Objective To promote worldwide standardization of methods to determine creatinine by tracing to reference measurement for achieving universal accuracy measurement of creatinine.Methods The results of external laboratory assessment (EQA) survey in China and CAP were compared and analyzed. Results There was significant difference among different measurement methods and assay systems.Conclusion It should promote worldwide standardization of determine creatinine, which makes it trace to reference measurement liquid chromatography-isotope dilution mass spectrometry (LC-IDMS).

Objective: To assess the effect of preoperative carbohydrate fluid intake on immediate postoperative insulin resistance. Methods: 32 patients for elective colorectal cancer resection were recruited to this randomized controlled study. These patients were randomly assigned to control group and test group. Control group were fasted before surgery, while test group were given oral carbohydrate 3 h before surgery. Patient's wellbeing scores on a visual analogue scale(VAS) were recorded at 3 PM the day before operation and 2 h after consuming carbohydrate fluid respectively. Blood sample were collected to measure the level of blood glucose and the serum concentrations of insulin 4 h before surgery and immediately after surgery, respectively. Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance (HOMA-IR), basic function of pancreatic ? cell (HOMA-? cell) and insulin sensitivity index (ISI). Results: Patients consumed carbohydrate-rich beverage before surgery reduced thirst, hunger and anxiety compared with fasting before surgery. Whole body insulin sensitivity decreased by 33% in the test group vs. 38% in the control group(P

Acquired growth hormone resistance(AGHR) in critical illness may be defined as the combination of a raised serum growth hormone concentration,low serum insulin-like growth factor-1 concentration and a reduced anabolic response to exogenous GH.GH given to reverse catabolism in critical illness increased mortality.Therefore,it has the theoretical significance and clinical value for better understanding of the mechanism of AGHR.The mechanism of AGHR and its prevention and cure are reviewed.

To provide an effective approach to select, develop, interpret and apply well-designed quality indicators. Then to promote the continual improvement of laboratory quality and to assure patient safety. We focused on the quality cycle of selecting, development, implementation and processing for quality indicators. And some examples for essential activities in the development and use of quality indicators were shown. Through the presentation of process and examples, we put forward an organized approach that provides the laboratory with a plan to structure its development of quality indicators to gather useful information. Quality indicators are important. However, they should be integrated with internal review plan, External Quality Assessment (EQA) and the process of activities in plan. Only then can we really promote the continual improvement of quality.

It was pointed out in this paper that the nature of values was invisible knowledge by analyzing the rela-tion between values and invisible knowledge,and the measures were put forward for constructing the values in medi-cal staff in view of their value construction process and its influencing factors.

ObjectiveTo investigate the early diagnosis and treatment of pleuropulmonary blastoma in children. Meth-ods The progress of pleuropulmonary blastoma from type 1 to type 3 was retrospectively analyzed.Results The male infant had no obvious abnormality in chest X-ray at 18 days. At one year old, X-ray iflm of the chest showed cystic lesions near hilum of the left lung (about 5 cm × 4 cm × 4 cm). The congenital cystic adenomatoid malformation was considered and an operation resection was suggested. However, it had been rejected by his parents. At 3 years and 2 months old, chest X-ray and CT showed left lung had a solid cystic lesion, the volume was signiifcantly enlarged, the back side was solid and the upper part had a large gas cavity. Two months later, the patient had asthmatic suffocation. The chest CT showed the tumor was completely solid. Pleuropulmonary blastoma type 3 was considered. The patient received the conventional chemotherapy after operation excision, and was followed up for 1 year. No recurrence was observed after the treatment.Conclusions Type 1 pleuropulmonary blastoma and congenital cystic adenomatoid malformation are hard to be differentially diagnosed. Early diagnosis and treatment of type 1 pleuropulmo-nary blastoma can improve the prognosis.

Objective To investigate the status of report appropriateness in Clinical Hematology and to identify its potential influence factors to improve the quality of laboratory reports.Methods 1 120 National External Quality Assessment ( EQA ) participants laboratories were enrolled in this study.The questionnaires were assigned to all the participants in both electronic and printed form.The participants were asked to retrospectively count the total reports and the affected reports while the following quality indicators occurred in 2012:report delay, inconformity of data between instrument and LIS as well as between report and request erroneous report transportation, report recall, and report modification.All quality indicators were evaluated in two ways:percentage and sigma (σ) scale.Mann-Whitney Test and Kruskal-Wallis Test were used to analyze the potential impacts of report appropriateness.Results Totally 609 (54.38%)laboratories submitted the survey results .The sigma metrics of six quality indicators on report appropriateness were more than 4.The main reason for report delay was equipment failure.Group comparison suggested that the report appropriateness of laboratories in tertiary-A hospitals and accredited by ISO 15189 werebetter.Report appropriateness with electronic request, electronic form and electronic transmission were superior than that inother ways. Conclusions Report appropriateness in China differs from laboratory to laboratory. Laboratories should develop emergency action plan in case the instrument breaks down and strengthen information technology .Long-term internal quality control and external quality assessment scheme are very meaningful to identify the insufficient performance and improve laboratory quality .(Chin J Lab Med, 2015,38:632-636)

ObjectiveTo investigate and analyze the upper and lower limits and their sources of reference intervals in blood gas and acid-base analysis assays.Methods The data of reference intervals were collected, which come from the first run of 2014 External Quality Assessment (EQA) program in blood gas and acid-base analysis assays performed by National Center for Clinical Laboratories (NCCL). All the abnormal values and errors were eliminated. Data statistics was performed by SPSS 13.0 and Excel 2007 referring to upper and lower limits of reference intervals and sources of 7 blood gas and acid-base analysis assays, i.e. pH value, partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), Na+ , K+, Ca2+ and Cl-. Values were further grouped based on instrument system and the difference between each group were analyzed.Results There were 225 laboratories submitting the information on the reference intervals they had been using. The three main sources of reference intervals wereNational Guide to Clinical Laboratory Procedures [37.07% (400/1 079)], instructions of instrument manufactures [31.23% (337/1 079)] and instructions of reagent manufactures [23.26% (251/1 079)]. Approximately 35.1% (79/225) of the laboratories had validated the reference intervals they used. The difference of upper and lower limits in most assays among 7 laboratories was moderate, both minimum and maximum (i.e. the upper limits of pH value was 7.00-7.45, the lower limits of Na+was 130.00-156.00 mmol/L), and mean and median (i.e. the upper limits of K+ was 5.04 mmol/L and 5.10 mmol/L, the upper limits of PCO2 was 45.65 mmHg and 45.00 mmHg, 1 mmHg = 0.133 kPa), as well as the difference in P2.5 and P97.5 between each instrument system group. It was shown by Kruskal-Wallis method that theP values of upper and lower limits of all the parameters were lower than 0.001, expecting the lower limits of Na+ withP value 0.029. It was shown by Mann-Whitney that the statistic differences were found among instrument system groups and between most of two instrument system groups in all assays.Conclusion The difference of reference intervals of blood gas and acid-base analysis assays used in China laboratories is moderate, which is better than other specialties in clinical laboratories.

It was proved that Phenolic alkaloids from Menisphermum dauricum (PAMD) has extensive pharmacological effects, manifested as affecting electrophysiology of the heart, resisting cardiac arrhythmia, inhibiting myocardial infarction, protecting nverves in cerebral ischemia, exerting resisting action in thrombogenesis, dementia, and tumor, and improving learning disorder, and so on. We made an overall sum up of researching progress on PAMD pharmaceutical actions in this article.

Precision controls monitor assay random error (reproducibility),accuracy controls assess total error,both random error and systematic error,and trueness (bias)of an assay represents systematic error.A trueness control should be metro-logical traceable,ideally with a target value determined by use of a reference material or a reference method,without metro-logical traceable to a reference measurement system,patient test results for the same patient from different laboratories may not be comparable.A trueness control should be commutable and its analytical response to a reference method and a routine field method should be equivalent to that of a patient sample.And trueness control values should generally be set at medical decision levels and be prepared by the providers of reference materials and manufactured in the same fashion as a calibrator.