Studying 338 new onset diabetic patients for 2 years, aged 30 to 69 years, were treated at Bach Mai Hospital from February to December 2004. All the patients have clinical examination and blood urine laboratory tests as well as vascular investigations. Results showed that characteristics of new onset type 2 diabetic patients as follow: BMI index is in normal range (22.92  2.66), however the waist/hip index is high (0.89  0.069). 22.6% of patients with type 2 diabetic are hypertensive. All the patients had indices above normal levels such as the fasting glycemia, after meal glycemia, HbA1c, serum cholesterol and triglyceride. Although 100% of patients had the normal results of peripheral vascular clinical examination, the vascular Doppler sonography showed a marked decrease of FMD and a significant greater thickness of carotid artery intimamedia
Diabetes Mellitus, Type 2 ; Clinical Medicine ; Laboratories

Exploring a new teaching mode of CHB laboratory diagnostics to improve the teaching quality through establishment a teaching model covered the whole process of CHB disease diagnosis and differential diagnosis, treatment, drug selection, the toxicity and side effects prediction, effect monitoring, and prognosis evaluation. According to the CHB clinical diagnosis and treatment guidelines, formulated the laboratory examination and detection strategies related to different stages of CHB, and established CHB clinical laboratory diagnostic pathway. Compared the classroom teaching effect by the questionnaire between the 2016 and 2017 eight-year undergraduates from the First Clinical College of Wuhan University. In this study,the CHB clinical laboratory diagnostic pathway was established and approved by clinicians, which covered the whole process of CHB disease diagnosis and differential diagnosis, treatment, drug selection, the toxicity and side effects prediction, effect monitoring, and prognosis evaluation. The teaching quality evaluation indicators and the scores on the class test had been greatly improved with the clinical diagnostic pathway teaching mode in the classroom teaching of 2017 clinical medicine undergraduates compared with the traditional teaching mode in the 2016 clinical medicine undergraduates. In summary, the medical students not only could realize the organic integration of laboratory diagnostics and clinical medicine, but also improves overall understanding of various laboratory tests in CHB diagnosis and treatment from the teaching model of laboratory diagnostics based on the CHB clinical laboratory diagnostic pathway,and the quality of teaching for CHB has been significantly improved.
Clinical Laboratory Techniques ; Hepatitis B, Chronic ; Humans ; Laboratories ; Laboratories, Clinical ; Records

Harmonization of clinical laboratory results means that results are comparable irrespective of the measurement procedure used and where or when a measurement was made. Harmonization of test results includes consideration of pre-analytical, analytical, and post-analytical aspects. Progress has been made in each of these aspects, but there is currently poor coordination of the effort among different professional organizations in different countries. Pre-analytical considerations include terminology for the order, instructions for preparation of the patient, collection of the samples, and handling and transportation of the samples to the laboratory. Key analytical considerations include calibration traceability to a reference system, commutability of reference materials used in a traceability scheme, and specificity of the measurement of the biomolecule of interest. International organizations addressing harmonization include the International Federation for Clinical Chemistry and Laboratory Medicine, the World Health Organization, and the recently formed International Consortium for Harmonization of Clinical Laboratory Results (ICHCLR). The ICHCLR will provide a prioritization process for measurands and a service to coordinate global harmonization activities to avoid duplication of effort. Post-analytical considerations include nomenclature, units, significant figures, and reference intervals or decision values for results. Harmonization in all of these areas is necessary for optimal laboratory service. This review summarizes the status of harmonization in each of these areas and describes activities underway to achieve the goal of fully harmonized clinical laboratory testing.
Chemistry, Clinical ; Documentation ; Guidelines as Topic ; Laboratories/*standards ; Reference Values

The purpose of this study was to investgate and evaluate whether the recording information contained in the work authorization was performed properly and master casts were designed accurately according to the rationale and principles of the removable partial denture when the work authorization and the master casts were sent to the dental framework. the accurate recording of the work authorization sent to dental laboratory in Hwasun for removable partial denture framework, the normal form of the occlusal rest guiding plan of the surveyed crown using the surveyor, the location analysis of the occlusal rest seat, the design patten of the maxillary and mandibulary major connectors, the use of the surveyor on the master cast, the status of the secondary impression taken in the distal extension edentulous areas were investigated for this study. The following results were obtained : 1. In the status of the occlusal rest seat prepared in the abutment, the occlusal rest seat with normal form was 81.25%, 95.45%, that without form was 6.25%, 0.00%, respectively in Class I and Class II on the maxillary cast and the occlusal rest seat with normal form was 76.92%, 95.45%, that without form was 7.69%, 0.00% respectively in Class I and Class II on the mandibular cast. 2. In the status of the guiding plan, the guiding plan with the normal form was 79.17%, 86.36% that with abnormal form was 20.84%, 13.64% respectively in Class I and Class II on the maxillary cast and the guiding plan with normal form was 79.49%, 77.27%, that with abnormal form was 20.51%, 22.73% respectively in Class I and Class II on the mandibular cast. 3. The abutment splinting in the distal extension removable partial denture was 20.78%, 27.27%, respectively in Class I and Class II on the maxillary cast and was 25.64%, 13.64% respectively in Class I and Class II on the mandibular cast. 4. The location and form of the major connector delineated on the maxillary and mandibular master cast was 95.83%, 98.41% respectively. 5. The delineation and recording on the work authorization was incomplete as group II(73.33%), group I(14.07%), group III(12.59%) and group IV (0.00%) in investigating the contents of the work authorization. 6. Aker's clasp of the types of the direct retainer was nots used 72.22%, 74.60%, in the maxillary and mandibular casts respectively. 7. The location of the indirect retainer delineated on the maxillary and mandibular master cast was 51.43%, 50.82% respectively. 8. The types of metal used were mostly Cr-Co non-precious metal alloy and the cases using color coding on the drawing paper of work authorization were not observed. 9. The cases taking secondary impression in the distal extension removable partial denture were 45.71%, 52.46% respectively in the maxillary and mandibular master cast. 10. The delineation of tripoding or reference line on the master cast was not observed in surveying procedure.
Alloys ; Clinical Coding ; Crowns ; Denture, Partial, Removable ; Laboratories, Dental ; Splints

In order to elucidate employees satisfaction levels in using graphic user interface(GUI) in a laboratory information system(LIS), users attitudes toward GUI versus CUI(Character User Interface) in a similar LIS were surveyed one month after implementing upgrade version of LIS in a tertiary care university hospital laboratory. The outcome of the study showed that approximately two third of users preferred to have GUI in LIS. There was no difference in preference of GUI or not. However the female and older employees tend to shy away from GUI. The employee productivity was improved with GUI although it takes slightly longer program loading time than that of CUI. In conclusion, the laboratory employee satisfaction was higher with GUI than CUI and their productivity was improved with GUI.
Clinical Laboratory Information Systems* ; Efficiency ; Female ; Humans ; Laboratories, Hospital ; Tertiary Healthcare

Biological Products ; standards ; China ; Clinical Laboratory Techniques ; instrumentation ; standards ; Laboratories ; standards ; Safety Management ; legislation & jurisprudence ; standards

BACKGROUND: The Korean Laboratory Accreditation Program (KLAP) by the Korean Society of Laboratory Medicine (KSLM) was started in 1999. We summarized history and achievement of KLAP for the last 8 yr. METHODS: We analyzed 8 yr data (1999-2006) of historical events, trends of participating laboratories, and scores according to the impact of the question to the outcome of the tests. Inspection check lists are for 'laboratory management', 'clinical chemistry', 'diagnostic hematology', 'clinical microbiology', 'diagnostic immunology', 'transfusion medicine', 'cytogenetics', 'molecular genetics', 'histocompatibility', 'flow cytometry', and 'comprehensive laboratory test verification report'. The laboratories with score 90 or higher got 2-yr certificate and laboratories with score between 60 and 89 got 1-yr certificate. The laboratories with score below 60 failed accreditation. RESULTS: The number of accredited laboratories was 2.4 times higher in 2006 (n=227) than in 1999 (n=96). Inspection check lists have been revised 5 times till 2006. The average accreditation rate was 99.6% during these periods and the 2-yr accreditation rate was 32.4% in 2000, 45.6% in 2001, 53.3% in 2002, 47.3% in 2003, 68.5% in 2004, 37.7% in 2005, and 47.7% in 2006. Number of participants in inspector training workshops increased from 89 in 2000 to 766 in 2006. CONCLUSIONS: The KLAP has been in place successfully and stabilized over the past 8 yr. It seemed to enhance the laboratory quality. Efforts for improvement of quality control and inspector training workshops appeared to be in the main contributing factors.
Accreditation ; Education, Medical, Continuing ; Korea ; Laboratories/*standards ; Pathology, Clinical/*standards ; *Program Evaluation

BACKGROUND: We investigated the influence of pre-analytical factors on the results of clinical tests and thereby analyzed approaches to improve quality management in clinical laboratories. METHODS: Unqualified clinical samples were selected from all the samples received at our clinical laboratory. The data were collected for 2009 and 2010, i.e., the years before and after the establishment of the laboratory quality management system. The rate and causes of generation of unqualified samples were analyzed, and measures to improve the laboratory practices were studied and implemented. RESULTS: A total of 1,051 unqualified samples were identified from among the 553,158 samples (the overall incidence rate of unqualified samples was 0.19%). The number of unqualified samples substantially varied according to the nature of the sample, and clinical samples collected for routine blood tests or coagulation tests were the predominant unqualified samples. The main causes of generation of unqualified samples were insufficient sample volumes and improper methods of mixing the samples. The rate of generation of unqualified samples decreased significantly after the implementation of improvement measures (0.26% in 2009 vs. 0.13% in 2010, P<0.001). CONCLUSIONS: The number of unqualified samples decreased significantly after the establishment of the laboratory quality management system, which promoted active communication among and training of the clinical staff to reduce the occurrence of pre-analytical errors. Comprehensive control of pre-analytical factors is an important approach in improving the clinical laboratory practices.
Clinical Laboratory Techniques/standards ; Diagnostic Errors/statistics & numerical data ; Humans ; Laboratories, Hospital/*standards ; Specimen Handling/standards

BACKGROUND: A questionnaire survey was performed to perceive the problem of the current medical insurance reimbursement system for laboratory tests referred to independent medical laboratories; then, we intended to find a way to improve the reimbursement system. METHODS: Questionnaires were distributed to 220 independent medical laboratories and 700 laboratory physicians from July through October 2005. Frequency analysis was used to analyse the replies from 109 respondents to 25 questionnaire items regarding the current medical insurance reimbursement system for referral tests, problems with the system, and suggestions for the improvement of the system. RESULTS: Among the 109 respondents to this survey, 49 (45.8%) considered the current reimbursement system to be unsatisfactory, while only 16 (15.0%) answered satisfactory. The problem was that the referral clinics-not the laboratories that performed the tests--would first receive their reimbursement for the laboratory tests from Health Insurance Review Agency (HIRA) and then give a portion of the laboratory test fees to the independent medical laboratories after the deduction of administrative fees. They (62.5% of the respondents) would prefer a separated reimbursement system by which the referral clinic-as well as the independent medical laboratory-would receive their reimbursement directly from HIRA through an Electronic Data Interchange (EDI) system. In this new system, 34% of the respondents expected the quality of the laboratory tests to be improved; however, 41.6% answered that the income of the referral clinic is expected to decrease. CONCLUSIONS: For the improvement of the medical insurance reimbursement system, the administrative fee for the referral clinic and the test fee for the independent medical laboratory should be reimbursed directly to the respective organizations. These changes could be made possible with the proper analysis of medical costs and the development of an effective EDI reimbursement system.
Clinical Laboratory Techniques/*economics ; Female ; Humans ; *Insurance, Health, Reimbursement ; Korea ; Laboratories, Hospital/economics ; Male ; Questionnaires

For many years, the clinical laboratory's focus on analytical quality has resulted in an error rate of 4-5 sigma, which surpasses most other areas in healthcare. However, greater appreciation of the prevalence of errors in the pre- and post-analytical phases and their potential for patient harm has led to increasing requirements for laboratories to take greater responsibility for activities outside their immediate control. Accreditation bodies such as the Joint Commission International (JCI) and the College of American Pathologists (CAP) now require clear and effective procedures for patient/sample identification and communication of critical results. There are a variety of free on-line resources available to aid in managing the extra-analytical phase and the recent publication of quality indicators and proposed performance levels by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) working group on laboratory errors and patient safety provides particularly useful benchmarking data. Managing the extra-laboratory phase of the total testing cycle is the next challenge for laboratory medicine. By building on its existing quality management expertise, quantitative scientific background and familiarity with information technology, the clinical laboratory is well suited to play a greater role in reducing errors and improving patient safety outside the confines of the laboratory.
Clinical Laboratory Techniques/standards ; Diagnostic Errors ; Humans ; Laboratories/*standards ; Quality Assurance, Health Care/standards ; Specimen Handling