Objective To study the situation of missing detection of HBsAg negative samples with high value and to explore the ways for reducing the missing detection .Methods According to the document EP15-A2 issued by the Clinical and Laboratory Standards Institute(CLSI) ,the precision and accuracy of the HBsAg quantitative detection by the ARCHITECT I 2000 were verified for ensuring the instrument conditions conforming to the test requirements .The 1 130 samples with the ratio of the sample absor-bance value to critical value(S/CO) in the range 0 .30-0 .99 in the HBsAg qualitative results by ELISA were collected during the study period and re-tested .After re-testing ,the quantitative HbsAg of 387 samples ,in which the ratio of S/CO was still in the range 0 .30-0 .99 ,were detected by the ARCHITECT I2000 and the detection results were taken as the reference .The missing detection situation of HBsAg negative samples with high value was researched .The ROC curve was adopted to reassess the cutoff value of negative HBsAg with positive HbcAb for searching better diagnostic performance .Results The HBsAg detection results by the i2000SR had good repeatability with total imprecision of less than 9 .88% and the deviation value with calibrator was less than 3 .91% ,which conformed to the clinical testing requirements .This study found that the HBsAg samples with the S/CO ratio of 0 .30-0 .99 had the significant distribution differences in the different batches of test (P<0 .05) .In the study period ,261 cases of HBsAg missing detection occurred ;then the critical value of HBsAg qualitative results detected by ELISA in the HbcAb positive group was re-determined as 0 .51 by using the ROC curve ,among them 239 cases were rejudged as positive .Conclusion Increasing the repeatability of HBsAg qualitative detection by ELISA and establishing the new positive judgement value of ELISA for qualita-tive HBsAg in the HbcAb positive population as 0 .51 possesses better diagnostic performance for detection the HBsAg samples with the S/CO ratio of 0 .30-0 .99 .

Objective To analyse clinical application of hepatitis B virus core antibody(HBcAb)detected by using the chemilu-minescence microparticle immunoassay.Methods A total of 1 6 830 specimen with positive HBcAb detected by using the two pairs of semi-hepatitis test from January 2012 to November 2014 were collected,and divided into three groups according to the cut off in-dex(COI)of detection results of HBcAb,including group 1.0-<9.0,group 9.0-<1 1.0 and group COI≥1 1.0,and detection re-sults were statistically analysed.The hepatitis B virus(HBV)DNA test was carried out in specimen with negative hepatitis B surface antigen(HBsAg)and hepatitis B surface antibody (HBsAb)and COI≥1 1.0.Results The detection rate of HBsAg(+)HBsAb(-) (13.84%)was significantly higher than other expression patterns in group ≥1 1.0(P <0.05).There was no statistically significant differences in positive rate among all expression patterns of HBsAg and HBsAb in the group 9.0-<1 1.0(P >0.05).The detec-tion rate of HBsAg(+)HBsAb(-)of group 9.0-<1 1.0 was significantly lower than that of the other two groups(P <0.05).A total of 304 specimen were HBsAg(-)HBsAb(-)and COI≥1 1,among them 64 specimen were HBV DNA postive and the posi-tive rate was 21.0%.Conclusion In the detection of HBcAb,COI≥1 1 and 1.0-<9.0 could be reference indicators for diagnosiing current and past HBV infection respectively,which should be combined with other laboratory indicators of HBV clinical data for comprehensive analysis.

Objective To observe effect of scalp acupuncture combined with cognitive rehabilitation training in ameliorating cognitive dysfunction in stroke patients. Methods Eighty-four stroke patients with cognitive dysfunction were randomly divided into a treatment group ( n = 42) and a control group (n = 42 ) . All of the patients in both groups received routine therapy including cognitive rehabilitation training by professional therapists aimed at improving their orientation, perception, attention and thinking. The patients in the treatment group also received prolonged scalp acupuncture, in which the acupuncture needle remained in the scalp for 6 hours. All cases were evaluated using Loewenstein's occupational therapy cognition assessment (LOTCA) before and 10 weeks after treatment. Results The LOTCA scores were significantly different before and after treatment in both groups. The effect in the treatment group was significantly better than in the control group. Conclusions Prolonged scalp acupuncture combined with cognitive rehabilitation training can significantly improve the cognitive ability of stroke patients.

Objective To investigate the patterns of change in thyroid functional parameters ( serum TSH,FT3, and FT4 ) in patients with papillary thyroid cancer (PTC) before and after the initial 131I treatment for thyroidal remnant ablation. Methods Seventy-four PTC patients, treated with 3.7 GBq 131 I therapy, were divided into two groups, group A with serum TSH＜30 mIU/L and group B with serum TSH ≥30 mIU/L the day before 131I treatment. Five days after the treatment, the patients were re-examined for serum FT3, FT4, and TSH levels.Results In group A (22 cases), 5 days after the 131I ablation treatment, FT4significantly increased by 88% and FT3 by 87%, while TSH decreased by 87% (all P＜0. 05 ), and 45% (10/22)cases manifested the signs of transient thyrotoxicosis. In group B (52 cases)after treatment, individual variance of FT3 and FT4 was obvious,with FT4 decreased by 13% and FT3 decreased by 14% ( both P＜0. 05 ), while TSH slightly increased by an average of 6% ( P＞0.05 ). Conclusion After the initial 131 I ablation therapy for thyroidal remnant, the thyroid hormone levels in some PTC patients significantly increase while in others may slightly decrease in the early stage. The supplementary and suppressive therapy after 131I ablation for PTC patients might be individualized depending on the thyroid hormone determination.

Adenoma ; pathology ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Parathyroid Neoplasms ; pathology ; Spinal Neoplasms ; secondary