Urinary albumin is a biomarker for kidney damage and is widely applied in clinical practice.With more evidence on urinary albumin, it is also recognized as a risk factor for cardiovascular disease and all-cause mortality.This paper focuses on thecurrent status of pre-analytical, mid-analytical and post-analytical process and discusses the progress in standardization of measurement for urinary albumin and the issues which call for the attention of clinical laboratorian.

The mortality of chronic kidney disease (CKD) is increasing because of renal failure,cardiovascular diseases and other reasons which has been a global public health problem.Glomerular filtration rate (GFR) is the important biomarker of kidney function evaluation and early diagnosis of CKD,whose direct measurement methods cannot be widely applied in clinical laboratory.With the development of studies on estimating glomerular filtration rate (eGFR) equations,eGFR has been a biomarker of kidney function evaluation in clinical diagnosis.The current paper reviews the research progress and clinical application of different eGFR equations.

Incidence of acute kidney injury ( AKI ) is increasing rapidly to epidemic proportions . Development of AKI is associated with increased morbidity , mortality and hospitalization costs .Currently available diagnostic tools are mostly insensitive for early diagnosis of AKI .Finding an early, reliable, easily reproducible , economical and accurate biomarker for AKI is a top research priority .In recent years , many serum and urinary proteins have been investigated as possible early markers of AKI .

Objective To investigate the advantages of three-dimensional (3-D) reconstruction of nasal fractures with spiral computed tomography (CT) in comparison with roentgenography in medico-legal expertise. Methods CT scanning was performed in 32 cases with complex nasal fractures by Somatom Balance on 2mm/2mm scan. The images were reconstructed with maximum intensity projection (MIP), multi-plannar reconstruction (MPR), shaded surface display (SSD), and volume rendering (VR) mode and compared with roentgenographic images. Result Nasal fractures evaluated by roentgenography were detected to be false-positive in 3 cases and misdiagnosed fracture type in 6 cases as re-evaluated by 3-D reconstruction. Conclusion 3-D reconstruction images are of advantages over roentgenographic images in evaluation of broken bone fragments, displacement, fracture type for clinical diagnosis and medicolegal expertise.

Laboratory developed tests ( LDT) are usually referred to the diagnostic methods for the medical laboratory , which can only be used in the medical laboratory and can not be sold to other medical laboratories , hospitals and individuals .The paper shows the draft guideline of LDT issued by Food and Drug Administration ( FDA) and the suggestions of clinical laboratory experts and relevant academic groups for different FDA monitoring models.

Objective A survey was conducted to learn the status of award winning for science and technology achievement among the medical institutions ranked level 2 and above in Sichuan province,to learn the research capacity in such medical institutions,and to provide the basis for research management and health decision.Methods Questionnaire survey was carried out among 555 hospitals ranked level 2 and above in Sichuan province,information on award winning for science and technology achievement during 2010 -2012 was collected and analyzed.Results Only 33％ of those medical institutions were awarded for their achievement in research with total number of 882 awards in three years:300,266,and 316 awards were obtained in 2010,2011 and 2012,respectively.Conclusions In the medical organization of Sichuan province,the number of awards of scientific and technological achievements showed no significant increase with an volatility state,and the overall level of award need to be improved.Awarded Research areas were mainly on clinical research-based,especially on surgery department.Most award winning hospitals are level 3,and the general hospitals win more award than specialized hospitals;furthermore,hospitals located in different regions are quite different in terms of award winning.

Urinary albumin used as an important indicator in diagnosis of renal disease , but there are still many problems in the clinical application .The urine specimen type , threshold value , reference measurement procedures and some more aspect were summarized in this article .

Objective To evaluate the performance of sST 2 ELISA kit and investigate the clinical application of sST2.Methods This verification study validated the precision , linearity of sST2 ELISA kit according to the CLSI EP-15A, EP-6A protocols.300 healthy adults(aged from 20 to 85, 124 male and 176 female) from 5 different districts of Shanghai were used to establish serum sST 2 reference interval .The correlations between sST2, NT-ProBNP, LVEF and NYHA class were analyzed in 117 patients diagnosed with heart failure who were grouped according to the New York heart association ( NYHA).Receiver operating characteristic (ROC) curve was used to compare the ablity of sST2, NT-ProBNP, LVEF in distinguishing heart failure patients .Results The within-lot and between-lot variation of three level samples were below 4% and 10% respectively.There was a good linear correlation ( Y=0.995X+0.005, R2 =0.999) between theoretical value and actual detection result in the range of 0 to 200 μg/ml.The reference interval of sST2 was 10.2 to 41.0μg/ml for males and 8.9 to 28.1μg/ml for females.sST2 was positively correlated with NT-ProBNP and NYHA class but did not correlate with LVEF in heart failure patients . Patients with NYHA class>II (Median:28.3,IQR:19.5-39.2)had higher serum sST2 level than patients with NYHA class≤II (Median:45.1,IQR:34.1 -85.6), P<0.05.The AUC of sST2 in distinguishing heart failure patients from normal people was 0.815(sensitivity :51.2%,specificity:92.7%).The AUC of sST2 ,sST2+NT-ProBNP and sST2+NT-ProBNP+LVEF in distinguishing patients between NYHA class≤II and>II were 0.743, 0.810, 0.831 respectively and the sensitivity of sST 2 +NT-ProBNP+LVEF was 94.7%.Conclusions Experimental results show that this sST 2 ELISA kit has a good performance in the precision, linearity.sST2 correlates with NT-ProBNP and NYHA class but do not correlates with LVEF . Serum sST2 level is not influenced by age , BMI, renal function.sST2 could be a good supplement of NT-ProBNP and LVEF in distinguishing patients between NYHA class≤II and>II.

Objective To investigate the urinary albumin excretion of the diabetes patients and application value in the monitoring of early impairment in kidney. Methods The random urine samples from diabetes patients and controls within three days were collectod. The changes of urinary albumin excretion within day and between days were analyzed. 24-hour urine albumin was used as a standard to evaluate early kidney damage. The correlations between results of random urine albumin at the different time points and different periods were comparod. The sensitivity and specificity of random urine albumin at the different time points and different periods was evaluated and compared to deduce the best diagnostic porformance of the random urine albumin. Results There are greater variations of the levels of urinary albumin of patients with diabetes and control. After the correction with urine creatinine and urine volume the variations can be reduced (CV:49%±23% and 64%±30%). Urinary albumin excretion rate change rhythmically within the 24 h in healthy and diabetes patients. We found the best correlation between overnight ratio of urinary concentrations of albumin and creatinine (ACR) and 24-hour urinary albumin (R2 = 0.976). It was superior to urina sanguinis (R~2 = 0.900), postprandial urine (R~2 = 0.584) and random urine (R~2 =0.791). When 24 h urinary albumin was taken as the standard, receiver operating characteristic (ROC) curve analysis showed there was significant difference between male and female(male 12.8 μg/mg urine creatinine vs female 27.0 μg/mg urine creatinine),and the the cut-off value of ACR was 27.7μg/mg urine creatinine. When the smallest available negative likelihood ratio (0.011) and the greatest positive likelihood ratio (481.000) were obtained,the concentration of 13.0 μg/mg creatinine and 87.4 μg/mg creatinine were set as the cut-off value of ACR. Conclusions The correction with urinary creatinine can reduce the variation between-days compared with urine volume, but still can not completely eliminate the variability. The ACR of overnight urine has the best correlation with the 24 h urinary albumin and can replace 24 h urinary albumin. Random urine as the most convenient collecting urine samples can also replace 24-hour urinary albumin, but the gender discrepancy need to be considered. When the concentration of 13.0 μg/mg and 87.4 μg/mg was set as a random ACR exclusion value and the confirmative value, it can basically rule out and confirm the existence of microalbuminuria.

Objective: To reconstruct adenovirus vector of breast eukaryotic initiation factor 4E and to observe its effect on the metastasis ability of breast cancer cell line MCF-7. Methods: eIF-4E gene was constructed into adenovirus vector pAD-X by gene recombination technique, which was transformed into 293 packaged cell for high titer adenovirus. Real-time PCR was applied to detect eIF-4E gene expression. eIF-4E siRNA was applied and then transwell cabin assay was used to observe changes of invasion and motor ability of MCF-7 cells transfected with reconstruction adenovirus. Result:The finding of digestion was coincided with expected. eIF-4E gene over-expression was detected in transfected MCF-7 cells with real-time PCR. And the invasion and motor abilities of transfected MCF-7 cells were more significantly inhibited in transwell cabin assay (respectively p