Point-of-care testing systems has been rapidly and widespreadly used in clinical practice.We ought to think about the speed, cost, quality and other aspects of the testing and formulate clinical guidelines for POCT as soon as possible.That will help to assure the reliable results of POCT and the correct application in the clinical management.

Cardiac troponin (cTn) is currently the most sensitive and specific marker of myocardial injuryandhas been widely used in clinical practice.Measurement of cardiac troponin in emergency room is every important in the diagnosis of acute heart disease, attention should be paid to cTn specimen type, turnaroud time and rapid detection methods and other issues when use cTn in emergency settings, in order to provide rapid and accurate results.

Urine albumin measurements are widely used to identify and monitor patients with kidney damage. The time of sample collection and the cut-off point which are used for interpretation are the important issues for the use of urine albumin measurements have been discussed. More clinical researches and investigations are needed in order to acquire the support from evidence-based medicine.

With the development of innovative technology such as molecular diagnostics and mass spectrometry in recent years , laboratory developed tests ( LDT ) in foreign laboratories have played an increasingly vital role in personalized medicine and precision medicine .However , the high complexity of technology itself and results interpretation are challenges in quality control and management .The paper shows monitoring models of LDT in foreign laboratories and states the outlook of development and management of LDT in our country.

Practical guidelines are commonly used for supporting medical decisions. This report presents the process and a list of criteria for the development of laboratory guidelines. Laboratory guidelines should be developed in a transparent process by a multidisciplinary team, with graded recommendations based on critically appraised scientific studies. The systematic, standardized and explicit methodology adapted to laboratory medicine should be followed when the developing recommendations involving the use of laboratory tests. Regular review is needed. The lack of timely updates is often a major cause of non-adherence to guidelines.

The evaluation of kidney function is helpful for early detection of impairment of renal function.The standardization of serum creatinine measurement is of vital importance for the assessment of glomerular filtration rate(GFR).When the Modification of Diet in Renal Disease(MDRD)equations applied to Chinese population with chronic kidney diseases(CKD),the original equation requires a correction factor.

Monitoring cardiac troponin Ⅰ(cTnI)or T(cTnT)for the detection of myocardial injury and for risk stratification in acute coronary syndromes(ACS)has been endorsed by the laboratory medicine community(IFCC,AACC,NACB)and the cardiology community(ESC and ACC).The clinical laboratories has long been argued on the best cut-point values for troponin assay-some believe it should be set at the 99~(th)percentile of the reference population,while others believe it should be at the level where the particular assay's coefficient of variation(CV)is less than 10%,with the 10% CV varying by test manufacturer.Besides,there are numerous cTnI measurement systems,confusion regarding cTnI measurements has resulted large variability demonstrated among the cTnI assays.The aim of this opinion is to reflect on some concepts related to using cTn in clinical practice.

Estimating glomerular filtration rate is very useful in the management of chronic kidney disease.The clinical laboratories should understand these eGFR equations.

The laboratorians are trying to make better communication and collaboration with clinical professionals in variety of ways, and to make better service for the clinicians.

hs-cTn was proved to has good clinical application value. The assay has physiological significance because hs-cTn can be measured in apparently healthy subjects. There is no consensus on the establishing 99th percentile values and choosing the critical values for different populations based on the age,sex or ethnicity.