Objective To have a general picture the history and existing problems of independent clinical labs in China, for the purpose of building a supervision mechanism for such novel clinical institutions-clinical labs. Methods By way of the nationwide network of clinical labs, ICLs in China were surveyed with written questionnaires and field check. Results ICLs have grown into a greater and diversified scale thanks to the development of China's economy and laboratory technology. However,such vulnerabilities as unbalanced staff ratio, full-range quality control bugs, cutthroat competition,asymmetrical information disclosure, and bio-safety have loomed large in the meantime. Conclsion It is time to formulate a stricter industry access system and appropriate regulatory modes; ICLs should take a good care of the "Four relations" in their development, and health regulators should play a tighter role in the "Four supervisions". All these aim at better sharing medical resources, and building a win-win environment for the people, hospitals and ICLs.

Objective To establish an external quality assessment (EQA) scheme for cell morphological interpretation of bone marrow smears and investigate its application value.Methods The Laboratories taking part in the assessment were periodically provided with diagnosed bone marrow smears,clinical data and other examination results for cell morphological interpretation of EQA.Results The coincidence rate was improved year after year from 50% in 1988 up to 85.8% in 2005 (P

Objective To observe the clinical characteristics of gestational diabetic retinopathy (DR)of 13 pregnants with vitreous hemorrhage.Methods The clinical data of 26 eyes retinopathy with 13 cases of gestational diabetes were retrospectively analyzed.After bilateral eyes were mydriatic by Pyrazole MAO amine compound,ophthal-mologist used fundus camera to check bilateral fundus.B ultrasonic was used to examine vitreous hemorrhage and the surfaces of vitreous and retinal.Results In 13 cases,26 eyes vision were between hand motion-0.6.Sudden vitre-ous hemorrhage in 13 eyes,accounted for 50.0%(13/26).Among them,the classⅠvitreous hemorrhage in 10 eyes, 76.9%(10/13).Ⅱ,Ⅲ grade vitreous hemorrhage in 2 eyes,15.4%(2/13).LevelⅣvitreous hemorrhage in 1 eye, accounted for 7.7%(1/13).26 eyes were diagnosed with stage IV(early or fiber hyperplasia period)DR.The fundus photography:the size,number of retinal neovascularization were found in 13 eyes without vitreous hemorrhage.Ultra-sound confirmed that the 13 eyes vitreous hemorrhage were fresh bleeding,and found 4 eyes with fiber membrane, accounted for 30.8%(4/13).The eyes without vitreous hemorrhage were timely treated by laser,and the eyes with vitreous hemorrhage were treated by stage laser treatment according to the condition of vitreous hemorrhage absorp-tion.Followed up for 4 to 6 months,in a stable condition.Conclusion Obstetrics and gynecology doctors and oph-thalmologists should pay attention to pregnancy DR with vitreous hemorrhage.Because they are all early or fiber hyper-plasia period.Timely and reasonable laser treatment can prevent permanent damage of visual function.

Cancer stem cells (CSCs) markers are specific molecules to identify CSCs.Recent findings demonstrate that CSCs markers associated with colorectal cancer mainly include CD133,CD29,CD166,CD44,Nanog,etc.These markers can take park in the initiation and progression of cancers by various molecular mechanisms,which have the potential to be used as therapeutic targets as well as prognostic indicators.

Objective To investigate the differences and harmonization of immunoassay systems in detecting CA19-9 and to assess the possibility of mutual recognition in different laboratories.Methods Data were collected and analyzed from External Quality Assessments (EQA) of NCCL(Lots:200811-201215) and ZJCCL(Lots:080309-120211).120 fresh serum with different concentrations of CA19-9 were collected.The CA19-9 results of healthy people were also collected from September 2010 to March 2012.Four kinds of stable immunoassay systems were involved in our research,including Abbott Architect i2000,Beckman UniCel DxI 800,Roche E170 and Siemens ADVIA Centaur XP.The differences among four system groups were calculated with the EQA data.The fresh serum comparisons were also performed following the guideline of CLSI EP9-A2 The 95％ confidence interval of each immunoassay system was calculated.Comparisons were made by scatter diagrams and weighted regression.Results Both EQA of NCCL and ZJCCL showed better correlation coefficients and larger bias (bw ranged from 1.340 to 4.683) than in fresh serum comparisons.Although the correlation coefficients were all unsatisfactory,the bw were all close to 1 in fresh serum comparisons.When the recommended serum concentration of 27 U/ml was used,the biases were Abbott-Roche-6.41％,Beckman-Roche-5.07％,Siemens-Roche 13.15％,Beckman-Abbott 2.46％,Siemens-Abbott 22.52％ and Siemens-Beckman 39.66％,respectively.Differences of 95％ confidence intervals were statistically significant among parts of the immunoassay systems.Conclusions Only in the lower concentration can CA19-9 results be mutual recognized among four different immunoassay systems,there will be larger differences and risks in the higher concentration.

Objective To detect the expressions of Y-box-binding protein-1(YB-1)and epithelial-mesenchymal transition(EMT)markers(E-cadherin and N-cadherin)in colorectal cancer(CRC),to analyze the relationship between the expression of YB-1 and clinicopathological parameters,to evaluate the correlations among YB-1,E-cadherin and N-cadherin. Methods The expressions of YB-1,E-cadherin and N-cadherin in 120 primary CRC tumors and corresponding normal tissues were detected by western blot and immunohistochem-istry and the results were analyzed. Results The expressions of YB-1,E-cadherin and N-cadherin in tumors were significantly different from those in corresponding normal tissues(χ2 = 47. 373,P ﹤ 0. 05;χ2 = 83. 145, P ﹤ 0. 05;χ2 = 41. 832,P ﹤ 0. 05). The expression of YB-1 in tumors was associated significantly with tumor differentiation,tumor invasion,lymph node metastasis and distance metastasis(χ2 = 8. 077,P = 0. 008;χ2 =8. 178,P = 0. 006;χ2 = 15. 152,P ﹤ 0. 001;χ2 = 7. 368,P = 0. 011). It was negatively correlated with E-cadherin expression(r = - 0. 238,P = 0. 009),but positively correlated with N-cadherin expression(r =0. 361,P ﹤ 0. 001). Conclusion YB-1 may promote the occurrence and development of CRC by participating in EMT program.

Objective To study the effects of human insulin-like growth factor 1(hIGF-1) gene transfection on the proliferation of NIH3T3 fibroblasts.Methods The plasmid of pcDNA3.1-hIGF-1 was transfected into NIH3T3 fibroblasts by using Lipofectin method.The positive cell clones were selected with G418 and cultured for 4 weeks.The stable expression of hIGF-1 in the positive cells was determined by in situ hybridization and immunocytochemical analysis.MTT assay and flow cytometer analysis were used to observe the proliferation of NIH3T3 fibroblasts.Results hIGF-1 mRNA and protein expressed in NIH3T3 fibroblasts transfected with pcDNA3.1-hIGF-1 by in situ hybridization and immunocytochemical analysis.MTT assay showed the A value of transfected NIH3T3 fibroblasts rose,compared with untransfected NIH3T3 fibroblasts group,the difference was significant(P

As a member of T-box family,Tbx3 (T-box3) is widely expressed in multiple organs and involves in the development of breast,limb,heart,eye,lung and pancreas during embryonic development stage.Moreover,Tbx3 plays an important role in maintaining the embryonic stem cells.Recent studies show that Tbx3 can work as a transcription factor to participate in the initiation and progression of tumor by epithelialmesenchymal transition,induction tumor stemness and methylation.A better understanding of Tbx3 will provide new insights into genetic diagnosis and targeted treatment of tumor.

Objective To investigate the synergistic efficacy of different antibiotic combinations against KPC-2 carbapenemase producing Klebsiella pneumoniae strains in vitro and search for effective antibiotic combination.Methods During 2008 - 2009,a total of 24 strains of K.pneumoniae producing KPC-2 carbapenemase were collected from 8 hospitals in the First Affiliated Hospital of Medical School of Zhejiang University,Ningbo LiHuiLi Hospital,Zhejiang People's Hospital,Hangzhou Third Hospital,the Second Hospital of Shaoxing,Hangzhou First Hospital,Fudan University Huashan Hospital,General Hospital of Nanjing Military Region.MLST technique was used for epidemiological analysis.The MIC of antibiotics,such as amikacin,minocycline,imipenem,amoxicillin/clavulanic-acid,ceftazidime,meropenem,gentamicin,cefoxitin,cefepime,rifampicin,polymyxinB,ciprofloxacin were determined by an agar dilution method,the MIC of tigecycline and piperacillin/tazobactain were determined by Etest.The antibacterial activities of cefepime in combination with amoxicillin/clavulanic-acid,amikacin,or ciprofloxacin,amikacin with ciprofloxacin,imipenem with amikacin,ciprofloxacin,polymyxinB,or minocycline,polymyxin B with rifampicin,ceftazidime with amoxicillin/clavulanic-acid were assessed by chequerboard synergy agar dilution tests against all the isolates.Results MLST showed 5 STs among 24 strains of KPC-2 carbapenemase producing K.pneumoniae,and the most prevalent clone was ST11 (15 strains).All isolates were susceptible to polymyxin B and tigecycline,and the resistance rate of minocycline was 4.2％.The synergetic effects were observed in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin,ceftazidime-amoxicillin/clavulanic acid combinations as 19 isolates,13 isolates,and 13 isolates,respectively.Conclusions KPC-2 carbapenemase producing K.pneumoniae is sensitive to polymyxin B,tigecycline and minocycline.The synergetic effect is predominant in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin ceftazidime-amoxicillin/clavulanic acid combinations in vitro,their clinical efficacy are worthy of further observation.

Objective To explore the difference of four calculating methods used to determine the obesity. Methods Two thousand four hundred and forty six (2446) men and three hundred and seventy nine (379) women were measured height and body mass, Standard body mass, BMI, body fat ratio and obesity index(OI) were calculated with formula. According to the BMI≥ 25 kg/m2 , BMI ≥ 27 kg/m2 and BMI≥28 kg/m2, the obese adults were 1419,680 and 435 respectively;there were 649 adults that their body mass was over 20％standard body mass; there were 639 adults that their body fat ratio was over 25％(male)and 33％(female). Results For obesity determination, the adults who were 20％overweight and over standard body fat ratio were significantly different from those whose BMI were over 25 kg/m2 ( P＜0. 05 ) ;Those who were 20％overweight and over standard body fat ratio were not significantly different from those whose BMI were over 27 kg/m2 ( P＞0.05 ) ; Those who were 20％overweight and over standard body fat ratio were significantly different from those whose BMI were over 28 kg/m2 ( P＜0. 05 ). Conclusion Determining obesity with BMI≥27 kg/m2 is feasible and rational.