Objective To discuss the application of allowable total error (Tea) and allowable imprecision derived from biological variation in routine chemistry external quality assessment ( EQA) and internal quality control (IQC) and set up quality specifications of routine chemistry in our country.Methods Data of test items including K,Na,CI,Ca,P,Glu,Urea,UA,Cre,Alb,TP,TC,TG,AST,ALT,Tbil,ALP,AMY,CK,LDH,Fe,Mg,Cu,Zn and GGT was collected and evaluated by a nationwide EQA.At the same time the coefficients of variation (CVs) of these test items during the month were acquired from the IQC reports of each laboratory and then the results were analyzed.Results Percent of pass was different in these test items based on Tea derived from biological variation in EQA results.Except for items of CI,Mg,Cu and Zn,about 80％ of participant laboratories could achieve the minimum performance of biological variation.About 80％ of participant laboratories could achieve the desired performance of biological variation for K,P,Glu,Urea,UA,Cre,TC,TG,ALT,AST,Tbil,AMY,CK,LDH,Fe and GGT.About 80％ of participant laboratories could achieve the optimum performance of biological variation for Urea,UA,TC,TG,ALT,AST,Tbil,C K,and GGT.And the IQC results showed that acceptable percents of different items based on three allowable imprecision were different.More than 80％ of participant laboratories could achieve the minimum allowable imprecision for K,P,Glu,Urea,UA,TC,TG,ALT,AST,Tbil,AMY,CK,LDH,Dbil,Fe,GGT,the desirable imprecision for P,Urea,UA,TG,ALT,AST,Tbil,CK,Dbil,Fe,GGT and the optimum imprecision for TG,ALT,CK,Dbil,Fe.Conclusions The quality specifications derived from biological variation can be as evaluation criteria for EQA and IQC in order to know the detection ability of each laboratory more completely and objectively,set up quality specifications derived from allowable total error and allowable imprecision in routine chemistry and to provide basis for mutual recognition of routine chemistry test results.

Objective To evaluate the mechanical characteristics of systolic left ventricular(LV) transmural torsion in different LV electro-mechanical patterns using speckle tracking imaging. Methods Five open-chest canine models were employed for the acquirement of the basal, apical short-axis and four-chamber views of LV during baseline(BASE) and right atrial appendage(RAA), right ventricular apical (RVA), left ventricular lateral wall (LVL) and left ventrieular apical (LVA) pacing. Subendocardial (subend),subepicardial(subepi) and bulk rotation angle(RA) and segmental angle excursion(AE) at basal and apical level were analyzed using a dedicated workstation. LV torsion at different layers and bulk and global LV ejection fraction (EF) were calculated. Results ① There were no significant difference of transmural torsion and RA at basal and apical level between BASE and RAA pacing (P>0.05);② LV torsion of subend, subepi and bulk during RVA pacing were lower than those during RAA pacing(P0.05);LV torsion of subend and bulk during LVA pacing were lower than those during RAA pacing(P0.05);LV RA of subend,subepi and bulk at basal level during RVA and LVA pacing were lower than those during RAA pacing (P<0.05); ③ For normal electro-mechanical pattern, LV torsion of subend were significant higher than that of subepi(P<0.05), there only were a higher tendency for all pacing models (P>0.05); ④AE of segments near the pacing site decreased during different ventricle paeings (P<0.05); ⑤At BASE and during RAA pacing, LV bulk and subepi torsion were positively correlated to EF; RA of subend,subepi and bulk at basal level were positively correlated to EF. Conclusions LV transmual torsion are significantly depressed during RVA and LVA pacing. There is a spatial co-relationship between LV EF and torsion and rotation of bulk and subepi at basal level in normal LV electro-mechanical patterns.

Objective To investigate the status of the disease of the fluorosis and arsenism caused by coal-burning in Ankang city of Shaanxi. Methods Nine survey spots were chosen to carry out the epidemiological investigation of adult skeletal fluorosis and arsenism in the coal-polluted areas of Ankang, respectively using Determination of Fluorine in Coal (GB/T 4633-1997) to determine the coal fluorine and using hydride generation atomic fluorescence spectrophotometry(HCAFS) to determine coal arsenic. The diagnose of the adult skeletal fluorosis followed the Diagnosis of Clinical Classification for Endemic Skeletal Fluorosis Standard(GB 16396-1996), that of arsenism using Standard of Diagnosis for Endemic Arsensim (WS/T 211-2001). Results Totally 569 adults were investigated over the age of 16, among which 121 cases were skeletal fluorosis, with a total detection rate of 21.27%. Four cases of II degree and higher skeletal fluorosis patients were identified, accounting for 0.70% of the number of subjects. One hundred and thirty-two cases of arsenic poisonin were detected, in a rate of 23.20%. Ninety-five patients were identified with moderate or severe arsenic poisoning, accounting for 16.69% of subjects. A positive correlation was found between the detection rates of the skeletal fluorosis and the arsenism(r = 0.816, P < 0.01), as well as between the detection rate of skeletal fluorosis and fluoride content of coal(r = 0.775, P < 0.05). The detection rate of arsenism and arsenic content of coal also had close relationship (r = 0.761, P < 0.05). The detection rate of skeletal fluorosis in the group aged 40 - ,50 - , and 60 - [27.20%(34/125) ,29.27%(36/123), 28.13%(36/128)] was increased, compared the group of less than 40 years age[7.77%( 15/193), X~2 = 21.969,25.648,23.856,P<0.01].For the detection rate of arsenism,male[33.67%(99/294)]was obviously higher than female[12.00%(33/275),)(X~2=37.162,P<0.01].Conclusions A high detection rate of fhorosis is correlated with arsenic poisoning,but the probability of the two diseases simultaneously occurred in a person is not high.In this polluted area.when fluoride accumulates to a certain level as in aduh,the detection rates no longer varies obviously;however,that of arsenism increases along with the age.

Objeetive To evaluate the changes of left ventricular(LV) global and segmental volume, LV outlet pressure and their co-relationship, and to access LV global and segmental systolic function and mechanical asynchrony in different LV electro-mechanical patterns using full volume three-dimensional echocardiography(3DE). Methods Nineteen open-chest canine models were employed for the acquirement of LV full volume dynamic 3DE imaging during right atrial appendage (RAA), right ventricular apical (RVA), LV lateral wall(LVL) and LV apical(LVA). LV outlet end-systolic pressure(ESP) was recorded simultaneously. End-systolic volume (ESV), end-diastolic volume (EDV), global and segmental ejection fraction(EF) and systolic dyssynchrony index(SDI) of LV were measured and calculated using a dedicated workstation. The average ascending rate of LV pressure during systole(+ dp/dt) and the average descending systolic pressure(ESP), + dp/dt and - dp/dt during RVA pacing were lower than those during RAA pacing (P <0.05). SDI during RVA pacing was higher than that during RAA pacing(P<0.05). ESP, + dp/dtand - dp/dt during LVL and LVA pacing were lower than those during RAA pacing (P <0.05). There and LVA pacing was higher than that during RVA pacing (P <0.05),SD1 during LVL pacing was lower than that during RVA pacing (P <0.05), there was no significant difference of SDI between RVA and LVA and LVL pacing. Segmental EF of septum and apex during LVI. pacing were higher than those during LVA pacing (P <0.05). @Segmental EF of anterior and post septum and all apical segments (except lateral wall) during RVA pacing were lower than those during RAA pacing (P <0.05). Segmental EF of lateral and anterior wall during I.VI. pacing were lower than those during RAA pacing (P <0.05). Segmental EF of anterior wall and anterior septum during LVA pacing were lower than those during RAA parameters. Conclusions The global and minority segmental systolic function of LV during RAA pacing could be reduced compared with normal sinus rhythm. All the ventricular pacing worsen LV systolic and diastolic function compared with RAA pacing. LV systolic function during LVL pacing was superior to RVA pacing. During ventricular pacing,the systolic function at nearby segments of the pacing site was depressed.

Objective To assess subendocardial systolic circumferential strain(CS),radial strain(RS)and radial displacement(RD)of left ventricle(LV)in short-axis view and LV global systolic function in open-chest canine model with acute myocardial ischemia using velocity vector imaging(VVI),and to establish their spatial correlationships.Methods Left anterior descending coronary artery(LAD)was ligated for 20 minutes to induce acute myocardial ischemia in 12 open-chest canine model.At baseline and 20 minutes after ischemia,two-dimensional dynamic gray-scale images of three standard left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex and the images of LV apical fourchamber and two-chamber view were acquired and transfefred to VVI workstation for off-line analysis.Peak systolic CS,RS and RD of eighteen segments and of three global short-axis sections of LV were measured at subendocardium.and LV ejection fraction(LVEF)and stroke volume(SV)were calculated using Simpson's method.The differences and correlationships were analyzed between them.Resuls Compared with the value at baseline,LVEF decreased significantly(P＜0.05)after ischemia.The peak systolic subendocardial CS,RS and RD of the affected segments,global CS,RD at papillary muscle and apex views and global RS at apex view were significantly lower than those at baseline after ischemia(P＜0.05).There was a good linear correlationship between the peak systolic CS and RD of 17 segments(except the middle segment of LV lateral wall after ischemia)and each global short-axis level before and after ischemia(r=0.662-0.995,P＜0.05,P＜0.01 or P＜0.001),The peak systolic RS of six segments and each global short-axis level(except the apex level at baseline)was correlated with RD(r=0.580-0.916,P＜0.05,P＜0.01 or P＜0.001);There was not statistical correlationship between global RDs and SV as well as LVEF.Conclusions Subendocardial circumferential strain and radial displacement may sensitively reflect the changes of regional and global myocardial systolic function induced by acute myocardial ischemia.The significant correlationship between subendocardial circumferential systolic strain and radial displacement might indicate that circumferential deformation of myocardium result in the changes of the radial displacement mainly.

Objectives To explore the expression of HER4 and VEGF in NSCLC and elucidate the relationship between their expression and the characteristic of clinical pathology. Methods 82 cases of paraffin-embedded tissues from informative NSCLC were used to detect the expression of HER4 and VEGF by means of immunohistochemical assay. Results HER4 is overexpressed in 65;9%of NSCLC cases. The overexpression of HER4 is correlated with the lymph node metastasis and TNM staging. VEGF is expressed in 53.7%of NSCLC cases. The expression of VEGF is also correlated with the lymph node metastasis and TNM staging, and the expression of VEGF is correlated with the overexpression of HER4.Conclusions HER4 and VEGF are the protein to regulate the growth of NSCLC and it might be a good way for the treatment of NSCLC by suppressing the overexpression of HER4 and VEGF.

OBJECTIVETo observe clinical therapeutic effect of combined acupuncture and moxibustion therapy on polyneuritis.

METHODSOne hundred and sixty cases were treated with combined scalp acupuncture, body acupuncture (stimulating root of nerve as main), cupping and pricking at segmental root of nerve, and electric hot moxibustion, and their therapeutic effects were observed.

RESULTSOne hundred and thirty-eight cases were cured (86.3%) and the total effective rate was 100.0%. The average recovery time for clinical symptoms was 12.81 days, the average recovery time for nervous system signs was 19.76 days, the average recovery time for recovery of ocular muscular dyskinesia was 15.14 days. There was significant therapeutic effect for improvement of simple symptoms, with significant differences when the first and second therapeutic courses compared with that before treatment (P < 0.01).

CONCLUSIONThe combined acupuncture and moxibustion therapy has a definite therapeutic effect on polyneuritis.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Neuritis ; therapy

ObjectiveTo describe upper and lower limits and their sources of reference intervals in routine chemistry assays and to make a comparison between routine and dry chemistry in these aspects.MethodsThe data of reference intervals were collected,which come from the third run of 2010 External Quality Assessment (EQA) programs in routine and dry chemistry performed by National Center for Clinical Laboratories(NCCL).All data from maternal and child care service center,children's hospital and corporations were excluded.Then all the abnormal values and errors (for instance,the lower limit was higher than the upper one or the upper limit was as the same as the lower one,etc.) were eliminated,either.Data statistics was performed by SPSS 13.0 referring to upper and lower limits of reference intervals and sources of 24 routine chemistry assays ( including serum potassium and serum sodium,etc).Comparison was made between routine and dry chemistry in these aspects in 23 assays.Data from adult men were reported when gender difference was present.ResultsThe three main sources of reference intervals were National Guide to Clinical LaboratoryProcedures, instructions of reagent manufacturesanddetermined by their own laboratory.In comparison of reference intervals between routine and dry chemistry,6 assays had statistical significant difference in both upper limits and lower ones while,4 assays in one-sided limits and 13 assays were not statistically significant in both limits.Conclusions The reference intervals of routine chemistry have big differences among institutions and the sources of them are various.Only a few assays have statistical significant difference in routine and dry chemistry among medical institutions,it might be discussed in further study whether the statistical results have clinical values.In order to achieve the result agreement among clinical assays,all the laboratories must share the common reference intervals on the basis of standardization.

Objective To investigate the effects of the intracellular delivery of HPV16E7_(49-57) epi- tope modified by cell-penetrating peptide HIV-Tat_(49-57) and its influential factors.Methods The unique HLA-A2+/H-2kb+ limited CTL epitope of HPV16E7 fused with a cell-penetrating sequence (HIV-Tat_(49-57)) was designed and a 18-mer peptide was synthesized with aid of polypeptide solid phase synthesis technique. The intracellular transport capabilities of these peptides were tested with indirect immunofluorescence assay and laser confocal microscopy.In addition,the CTL epitope and 18-met peptide were used to stimulate PBMC of healthy C57BL/6 mice,and the E7_(49-57) specific CTL responses were measured by LDH cytotoxicity detection kit in PBMC of those mice.Results The HIV-Tat_(49-57) peptide could efficiently assist HPV 16E7_(49-57) peptide in penetrating into BHK cells in a time and dose-dependent manner (P＜0.05).Further- more,the specific CTL activity induced by the 18-mer peptide was much stronger than that induced by the single epitope.Conclusion The results show that HIV-Tat_(49-57) can efficiently deliver the exogenous anti- genic peptide into the cytoplasm of live cells,and induce specific CTL response.This is a new way to de- sign peptide-based vaccine of HPV.

Objective To explore the feasibility of culturing dermal papillae cells (DPC) of hu- man hair in a serum-flee medium,and to observe the growth characteristics of these cells.Methods Cell culture flasks (plates) were pretreated with fibronectin,and DPC (2nd passage) were incubated with Williams E serum-flee medium supplemented with insulin-transferrin-selenite (ITS).Cells were observed by an inverted phase-contrast microscope.Proliferation of DPC was evaluated with 3-(4,5-dimethylthia- zol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and by their growth curve.Results In a serum-free medium,2nd passage DPC adhered to the flask surface within two to four hours of incubation; two to three days later,confluence,of the cells was observed,without noticeable proliferation.Four days later,cell connection was interrupted,isolated cells or cell clusters were seen,and detachment of some cells from the flask surface was observed.One to two weeks later,most cells had died.After incubation with 4% bovine serum for ten hours,cell proliferation was observed surrounding the remaining viable cell colonies. DPC growth curve showed stagnant phase and slow growth phase;however,log growth phase was not ob- served.Conclusion DPC could be successfully cultured in serum-free medium.However,the culture con- dition needs to be further optimized.