Objective To review the performance of the IFCC enzyme reference methods in China laboratories and to evaluate the competence of enzyme reference measurement in China.Methods The Intemational Federation of Clinical Chemistry and Laboratory Medicine(IFCC)enzyme reference methods were performed in 8 China laboratories.Reference procedures were developed by each laboratory and the performances were evaluated.The Clinical and Laboratory Stadards Institute(CLSI)EP-5 protocol was used for the evaluation of precision and certified reference materials(CRMS)were used for the verification of trueness.Seven of the 8 laboratories participated in the 2006 IFCC external quality assessment program for reference laboratories(RELA)for the assessment of the measurement performance.Results Within-run CVs of less than 1.5%and between-run CVs of less than 2%were achieved bv all the China laboratories.Results on CRMs by some of the laboratories agreed with the certified value within the stated uncertainty.In the 2006 RELA,the averages and the interlaboratory CVs of the China laboratories were similar to those of international laboratories.Conclusion A preliminary enzyme reference method laboratory network has been established in China.

Objective To evaluate the effect of Tandospirone citrate in the treatment of Alzheimer's disease with depression and anxiety disorder. Methods A total of 122 patients with Alzheimer's disease with depression and anxiety were enrolled at the Second Hospital of Jinhua City from January 2015 to December 2016.They were randomly divided into the Lorazepam group(n=61) and the Tandospirone citrate(ADHA)(n= 61).The behavioral pathology in Alzheimer's disease (BEHAVE-AD),self-care ability scale(ADL),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were evaluated in the two groups after three weeks of treatment.The BEHAVE-AD,ADL,HAMA,and HAMD scores and the incidence of adverse reactions were compared between the two groups before and after treatment. Results Baseline scores of BEHAVE-AD, ADL,HAMA and HAMD were not significantly different between the two groups(all P> 0.05). However,post-treatment scores of BEHAVE-AD,ADL,HAMA and HAMD were significantly lower than pre-treatment scores(all P< 0.05),and were more significantly decreased in the Tandospirone citrate group(all P<0.05).Furthermore,the incidence of adverse reactions was significantly lower in the Tandospirone citrate group than that in the Lorazepam group(6.5% vs.19.7%,P< 0.05). Conclusions Compared with Lorazepam,Tandospirone citrate is clinically more effective for Alzheimer's disease complicated with anxiety and depressive disorder.

Objective:To evaluate the association between the use of emergency medical services (EMS) and the severity of disease among patients admitted to the emergency room, to analyze the characteristics of the patients, and to build prediction model providing evidence-based use of EMS resources.Methods:The data of patients admitted to the Emergency Room of the First Affiliated Hospital of University of Science and Technology of China from January 2020 to July 2021 were extracted from the Chinese Emergency Triage Assessment and Treatment (CETAT) database. Patients were divided into the EMS use group (AB+ group) and self-seeing group (AB-group) according to whether they used EMS. The patients’ general condition, vital signs and laboratory tests results were recorded. The severity of patients’ condition was judged based on whether the patient was admitted to the department of critical medicine, specialized care unit, emergency operation and/or emergency percutaneous intervention. A 9-variable model that did not require laboratory inspection and 22-variable model that required laboratory inspection were established to correct the propensity score to analyze the correlation between the severity of disease and the EMS use. In the subgroup analysis, the correlation between the EMS use and severity of the patients was analyzed according to the reason of the patient’s visit.Results:During the study period, 16 489 patients were admitted to the emergency room, and 6975 patients were finally enrolled in this study. There were 2768 patients (39.7%) in the AB+ group and 4207 patients (60.3%) in the AB-group. In the AB+ group 522 patients (18.9%) were in high risk, and in the AB-group 563 patients (13.4%) were in high risk. Compared with the AB-group, patients in the AB+ group were older and had a higher proportion of coma, a faster autonomic heart rate, and a lower diastolic blood pressure and peripheral oxygen saturation (SpO 2). In the 9-variable model, sex, consciousness, temperature, heart rate and diastolic blood pressure were associated with the EMS use. In the 22-variable model, consciousness, SpO 2, neutrophils, and albumin were the relevant factors for patients using EMS. Before the correction of propensity score, the EMS use was an independent risk factor for critically ill patients ( OR=1.5, 95% CI 1.32-1.72, P<0.001). After adjusted using 9-variable propensity score, the EMS use ratio decreased significantly compared with that without correction ( OR=1.24,95% CI 1.08-1.42, P<0.001). Interestingly, after adjusted with propensity score match with 22-variable model, there was no association between the severity of disease and t the EMS use ( OR=1.10,95% CI 0.95-1.28, P=0.195). In subgroup analysis, patients’ chief complaint of central nervous system, cardiovascular system, and trauma were the top three reasons at admission. Before the propensity score correction, the EMS calling patients with chief complaint of central nervous system, digestive system, and trauma were related to the severity of the patients. After adjusted with 9-variable model the EMS use was associated with the severity of the disease only in trauma patients, and after adjusted with 22-variable model there was no statistical difference considering the severity of the disease in all subgroups. Conclusions:The EMS use is common. However, the association of the EMS use with the severity of disease is decreased with variable models using propensity score. These findings indicate that the EMS use should be based on multivariable models, which may be important in detecting critically ill patients, optimizing the EMS use, and avoiding unnecessary call in the future.