A total of 306 fresh human serum samples were randomly selected. Alb concentrations were measured by bromcresol green ( BCG) method, modified bromcresol purple ( mBCP) method, and immunoturbidmetic assay ( ITA) , respectively. GA was measured by an enzymatic method. GA value was expressed as the percentage of GA in the total serum Alb [ GA%(%) =GA/Alb?100%] . When Alb≥40 g/L, the clinical differences between BCG and mBCP, BCG and ITA, and mBCP and ITA were not significant, and there was no statistical difference between GA% BCG and GA% mBCP(P=0. 537); when Alb<40 g/L, BCG had statistical difference between mBCP and ITA ( P<0. 01 ) , and GA% BCG was significantly lower than GA% mBCP ( P<0. 01 ) . No obvious clinical signifi-cance of Alb concentrations was observed measured by BCG, mBCP, and ITA when Alb≥40 g/L. There was no difference in different Alb methods for GA% calculation. When Alb<40 g/L, the consistency of mBCP and ITA was better than that of BCG and ITA, which indicated that mBCP method may be more suitable for the assay of gly-cated albumin value ( GA%) , whereas the GA% may be underestimated if using BCG method for the determination of Alb.

Objective To evaluate the effects of analytic variations in creatintine measurements on estimated glo -merular filtration rate (eGFR) and the classification of chronic kidney disease ( CKD).Methods A total of 13 157 patients, including inpatients, outpatients and health individual , were enrolled, whose creatinine range from upper reference limit (URL) -12% ×URL to URL +12% ×URL.There were 9 886 males and 3 271 fe-males with an age range of 20 ~89 years.The results of sCr incremented or decremented 4%, 8%, 12% and orig-inal results were divided into 7 groups.The effects of different degree of analytic variation in sCr measurement on eGFR and classification of CKD using eGFR were evaluated .Results When sCr was in the range of URL ±12%×URL, creatintine increased with age, on the contrary, eGFR decreased with age (P <0.05).The mean bias of the results of eGFR compared with the original results of eGFR was increased with the analytic variation of sCr . When the results of sCr had a reverse analytic bias of 12%, the results of eGFR had a forward bias of 16.73%. When sCr results had a forward analytic bias of 12%, the male patients in stage G3 (eGFR in 30 ~59 ml/min/1.73 m 2 ), according to the classification of CKD using eGFR, increased about 20%; while women in this stage could increase by nearly 30%.When sCr results had a reverse analytic bias of 12%, the percentage of female pa-tients in stage G3 could decrease from 38.65% to 10.42%; while male patients could decrease by 7%.Conclu-sion The analytic variation of creatinine change in laboratory testing tolerance range can cause large shift in the distribution of eGFR, which can cause change in the classification of patients .The correct eGFR report relies on the accurate detection of sCr.Routine reporting of eGFR alongside creatintine should pay attention to the detection accuracy of sCr.

Objective To explore the clinical application value of low contrast medium dosage combined with segmented injection in head and neck computed tomography angiography(CTA).Methods A total of 139 patients who underwent head and neck CTA examination were prospectively and continuously selected.All patients were divided into the two groups,including group A with the original protocol and group B with the new protocol.The differences of arterial hemodynamic parameters between the two groups were compared.Results It was observed that statistically significant differences in CT values at the level of the aortic arch,the middle of the common carotid artery,and the cervical segment of the internal carotid artery between group A and group B(P＜0.05);however,there was no statistically significant difference in CT values at the communicating level of the internal carotid artery between the two groups(P＞0.05).There were no statistically significant differences in subclavian vein artifact scores between the two groups(P＞0.05).The R2 values for test-bolus kurtosis in group A were 0.589,0.588,0.496,and 0.370 for each level,while theR2 values were 0.531,0.531,0.642,and 0.615 in group B,respectively.The intraclass correlation coefficient(ICC)values between each level of groups A and B were 0.872 and 0.888,respectively.Conclusion The segmented injection protocol provides a more stable angiography of intracranial vessels.It also shows more uniform and homogeneous CT values in head and neck vessels,with clinical diagnostic requirements.

Objective: To evaluate the differences of serum total light chain(sTLC), urine total light chain(uTLC) and serum free light chain(sFLC) in different stages of chronic kidney disease(CKD) and their correlation with renal function indexes. To investigate the predictive value of light chain indexes in CKD staging. Methods: 292 patients with CKD were analyzed retrospectively, and plasma cell diseases, acute kidney injury and tumor diseases were excluded. According to the estimated glomerular filtration rate(eGFR), CKD patients were divided into five groups from CKD 1 stage to CKD 5 stage. The levels of sTLC, uTLC, sFLC and corresponding biochemical indexes of CKD patients were detected, and the differences and correlations among the indexes of each group were compared. The receiver operating curve(ROC curve) was used to analyze the predictive value of each light chain index in CKD stage, with CKD1-2 stage combined as control group and CKD3-5 stage combined as case group. Results: There was no significant difference in sTLC κ, sTLC λ, sTLC κ/λ and sFLC κ/λ among CKD1-5 stage(P>0.05). There were significant differences between sFLC κ, sFLC λ and uTLC κ, uTLC λ among CKD1-5 stage(P<0.05), which increased with the increase of CKD staging. The correlation between sFLC κ, sFLC λ and serum creatinine(Scr), blood urea nitrogen(BUN), eGFR were better than uTLC κ, uTLC λ(P<0.001). The sTLC κ, sTLC λ, sTLC κ/λ and sFLC κ/λ had no correlation with renal function indexes(P>0.05). The best critical points of sFLC κ and sFLC λ for predicting CKD3-5 stage were 35.4 mg/L and 52.8 mg/L, and AUC was 0.916(0.883-0.949) and 0.915(0.881-0.949), which were higher than uTLC κ and uTLC λ,AUC was 0.811(0.754-0.869) and 0.787(0.728-0.846), respectively. Conclusion With the increase of CKD staging, the levels of sFLC and uTLC gradually increase. The sFLC and uTLC can effectively predict patients with CKD3 and above, which has an important reference value in stratified management of patients with CKD.