, effect evaluation, best procedure selection, and real-time operation. The performance evaluation indexes of the best PBRTQC procedure establishment, the cut-off limit range, weighting coefficient, cumulative mean, standard deviation (SD), coefficient of variation ( CV) of the EWMA real-time quality control chart, and the cumulative mean, SD, and CV of its internal quality control data in the same period were counted, and at the same time compared with the quality target (1/3TEa). Coefficient of variation analyses were performed to compare the quality control status of PBRTQC and conventional internal quality control in the presence of warning or alarm prompts based on quality control process records, and alarm messages. Results:The evaluation indexes of the optimal procedures for RBC count, WBC count, and DHEA-S were the probability of error detection (Ped) between 93%-97% and greater than 90%, the false positive rate (FPR) between 0.0%-0.5%, the false negative rate (FNR) between 3.0%-7.0%, and the average number of the patient sample until error detection (ANPed) between 5-11, which is in line with the optimal quality control efficacy quality requirements for the PBRTQC procedure. The patient outcome cut-off concentrations for the optimal procedure EWMA quality control charts ranged from RBC count (3.92-5.16)×10 12/L, WBC count (4.28-7.50)×10 9/L, and DHEA-S (830-2 160) μg/L; (2 160-4 210) μg/L. The weighting coefficients were 0.05, 0.03, and 0.03, respectively. The real-world application of the EWMA real-time quality control charts showed stable and excellent analytical performance of the measurement system, such as out-of-control alarm: RBC count, 1 true alarm, Ped of 95.85%, and FPR of 0%. The cumulative CV of EWMA was less than the quality target; the cumulative CV of DHEA-S was 7.66% and 9.47%, respectively, and the cumulative CV of low level was greater than the quality target (8.33%), and the cumulative CV of high and low levels were 4.12% and 6.25%. Conclusion:The PBRTQC EWMA method can monitor the patient data - in real-time and continuous way. It can also dynamically identify and provide early indication of small changes in analytical performance during the analysis process, and can be used as a supplement to quality control products to improve the efficacy of laboratory quality management.

OBJECTIVEProviding evidences for further modification of China Infectious Diseases Automated-alert and Response System (CIDARS) via analyzing the outbreak detection performance of Moving Percentile Method (MPM) by optimizing thresholds in different provinces.

METHODSWe collected the amount of MPM signals, response results of signals in CIDARS, cases data in nationwide Notifiable Infectious Diseases Reporting Information System, and outbreaks data in Public Health Emergency Reporting System of 16 infectious diseases in 31 provinces in Chinese mainland from January 2011 to October 2013. The threshold with the optimal sensitivity, the shortest time to detect outbreak and the least number of signals was considered as the best threshold of each disease in Chinese mainland and in each province.

RESULTSAmong all the 16 diseases, the optimal thresholds of 10 diseases, including dysentery, dengue, hepatitis A, typhoid and paratyphoid, meningococcal meningitis, Japanese encephalitis, scarlet fever, leptospirosis, hepatitis, typhus in country level were the 90(th) percentile (P90), which was the same as provincial level for those diseases.For the other 6 diseases, including other infectious diarrhea, influenza, acute hemorrhagic conjunctivitis, mumps, rubella and epidemic hemorrhagic fever, the nationwide optimal thresholds were the 80th percentile (P80), which was different from that by provinces for each disease. For these 6 diseases, the number of signals generated by MPM with the optimal threshold for each province was decreased by 23.71% (45 557), 15.59% (6 124), 14.07% (1 870), 9.44% (13 881), 8.65% (1 294) and 6.03% (313) respectively, comparing to the national optimal threshold, while the sensitivity and time to detection of CIDARS were still the same.

CONCLUSIONOptimizing the threshold by different diseases and provinces for MPM in CIDARS could reduce the number of signals while maintaining the same sensitivity and time to detection.

China ; Communicable Diseases ; Disease Notification ; Disease Outbreaks ; prevention & control ; Humans ; Population Surveillance ; methods