2.Application of the customer satisfaction theory in quality management system of medical laboratories
Lixin WANG ; Feng LI ; Liru WANG ; Lin PAN ; Jun WEI
Chinese Journal of Hospital Administration 2014;30(1):34-36
Medical laboratories provide test data and consultation services and are engaged in ensuring test results being timely,accurate and reliable,which are satisfactory for their service recipients.A summary of the customer satisfaction theory and quality management system,and an analysis of problems found in the quality management of such laboratories,attempt to pinpoint underlying causes of service quality setbacks.Based on such studies,the quality management system is built in accordance with customer satisfaction theory and CNAS-CL02 Accreditation Criteria for the Quality and Competence of Medical Laboratories (ISO 15189:2007).Such efforts aim to continuously improve service quality and ensure customer satisfaction.
4.Development of a duplex fluorescence RT-PCR assay for identifying SRBⅠgene knockout mice
Lili PAN ; Lu ZHENG ; Jun ZHANG ; Yang YU ; Shuang YAO ; Miaomei YU ; Yuehua FENG ; Guanghua LUO
Tianjin Medical Journal 2015;(7):732-734
Objective To develop a duplex fluorescence RT-PCR assay for detection of scavenger receptor class B, typeⅠ(SRBⅠ) knockout mice. Methods Primers and probes were designed according to knockout region of SRBⅠgene and related substituted sequence. DNA samples were extracted from tails of mice and performed amplification using real-time PCR. SRBⅠgenotypes of mice were analyzed according to amplification curves of FAM and CY5 channels. Finally, the sensitivity of the method was detected and the accuracy was verified by the direct sequencing. Results The homozygous SRBⅠwild genotype showed an amplification curve only in FAM channel. When the homozygous SRBⅠknockout genotype was present, the typical S amplification curve appeared only in the CY5 channel. Heterozygous genotype showed two typical S amplification curves in both FAM and CY5 channels, respectively. The results showed that the sensitivity reached 4×101 copies/μL, and there was complete concordance between this method and direct DNA sequencing. Conclusion The new method is simple, rapid and accurate, which is suitable for genotyping SRBⅠknockout mice.
5.Change of dietary intake before and after hematopoietic stem cell transplantation in pediatric patients
Jun FEI ; Liya PAN ; Chenlin ZHU ; Yi FENG ; Zhuoqi ZHAO ; Li HONG
Chinese Journal of Clinical Nutrition 2014;22(2):67-73
Objective To explore the change of dietary intake and nutritional status before and after hematopoietic stem cell transplantation (HSCT) in pediatric patients to assess the importance of nutritional interventions.Methods In this observational cohort study,65 children undergoing HSCT between January 2012 and November 2012 in the Department of Hematology and Oncology,Shanghai Children's Medical Center were enrolled.The data collected before preconditioning were considered as the baseline data.We also collected data twice a week between preconditioning and 30 days after HSCT,and once a week from 30 days to 100 days after HSCT.Dietary analysis and urea nitrogen analysis were conducted in parallel.Results The baseline level of energy intake was (5 844.9 ±2 490.4) kJ/d,protein intake was (56.4 ±28.6) g/d,fat intake was (49.7 ±38.9) g/d,and carbohydrate intake was (190.9 ± 91.1) g/d.With the hematopoietic reconstruction,the oral nutrients intake significantly decreased compared with the baseline levels (all P =0.000).During the recovery period after HSCT,the energy intake showed no significant difference when compared with the baseline level in the 6th postoperative week,protein in the 13th week,carbohydrate in the 4th week,and fat in the 6th week.The urine nitrogen was (3.9 ± 2.4) g/d before HSCT,which increased to (16.7 ± 11.0) g/d after preconditioning (P=0.000).In the 1st postoperative week,the weight (P =0.000),triceps skin fold thickness (P =0.003),mid-upper arm circumference (P =0.000),serum albumin (P =0.000) and prealbumin (P =0.000) of the patients all significantly decreased compared with the baseline levels.In the 9th postoperative week,the fat-free body weight percentage (P =0.010),muscle percentage (P =0.001) and protein percentage (P =0.000) were significantly lower than the baseline levels,while the body fat percentage was higher than the baseline level (P =0.002).Conclusions Children undergoing HSCT exhibit a marked reduction in nutrient intakes at the early stage of HSCT,which may gradually return normal during the recovery period.This process may be slow,especially for the protein,and therefore may affect the serum protein level in these pediatric patients.Thus,more careful nutrition guidance is necessary during HSCT for pediatric patients,emphasizing oral nutrients intakes,and high protein dietary or formula may be helpful.
6.In vitro induction, differentiation and seeding of source cells for the endothelialization of small-diameter artificial blood vessel of polyurethane
Zhen YANG ; Jun TAO ; Chang TU ; Lianqiang FENG ; Mingguo XU ; Shirong PAN
Chinese Journal of Tissue Engineering Research 2006;10(29):184-186,封三
BACKGROUND: At present, after transplantation of small diameter artificial blood vessel, long-term patency rate is low due to being lacking of endothelial cells for lining and anti-thrombus characters. In some studies,mature endothelial cells were tried to be seeded in the artificial vessel to boost up its anti-thrombus capability so as to improve the long-term patency rate, but we got unsatisfied effect due to the defects of seed cells and scaffolds. Therefore, in clinic, proper seed cells and vascular scaffolds have been searched for improving the long-term low pateney rate in transplantation of small diameter artificial blood vessel.OBJECTIVE: To investigate the feasibility that differentiation of bone marrow mononuclear cells induced in vitro into endothelial-progenitor cells (EPCs) and seed polyurethane small diameter artificial blood vessel so as to provide proper seed cells for endotheliazation of polyurethane small diameter artificial blood vessel.DESIGN: Observation experiment SETTING: Cardivascular Medical Department and Staff Room of Immunology, First Hospital Affiliated to Sun Yat-sen University MATERILAS: This experiment was carried out at the First Hospital Affiliated to Sun Yat-sen University from September 2004 to May 2005. About 10 mL of bone marrow from healthy adult volunteers (n=7) was used in this experiment.METHODS: Bone marrow mononuclear cells of healthy adult were collected and put in the fibronectin pre-coated DMEM culture medium, then induced by vascular endothelial growth factor and basic fibroblast growth factor. Induced cells were observed under fluorescence microscope and identified with immunohistochemical staining. The induced and proliferated EPCs were seeded onto the surface of polyurethane small diameter artificial blood vessel. Morphological change was observed under scanning electron microscope.MAIN OUTCOME MEASURES: ① Cellular morphological change.② Staining results of immunohistochemical VWF and CD 34 antibody . ③ Adhesive growth status of EPCs on the polyurethane small diameter artificial blood vessel RESULTS: ① In the vascular endothelial growth factor and basic fibroblast growth factor and other inducers , bone marrow mononuclear cells differentiated into EPCs , presenting typical "spindle-shaped" appearance under an inverted fluorescence microscope and became to form a monolayer that arrayed in "cobblestone-like" ② Immunohistochemical staining showed von willebrand factor(VWF) and CD34 antigen stained positive. ③ Under the scanning electron microscope, surface of polyurethane small diameter artificial blood vessel without seeded cells presented typical polyporous honeycomb-like structure , and the size of hole suited the crawling of EPCs. After seeding the cells, we observed the adhesion, crawling and spreading of the EPCs on the surface of polyurethane small diameter artificial blood vessel. Some EPCs grew into the honeycomb-like holes were seen occasionally.CONCLUSION: Bone marrow mononuclear cells can be induced and differentiated into EPCs, while induced and differentiated EPCs well grow adhesively in the polyurethane small diameter artificial vessels, suggesting that differentiation of bone marrow mononuclear cells induced in vitro into EPCS, which can be used as seed cells for endothelialization of polyurethane small diameter artificial blood vessels.
7.Treatment of subtrochanteric femur fractures with minimal invasion dynamic hip plate through percutaneous limited open reduction
Yimin WENG ; Jianzhong KONG ; Jun PAN ; Xiaolong SHUI ; Yongzeng FENG ; Xiaoshan GUO
Chinese Journal of Trauma 2013;(4):325-329
Objective To investigate the possibility,surgical methods,outcome and surgical indications of minimal invasion dynamic hip plate (MIDHP) through percutaneous limited open reduction in treatment of subtrochanteric femur fractures.Methods All cases underwent percutaneous limited open reduction with MIDHP.Duration of operation,intraoperative bleeding volume,length of incision,incidence of intra-or post-operative complications of all case were recorded.X-ray films were reviewed periodically after operation to analyze aspects of fracture displacement,loosening of intemal fixation,screw cutting femoral neck,screw penetrating out of or withdrawing from femoral head,bending or breaking of internal fixation,and fracture healing.Hip joint function was evaluated according to Huang' s criteria.Results Operation lasted for 45-55 minutes (average 50 minutes),showing the incision length of 4.0-5.0 cm (average 4.5 cm) and blood loss of 50-200 ml (average 150 ml).A total of 21 cases were enrolled in the study and were followed up for 6-28 months (average 18 months).In the follow-up,loosening or bending of internal fixation,fracture displacement,screw cut-out,and screw penetrating or withdrawing from femoral head did not occur.In the meantime,incision,bone,and joint were not infected.All cases had bony fusion within 3 months with the fracture healing rate of 100%.According to Huang' s criteria,hip function was excellent in 19 cases and good in two.Conclusions MIDHP with percutaneous limited open reduction is characterized by less trauma,small incision,less blood loss,less postoperative complications,firm fixation,early functional exercise,free load,and good hip functional recovery and hence is suitable for cases of different subtrochanteric femur fractures,especially for cases combined with osteoporosis.
8.The cell-mediated immune status of patients with cytomegalovirus pneumonia after renal transplantation
Heli XIANG ; Wujun XUE ; Puxun TIAN ; Xiaoming DING ; Xiaoming PAN ; Hang YAN ; Jun HOU ; Xinshun FENG
Chinese Journal of Organ Transplantation 2011;32(10):592-595
Objective To evaluate the clinical value of adenosine triphosphate (ATP) determination in CD4+ cells in cytomegalovirus pneumonia after renal transplantation.Methods The ATP level of CD4+ T cells was measured by ImmuKnowTM kit.The ATP levels were determined in 187 renal transplant recipients before and 30,60,90,180 days after operation,and at the time of CMV pneumonia and 4 weeks after treatment of CMV pneumonia.The associations between ATP levels and CMV pneumonia were analyzed.Analysis of variance (ANOVA),Pearson-Spearman and relative risks were used for data analysis.Results 17 cases out of 187 renal transplant recipients were diagnosed as CMV pneumonia (9.1%),and the onset of CMV pneumonia started on the (2.8 ±1.2)month after renal transplantation.ATP concentrations in CD4+ T cells were significantly lower after operation than those before operation (P<0.01).ATP concentrations reached the lowest on the about postoperative day 90 (P<0.05),then increased gradually.In 17 recipients with CMV pneumonia,the ATP levels before and 30,90 days after operation,at the time of CMV pneumonia and 4th week after treatment of CMV pneumonia were (376 ±182),(283 ± 146),(196 ± 112),(145 ± 102) and (236 ± 117) μg/L respectively.ATP levels at the time of CMV pneumonia were significantly lower than any other time points (P<0.05).There was close correlation between ATP levels and CMV pneumonia.Conclusion The determination of ATP in CD4+ cells could reflect the status of cell-mediated immunity in renal transplant recipients,and could evaluate the severity and prognosis of CMV pneumonia and guide the clinical treatment.
9.Biomechanical study of Essex-Lopresti injury
Jun PAN ; Xianhong YI ; Jia SU ; Hongwei CHEN ; Xiaoshan GUO ; Feng CHEN
Chinese Journal of Orthopaedics 2010;30(12):1202-1205
Objective To study the biomechanical mechanism of Essex-Lopresti injury, and provide biomechanical basis for diagnosis and treatment of Essex-Lopresti injury. Methods Twelve fresh frozen adult upper limbs were addressed. Firstly, 12 samples ("complete state group") were loaded 100 N of a compressive force lasting 30 seconds in pronation, supination and neutral position on the mechanical testing machine. Secondly, 12 specimens were randomly divided into 2 groups. In the group named resection of radial head, the radial head was removed and interosseous membrane (IOM)was intact. In the group named the section of interosseous membrane, IOM was cut off. Finally, the radial head were removed and IOM was cut off in all specimens. The group was named as resection of radial head and IOM. Each sample was tested according to the method as described. Results The forearm rotation or single excision of the IOM had no effect on radial longitudinal displacement. Simple radial head excision or resection of the IOM and the radial head increased the vertical displacement of the radius. The radial stiffness had a gradual decline in forearm supination, neutral position and pronation. Simple excision IOM has no effect on the radial stiffness. The radial stiffness had decreased under the condition of excision of radial head or resection of the IOM and the radial head. Conclusion These in vitro measurements validate that the radial head fracture with IOM injury may be important reason for complications of the Essex-Lopresti injury. Radial head fracture play a key role for Essex-Lopresti injury and the injury of IOM is secondary cause. IOM is responsible for maintaining the vertical stability of the forearm after radial head resection.
10.Effect of ligustrazine hydrochloride on coagulation reaction and inflammation reaction in single valve replacement patients with rheumatic heart disease undergoing cardiopulmonary bypass.
Yi-Jun CHEN ; Chang-Shun HUANG ; Feng WANG ; Ji-Yong GONG ; Zhi-Hao PAN
Chinese Journal of Integrated Traditional and Western Medicine 2014;34(5):531-535
OBJECTIVETo observe the protection effect of Ligustrazine Hydrochloride (LH) on coagulation reaction and inflammation reaction in single valve replacement patients with rheumatic heart disease undergoing cardiopulmonary bypass (CPB).
METHODSTotally 40 patients undergoing single valve replacement were recruited in the study and randomly assigned to the two groups, the treatment group and the control group, 20 in each group. In treatment group LH (3 mg/kg) was intravenously infused from the jugular vein. LH (3 mg/kg) was also added in the CPB priming. In the control group LH was replaced by equal amount of normal saline. Endothelial micro-particles (EMP) count was detected before CPB, 30 min after CPB, 1 h and 24 h after CPB finished. The coagulation reaction time (R), coagulation time (K), clotting formation velocity (alpha angle), maximum amplitude (MA), coagulation index (CI), platelet (PLT), hypersensitive C reactive protein (hs-CRP), IL-6, and IL-10 were detected before CPB, 1 h and 24 h after CPB finished.
RESULTSThere was no statistical difference in aorta arresting time, period of CPB, post-operative drainage volume, plasma transfusion volume, post-operative respirator assistant time, and hospitalization time between the two groups (P >0.05). Compared with pre-CPB in the same group, the count of EMP was much higher at 30 min after CPB and 1 h after CPB finished (P < 0.01). R and K, hs-CRP, IL-6, and IL-10 increased at 1 h and 24 h after CPB finished (P <0.01,P < 0.05). The alpha angle,.MA, CI, and PLT decreased 1 h after CPB finished (P <0.01). The a angle increased, while CI and PLT decreased 24 h after CPB finished (P <0.05). Compared with the control group in the same period, the count of EMP was lower in the treatment group 30 min after CPB and 1 h after CPB finished (P <0. 05, P <0. 01). R and K values obviously decreased in treatment group 1 hour after CPB finished (P <0. 05), while a angle, MA, CI, and PLT increased (P <0. 05, P <0. 01). hs-CRP and IL-6 decreased in the treatment group 1 h and 24 h after CPB finished (P <0.05), while IL-10 increased (P <0.05). The count of PLT increased 24 h after CPB finished in the treatment group (P <0. 05).
CONCLUSIONLH had certain protection effect on the vascular endothelium undergoing CPB, and lower excessive activation of coagulation reaction and inflammation reaction in patients undergoing CPB.
Blood Coagulation ; drug effects ; C-Reactive Protein ; metabolism ; Cardiopulmonary Bypass ; methods ; Humans ; Inflammation ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Pyrazines ; pharmacology ; therapeutic use ; Rheumatic Heart Disease ; drug therapy