Clinical laboratory information system is the key to the realization of total laboratory automation,standardization,intelligent and digitization.In recent years,with the establishment,application,popularization and upgrading of clinical laboratory information system,it is very important to establish the construction criterion of clinical laboratory as soon as possible.Now according to the requirements of construction and management of modern clinical laboratory and combining with the practical application of clinical laboratory information system in our hospital at domestic settings,the standardization construction of clinical laboratory information system was discussed in this article.

The pre-analytical process is the first key step in the total testing process of clinical laboratories,which will directly influence the accuracy and timeliness of testing results.Efficient preanalytical quality assurance system consists of scientific personnel structure,regular training and monitoring,bright and comfortable phlebotomy environment,advanced comprehensive phlebotomy facilities,strict biosafety practice in each procedure and harmonious relationship between clinicians/patients and laboratory.Besides,the application and monitoring of sound quality indicators in pre-analytical process will promote the improvement of quality and finally get the aim of assuring patients' safety.

With the development of detection technology,point of care testing POCT) presents a tendency of diversity.However,the blood glucose meter and blood gas analyzer are still the major types of POCT in most hospitals.How to manage them effectively has become everyone's concern.The decrease in detection quality is caused by personnel,equipment,reagents,quality control and result reports.According to the baseline survey of POCT carried out in Guangzhou Women and Children's Medical Center,6 key points to improve the quality management were found.Meanwhile,the application of plan-do-check-action (PDCA) may allow access to an effective POCT management program.

Objective In order to assess the value of Echinoccocus granulosus cyclophilin A (EgypA) in immune diagnosis,this novel gene was cloned and expressed.Methods By screening the EST library,the coding region of EgCypA was identified,and the PCR primers were designed based on this sequence.Bioinformatic tools were used to deduce the amino acid sequence of EgCypA and analyzed its biological characteristics.EgCypA was amplified from E.granulosus cDNA library by using PCR.Then,it was cloned into the prokaryotic expression vector pET28a and transformed into E.coli BL21.The recombinant protein was expressed in E.coli BL21 after IPTG induction.The immunogenicity of EgCypA was evaluated by Western blot using the Echinoccocus granulosus and other parasites infected animals' sera.Results Results of SDS-PAGE electrophoresis show that the recombinant BL21 expressed 18 400-25 000 protein,which was identical with the molecular weight calculated by bioinformatic analysis.Western blot shows that the recombinant protein only reacted with its immune serum and E.granulosus cystic fluid immune serum,and EgCypA immune serum could react with the excretion and secretion antigen from E.granulosus protoscolexes,and no cross-reaction between EgCypA and sera from other parasites infected animals.Conclusions Cloning and expression of EgCypA are successful.EgCypA has good immunologic activity and could be a candidate molecular for immune diagnosis of echinococcosis in early stage.

Objective To investigate the association between single nucleotide polymorphisms (SNPs) of ATP-binding cassette B1 (ABCB1),ATP-binding cassette C2 (ABCC2) and solute carrier organic anion transporter 1B1 (SLCO1 B1) genes with high dose methotrexate (HDMTX)-induced toxicity in children with acute lymphoblastic leukemia (ALL).Methods This study was designed as a casecontrol.From September of 2005 to December of 2011,the blood samples were randomly collected from 142ALL patients from Nanjing Children's Hospital,Enzyme-multiplied immunoassay technique (EMIT) was used to measure the plasma concentration of MTX,Seven SNPs in ABCB1 (rs1045642,rs2032582,rs1128503),ABCC2 (rs717620,rs2273697) and SLCO1 B1 (rs4149081,rs11045879) genes were detected by polymerase chain reaction-ligase detection reaction (PCR-LDR).Results A significantly increased risk of MTX-induced toxicity was observed in patients with MTX elimination delay (OR ＝ 2.828,95％ CI:1.217-6.571,P ＜ 0.05).Two SNPs in SLCO1B1,rs4149081 and rs11045879 were linkage disequilibrium (LD) with each other (R2 =0.979,P ＜ 0.05).Multivariate analysis revealed that individuals with SLCO1B1 rs4149081 AA genotype or SLCO1B1 rs11045879 CC genotype showed increased incidence of MTX elimination delay (OR =4.41,95％ CI:1.537-12.654,P =0.042),and the two genotypes were also associated with significantly increased risk of MTX-induced toxicity (OR =4.118,95％ CI:1.135-14.944,P =0.022).No association of MTX elimination delay or MTX-induced toxicity with the other SNPs analyzed was found.Conclusions SLCO1B1 rs4149081 AA or SLCO1B1 rs11045879 CC genotypes might be a risk factor for the susceptibility to MTX-induced toxicity in children with ALL.

Objective To explore the association of lectin-like oxidized low-density lipoprotein (oxLDL) receptor-1 (LOX-1),CX3C chemokine receptor 1 (CX3CR1) with coronary artery stenosis disease and its outcomes.Methods A case-control study was conducted.A total of 176 cases of coronary artery stenosis which were confirmed coronary artery stenosis ≥ 50％ by coronary angiography(CAG) were served as case group from department of cardiology of TEDA International Cardiovascular Hospital of Tianjin from May 2011 to April 2013.A total of 129 patients without coronary artery lesion by CAG from this hospital in the same period were served as control group,which has no history of heart disease,liver and kidney dysfuction,brain disease,hematological disease,other disorders that could bring out atherosclerosis and thrombosis.General information and laboratory parameters,LOX-1,CX3CR1,uric acid (UA) and creatinine (CREA) were measured in 2 groups.These parameters of each group were compared,the levels of LOX-1 and CX3CR1 in one-vessel stenosis were compared than that in multi-vessels stenosis in case group,the correlations between LOX-1,CX3CR1 and Gensini score and other variables were analyzed.Comparison of the levels of LOX-1 and CX3CR1 between major adverse cardiovascular events (MACEs) group and nonmajor adverse cardiovascular event (MACE) group was made during follow up 1.5 years.MACEs in patients with different levels of LOX-1 and CX3CR1 were compared during 1.5-year follow up.All of the data were analyzed by SPSS 16.0 software.The independent-samples T test,Mann-Whitney U test,Chi-square test,Spearman correlation,Binary Logistic Regression and Kaplan-Meier probability were adopted for data analysis.Results Comparison between case group and control group,LOX-1:3.72 (1.44,8.15) μg/L vs 0.75(0.50,1.19) μg/L,z =11.072,P ＜0.001 ;CX3CR1:(2.82 ± 1.85) μg/L vs (2.32 ±0.79) μg/L,t =2.021,P ＜ 0.05 ; UA:(351.34 ± 94.82) μmol/L vs (326.74 ± 79.51) μmol/L,t =2.094,P ＜ 0.05 ;CREA:(70.86 ± 20.94) μmol/L vs (65.55 ± 12.96) μmol/L,t =2.077,P ＜ 0.05.CX3CR1 level was significantly higher in patients with multi-vessels stenosis (2.84 ± 1.78) μg/L than that in one-vessel stenosis(2.48 ± 1.64) μg/L,there was significance in difference (t =2.207,P ＜ 0.05).There were no statistically significant correlation between LOX-1,CX3CR1 and Gensini score (R was 0.032,0.079 respectively,P＞ 0.05).LOX-1 was negatively related to left ventricular ejection fraction(LVEF) (R =-0.272,P ＜ 0.01),but positively related to left ventricular end-diastolic diameter (LVDD)(R =0.190,P＜0.05),positively related to UA (R =0.121,P ＜ 0.05).Comparison between MACE group and nonMACE group,LOX-1:7.38(4.97,11.88)μg/L vs 3.52(1.45,7.75) μg/L,z =2.762,P ＜0.01;CX3CRl:(4.02 ±2.90) μg/L vs (2.67 ± 1.48) μg/L,t =3.086,P ＜0.01.LOX-1 and TG were independent risk effects of coronary artery stenosis disease.MACEs were increased in patients with high levels of LOX-1 after PCI during following up 1.5 years (comparison between high-LOX-1 group and lowLOX-1 group,the probability of non-MACE was 87.1％ (115/132) vs 97.7％ (43/44),Log-ranK test,x2 =6.957,P ＜ 0.01).Conclusions LOX-1 and CX3CR1 may be involved in the process of coronary artery stenosis,and a high level of LOX-1 may be associated with left ventricular systolic dysfunction in patients with coronary artery stenosis.Elevated LOX-1 level are closely related to afterwards MACE incidence after PCI in patients with coronary artery stenosis.

Noninvasive early diagnosis of colorectal cancer is conducive for patients to reduce the mortality rate and their suffering from diagnosis procedures.One of the most significant methods to proceed noninvasive early diagnosis of colorectal cancer is analysis of stool DNA.Extracting high quality and great quantity of human genomic DNA from stools guarantees diagnosis accuracy.However,the complexity of stool component hinders DNA extraction.Hence,it is crucial to develop highly efficient extraction methods of human genomic DNA from stools for the DNA analysis-based early diagnosis of colorectal cancer.Currently,two kinds of extraction strategies are employed:one is to directly extract total DNA from stools,the other is to enrich exfoliated colonocytes in stools before DNA extraction.This article reviews the advances on these two kinds of extraction techniques and summarizes their applications.

Based on the developing trend of laboratory medicine and the internal rules of discipline construction,series of research and reform practices in the curriculum system were put forward,including practice teaching,innovation education and instructional technology for laboratory medicine.An innovation talents training mode for laboratory medicine is gradually formed and innovative education is pushed on systematically,effectively and abidingly.The new mode has made periodical results and good prospects in cultivating students with innovative quality and ability.

Hepatic fibrosis is the final common pathway for liver injury caused by various chronic liver diseases.Noninvasive assessments of liver fibrosis are valuable in clinical use since they are easy to apply and monitor disease progression.Serologic biomarkers for liver fibrosis consist of direct markers which reflect ECM turnover and indirect markers which show liver function of synthesis,metabolism and reservation.A number of assessment models can identify significant fibrosis and cirrhosis,and avoid unnecessary liver biopsy.They can be used for disease staging,prognosis prediction,and treatment surveillance.Variation of analytical performances exists among diverse analyzers and assays.The standardization of these tests will enhance their comparability.Large scale and multicenter clinical verification studies are needed for the clinical utility of these assessment models based on Chinese population of chronic hepatic diseases.

Objective To investigate the population and role of IL-10+ CD19+ regulatory B cell (Breg) in patients with chronic hepatitis B.Methods Patients with acute hepatitis B (AHB) (n =28),chronic hepatitis B (CHB) (n =31) and normal subjects (n =25) were collected from Changshu No.2 People's Hospital between 2011 June and 2012 October.Peripheral blood mononuclear cells (PBMC) were isolated and stimulated with CpG ODN 2006 and PMA.Flow cytometry was used to analyze the population of IL-10-CD19 + Breg,CD4 + CD25high Treg,and ELISA was used to analyze the concentration of IL-10 in culture supernatant.Results The population of Breg in Peripheral blood of the CHB group [1.28％ (1.05％-2.20％)] was higher than that in the AHB group [0.87％(0.55％-1.22％)] and the HCs group [0.89％ (0.51％-1.37％)] (P =0.001,0.006),and the difference between the AHB group and the HCs group was not statistically significant (P=0.669).Breg in the CHB group [14.30％ (10.70％-16.70％)] was higher than that in the AHB group [10.30％ (7.05％-13.30％)] and the HCs group [10.40％(6.85％-12.60％)] (P =0.003,0.001),treg in the CHB group [5.80％ (4.20％-9.10％)] was also higher than that in the AHB group [4.05％ (2.53％-5.40％)] and the HCs group [4.50％ (2.55％-5.50％)] (P ＜0.001,P =0.005),and there was no significantly difference between the AHB group and the HCs group (Breg:P =0.796 ; Treg:P =0.227).Spearman correlation analysis showed that Breg was positively correlated with Treg in the CHB group (r =0.50,P =0.004),however there was no significantly correlation in the AHB group and the HCs group (r =-0.15,P =0.462; r =0.09,P =0.669).The concentration of IL-10 in the CHB group was higher than that in the AHB group and the HCs group (P ＜ 0.001),and the difference between the AHB group and the HCs group was not statistically significant (P=0.341).Spearman correlation analysis showed that IL-10 were positively correlated with the population of Breg in the CHB group (r =0.409,P =0.022).Conclusion The poluations of regulatory B cell and regulatory T cell increased in patients with chronic hepatitis B,and Breg cell might play the immune regulation role through secreting IL-10 in chronic HBV infection.