Objective To study the chitin enzyme protein(YKL-40),sCD40L,AFP and the correlation of hypertension with cor-onary heart disease(CHD).Methods 75 cases of elderly patients with CHD were selected as observation group,and then were di-vided into hypertension group and non hypertension group according to the blood pressure.103 cases of healthy elderly were select-ed as control group.ELISA method was used to detect YKL-40 and sCD40L,and AFP was detected by chemiluminescence immuno-assay.Results Clinical data comparison revealed that the relative risk of CHD with hypertension group and non hypertension of hy-perlipidemia,drinking,smoking,diabetes mellitus,were 1.56,1.33,1.23,1.15 times,data show that relative risk of CHD with hy-pertension were much greater than CHD without hyperlipidemia.The concentration of YKL-40 in CHD with hypertension(92.66± 12.04)ng/mL was significant higher than that in CHD without hypertension (57.08 ± 10.07 )ng/mL,and the concentration of sCD40L in CHD with hypertension (186.59 ± 69.63 )ng/mL was significant higher than that in CHD without hypertension (128.14±48.37)ng/mL(P <0.05).There was no significant difference in the concentration of AFP in patients with CHD with hy-pertension and non hypertension(P >0.05).Conclusion The levels of YKL-40,CD40L and AFP in the peripheral blood of elderly patients with CHD were significantly increased.And the concentration of sCD40L and YKL-40 was positively correlated with hy-pertension,which can be used to assess the stability and prognosis of CHD.

ObjectiveTo observe the effects of different doses of Xuebijing on cerebral cortex apoptosis factors bcl-2 and bax in rats at early stage after cardiopulmonary resuscitation (CPR).Methods Thirty-two healthy SD rats aged 12 weeks were divided into four groups by using a random number table method (each,n = 8); all the rats were intubated through the opening of tracheotomy, and the blood pressure was measured through the left/right femoral artery catheter. Asphyxiation was applied to rats, resulting in cardiac arrest (CA), and then cardiopulmonary resuscitation (CPR) was carried out. After restoration of spontaneous circulation (ROSC), 0.9% normal saline 8 mL/kg, 0.9% normal saline 4 mL/kg + Xuebijing 4 mL/kg, 0.9% normal saline 2 mL/kg + Xuebijing 6 mL/kg and Xuebijing 8 mL/kg were given to model group, Xuebijing low dose group, middle dose group and high dose group respectively. The rat body weight, time of CA, CPR-ROSC time, ROSC ratio and the amounts of dopamine and 0.9% saline used in 24 hours were recorded. The positive protein expression levels of bcl-2 and bax in rat cerebral cortex and the ratio of bcl-2/bax was measured at 24 hours after ROSC.Results Compared with the model group, the amount of 0.9% normal saline (mL: 4.2±1.2, 2.6±1.0, 2.5±1.0 vs. 5.5±1.1,P < 0.05) and of dopamine used in 24 hours (μg: 1865±189, 1376±197, 1215±145 vs. 3526±141,P < 0.05), the levels of positive protein expression of bcl-2 (%: 33.4±4.3, 25.5±4.6, 26.1±4.2 vs. 38.5±5.1), and of bax at 24 hours after ROSC (%: 39.5±4.3, 32.8±3.8, 31.9±3.7 vs. 44.3±5.1) and the ratio of bcl-2/bax (0.87±0.16, 0.72±0.13, 0.71±0.14 vs. 0.89±0.11) was significantly decreased in low, middle and high dose groups (allP < 0.05). Compared with the low dose group, the amount of 0.9% normal saline and dopamine used in 24 hours, protein expression levels of bcl-2 and bax at 24 hours and the ratio of bcl-2/bax in middle dose and high dose groups were all lower than those in low dose group (allP < 0.05).Conclusion Xuebibing 6 mL/kg applied at early stage after CPR in rats may show relatively good protective effect on cerebral cortex.

Objective To investigate the results of different measuring procedures of hemoglobin A1c (HbA1c) trueness verification scheme in China.Methods Cross sectional survey.The data were collected via the External Quality Assessment (EQA) software from laboratories participated in the First HbA1c trueness verification EQA.Then the collected data were divided into several groups based on laboratory instruments and the data from less than 5 group were excluded.The observed imprecision, bias and sigma (σ) were calculated and the bias％ and CV％ were drew in the sigma chart.The average bias％, CV％ and weighted average σ of each level were also calculated.Results Total 123 laboratories were divided into 9 groups and setting 6％ as the Allowable Total Error, the average bias％, CV％ and weighted average σ of 201411 (target value was 5.4％) were 3.70％, 4.55％ and 0.51 respectively σ, of 201412 (target value was 7.8％)were 2.42％ , 3.56％ and 1.24σ respectively.None of the group achieved the 2σ quality of 201411, and 1 group achieved the 2σ quality of 201412.Conclusions There are obvious biases among the results of many measuring systems and the target value assigned by reference measuring procedures of HbA1c, as well as the imprecision.The Sigma External Quality Assessment Chart is a visual tool, indicating that the quality of measuring systems necessitate improvement therefore to ensure the reliability of results and make better use of HbA1c in clinical application.

Objective To study the early changes of the coagulation system in type 2 diabetic nephropathy.Methods Sixty-two cases of patients with type 2 diabetic nephropathy were divided into two groups:normal albuminuria group ( N-UAlb group,UACR ＜ 30 mg/g,32 cases ),microalbuminuria group ( MUAlb group,UACR:30～300 mg/g,30 cases).Thirty healthy persons constituted a control group (NC group).Fibrinogen( FIB ),antithrombin Ⅲ ( AT-Ⅲ ),protein C ( PC ),protein S ( PS ) were measured by coagulation analyzer,while yon willebrand factor (vWF) and platelet granule membrane protein 140 (GMP-140) were detected by ELISA assay,platelet count (PLT),mean platelet volume(MPV),platelet hematocrit (PCT),platelet distribution width(PDW) by hematology analyzer.Results The level of fibrinogen,GMP-140 and vWF in the M-UAlb group were (4.20 ± 1.53 ) g/L,( 30.03 ± 7.77 ) μg/L,and ( 315.53 ± 47.24 ) ％ respectively,vwhich were significantly higher than those in the N-UAlb group [ ( 3.21 ± 0.89 ) g/L,( 18.22 ± 5.08 ) μg,/L and ( 191.88 ± 57.25 ) ％ respectively ] and the NC group [ ( 2.75 ± 0.53 ) g/L,( 14.26 ± 2.29 ) μg/L and ( 138.12 ± 61.27 ) ％ respectively ] ( F =5.42,10.42,30.44,P ＜ 0.05 or 0.01 ).The fibrinogen,vWF,GMP-140 were positively correlated with UACR ( r =0.313,P ＜ 0.05 ; r =0.620,P ＜ 0.01 ; r =0.680,P ＜ 0.01 ) and PC was negatively correlated with UACR ( r =-0.255,P ＜ 0.05 ).Conclusion Hypercoagulable state in diabetic nephropathy is associated with the high fibrinogen,endothelial dysfunction and platelet activation,and these changes have already emerged in patients without albuminuria.This might mind us that we should strengthen anticoagulant therapy on patients when they are not progressing to albuminuria.

Objective To investigate preanalytical and intraindividual biological variations of 19 biochemistry analytes. Methods For the study of preanalytical variations, 10 consecutive blood specimens were taken from each of 21 individuals and the specimens were taken from different arms and with various evacuated blood tubes and venous occlusion durations and processed with different storages before and after centrifugal separation of serum. Another 3 aliquots of blood, each at an interval of 1 week, were taken from the individuals for the study of intraindividual biological variations. All the serum samples were analyzed in duplicate for 19 biochemistry analytes. Analysis of variance was performed on the results for the estimation of preanalytical and biological variations. Results Various preanalytical treatments or factors caused some systematic variations but random specimen errors were the main contributors of preanalytical variations. Chloride, sodium and calcium showed preanalytical variations of less than 1% and other analytes ranging from 1%-7%. Different analytes showed varied intraindividual biological variations. The least biological variations ( <2% ) were observed on chloride, sodium and calcium and the largest ( >20% ) on bilirubin,triglycerides, alanine aminotransferase and creafine kinase. Conclusions Preanalytical variations under laboratory settings in China and intraindividual biological variations in Chinese for 19 biochemistry analytes have been estimated. These data will be useful in the estimation of measurement uncertainty and the interpretation of clinical laboratory results.

Objective The article aimed to investigate the effect of application of phase learning teaching method in teaching of clinical nursing skills.Methods A total of 97 undergraduate nursing students in grade 2008 were grouped as the experimental group,these students adopted phase learning teaching method,which divided clinical nursing skills course into three stages.A total of 103 undergraduate nursing students in grade 2008 were set as the control group,the students were given traditional teaching method.The teaching effect was compared between two groups.Results Compared with the control group,theoretical knowledge,practical skills,professional emotion and critical thinking were better in the experimental group,the difference was significant,t value was-4.566,-6.332,-2.371 and-4.308.Conclusions The phase learning teaching method is an effective and practical method to improve the teaching effect of clinical nursing skills.

Purpose To investigate the clinicopathological features,diagnosis and differential diagnosis of myxoid synovial sarcoma (MSS).Methods Clinicopathological changes and immunophenotype were retrospectively evaluated in two MSS cases collected from Fujian Provincial Hospital,conbined with genetic mutation analysis.The relevant literatures were reviewed to explore its clinical and pathological features of this tumor.Restilts The two cases,one man and one woman,aged 71 and 15years,respectively.Tumor was located in the left down abdomen in case 1,and left frontal temporal lobe in case 2.Histopathologically,at low magnification in case 1,the tumor was nodular,which was made up of areas of hypercellularity and hypocellularity.In some areas of hypocellularity,the tumor cells were arranged in fascicular,story-form,sheet arrangements with mucoid degeneration.In hypercellularity area,the tumor cells were arranged in fascicular,fish bone-liked arrangenents.At low magnification in case 2,the tumor was nodular,which was made up of areas of hypercellularity and hypocellularity.In hypocellularity area,the tumor cells were arranged in net-like,sheet arrangements,and fascicular,sheet arrangements in case 2.In some area,the tumor cells were epithelioid with cluster distribution,without infringing brain tissue.Immunohistochemically,the tumor cells were diffusely positive for BCL-2,vimentin,and α-SMA and EMA were partially positive,while CD34,CD57,S-100,CD117,PLAP were negative.However,in case 2,only BCL-2 was positive,and MyoD1,GFAP,Olig-2,EMA,Syn,CD99,CgA,S-100,Myogenin,STAT6,CD34,desmin and α-SMA were negative.Molecular detection SYT-SSX fusion gene was detected in both cases.Conclusion MSS is a rare malignancy of soft tissue.The diagnosis of MSS depends on molecular pathology.The clinical and pathological findings are different from mucinous fibrosarcoma and solitary fibrous tumor.The treatment is surgical resection,combined with radiotherapy,with poor prognosis.

In clinical laboratory medicine,measurement uncertainty (MU) is a fixed property of testing results in the measuring system.As an important part of ISO 15189,it is necessary for clinical laboratories to determine MU during the period of validation and verification for each measurement procedure and to review MU over time.Now,testing reports provided by clinical laboratories usually do not offer MU,but some clinical laboratories have already estimated MU in their routine work.Estimation andmonitoring of MU can help clinical laboratories offering more accurate results and provide objective tools for clinicians used in result intcrpretatinn.Generally,result interpretation can be achieved by the result comparison with three main comparators,including a previous result from the same patient,a population reference interval and a clinical decision point.The means of true value and the components contributing to the estimation of MU are both different when the com parison is conducted between testing results and different comparators,so the optimum estimation method of MU is accordingly different,which will subsequently affect the MU value and the determination of clinical decisions.Obviously,depending on the actual clinical uses,laboratories can choose appropriate comparators to the result interpretation and the determination of optimum estimation method of MU.For different clinical uses (diagnosis or monitoring) of the same mearurands,the adoption of different estimation methods should be used to acq uire reasonable MU.By interpreting the concept,characteristics,estimation,and uses of MU,as well as explaining how three main comparison methods of results exploit their own traceable chain to get MU,this paper intends to help clinical laboratories get further understanding of the importancc of MU and provide guidance for the MU estimation in routine work.

OBJECTIVE: To investigate the effect of Xuebijing injection on the cardiac function and calcium ions of cardiocyte in rats after anoxia-induced cardiac arrest-cardiopulmonary resuscitation(CA-CPR).METHODS: CA-CPR model was induced in rats and then the model rats were randomized to 4 groups,i.e.sham group,model group,Xuebijing injection high dose group(4 mL?kg-1),and Xuebijing injection lowdose group(Xuebijing injection 2 mL?kg-1).Mean arterial pressure(MAP),?LVdp/dt max,average fluorescence intensity of calcium and pathological changes of cardiocytes were observed at 0 and 6 hours after resuscitation,respectively.RESULTS: Compared with model group,Xuebijing ingection high dose group at 6 h showed significantly increased MAP(P

In the clinical laboratory medicine,the measurement uncertainty (MU)is a relatively new concept.Over the years, experts of clinical laboratory medicine from all over the world made a great number of further researches and promote the development of MU,which led clinical laboratories to pay more and more attention to the meanings and functions of MU at the same time.However,because of the habitual using of the total error (TE)in clinical laboratories and similarities between concepts of MU and TE which easily resulted in confusion,a lot of laboratories still cannot completely accept MU.By explai-ning concepts of TE and MU and analyzing the pros and cons of models of TE and MU as well as their functions,the obj ec-tive of this paper is to help clinical laboratories make further comprehensions of TE and MU and understand how to properly use them in practice.