Lung cancer has become the leading cause of death from malignant tumors worldwide. At the same time, statistics show that the incidence and mortality of lung cancer are increasing year by year. Because patients with lung cancer do not have typical symptoms in the early stage, this directly leads to the majority of patients who are already at advanced stage at the time of diagnosis, and the prognosis is not good. How to diagnose lung cancer early and accurately and find patients with potential risks and predict the prognosis is of great significance for the formulation of further treatment plans. In recent years, the field of artificial intelligence has been booming. As a branch of artificial intelligence, machine learning could learn efficiently from complex and large amounts of data. Besides, the learned model has good generalization ability. These characteristics can take greatly advance on the research about lung cancer

OBJECTIVE:To provide the basis for the formulation of the health intervention strategy for medical and health insti-tutions'pharmacists and provide reference for other related research. METHODS:A total of 180 medical and health institutions' pharmacists in Heilongjiang province were investigated and evaluated by work satisfaction MMSS scale(modified)and quality of life(SF-36)scale,and the relevant data were analyzed statistically. RESULTS:A total of 180 questionnaires were distributed and 134 valid questionnaires were collected. The effective recovery rate was 74.44%. The average score of work satisfaction degree was (3.44±0.79),which was at the middle level. The highest score was the relationship with colleagues and the lowest score was wel-fare. The physical function,the physiological function and the social function dimension of the respondents were higher thanChi-nese norm. The scores of physical pain,general health,vitality,emotional function and mental health were lower thanChinese norm,and there was statistical significance between the scores of the other dimensions andChinese norm(P<0.05),except for the physiological function and vitality dimension. Multivariate analysis showed that gender,duties,education,length of service and work satisfaction score had an effect on quality of life(P<0.05),among these factors,work satisfaction score was positively correlated with quality of life. CONCLUSIONS:The quality of life of medical and health institutions'pharmacists still needs to be improved,which is related to many influential factors,and job satisfaction is an important influential factor.

BACKGROUND:After internal fixation, limb fracture nonunion is the most common complication. Many factors affect fracture healing, but in recent years researchers have found that serum leptin may be involved in the process of fracture healing to regulate a variety of metabolisms. OBJECTIVE:To analyze the relationship between the changes of serum leptin and fracture healing in patients with long tubular fracture of the limbs after internal fixation. METHODS:Sixty patients with long tubular bone fracture who underwent internal fixation treatment were selected, and divided into two groups, union group (n=30) and nonunion group (n=30), according to the degree of fracture healing at 8 months after operation. Another 30 healthy volunteers served as normal control group. Peripheral blood samples were extracted before and after internal fixation to detect the changes in serum leptin levels using ELISA. RESULTS AND CONCLUSION:Preoperative serum leptin level was higher in the union group and nonunion group than the normal control group as wel as higher in the union group than the nonunion group (P < 0.05). There was no difference in the serum leptin levels in the union group before and after operation, but the nonunion group had a higher preoperative serum leptin level than the postoperative level. These findings indicate that the serum leptin may have an influence on fracture healing.

Objectives To evaluate the value of Treponema pallidum (TP) antibody analytical methods for syphilis screening.Methods A total of 4870 samples of Peking University First Hospital from May to October 2010 were detected of antibodies against TP by chemiluminescent microparticle immunoassay (CMIA),ELISA,rapid plasma reagin test (RPR),Treponema pallidum particle agglutination assay (TPPA) and dot-immunoblotting test (dot-IBT).The positive rates were compared by McNemar test for paired data;Using dot-IBT as gold standard,the sensitivity,specificity and total accordance rate of the other four methods were analyzed.Results In 4870 screening samples,the positive rate of dot-IBT was 2.5％(122/4870).The positive rate of CMIA and RPR was 3.1％(149/4870) and 1.2％(58/4870),respectively.According to McNemar test for paired data,there was significant difference when compared with dot-IBT (P ＜0.01).The positive rate of ELISA and TPPA was 2.4％ (119/4870) and 2.4％ (116/4870),respectively.There was no significant difference when compared with dot-IBT (P ＞ 0.05).When the dot-IBT results for the standard,CMIA has highest sensitivity,96.7％ (118/122),the specificity was 99.6％(4705/4724).The sensitivity and specificity of ELISA was 93.4％ (114/122) and 99.9％ (4720/4724),respectively,TPPA was 91.0％ (111/122) and 99.9％ (4721/4724),respectively,and RPR was 46.7％(57/122) and 100.0％ (4724/4724),respectively.The accordance rate of CMIA,ELISA,TPPA and RPR with the dot-IBT was 99.5％ (4823/4846),99.8％ (4834/4846),99.7％ (4832/4846) and 98.7％(4781/4846).When the TPPA results for the standard,sensitivity of CMIA was 96.6％ (112/116),the specificity was 99.2％ (4717/4754).The sensitivity and specificity of ELISA was 98.3 ％ (114/116) and 99.9％ (4749/4754),respectively,and RPR was 47.4％ (55/116) and 99.9％ (4751/4754),respectively.The accordance rate of CMIA,ELISA and RPR with the dot-IBT was 99.2％ (4829/4870),99.9％ (4863/4870) and 98.7％ (4806/4870).Conclusions Because of the low sensitivity of RPR,it is not fit for screening test.There are high sensitivity and specificity for detection of TP antibody using CMIA and ELISA,so they could be used as a screening test for TP.Due to the complexity of the operating steps,TPPA can be used to further confirm the test.

Objective: To validate a nomogram model based on prostate health index (PHI) for predicting prostate cancer (PCa). Methods: The pre-operation serum and clinical data were collected for suspected PCa patients (aged 34 to 90 years), who visited Peking University First Hospital from August 2015 to May 2017 and received transrectal ultrasound-guided prostate biopsy. A total of 391 suspected PCa with total prostate-specific antigen (tPSA)>4 ng/ml were selected into this study, including 235 cases with tPSA level of 4-10 ng/ml and 156 cases with tPSA>10 ng/ml. The p2PSA was tested in all cases and then PHI was calculated. The biopsy results were considered as the gold standard to diagnose PCa. The nomogram model established in Shanghai based on PHI, age and prostate volume was validated in all cases enrolled in this study. Receiver operator curves (ROC) were used to assess the ability of nomogram model to predict PCa. Results: Of 391 male patients included in this study, 175(44.8%)were finally diagnosed as PCa. ROC curves indicated that, the area under the curve (AUC) of the nomogram model for predicting PCa among 391 cases was higher than that of the traditional indicator tPSA (AUC: 0.786 vs 0.578, P<0.000 1). And f/t(AUC: 0.786 vs 0.672, P=0.000 2). For those people with tPSA level of 4-10 ng/ml, the AUC of the nomogram model was also higher than that of tPSA (AUC: 0.720 vs 0.513, P=0.000 3) and f/t(AUC: 0.720 vs 0.626, P=0.042 5). Conclusion The nomogram model based prostate health index (PHI) was validated to have a good auxiliary diagnostic value for PCa in our center.(Chin J Lab Med, 2018, 41: 536-540)

OBJECTIVE To provi de reference for scholars to carry out the research on the competency of pharmacists in pharmaceutical care and the human resource management of hospital pharmaceutical personnel. METHODS The questionnaire was designed with Pharmacist Pharmaceutical Service Competency Evaluation Standard （Trial）as the competency evaluation indexes. The convenient sampling method was used to investigate the pharmaceutical technicians from two third-class grade A hospitals in Harbin. Exploratory factor analysis was used to judge whether each dimension and item of competency index system needed to be adjusted；the final weight of each evaluation index was calculated by analytic hierarchy process ；fuzzy comprehensive evaluation method was used to evaluate the competency of pharmacists in pharmaceutical care. RESULTS Totally 152 questionnaires were collected and 142 valid questionnaires were collected ，with an effective recovery rate of 93.42％. In this study ，women accounted for 76.8％，those aged 40 and below accounted for 60.6％，those with bachelor ’s degree and above accounted for 84.5％，those with intermediate professional title accounted for 45.1％，and those with 10 years of work or below accounted for 60.6％. Four common factors were extracted in exploratory factor analysis ，and the cumulative variance contribution rate was 78.841％，which were named knowledge and skills ，motivation，personal literacy and professional ethics. The average score of the pharmacist ’s pharmaceutical care competency was （5.884±0.810），and the development of various dimensions of competency was not balance ； honesty and trustworthiness ，conscientiousness and responsibility and dedication scored higher ，while the scores of statistical knowledge，foreign language knowledge and drug treatment evaluation ability were lower. According to the evaluation method of fuzzy comprehensive evaluation ，the final comprehensive evaluation result was “consistent”. CONCLUSIONS The evaluation indexes of pharmacist competency have good reliability and validity in the competency evaluation of pharmacists in medical institutions. At the same time ，the basic knowledge of 32 hospital pharmacists and their ability to participate in clinical rational drug use need to be further improved.

Objectives In order to provide valuable information for the diagnosis and treatment of allergic diseases,the prevalence and trend changes of common allergens in Beijing were investigated and analyzed.Methods This study was a retrospective data collection study.A total of 11 641 patients with allergen examinations were collected from Peking University First Hospital from 2013 to 2017.The positive rate of each allergen was counted according to age,season and year.The epidemiological characteristics and trends were analyzed.Results In the past five years,20 636 total IgE and 45 620 allergen-specific IgE were collected,and the total positive rate of total IgE was 47.8％ (9 874/20 636).The top three positive rates of inhaled allergens were Dermatophagoides farina (28.1％,509/1 812),Dermatophagoides pteronyssinus (26.8％,503/1 876) and Mugwort (24.7％,240/971).The top three positive rates of food allergen were egg (17.3％,188/10 88),milk (16.7％,186/1 114) and wheat (15.3％,127/829).The positive rate of inhaled allergens (phad as an example) increased year by year.The positive rate of food allergens (fx5 as an example) reached its peak in 2015 (16.3％,511/3 139) and decreased slightly in the last two years (2016:13.0％,571/ 4 396;2017:7.4％,330/4 461).In inhaled allergens,the positive rate of weed pollen increased significantly in autumn.The positive rates of mx2 and dust mites were higher in summer.Food allergen did not change significantly with the seasons.Conclusions This study shown the distribution of allergens in patients with allergic diseases to a certain extent.It provided epidemiological data and clinical evidence for the prevention and treatment of allergic diseases.

Objective:To investigate the current situations and development requirements of emergency testing among secondary and tertiary hospitals in China.Methods:The data were collected from secondary and tertiary hospitals via online questionnaire across 31 provinces in China from February 1 to March 1, 2021. The questionnaire involves various aspects of emergency testing, including area of emergency laboratory, staffs and equipment configuration, inspection items, Turn-around time (TAT), reagents and consumables management, pre-analysis quality control, laboratory information system, critical values management and biosafety, etc.Results:A total of 2 187 questionnaires were obtained, and 1 503 valid questionnaires from 755 secondary hospitals and 748 tertiary hospitals were finally analyzed. The research data showed that daily average number of patients visiting emergency department exceeding 300 person-time in 29.41% (220/748) tertiary hospitals, but that number was less than 100 person-time in 76.69% (579/755) secondary hospitals; daily average emergency tests exceeding 5 000 was reported in 24.47% (183/748) tertiary hospitals, and less than 2 000 was reported in 93.51% (706/755) secondary hospitals; the area of emergency laboratory was less than 100 m 2 in 68.79% (238/346) tertiary hospitals with independent emergency testing laboratory; there were no fixed staffs of emergency testing in 56.02% (842/1 503) hospitals; the biochemical/immunoassay analyzer in 8.65% (130/1 503) hospitals did not have STAT position; one hundred and twenty-six hospitals (8.38%) did not have stock in and stock out record for reagents and consumes materials; the conventional statistical analysis of unqualified specimen was not carried out in 24.62% (370/1 503) hospitals; priority on emergent specimen was not set in 58.62% (881/1 503) hospitals; whole process monitoring function was not equipped in 48.64% (731/1 503) hospitals; there was no conventional communication working mechanism with clinicians on critical value in 7.32% (110/1 503) hospitals; overall, 50.23% (755/1 503) participants did not consider that biosafety risks exist in their emergency testing laboratory. Conclusions:This survey objectively presents the current situations and future development requirements of emergency testing among secondary and tertiary hospitals in China. The survey also reflects that some important process and concepts need to be improved, and extensive attention should be paid by laboratory and hospital administrator, in the area such as communication with clinician, site construction and staff configuration, administration on the priority of emergency testing, administration on the reagent and consumable materials, laboratory informatization construction, laboratory biosafety, and so on.

Objective Investigate the effect of neonatal hyperbilirubinemia on the detection of HBsAg by chemiluminescence and its elimination methods.Methods Case control study.The HBsAg in human serum was detected in 200 cases of hyperbilirubinemia neonates who were hospitalized in Beijing Children's Hospital,Capital Medical University from July 2015 to May 2016 and whose serum total bilirubin level exceeded 200 μmol/L.The positive serum was further detected by 16 200×g high-spoed centrifugation or blue light irradiation for 8 hours,and the results of re-assay of HBsAg were recorded.The retest positive serum wastested for HBV DNA load and checked the results of their mother's examination in HBV.136 adult serum samples with total bilirubin levels exceeding 200 μmol/L in the Peking University First Hospital,were taken as reference to compare the influence of hyperbilirubinemia between adults and newborns on the determination of HBsAg.Results The median level of serum total bilirubin in neonates was 259.0 μ mol/L (226.5,312.5);median level of indirect bilirubin 244.1 μmol / L(212.5,295.8).Median level of serum total bilirubin in adults 356.4 μmol/L(295.9,435.1);median level ofindirect bilirubin 137.1 μmol/L (107.8,172.7).The HBsAg test was negative in adults,11 cases (5.5％) were positive in newborns,their" HBV DNA load was less than＜100 IU/ml.Among them,9 have inoculated hepatitis B vaccine and 2 were unknown.10 of 11 mothers of infants were healthy and 1 was positive for HBsAg,HBeAb,HBcAb.2 of the 11 positive specimens turned negative of HBsAg after high-speed centrifugation.In addition to high speed centrifugation,4 cases turned negative after blue light irradiation.5 cases remained positive after high speed centrifugation and blue light irradiation.Conclusions Neonatal hyperbilirubinemia,which is different from that of adults,is mainly caused by indirectly bilirubin increased,which is one of the main reasons for false positive detection of HBsAg by chemiluminescence in neonates.High-speed centrifugation and blue light irradiation can eliminate the influence of serum indirect bilirubin on the detection of HBsAg to the greatest extent.