ObjectiveTo evaluate creatinine proficiency testing data by robust Z-score analysis.MethodsThe data were collected from three proficiency surveys of routine biochemical test in 2009,to which 1 179,1 169 and 1 168 laboratories participated respectively.Creatinine data were divided into Jaffe group and enzymatic group based on the analytical method used.The results tested by both methods were compared using Mann-Whitney test.The outliers were deleted using the TUKEY fence established by quartile values.The normality of raw data and trimmed data was tested using one-sample Kolmogorov-Smirnov test.The performance of the laboratories was assessed using robust Z-score,whose values were considered satisfactory when ｜ Z-score｜ ≤2,questionable when 2 ＜ ｜ Z-score ｜ ＜ 3 and unsatisfactory when ｜ Z-score ｜ ≥3.Results86.7％ results tested using Jaffe and enzymatic methods were not comparable.The raw data in all research groups were not normally distributed.After deletion of outliers,73.3％ trimmed data in most research groups were normally distributed.For the three proficiency tests in 2009,in Jaffe group,the satisfactory rates were 89.8％( 495/551 ),87.2％( 468/537 ) and 89.5％( 476/532 ) respectively,unsatisfactory rates were 3.3％ ( 18/551 ),6.5％ (35/537) and 4.5％ (24/532) respectively; while in enzymatic group,the satisfactory rates were 88.8％ (558/628),89.3％ (564/632) and 88.1％ (560/636) respectively,unsatisfactory rates were 5.6％( 35/628 ),5.2％ (33/632) and 6.6％(42/636) respectively.Conclusion It is reasonable to choose robust Z-score as a proficiency testing assessment index,because it avoids the influence of the outliers on evaluation results.

Objective To perform calibration verification for the blood glucose test in Hitachi and Olympus automatic biochemistry analyzers and present a method of calibration verification and evaluate the results.Methods The glucose test results were divided into two groups:Hitachi and Olympus groups according to the different analytical instruments.The calibration verification was performed following the current College of American Pathologists strategies.The slope and intercept of the calibration line were tested by one-sample t test and the percentage differences were calculated.The percentage differences were compared with allowable errors.If the slope and intercept had no statistically significant difference from 1 and 0 respectively and the percentage differences were within the limits of allowable errors,the calibration line was evaluated as verified 1 ; if the slope and intercept had no statistically significant difference from 1 and 0 respectively and at least one of the percentage differences exceeded the limits of allowable errors,the calibration line was evaluated as different 1 ; if the slope or intercept had statistically significant difference from 1 and 0 respectively and the percentage differences were within the limits of allowable errors,the calibration line was evaluated as verified 2; if the slope or intercept had statistically significant difference from 1 and 0 respectively and at least one of the percentage differences exceeded the limits of allowable errors,the calibration line was evaluated as different 2.Results In Hitachi group,verified 1,different 1,verified 2 and different 2 were 5.4％ ( 4/74 ),0.0％ ( 0/74 ),68.9％ ( 51/74 ) and 25.7％ ( 19/74 ),respectively.In Olympus group,verified 1,different 1,verified 2 and different 2 were 16.4％ (12/73),0.0％ (0/73),58.9％ (43/73) and 24.7％ ( 18/73 ),respectively.Conclusions The current College of American Pathologist strategies could be performed as a reasonable and feasible method for calibration verification.Most of participating laboratories ( 74.8％,110/147 passed the assessment of calibration verification.

Objective To investigate the linearity on testing creatinine in various assay instntments,in order to evaluate creatinine testing ability of clinical laboratories. Methods Statistically standard linearity and nonlinearity were judged via polynomial regression analysis recommended by EP6-A guideline. The imprecision of analytical data were analyzed and the average deviation of best fitting curve from linearity were determined by Dr. Kroll's EP6-A extended methods. In accordance with the instruments used, the testing data were divided into four groups: Beckman LX (28 Labs), Beckman CX ( 14 Labs), Hitachi (62 Labs)and Olympus (72 Labs) groups. Results This research found that in samples analyzed by Beckman LX,Beckman CX, Hitachi and Olympus instruments, the imprecision ranged from 0. 30%-3.01%, 0.09%-3.46%, 0. 14%-4. 91% and 0. 17% -16. 44%, respectively. The imprecision in one laboratory in Olympus group exceeded the acceptable limit, while the imprecision in the remaining laboratories were precision for linear survey. The average deviations of best fitting curve from linearity ranged from 0%-2. 38%, 0%-2. 51%, 0% -5.46% and 0% -4. 66%, respectively. The linearity with statistical significance were 21.4% (6/28), 35.7% (5/14), 11.3% (7/62) and 18. 1% (13/72), respectively. The linearity with clinical significance were 78.6% (22/28), 64. 3% (9/14), 88. 7% (55/62) and 80. 6% (58/72), respectively.The percentages of laboratories whose creatinine testing met the linearity criteria were 100% (28/28),100% ( 14/14 ), 100% ( 62/62 ) and 98. 6% ( 71/72 ), respectively. Conclusion Majority of the laboratories involved in the linearity survey present good capability for creatinine testing.

Objective To assess the safety and effectiveness of nasegastric enteral nutrition (NGEN) in patients with severe acute pancreatitis (SAP).Methods A meta-analysis of all the relevant clinical trials was performed.Clinical trials were identified from the following electronic databases:Medline,EMBASE,the Cochrane Controlled Trials Register,and Chinese Bio-medicine Database.The search was undertaken in October 2008.The literature quality was evaluated with Cochrane Handbook 5.0.The statistical analysis was performed by RevMan 4.2 software.Results Four trials involving 157 patients were included.The combined results showed that no significant differences in the safety and tolerance between nasogastric and conventional routes in patients with SAP.Conclusions Currently available data show early NGEN appears to be effective,safe,and tolerable in patients with SAP.However,more large-scale high-quality trials are required to further elucidate this topic.

Objective To study the effect of moxonidine (Mox) on the His bundle electrogram (HBE) of normal rabbits. Methods A total of 24 healthy rabbits were randomly divided into four groups: control group, small dose of Mox (0.1 mg?kg -1), medium dose of Mox (0.3 mg?kg -1) and large dose of Mox (0.9 mg?kg -1). The electrode catheter was inserted from the right carotid artery to record the HBE. The HBE and the synchronism surface ECG were recorded before and after intravenous injection. Results In normal rabbits, the R-R interphase, P-R interphase of the ECG and the H-V interphase of the HBE were prolonged in a dose-dependent manner after intravenous injection of Mox. Mox exerted no significant influence on the A-H interphase. Conclusion ① Mox decreases the heart rate of rabbits in a dose-dependent manner in vivo. ② Mox dose-dependently prolongs the P-R interphase of the surface ECG and the H-V interphase of HBE. This indicates that Mox mainly acts on the intraventricular conducting system.

The aging of population and the increasingly morbidity rate of chronic disease had brought great influence on public health and economy.And community whose scientific management model could improve effectivity was a main prevention place for chronic disease.Thus on the basis of domestic and foreign literatures,several types of chronic disease community management models were introduced,and aimed at providing a reference for community chronic disease management.

Objective To determine whether the anti-inflammatory properties of Shuxiong Tablet(SXT)and the effective components group of SXT(ECGS)are equivalent and to assess the formulary rationality.Methods ECGS consisted of Panax notoginsen saponion(PNS),hydroxysafflor yellow A,and ferulic acid plus volatile oil of Ligusticum chuanxiong,which was based on the active ingredients and their ratios in SXT.We compared the anti-inflammatory actions of ECGS and SXT using the xylene-induced edema model and the carrageenan-induced edema model,as well as the analgesic activity of them using the acetic acid-induced writhing model.Moreover,cultured macrophages were incubated with media containing serum isolated from SXT-,ECGS-,or every component of ECGS-treated rats,to compare the depress effects on lipopolysaccharide(LPS)-stimulated NO production and inducible nitric oxide synthase(iNOS)expression.Results ECGS and SXT had equivalent anti-inflammatory actions and analgesic effects at an equipotent dosage in a dose-dependent manner.The drug-containing media could inhibit the LPS-stimulated NO production and iNOS expression in cultured macrophages.A 2 × 2 × 2 ANOVA revealed that three effective components could produce synergistic effect on the inhibition of NO production,and PNS was the capital component.Conclusion ECGS and SXT display an equivalent anti-inflammatory effect,and the formula follows traditional Chinese medicine compatibility principle,which shows obvious formulary rationality.

Objective To discuss the imaging technology and characteristic of perfusion-weighted imaging in rabbit models of hepatic VX2 tumors. Methods Twenty-eight New Zealand rabbits were implanted in liver with VX2 tumor by tissue block. After routine scans were performed on 1.5 T MR scanner, 28 New Zealand white rabbits with VX2 carcinoma were divided randomly into treatment group and control group. Treatment group was divided randomly into group A, group B and group C, 7 animals per group. Perfusion weighted imaging(PWI) was performed in day 14, 25 and 35, respectively, after tumor implantation in all animals. Select the regions of interest (ROI) of the VX2 tumor center, tumor border and pars-tumor parenchyma. Maximal signal reduction slope ( SRSmax ) of the signal intensity versus time curves were created as quantitative variable, and the parameters were calculated and compared in all groups. Results Maximal signal reduction slope ( SRSmax ) of the signal intensity versus time curves were studied in 4 groups, 23 VX2 rabbits,7,5 and 6 in group A , B and C, respectively. The SRSmax of tumor center were ( 12. 6 ± 3.4), ( 9. 8 ± 2. 6 ) and ( 1.0 ± 0. 4 ), the difference was significant ( F = 10. 855, P < 0. 05 ). The SRSmax of tumor border were(48. 3 ± 2.4), (46. 2 ± 1.5 ) and (43. 6 ± 1.8 ) ( P > 0. 05 ). The SRSmax of para-tumor parenchyma were ( 14.4 ± 3.0 ), ( 12. 2 ± 1. 4 ) and ( 14. 8 ± 5.0 ) ( P > 0. 05 ). The difference was significant in different ROI in treatment groups( F value was 7. 435,8. 625 and 12. 595, respectively, P < 0. 05 ). Conclusion PWI can be used in evaluating the liver tumor angiogenesis and angio-degeneration with the treatment of HIFU. It will be possible for qualitative analysis of rabbit models of hepatic VX2 tumors by different treatments.

Based on the investigation of a hospital's grants during 2004-2005 and the authorized during 2002-2005 (385 in total), we tried to find the trends and bias of clinical sciences at present. We analysed on the types of grants (clinical or basic), research objects, experimental methods, discipline involved, modes of cooperation, and background of applicants. A close connection between research and clinical trial, interdisciplinary study, patient-centered practice and international competitions are becoming more and more important. To meet the needs of clinical research, policies and devotions such as technical platforms are needed.

Objective To evaluate the NLRP7 gene mutations and variants and their expression of genetic approach in hydatidiform mole patients with family history.Methods Six cases of mole patients with family members of mole history and 60 healthy women, taking blood, extracting DNA, the genetic mutation on NLRP7 screening and analysis, looking for mutations and corresponding amino acids, proteins control gene mutation found NLRP7 area.Results In 6 mole patients with family history:three patients were with sister's history of mole, and 2 of them familial recurrent hydatidiform mole(from family MoCh76 and family Ch77), there are 2 loci NLRP7 gene mutation.Screening patients from family MoCh76 for mutations in NLRP7 revealed in exon 3 and exon 5, amino acids [295G ＞ T] and [1970A ＞ T], proteins [Glu99X] and [Asp657Val], in a heterozygous.Screening patients from family Ch77 for mutations in NLRP7 revealed in exon4 and exon 7, amino acids [1294C ＞ T] and [2471 + 1G ＞ A], proteins [Arg432X] and [Leu825X], in a heterozygous.Screening patients from family 105 for mutations in NLRP7 revealed no NLRP7 gene mutation.There were mother's history of mole in three patients, and they were not familial recurrent hydatidiform mole.Screening patients from family MoCh73 for mutations in NLRP7revealed in exon 4, amino acids [1137G ＞ C], proteins [Lys379Asn], in a heterozygous.Screening patients from family 106 and family 110 for mutations in NLRP7 revealed no NLRP7 gene mutation.There were not found mutations and variations in 60 cases of ethnic matched control group.Conclusion NLRP7 mutations may be lead to familial recurrent hydatidiform mole.