1.Proper report of estimated glomerular filtration rate in clinical laboratory
Chinese Journal of Laboratory Medicine 2016;39(12):888-891
Estimated glomerular filtration rate ( eGFR ) is important for diagnosis and staging of chronic kidney disease ( CKD ) , disease risk evaluation and prediction of prognosis , precise dosing and public health management .Automatic reporting eGFR when creatinine and/or cystatin C is measured could improve the quality of service of clinical laboratory .Here we discussed the clinical significance of automatic reporting of eGFR , the status of automatic reporting of eGFR at home and abroad , and matters needing attention when eGFR was reported by clinical laboratory .Wish eGFR to play a better role in clinical practice .
2.Methodology evaluation of a kit for urine type Ⅳ collagen measurement and influence by pre-analytical factors
Medical Journal of Chinese People's Liberation Army 2001;0(10):-
Objective Urine type IV collagen has been recognized as an early sensitive marker for diabetic nephropathy. For quality assurance in clinical use, the function was initially evaluated as a one-step ELISA of sandwich method, and the reference intervals were established and the pre-analytical and influential factors were investigated. Methods ELISA was used to determine the concentration of type Ⅳ collagen in urine. Kit was evaluated on sensitivity, linearity, precision, specificity and recovery rate. Interference factors were also investigated, and a rough reference range was obtained. Pre-analytic factors, such as specimen collection, centrifugation, storage condition and duration, frozen and thawing, even diurnal periodicity, were all included in this test. Results The assay was satisfactory in sensitivity (0.2ng/ml), linearity (0.8-50ng/ml), precision (CV
3.Progress of laboratory examination of calcium calculi of urinary system
Dongfang QIN ; Ke GONG ; Xuejing WANG
Chinese Journal of Laboratory Medicine 2021;44(5):446-451
Calcium calculi account for about 80% of urolithiasis with high incidence and recurrence rate. Recurrent urolithiasis increases the risk of hypertension and chronic kidney disease. Comprehensive metabolic evaluation is of paramount importance for the prevention of calcium calculi. With deepening of the study on the pathogenesis of calculi, we find crystallization inhibitors, inflammation and oxidative stress molecules play an important role in the formation of calculi, and susceptibility gene sites of urinary calculi are identified in succession. These may be used as novel markers for the prevention and evaluation of urinary calculi. Models that predict the risk of kidney stone recurrence can help warn people at high risk.
4.Performance evaluation of nine commonly used urine albumin assay systems
Xuejing WANG ; Guobin XU ; Jie ZHANG
Chinese Journal of Laboratory Medicine 2012;(11):1038-1044
Objective By investigating precision,linearity and accuracy of 9 commonly urine albumin assay systems (8 of immuno-turbidimetric assays and 1 of immuno-nephlometric assay),and comparing the concordance of measurement results,to elucidate the quality of the existing analytical systems.Methods Referring to Clinical and Laboratory Standards Institute (CLSI) EP15-A2,two mixed urines with U-Alb levels of 20 mg/L and 200 mg/L were made to validate precision; Referring to CLSI EP14-A2,fourty fresh urines were selected to evaluate matrix effect of saline diluted European Reference Materials (ERM) DA 470 and saline diluted urine,also to reflect the variation of measurement results among systems; Referring to EP6-A,saline diluted urines (10 levels) were made to validate linearity; Taking the theoretical concentration of precisely saline-diluted ERM-DA 470 as the target value,accuracy of each assay system was evaluated.Maximal allowable coefficient variation (CV) of ≤ 15% was taken as the acceptable precision for each assay system,as rccommcnded by International Federation of Clinical Chemistry (IFCC)-and National Kidney Disease Education Program (NKDEP) ; maximum allowable bias of ≤25% was taken as criteria for accuracy evaluation as used in Proficiency Test (PT) sponsored by College of American Pathologists (CAP).Results At level of micro-albuminuria(20-200 mg/L),all 9 systems total CVs were ≤ 15% ; No matrix effect or interference were found in saline diluted ERM DA 470 and saline diluted urine.For A,B,E,F,G and I systems,validated linear regions were close to those stated in kit instruction;For C,D and H systems,the lower limits of validated linear region (18.7,3.6 and 12.0 mg/L,respectively) were higher than those stated in kits instruction (0,0.9 and 5.0 mg/L,respectively) ;For B and C systems,the lower limits of validated linear region were close to the upper limits of reference interval stated in kit instruction.When urine albumin was ≤ 12.6 mg/L,A,E,F,G and I systems showed good accuracy,absolute biases at all dilution were below 3 mg/L,D system showed higher positive bias (5.0-14.4 mg/L),B,C and H systems' biases were not evaluated because of high in-batch CV (the CV of B system≥ 18.1%,of C system ≥ 14.5%,of H system ≥ 39.1%); when U-Alb ranged in 25.2-201.0 mg/L,all 8 systems' relative biases were ≤25%,except D systems,which showed an un-acceptable positive bias (15.9%-44.3%).Good concordance among systems' results was present at level of microalbuminuria(20-200 mg/L),with CV among systems < 15% ;when urine albumin was < 20 mg/L,CV among systems increased as allumin concentration decreased.The main contribution of variation came from B,C and H systems,which lower limits of linearity were relatively high.Conclusions At level of microalbuminuria(20-200 mg/L),except D system,the other 8 systems show good precision and accuracy;at low level of urine albumin(<20 mg/L,especially < 10 mg/L),precision and accuracy of some systems(B,C and H system) needs to be improved.
5.Clinical significance of urine albumin and current progress in measurement
Xuejing WANG ; Guobin XU ; Jie ZHANG
Chinese Journal of Laboratory Medicine 2012;(12):1097-1101
Urinary excretion of albumin indicates kidney damage and is recognized as a risk factor for progression of kidney disease and cardiovascular disease,resulting a widespread clinical utilization of urine albumin measurement.Considerable inter-method difference has been reported for urine albumin,there are no available reference materials and no reference measurement procedures for urine albumin.This review discusses the clinical utilization of urine albumin in recent years,the principles of existing measurement systems and difference of results among systems,and the current status of work about reference materials and reference measurement procedures.
6.Resistin concentration in healthy volunteers, patients with obesity, diabetes mellitus and hyperthyroidism
Xuejing WANG ; Guobin XU ; Lihua ZHU
Chinese Journal of Laboratory Medicine 2000;0(06):-
0.5). Conclusions There is an increasing trend of resistin level in healthy volunteers and patients with obesity, diabetes mellitus and hyperthyroidism in order Resistin also was a positive and an inverse correlation with BMI and resistance index respectively. These results support the hypothesis of Steppan that resistin causes insulin resistance and links obesity to diabetes, and that the high level of resistin in hyperthyroidism can help to explain the phenomenon of its insulin resistance.
7.Treatment of hilar cholangiocarcinoma with inserting biliary double stents
Guangzhi JIA ; Zidong ZHANG ; Xuejing WANG
Journal of Interventional Radiology 2001;0(05):-
Objective To investigate the inserting technique of biliary double stents in treating hilar cholangiocarcinoma. Methods 6 patients with hilar cholangiocarcinoma (Bismuth Ⅳ) were treated by percutaneous transhepatic insertion of biliary stents. Double stents were inserted in each patient. Different inserting methods were adopted acording to the branch angles formed by left and right hepatic ducts. Results The jaundice of all patients alleviated or disappeared obviously after stent implantation. The average difference between post-and pre-operation in the serium total bilirubin level was (104?29) ?mol/L(P
8.Inhibition of Smilax Glabra Roxb on VCAM-1 Expression Induced by IL-1 of Human Vascular Endothelial Cells
Xiulan HUANG ; Xuejing ZHANG ; Wei WANG
Chinese Journal of Information on Traditional Chinese Medicine 2006;0(03):-
Objective To investigate the protective effect of Smilax Glabra Roxb on the expression of vascular cell adhesion molecule-1 (VCAM-1) induced by IL-1 in human vascular endothelial cells (HUVECs). Methods Take human umbilical vascular endothelial cells as study subject, use immunofluorescence staining, serum pharmacology of the traditional Chinese medicine and flow cytometer. The level of VCAM-1 is represented by the mean fluorescence intensity. Results IL-1 increases the expression of VCAM-1, the expression of VCAM-1 in group of serum containing drugs is lower than control group. Conclusion Smilax Glabra Roxb can inhibit the effect of IL-1 induced increase of VCAM-1 expression in HUVECs.
9.The neuroprotective effect of hyperbaric oxygenation on the mitochondria of dopaminergic neurons in a mouse model of Parkinson's disease
Mingming MA ; Xuejing WANG ; Xuebing DING ; Jiewen ZHANG ; Wei LI
Chinese Journal of Physical Medicine and Rehabilitation 2012;34(9):641-645
Objective To investigate any neuroprotective effect of hyperbaric oxygenation (HBO) on the mitochondria of dopaminergic neurons using a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mouse model of Parkinson's disease.Methods Forty-eight male SPF C57BL/6 mice were randomly assigned to either a normal control group (treated with a 30 ml/kg intraperitoneal injection of physiological saline once a day),a model group ( treated with a 30 mg/kg intraperitoneal injection of MPTP once a day) or an HBO therapy group ( treated with a 30 mg/kg intraperitoneal injection of MPTP and HBO once a day).The expression of tyrosine hydroxylase (TH) protein,PINK1 protein and caspase-3 in brain tissue was measured using immunohistochemistry and Western blotting assays.Results Compared with the control group,the expression levels of TH protein and PINK1 protein were significantly lower in the neurons of the substantia nigra in the model mice.HBO therapy upregulated the expression of TH and PINK1 protein.Compared with the control group,the average level of caspase-3 protein in the neurons of the substantia nigra in the model mice was significantly higher.HBO therapy downregulates the expression of caspase-3 protein.Conclusions HBO can protect mitochondria and inhibit apoptosis of dopaminergic neurons in the substantia nigra of brains with (MPTP-induced) Parkinson's disease by upregulating the expression of PINK1 protein and TH protein,and downregulating the expression of caspase-3 protein.
10.Individualized lifestyle intervention on the control of metabolic status of type 2 diabetes and evaluation of patient compliance
Xuejing GU ; Jiangtao WU ; Yan WANG ; Haiying FAN ; Jianxia MENG
Clinical Medicine of China 2012;28(12):1310-1314
Objective To analyze the effects of individualized lifestyle intervention on compliance and metabolic status of patients with type 2 diabetes mellitus (T2DM).Methods Two hundred T2DM patients were selected and randomly divided into experimental and control groups of 100 patients respectively.The experimental group was given individualized lifestyle intervention for 6 months in addition to conventional oral medications.The intervention was to prescribe diet control and exercise therapy according to the patients' individual conditions.The control group was given conventional treatment and verbal lifestyle intervention for 6 months.Comparison was made in patients compliance and various metabolic markers between the two groups.Results The percentage of conduction of diet control and exercise therapy in experimental group was significantly higher than control group ( Diet control:80 vs.52,x2=7.08,P=0.029;Exercise therapy:78 vs.44,x2=11.207,P=0.004).After intervention,the fasting plasma glucose (FPG),2-hour postprandial blood glucose (2hPG),glycated hemoglobin ( HbA1c),body mass index ( BMI),triglyceride ( TG),total cholesterol (TC),low-density lipoprotein ( LDL-C ),and insulin resistance index ( HOMA-IR ) in experimental group decreased significantly,and high-density lipoprotein ( HDL-C ) increased significantly [FPG:( 8.45 ± 1.46 ) mmol/L vs.(6.66 ± 0.67) mmol/L,P=0.000;2hPG:( 12.76 ± 2.25 ) mmol/L vs.(8.22 ± 1.79) mmol/L,P=0.000;HbA1c:(7.68 ± 1.06 ) % vs.( 6.48 ± 0.69 ) %,P=0.000;BMI:( 25.90 ± 1.72 ) kg/m2 vs.( 22.81 ±1.41 ) kg/m2,P=0.016;TG:(2.57 ±0.68) mmol/Lvs.( 1.88 ±0.35) mmol/L,P=0.006;TC:(5.72 ±0.13) mmol/L vs.(5.14 ± 1.38) mmol/L,P=0.043;LDL-C:(3.28 ±0.10)mmol/L vs.(2.81 ±0.57)mmol/L,P=0.009;HOMA-IR:7.58 ± 0.19 vs.4.58 ± 1.98,P=0.000;HDL-C:( 1.29 ± 0.04) mmol/L vs.( 1.62 ± 0.27 ) mmol/L,P=0.003].The levels of FPG,2hPG,HbA1c,BMI,TG,HOMA-IR also decreased in control group after intervention compared with before intervention [FPG:( 8.67 ± 2.71 ) mmol/L vs.( 7.26 ± 1.21 ) mmol/L,P=0.001;2hPG:( 12.82 ± 2.15 ) mmol/L vs.( 10.85 ± 1.98 ) mmol/L,P=0.000,HbA1c:( 7.75 ± 1.08 ) % vs.( 7.01 ± 0.87 ) %,P=0.002;BMI:( 25.82 ± 1.74 ) kg/m2 vs.( 24.23 ± 1.36 ) kg/m2,P=0.024;TG:(2.47 ±0.75) mmol/L vs.(2.13 ± 0.43 ) mmol/L,P=0.018;HoMA-IR:7.88 ± 0.20 vs.6.15 ± 2.01,P=0.042].No significant difference was found on the values of TC,HDL-C and LDL-C before and after intervention in control group (P > 0.05).The effect of intervention of experimental group was more obvious when compared with control group ( FPG:P=0.036;2hPG:P=0.000;HbA1c:P=0.045;BMI:P=0.037;TG:P=0.022;HoMA-IR:P=0.000).Conclusion Individualized lifestyle intervention can improve the compliance of T2DM patients,and was in favor of control metabolic status of T2DM patients to delay the occurrence and development of complications.