Although BNP/NT-proBNP has been widely accepted as the gold standard biomarker for the diagnosis and prognosis of heart failure, and current guidelines on heart failure list the application of natriuretic peptide in the diagnosis and prognosis of heart failure as ⅠA recommendations, the latest studies discovered a lot of new finding, which show that some of our thoughts on the test result of BNP/NT-proBNP is wrong. It is important for clinical and laboratory physicians to understand the latest progress on natriuretic peptide family. It will help them use BNP/NT-proBNP more properly. In the future, as the new drugs, which work via natriuretic peptide family, will be used widely in patients, the test of natriuretic peptide family will become more important.

BNP/NT-proBNP is very important for the diagnosis,evaluation of treatment and progoosis of heart failure.As heart failure is a very complicated heterogeneous condition,and there are many factors would affect the measurement of BNP/NT-proBNP,doctors should comprehend the BNP/NT-proBNP test result in clinical context considering the patient's specific condition and taking the influencing factors in the post-analytical step into account in order to utilize this test correctly.

The new generation test of high sensitivity cardiac troponin has been used by European clinicians nearly for four years.In 2011,it was recommended by the latest ESC clinical guidelines for rapid exclusion of NSTE-ACS.In China,high-sensitivity cardiac troponin test has been oppreciated in many hospitals for three years actually,but it's not utilized well due to the poor communication between clinical laboratory and clinicians.Clinicians have various opinions about this new test,Some doctors are interested in this new test,while some doctors do not know much about it.Consensus has been reached on the importance of cardiac troponin for the diagnosis and treatment for ACS.The new generation test solves many problems of the previous generations,such as low sensitivity,accuracy and delayed diagnosis.Therefore it could give doctors more help.In order to utilize this useful test well,the clinical laboratory should study it well first and then introduce it to clinicians.

Anti-platelet therapy plays a key role in acute coronary syndrome ( ACS ) treatments.Platelet function tests could monitor the effect of anti-platelet drugs′, however, it is still under debate that whether platelet function monitoring could be used to adjust antiplatelet therapy.Additionally, there are a number of platelet function assays, and each of them has specifically advantages and disadvantages.This article reviewed evidence-based information, guidelines, consensus and clinical experience about platelet function monitoring in ACS patients, which was intend to help laboratory technicians and clinicians understanding the value of platelet function tests in monitoring anti-platelet therapy.

The new generation high-sensitivity cardiac troponin assays have been used in clinic for nearly 5 years in China.In 2012,several new high-sensitivity assays have been approved to be used in clinic in other countries,and they are under inspection of Chinese Food and Drug Ddministration.Because the new generation assays' sensitivity is improved,acute coronary syndrome could have been diagnosed 2-3 hours earlier,and small cardiac injuries that could not be detected by previous assays are detectable now.But its advantages also bring challenges to doctors.Many doctors can't even use previous assays well.The clinical doctors and laloiatory stuffs need to comunicate and reach a consensus just like American doctors do before American food and drug administration approve it.

Objective To evaluate the value of the combination detection of serum amylase (AMY) and lipase(LPS) in the diag‐nose of acute pancreatitis .Methods Serum AMY and LPS were detected in 51 patients with acute pancreatitis ,418 patients with a‐cute abdomen disease and 78 healthy control subjects .Results The sensitivity of serum AMY and LPS increase in 51 patients with acute pancreatitis was 86 .3 % and 92 .2 % respectively .The specificity of serum AMY and LPS increase ,and both AMY and LAS increase in 418 non‐pancreatitis patients with acute abdomen disease was 90 .4% ,91 .7% and 100% respectively .Conclusion The combination detection of serum AMY and LPS can increase the sensitivity and specificity for diagnosing acute pancreatitis and has an important significance for rapid diagnosis of acute pancreatitis .

Background Constipation is a common complication after stroke, and the results investigated overseas showed the incidence was about 30% ～60%. The difference of results is so significant because the time investigated and the diagnosis criterion used are different. There are less relative report about risk factors of constipation and no report about the impact of constipation on pragnosis. The study is to investigate the incidence and risk factors of new-onset constipation after stroke in the patients with acute stroke and to evaluate the impact of new-onset constipation occurrence on the prognosis in the patients.Methods A prospective cohort study of new-onset constipation was performed to investigate 154 cases of acute stroke patients who were hospitalized from December 2003 to October 2004 in the department of neurology, the first Affiliated Hospital of Sun Yat-sen University. We recorded the demographics, medical history,stroke severity and medication used. National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI)and Modified Rankin Scale (MRS) were evaluated in the 1st week and 4th week after stroke to evaluate the neurological function and ability of an independent life. BI and MRS were recorded at the 12th week after stroke.Patients were then followed for the development of stroke, the event such as recurrence or death. Constipation was defined by Rome Ⅱ criteria.Results The incidence of new-onset constipation after stroke within 4 weeks was 55. 31%, and the highest risk was within seven days after onset of stroke. Cox regression showed that the incidence of constipation occurrence was strongly related to neurological functional status of patients in the 1st week assessed by BI and the transform of surrounding for defecation. In the 4th week and 12th week after stroke, the rates of poor prognosis in patients with constipation in middling state were both higher than patients without constipation, and the difference was statistically significant respectively(P ＜ 0. 01 ;P = 0. 012).Conclusions The new-onset constipation occurrence in acute stroke is very common and its main risk factor is functional status assessed by Barthel Index at the 1st week after onset and the transform of surrounding for defecation. The results indicate that the new-onset constipation occurrence after stroke has negative effects on the outcome of partial stroke patients.

Objective To study the relationship between the inherit gene and the pharmic efficacy by observing the apolipoprotein E polymorphism and the nylestroil effect in lowering serum lipids in postmenopausal women. Methods Ninety-four postmenopausal women were divided into three groups according to their types of the apoE gene: E2, E3 and E4. Thirty-six women who received nylestroil therapy were compared with controls, 58 women who had not received the therapy, in lipids, apolipoprotein E and lipoprotein(a)〔LP(a)〕. Results Compared with the control groups, the treatment groups showed an increase in HDL-C (high-density lipoprotein) and decrease in LDL-C(low-density lipoprotein) and LP(a). Though Group E2 showed an increase in the HDL-C and TG and a decrease in the LDC-C and LP(a), no significance was shown compared with the controls. Group E3 was increased in the HDL-C(2.7?0.9)mmol/L and decreased in the LDL-C (3.2?1.0)mmol/L and Lp(a) (0.4?0.2)g/L, and the differences were significant in HDL-C(1.7?0.5)mmol/L and Lp(a) (0.5?0.3)g/L compared with the controls. Group E4 was increased in the HDL-C (2.6?1.0)mmol/L and decreased in the LDL-C(2.5?1.6)mmol/L, TC and LP (a), and the differences were statistically significant(P

Objective To evaluate the interference of ALP on cTnI assays. Methods One normal mixed plasma sample and 2 abnormal mixed plasma samples with different cTnI levels were prepared, and then divided them into 8 groups respectively. One group was randomly chosen as control while different amounts of ALP were added into the other seven groups. The concentrations of cTnI and ALP in each plasma portion were detected by ACCESS2 (Beckman-Coulter, Inc ) and AXSYM (Abbott Laboratories )separately. The results of the seven tested groups were then compared with those of the control, so as to evaluate whether ALP could interfere with the cTnI assay. Results When the chemiluminescent Access cTnI assay was carried out for detection of normal plasma, the concentration of ALP was up to 3 716 U/L and did not interfere with the test results of cTnI [(0. 04 ±0.01) μg/L] compared with those of the control portion [(0. 04 ± 0. 01 ) μg/L] (t = 0. 40, P ＞ 0. 05 ). Once the concentration of ALP went beyond 917 U/L, the AXSYM cTnI assay results [( 0.08 ± 0. 01 ) μg/L] were higher than those of the normal control ( t =-4. 89, P＜0. 01 ); When the concentration of ALP was up to 3 534 U/L, the test results of abnormal plasma cTnI detected by the Access assay [( 13.41 ±0. 17) μg/L] did not show significant differences from those of the control [(13.48±0.16) μg/L] (t=0. 52,P＞0.05).Conclusions High concentration ofALP did not interfere with the Access cTnI assay or lead to false positive results. However, the high level of ALP( ＞ 917 U/L) could interfere with the AXSYM cTnI assay and cause a false positive result.

Objective To evaluate the efficacy and safety of a 595-nm flashlamp-pumped pulsed dye laser in the treatment of patients at different ages with port-wine stains (PWS).Methods A retrospective review was performed in 1560 patients with PWS who had been treated with a 595-nm flashlamp-pumped pulsed dye laser.Treatment parameters were selected according to the age of and types of lesions in patients.Results The total response rate was 76.73％ (1197/1560) in all of the patients.Clinical efficacy of the flashlamppumped pulsed dye laser was closely correlated with patients'age (x2 =83.47,P ＜ 0.01) and types of lesions (x2 =46.30,P ＜ 0.01 ).There was a low incidence of adverse reactions which were well tolerable.Conclusion The 595-nm flashlamp-pumped pulsed dye laser is safe and effective for the treatment of PWS.