1.Application of MSCT and postprocessing techniques in the diagnosis of pulmonary sequestration
Falin ZHANG ; Fang YONG ; Aizhen PAN ; Hai ZHAO
Chinese Journal of Medical Imaging Technology 2009;25(7):1199-1201
Objective To assess the value of MSCT and postprocessing techniques in displaying abnormal blood vessels of pulmonary sequestration. Methods Ten patients with pulmonary sequestration proved with operation and pathology underwent both plain and enhanced chest CT scan. The reconstructed images of maximum intensity projection, multiplanar reconstruction and volume rendering were analyzed retrospectively. Results Of 10 patients, intra-lobe type sequestration was seen in 9 patients and extra-lobar type in 1 patient. The lesions located in the left lower lobe in 8 patients and in the right lower lobe in 2 patients. Angiography postprocessing technique displayed abnormal supplying vessels in 9 patients (7 from descending aorta and 2 from abdominal aorta) and displayed the origin, courser, branches and distribution of lesions clearly. Vessels in 9 patients drained into inferior pulmonary veins except in one drained into azygos vein. Conclusion MSCT angiography with postprocessing reconstruction techniques can display abnormalities of pulmonary sequestration clearly and has great value in the diagnosis of pulmonary sequestration, so as might be the first choice in diagnosing pulmonary sequestration.
2.Investigation and Analysis of the Coefficient of Variation of Internal Quality Control of Homocysteine
Lu ZHANG ; Wei WANG ; Falin HE ; Kun ZHONG ; Zhiguo WANG
Journal of Modern Laboratory Medicine 2015;(4):132-134
Objective To carry out the current status of internal quality control by statistical analysis of the Internal Quality Control (IQC)data of homocysteine in 2014 March.Methods Web-based External Quality Assessment (EQA)system was used to collect IQC data of homocysteine from 292 EQA participant laboratories nationwide.The data include thecoefficient of variation (CV)of IQC data under control in March 2014 and long-term cumulative data.Acceptable rates of CVs of two-lot internal quality controls in homocysteine were calculated according to 5 criteria,that were 1/3TEa,1/4TEa and the speci-fications based on biological variation including the minimal,appropriate and optimal allowable imprecision.The instrument the participant laboratories used were sorted into 6 groups and the passing rate of each group were calculated by the 5 crite-ria.Results 292 laboratories reported the data of level 1 IQC for homocysteine,106 of which reported the data of level 2 IQC.The passing rate was different according to different criteria.The passing rate had few difference by the criteria of 1/3TEa and the minimal allowable imprecision based on biological variation,which were from 63.36% to 76.42%.It was also true for 1/4TEa and the appropriate allowable imprecision based on biological variation,which were from 34.25% to 57.55. The passing rate was only 10.62%~16.98% by the criteria of appropriate allowable imprecision based on biological varia-tion.Statistical results showed that instruments the participant mainly used were HITACHI (77/292),Olympus (61/292), Roche (19/292),Beckman (14/292),Abbott (10/292)and Simens (10/292).The passing rates of all the instrument group had few difference except Simens group.Conclusion Most of the laboratories could meet the criteria of 1/3TEa and the min-imal allowable imprecision based on biological variation.But less than half of the laboratories could meet the criteria of 1/4TEa and the appropriate and optimal allowable imprecision based on biological variation.The precision performance of ho-mocysteine among laboratories needs further improvement.
3.Investigation and analysis of current situation about reference intervals of lymphocyte subsets by flow cytometry tests in China
Shishi ZHANG ; Wei WANG ; Falin HE ; Kun ZHONG ; Zhiguo WANG
Chinese Journal of Laboratory Medicine 2016;39(5):356-360
Objective Discussthe reference intervals and their sources of lymphocyte subsets by flow cytometry tests by all Chinese clinical laboratories at 2014 with a comparison of difference between different test systems.Methods Questionnaires about reference intervals were distributed to 212 clinical laboratories participating in October 2014 national external quality assessment scheme of lymphocyte subsets by flow cytometry tests of National Center for Clinical Laboratory.Relevant information about reference intervals of 5 relative counting items CD3 + (%),CD3 + CD4 + (%),CD3 + CD8 + (%),CD3-CD16 + CD56 + (%) and CD3-CD19 + (%) was collected by a internet-based external quality assessment software systems.Microsoft Excel 2010 and SPSS 19.0 were used to sort out raw data,eliminate unreasonable or incorrect data,and only analyze source distribution,arithmetic average,median,minimum value,maximum value and percentiles (P2.5 and P97.5) of upper and lower limits about healthy adults' reference intervals.Laboratories derived from the highest percentage of source distribution whose reagent and instrument were matching with each other were grouped according to the test systems used and the differences of reference intervals between different systems were compared with Mann-Whitney test.Results For five items collected,in the clinical laboratories who accepted statistical analysis,respectively 39.32% (81/ 206),37.44% (79/211),37.68% (78/207),37.11% (72/194),36.98% (71/192) of them had verified the reference intervals they used.The top three sources of reference intervals were instructions of reagent and instrument manufactures (49.70%-52.54%),calculations by laboratories themselves (18.64%-20.00%),and calculations by other laboratories (14.12%-15.43%).The arithmetic averages and medians of upper and lower limits about every item were relatively close.But the minimum and maximum values of upper and lower limits of certain items had moderate differences.As Mann-Whitney test later showed,all items with the P values of upper and lower limits between different test systems,except for the lower limit of CD3 + CD4 + (%) (P value is 0.052) and the upper limit of CD3-CD19 + (%) (P value is 0.117),were lower than 0.05 which meant an existing statistical difference.Conclusions The sources of lymphocyte subsets by flow cytometry tests in all Chinese clinical laboratories were different and the instructions of reagent and instrument had the highest percentage,but the reference intervals among differenttest systems had statistically significance.
4.Effects of caffeine citrate on neuronal proliferation and apoptosis and long-term learning ability in neonatal rats with hypoxia-ischemic brain damage
Falin XU ; Caihong WANG ; Yanhua ZHANG ; Jiajia GUO ; Huiqing CHENG
Journal of Clinical Pediatrics 2015;(4):368-372
ObjectiveTo investigate the effects of caffeine citrate (CC) on the neuronal proliferation and apoptosis and long-term learning ability in neonatal rats with hypoxia-ischemic brain damage (HIBD).MethodsForty-eight 7-day-old Sprague-Dawley neonatal rats were randomly divided into 3 groups: sham operation group (n=16), HIBD group (n=16), HIBD + caffeine citrate group (CC group,n=16). Rats in HIBD and CC groups received ligation of left common carotid artery followed by 2 hours of hypoxia to establish HIBD model. Rats in CC group were injected intraperitoneally with CC (20 mg/kg) before and at 0 min, 24 h, 48 h, and 72 h after hypoxia-ischemic (HI), and rats in the other two groups were injected intraperitoneally with an equal volume of normal saline at the corresponding time. Meanwhile, from postnatal day 10, each rat was injected intraperitoneally with 5-bromo-2’-de-oxyuridine (BrdU) (50 mg/kg) for 5 consecutive times, once every 12 h. On postnatal day 12, BrdU in the hippocampal dentate gyrus and cleaved caspase-3 in the hippocampal CA1 area were detected by immunohistochemistry, and neuronal apoptosis in hippocampal CA1 area were detected by TUNEL staining. On postnatal day 28, long-term learning and memory ability of rats was tested by Y maze.ResultsThere was signiifcant difference in the number of BrdU-positive cells in brain tissues of rats among three groups (F=101.38,P<0.01). The BrdU-positive cells in HIBD group and CC group were signiifcantly more than those in sham operation group (P<0.05). There was signiifcant difference in the number of cleaved caspase-3-positive cells in hippocampal CA1 area among three groups (F=379.77,P<0.01). The cleaved caspase-3-positive cells in CC group were signiif-cantly fewer than those in HIBD group but signiifcantly more than those in sham operation group (P<0.05). The TUNEL-pos-itive cells in hippocampal CA1 area were signiifcantly different among three groups (F=505.92,P<0.01) which was most in HIBD group and fewest in sham operation group and signiifcant difference was found through multiple comparison (P<0.05). The total learning number of avoiding electric shock tested by Y maze was signiifcantly different among three groups (F=32.05, P<0.01) which was most in HIBD group. Correct response rate was significantly different among three groups (F=24.99, P<0.01) which was lowest in HIBD group.ConclusionsCaffeine citrate can improve the ability of long-term learning and memory in neonatal rats with hypoxia-ischemic brain damage, the mechanism of which may be related to reducing the neuronal apoptosis after hypoxia ischemia.
5.Investigation and Analysis of Reference Intervals and Decision Limits of Reticulocyte Count in China
Xiaoyan ZHANG ; Wei WANG ; Falin HE ; Kun ZHONG ; Zhiguo WANG
Journal of Modern Laboratory Medicine 2016;31(3):158-161
Objective To investigate and analyze the current situation of reference intervals and decision limits of reticulocyte count in China.Methods The information related to upper/lower limits,decision limits,data resources,method principles, instruments and reagents of reticulocyte count in 2014 was collected via the external quality assessment software system based on website.The participants were divided according to their methods and instruments.The SPSS 1 9.0 was used for conducting the data analysis and statistics of results for each group.Results There were 276 laboratories submitting the val-id results.The major resources for reference intervals came from national guide to clinical laboratory procedures (53.99%), instructions of instrument manufacturers (16.30%),textbook (9.78%),instructions of reagents manufacturers (9.06%) and others.The major resources for decision limits were national guide to clinical laboratory procedures (56.06%),instruc-tions of instrument manufacturers (16.67%),textbook (7.58),instructions of reagents manufacturers (7.58%)and others. The medians and averages of upper/lower limits and decision limits among subgroups were close,whereas the P2.5 and P97.5 were significant discrepancies.Only 45.65% and 48.48% of participant laboratories had verified reference intervals and deci-sion limits before clinic use.The lower limits and decision limits among subgroups had nostatistical difference (P>0.05), where as the upper limits of different instrument groups had significant differences (P<0.001).Conclusion The current situation of reference intervals and decision limits of reticulocyte count is unsatisfactory.It is certain to establish a uniformed reference interval and decision limits for reticulocyte count,which provides a reference for the standardization of reticulocyte count testing.
6.Transplantation of free latissmus dorsi osteocutaneous flap using bridge-like vascular anastomosis in treatment of tibial defect:5-case report
Gonglin ZHANG ; Ming ZHANG ; Ao GUO ; Defu YANG ; Lingzhi ZHANG ; Falin WU ; Liping XIA ; Faming DING
Chinese Journal of General Practitioners 2008;7(9):639-640
From September 2002 to May 2006, five patients ( age range, 24 to 46; mean, 32) with tibial defect underwent transplantation of free latissmus dorsi osteocutaneous flap using bridge-like vascular anastomosis. All the osteocutaneous flaps survived without any serious complications, and tibial defects were improved completely. After 1.5 to 4.5 years' follow-up ( mean, 2.6), no remarkable dysfunction was found at donor sites, and local injury was reduced. This study indicates that transplantation of free latissmus dorsi osteocutaneous flap using bridge-like vascular anastomosis might be useful in leg reconstructive surgery if only one vessel is remained.
7.Effect of estrogen on the gene expression of caveolin-1 in rat vascular smooth muscle cells
Falin YANG ; Xianxi LIU ; Hong HE ; Jianye ZHANG ; Weihua XU ; Ya ZHANG
Chinese Journal of Pathophysiology 1999;0(09):-
AIM: To assess the effect of estrogen on the gene expression of caveolin-1 in rat vascular smooth muscle cells (VSMCs). METHODS: Wistar rats were ovariectomized and subjected to subcutaneous implantation of placebo pellets (OVX+V group) or estradiol pellets (OVX+E group). 2 weeks after implantation, the expression of caveolin-1 gene in endothelium-denuded aortic tissue was examined by RT-PCR. Furthermore, Northern blotting was used to analyze the mRNA expression of caveolin-1 in cultured rat VSMCs. RESULTS: RT-PCR showed that expression of caveolin-1 gene was significantly higher in OVX+E group than that in OVX+V group. Northern blot analysis showed that the mRNA expression of caveolin-1 was higher in VSMCs pretreated with 17?-estradiol (17?-E 2) than that in VSMCs without 17?-E 2 pretreatment. CONCLUSION: Estrogen up-regulates the gene expression of caveolin-1 in the vascular wall, partially indicating the cardiovascular effect of estrogen. [
8.Analysis of the inter-lab comparability and intra-lab precision of blood gas and acid-base testing
Haijian ZHAO ; Chuanbao ZHANG ; Falin HE ; Rong MA ; Jiangtao ZHANG ; Zhiguo WANG
Chinese Journal of Laboratory Medicine 2013;36(12):1085-1090
Objective To investigate the comparability between laboratories and the performance of precision in clinical laboratories for blood gas and acid-base analysis by external quality assessment (EQA) and internal quality control (IQC).Methods Fifteen vials of EQA materials were distributed to the laboratories by global Express Mail Services (EMS).The activities were carried out three times,five-level samples were determined every time.After the measurement results and coefficients of variation of internal quality control data of April were reported,the collected data were divided into peer groups based on laboratory instruments.The medians of each group were taken as the target value to analyse the pass rate and coefficient of variation (CV) of each group after the removal of outliers.Internal quality control data was collected by Web-based the EQA software acquisition system which collect the CVs of the control data of nationwide blood gas and acid-base analysis project in April 2012 internal quality control,the CVs of IQC data were compared according to analyzers and testing items after the removal of outliers.All the data were analyzed using EXCEL 2007 and SPSS.Results A total of 570 laboratories participate in the EQA scheme.The CV of Inter-laboratory of PO2 was largest in all the same instrument groups; For the same item,Siemens group displayed larger CVs than other instrument groups.A total of 525 laboratories returned internal quality control data in accordance with the provisions,there are no significant difference in CVs among the same instrument group and among the same test of inter-instrument.Conclusions The comparability of results for blood gas and acid-base analysis are mostly good between laboratories in China,besides,some of which need to improve.The laboratories should pay more attention to IQC so as to secure the reliability of results.
9.Analysis of the coefficient of variation of internal quality control of lipid testing
Haijian ZHAO ; Chuanbao ZHANG ; Wei WANG ; Jiangtao ZHANG ; Falin HE ; Rong MA ; Weiyan ZHOU ; Zhigua WANG
Chinese Journal of Laboratory Medicine 2012;(12):1172-1175
Objective To investigate the current situation of precision of internal quality control (IQC) in total cholesterol,triglyceride,HDL-cholesterol,and LDL-cholesterol and provide improvement measurements.Methods Web-based External Quality Assessment (EQA) system was used to collect IQCdata of lipid tests from 581 EQA participant laboratories nationwide.The data include the coefficient of variation (CVs) of IQC data under control in April 201 1 and long-term cumulative data.Excel 2007 was applied for data processing after excluding the invalid data.Acceptable rates of CVs of two-lot internal quality controls in 4 lipid testing were calculated according to 6 criteria,that were 1/4TEa,1/3TEa,allowable imprecision of National Cholesterol Education Program (NCEP) and the specifications based on biological variation including the optimal,appropriate and minimal allowable imprecision.Results Four hundred and thirty-five,434,405 and 360 laboratories reported the data of level 1 IQC for total cholesterol (TC),triglyceride (TG),HDL-C,LDL-C respectively,while 214,214,192 and 171 reported the data of level 2 IQC respectively.Acceptable rates of TC,TG,HDL-C,LDL-C based on NECP criteria were 69.2% (304/435),85.3% (370/434),61.3% (48/405) and 69.0% (248/360) for level 1 respectively while 81.3%(174/214),91.6% (196/214),75.5% (145/192) and 81.3% (139/171) for level 2 respectively.In the group which met the NECP criteria,the proportion of using matching detection system was much higher than the group which did not meet the criteria.Conclusions It is an effective way for clinical laboratories to improve test quality by monitoring the current and cumulative CVs of internal quality control and comparing them against proper evaluation criteria to evaluate if the analysis system can meet quality requirements.
10.Investigation and Analysis of Reference Intervals of Cystatin C andβ2-Microglobulin
Kun ZHONG ; Wei WANG ; Falin HE ; Yan ZHANG ; Yan ZHAO ; Guohua LI ; Zhiguo WANG
Journal of Modern Laboratory Medicine 2015;(4):32-34,38
Objective To know the current application status of reference interval of cystatin C andβ2-microglobulin in medi-cal institutions of China.Methods Every laboratory which attended 2014 specific protein external quality assessment pro-gram of national center of clinical laboratories has been received an internet questionnaire to survey reference intervals of cystatin C andβ2-microglobulin.After eliminating outliers the trimmed data was statistical analyzed by Microsoft Excel 2007 and SPSS 13.0.The resources of RIs,traditional statistical analysis,normalized analysis,comparison between overall median and lower and upper limits of different measurement system,and verification status of RIs were included.Results 106 and 127 medical laboratories submitted the questionnaire and the number of province with submission of RIs for the two renal function measurement items were 24 and 29,respectively.Less than 5 laboratories grouped their RIs according to age and/or gender.Approximately 75% of laboratories had been using the RIs referring to reagent manufacturers’instructions.All me-dians of upper or lower limits of analytes were as same as the Mode values of the same group.The 2.5th percentiles had tre-mendous differences compared with 97.5th percentiles.More than half of laboratories did not verify their RIs beforeusing them.The overall medians of lower and upper limits of RIs were (in serum):Cystatin C (mg/L)0.55 and 1.09;β2-micro-globulin (μg/ml)1.00 and 2.80.Conclusion The RIs of cystatin C and β2-microglobulin used in medical institution had some differences between each other,and there were too many kinds of reagents and instruments which made different meas-urement systems.The consistent and standardized reference intervals should be established in a short time.The RI for cysta-tin C was 0.55~1.09 mg/L,forβ2-microglobulin was 1.00~2.80 μg/ml considered by this study.