Aim To explore the differences of pathogenesis for the hepatotoxicity induced by chronic treatment of valproic acid(VPA) in different ages,and in combination administration with inducers of liver enzyme.Methods Animal models were established by oral administration chronically with VPA at doses of 200 or 500 mg?kg~(-1) per day in 30 days for 50 Wistar rats(infant and adult rats) with inducers of liver enzyme Phenobarbital(PB) or not.Mitochondria were obtained by differential centrifugation.Levels of liver enzymes,coagulation factors,plasma ammonia,VPA and PB serum levels,and L-carnitine in sera,as well as the changes of respiratory enzymes and lipid peroxidation in hepatic mitochondria were measured.Mitochondrial membrane potential(MMP) and mRNA expression of CYP450 reductase in liver were determined by flow cytometer and in situ hybridization,and morphological changes of hepatocytes were observed under microscope with Oil-Red-O staining.Results ① In all rats treated with higher dose of VPA added with PB or not,there were no significant elevations of liver enzymes(ALT and AST).However significant abnormalities of function of blood coagulation and serum fibrinogen were shown, and the levels of plasma ammonia and L-carnitine were also changed significantly,and the changes were notable in infant rats or in those rats added with PB. ② Average contents of cytochrome aa3 in liver mitochondria of infant rats were reduced by 58.80% and 61.80% because of administration of high dose VPA and high dose VPA added with PB,but were reduced by 37.55% and 46.53% in adults.As for activities of SDH,which affected by high dose VPA in infants,were significant decreased by 44.8% and 57.9%,respectively,but still in normal range in adult groups.Activities of CCO in liver mitochondria were significantly lowered by high dose VPA or added with PB compared with controls(P

The medical consulting service, disease inquiry and seeking medical advice functions of 10 commonly available APP software in China for seeking medical advice, such asRapid Asking Doctors,Handholding Doc-tor Selection, andChunyu Handholding Doctors, were compared, which showed that although the functions of APP software in China for seeking medical advice could meet the requirement of people for seeking medical advice, importance should be further attached to their accurate and integrative information and establishment of profit-making model in order to promote the sustainable development of medical APP software.

Objective Analyze the historical data of critical values lists,providing scientific evidence for continuous improvement of critical value systems.Methods Screen out critical value lists data of 2006 from laboratory information system,after pretreatment and transformation of data,calculate the percentage of critical value,and its daily distribution,weekly distribution and department distribution, evaluate the range and turnaround time for critical value.Results The rate of critical value was 1.67%.It was mainly concentrated from 8 to 13 O'clock.Monday and Thursday have more critical value than other days.From the perspective of department,the majority critical value was from hematology department and transplantation department.After the evaluation of distribution diagram of critical value range,the lower critical value limit of blood potassium was adjusted from 3.0 mmol/L to 2.8 mmol/L,the blood platelet and leukocyte counts for parlents with hematology disease were a(Ijusted from 20×109/L,1.5×109/L to 10×1O9/L,1.0×109/L respectively.The laboratory turnaround time for 76.2% critical value was less than 1 hour.Conclusion Review and analyze critical value lists data regularly can improve the work efficiency and quality for the laboratory and clinic department and better meet patients' safety needs.

Objective To explore the clinical users′experience on using the intelligent laboratory test system so as to provide reference for its optimization.Methods Fifteen laboratory staff with different sub specialty was selected for in-depth interviews and data were analyzed using phenomenological approach.Results Intelligent laboratory system could improve the quality of test result verification and interpretation,shorten the turnaround time and improve the work efficiency.It took about 1-2 months for users to accept the automatic verification function.After that,the users could believe in the system and used it in their daily work.The sys-tem could reduce the work stress and verification duty,while balancing the technical gap between laboratory technicians.Users could only understand the general rule of the intelligent system and it was difficult for them to manage the rule repository.Conclu-sion The intelligent laboratory system is one of the artificial intelligent system used for the medical laboratory,it can provide com-prehensive clinical decision support for the laboratory staff.

Objective To investigate the prevalence and trends of human papillomavirus (HPV)infections in gynecology outpatients in Zhejiang province.Methods Samples of cervical exfoliated cells were collected from gynecology outpatients in 11 sentinel hospitals in Zhejiang Province from January 2011 to December 2013.Twenty one HPV subtypes were detected by flow-through hybridization technique.Chisquare test was performed to analyze the prevalence rates of HPV infections in different years and in different age groups.Results A total of 14 569 patients were enrolled in the study,among whom 3 552 (24.38％)were positive for HPV.HPV-16 (5.77％,840/14 569),HPV-52 (4.71％,686/14 569) and HPV-58 (4.52％,659/14 569) were the most prevalent subtypes.Among all patients,2 244 (15.40％) were infected with a single high-risk subtype,426 (2.92％) were infected with a single low-risk subtype,and 882 (6.05％) were infected with multiple subtypes.The rate of multiple infection was on the rise during 2011 and 2013 (x2 =23.65,P ＜0.01).The positive rates of HPV in patients with 15-24 y age group and ＞54 y age group were 27.91％ (211/756) and 27.73％ (439/1 583) respectively,which were higher than those in other age groups (x2 =18.664,P ＜ 0.01).Conclusion HPV infection is popular in gynecology outpatients in Zhejiang province,especially in patients aged 15-24 y and ＞ 54 y,and a certain proportion of patients are infected with multiple subtypes.

Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.

Therapeutic nanoparticles are designed to enhance efficacy, real-time monitoring, targeting accuracy, biocompatibility, biodegradability, safety, and the synergy of diagnosis and treatment of diseases by leveraging the unique physicochemical and biological properties of well-developed bio-nanomaterials. Recently, bio-inspired metal nanoclusters (NCs) consisting of several to roughly dozens of atoms (<2 nm) have attracted increasing research interest, owing to their ultrafine size, tunable fluorescent capability, good biocompatibility, variable metallic composition, and extensive surface bio-functionalization. Hybrid core-shell nanostructures that effectively incorporate unique fluorescent inorganic moieties with various biomolecules, such as proteins (enzymes, antigens, and antibodies), DNA, and specific cells, create fluorescently visualized molecular nanoparticle. The resultant nanoparticles possess combinatorial properties and synergistic efficacy, such as simplicity, active bio-responsiveness, improved applicability, and low cost, for combination therapy, such as accurate targeting, bioimaging, and enhanced therapeutic and biocatalytic effects. In contrast to larger nanoparticles, bio-inspired metal NCs allow rapid renal clearance and better pharmacokinetics in biological systems. Notably, advances in nanoscience, interfacial chemistry, and biotechnologies have further spurred researchers to explore bio-inspired metal NCs for therapeutic purposes. The current review presents a comprehensive and timely overview of various metal NCs for various therapeutic applications, with a special emphasis on the design rationale behind the use of biomolecules/cells as the main scaffolds. In the different hybrid platform, we summarize the current challenges and emerging perspectives, which are expected to offer in-depth insight into the rational design of bio-inspired metal NCs for personalized treatment and clinical translation.

Compared to conventional cancer treatment, combination therapy based on well-designed nanoscale platforms may offer an opportunity to eliminate tumors and reduce recurrence and metastasis. In this study, we prepared multifunctional microspheres loading I-labeled hollow copper sulfide nanoparticles and paclitaxel (I-HCuSNPs-MS-PTX) for imaging and therapeutics of W256/B breast tumors in rats. F-fluordeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) imaging detected that the expansion of the tumor volume was delayed (<0.05) following intra-tumoral (i.t.) injection with I-HCuSNPs-MS-PTX plus near-infrared (NIR) irradiation. The immunohistochemical analysis further confirmed the anti-tumor effect. The single photon emission computed tomography (SPECT)/photoacoustic imaging mediated by I-HCuSNPs-MS-PTX demonstrated that microspheres were mainly distributed in the tumors with a relatively low distribution in other organs. Our results revealed that I-HCuSNPs-MS-PTX offered combined photothermal, chemo- and radio-therapies, eliminating tumors at a relatively low dose, as well as allowing SPECT/CT and photoacoustic imaging monitoring of distribution of the injected agents non-invasively. The copper sulfide-loaded microspheres, I-HCuSNPs-MS-PTX, can serve as a versatile theranostic agent in an orthotopic breast cancer model.