International Standard for Medical Laboratories Accreditation demanded monitoring the quality of the total testing process (TFP).Recently, the errors in the analysis phase had been effectively controlled, while the errors in pre-and post-analytical phases still remained comparably high, and became the major factors influencing the TTP quality.Thus, monitoring and improving the quality of the extraanalytical phases became the major challenge.Monitoring the TTP quality required the laboratory staff to extend the quality management to the influential elements outside the laboratory.In addition, it also prompted the organizers of external quality assessment (EQA) in China to provide a quality assurance program for extra-analytical phases.The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) had developed a model of quality indicators.The Q-Probes and Q-Tracks programs of the College of American Pathologists provided a good practice of monitoring and improving quality for the extraanalytical phases.Based on the related international guidelines, the QIs system was established for quality management and control in clinical laboratory, so as to manage EQA of extra-analytical phases.

Objective To investigate the relationship between the change of HDL level and the severity in patients with sepsis.Methods The levels of HDL were measured in 68 patients with sepsis who were divided into light,middle and heavy group by APACHEⅡscore after final diagnosis of 0,1,2,3,7,14.28 days.Results The levels of HDL in patients with sepsis were lower than those of the normal:the levels of HDL began to decrease at 0 day,got to lowest point after 3 days,and up-regulated gradually after 7 to 28 days.The levels of recovery were the highest in light group,and the lowest in heavy group.Conclusion The levels of HDL in patients with sepsis are low,which is related with the severity of sepsis.

Objective To observe the effect of Chinese Medicines with the function of antioxidation on lupus nephritis(LN)pa- tients.Methods The 25 LN patients consisting of renal function normal group(15 cases)and renal failure group(10 cases)were treated with Huang Qi(Radix Hedysari)and Shu Dihuang(Radix Rehmanniae Praeparata)as main ingredients for 6 months in suc- cession.Changes of symptom,systemic lupus erythematosus disease activity index(SLEDAI),activity index(AI),lipid peroxide (LPO),superoxide dismutase(SOD),glutathione peroxide(GSH-Px),malondialchehyche(MDA),nitric oxide(NO),blood and urine routine examination,24-hour urine protein quantity,liver and kidney function,anti-double-stranded DNA(anti ds-DNA),complement 3(C_3)and complement 4(C_4),after treatment were observed.Results SLEDAI and AI scores were remarkably different from those before treatment(P

Objective To investigate the significance of cyclooxygenase-2 (COX-2),vascular endothelial growth factor(VEGF) protein expression and angiogenesis in hepatocellular carcinoma(HCC).Methods Tissue sec- tions from 40 HCC patients were examined immunohistochemically for protein expression of COX-2 and VEGF.Mi- crovessel density(MVD) was counted by endothelial cells immunostained by anti-CD34 antibody.Results The ex- pression of COX-2 protein in well differentiated HCC was stronger than that in moderately differentiated HCC and poorly differentiated HCC(P

Objective To explore the influence of helicobacter pylori(Hp) on gastric motor function in children with chronic gastrictis.Methods Forty-seven children with chronic gastrictis were classified into Hp positive and negative groups according to Hp and histology exa-mination.Each child underwent gastric emptying test of solid by using nuclide method and electrogastrogram(EGG) examination.These cases with Hp-positive acceptted these triple eradication therapy[clarithromycin 15 mg/(kg?d),amoxicillin 50 mg/(kg?d),omeprazole 0.8 mg/(kg?d)]for 2 weeks,and underwent EGG examination again after eradicating Hp.Results The half emptying time(GET_1/2)in Hp-positive gastric group were significantly longer than those in Hp-negative group(t=6.403 P

Objective Using the frozen human-pooled serum samples,with values assigned by the enzyme reference procedure in laboratory network to explore the way of quantity value transfer from enzyme reference measurement system to routine ones.Methods The study is about quantity value transfer.The frozen human-pooled serum sample was assigned by the enzyme reference laboratory network including six domestic reference procedure laboratories,namely Beijing Chaoyang Hospital affiliate of Capital University of Medical Sciences,Beijing Aerospace general Hospital,Beijing Shijitan Hospital affiliate of Capital University of Medical Sciences,Peking Union Medical College Hospital,Beijing Leadman Biochemistry Co.,Ltd.and Sichuan Maker Biotechnology Co.,Ltd.,which used the reference measurement procedures of creatine kinase (CK) and lactate dehydrogenase (LDH) from the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).First,the assigned serum was used to calibrate or verify trueness of routine measurement systems from the 49 laboratories of tertiary hospitals in Beijing in Feb,2013 by Beijing Centerfor Clinical Laboratories.Second,the assigned serum and two levels of patient samples were tested in duplicate by laboratory 's measurement systems after calibration with manufacturer's calibrator and with assigned serum.During this procedure,all laboratories data were collected.Harmonization of results was observed after calibration with the assigned serum according to the statistics.Results After calibration,the interlaboratory coefficients of variation (CVs) of two patient samples were decreased from 4.67％ and 5.96％ to 1.86％ and 1.47％ for CK and from 5.72％ and 5.04％ to 3.67％ and 3.62％ for LDH.For peer group of A and B instrument,after calibration,both CVs of the assigned serum and two patient samples were less than 2％ for CK,and less than 4％ for LDH ; For C instrument group,which was not calibrated with the assigned serum,the biases were-4.75％ for CK and-13.1％ for LDH,while the biggest CVs were 3.64％ for CK and 7.57％ for LDH.For peer group of reagents,after calibration,the CVs were decreased from 1.60％-4.44％ to 0.23％-1.62％ for CK and from 0.93％-6.07％ to 1.06％-2.72％ for LDH.Conclusions It is one of the feasible ways for quantity value transfer by using the frozen human-pooled serum samples,which were assigned by the enzyme reference laboratory network for calibration or verification.It can effectively solve the problem of trueness and harmonization of enzyme testing results.In addition,for those measurement systems which are not applicable for this calibration.

Objective Study on the traceability of serum enzyme ass ays by testing enzyme reference material in clinical laboratories. Methods 50 laboratories were involved in this survey. One enzyme reference material was send to each participate lab. The reference material was tested by use of routine method and the results were recorded. All lab data were processed with computer. Results Compare with the target values, the bias of alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK) and lactate dehydrogenase (LD) assays were 6 3%, 5 5%, -5 9% and -5 0% respectively, the bias of alkaline phosphatase (ALP) assays was -36 6. The inter laboratory coefficient variation of the amylase assay was 29 2%. Conclusions The results of enzyme assay in clinical laboratories could be traced to the international reference material.

Background:Enteroids are considered to be the best tool for studies on intestinal epithelium in vitro and have a widely application prospects,however,there are no associated reports in China. Aims:To establish and optimize the culture technique for enteroids and provide a fantastic platform for the basic research of small intestinal epithelial cells in China. Methods:L-WRN cells were cultured routinely and the conditioned medium with different concentrations of fetal bovine serum(FBS)was collected. Six to eight weeks old C57BL/ 6 mice were sacrificed and 15 cm small intestine from the terminal ileum was removed and cut longitudinally. Crypts were digested with EDTA and then collected and embedded in Matrigel? Matrix;after polymerization of Matrigel? Matrix,L-WRN conditioned medium at different concentration gradient was added. The budding ratio and length of buds were measured dynamically under microscope. The enteroids were re-embedded for subculture when certain length of buds was reached. Results:Compared with L-WRN conditioned medium containing 20% FBS,the conditioned medium containing 10% FBS was more favorable for enteroids culture in vitro. When conditioned medium accounted for 10% ,15% ,20% ,25% or 30% of the mixed medium,they all promoted the growth of enteroids and the 15% one seemed to yield better result. Conclusions:An enteroids culture technique was successfully established for the first time in China. When the L-WRN conditioned medium containing 10% FBS accounts for 15% of the mixed medium,it might promote budding better than the others.

We investigated the Toxop lasma infection prevalence among planned pregnant women in Chongqing ,and to pro‐vide reference for the first level intervention of birth defects in the region .A total of 11 953 planned pregnant women were se‐lected by proportionally stratified multi‐stage random sampling method .Questionnaire survey was given to the women ,and blood samples were collected .Specific IgM and IgG antibodies against Toxoplasma were detected with ELISA .Results showed that among the 11 953 cases surveyed ,Toxoplasma IgM was positive in 71 cases ,with the positive rate of 0 .59% ;IgG was positive in 771 cases ,with the positive rate of 6 .54% .The positive rate of IgM and IgG antibodies in the metropolitan core re‐gion of the city was higher than that in the suburb areas (χ2 =35 .28 ,P<0 .000 1 ;χ2 =82 .65 ,P<0 .000 1) .The positive rate of IgM antibody increased with the educational level (χ2trend=3 .25 ,P=0 .001 1) .The positive rates of IgM and IgG varied in occupations among women (χ2 =13 .93 , P= 0 .016 0;χ2 = 15 .58 ,χ2 =0 .008 1) ,with the highest rate of public officials . Planned pregnant women with the history of abnormal pregnancy outcomes had higher positive rate of T .gondii IgM and IgG antibodies than those in the control (χ2 =6 .85 ,P=0 .008 9;χ2 =59 .25 ,P<0 .000 1) .There was no significant difference of IgM positive rate between the planned pregnancy women who had closed contact to cats and the control group (χ2 =0 .23 ,P=0 .628 6) ,while the positive rate of IgG was higher than that of the control group (χ2 =9 .95 ,P=0 .001 6) .T .gondii infec‐tion rate was on the low level of planned pregnant women in Chongqing .Adverse pregnancy outcomes are related to Toxoplas‐ma infection .

Objective: To observe the influence of acupoint application therapy on serum eosinophilic granulocyte cationic protein (ECP), 6 keto prostaglandin F 1 (6-keto-PGF 1) and thromboxane B2 (TXB2). Methods: 300 cases of asthma out-patients in a remission period were divided into a treatment group (150 cases) and a control group (150 cases). The control group was given the basic treatment, and the treatment group was given external application on the acupoints in July and December every year, as well as the basic treatment of the control group, with continuous treatment for 2 years as one course. ECP, 6-keto-PGF 1, and TXB2 were checked every year in the patients of the two groups, and an Asthma Control Test Table was filled in for comparative analysis. Results: After the external application on the acupoints, the frequency of seizures, dyspnea and frequency of medication administration of the patients had been more reduced than those in the control group, indicating that the levels of ECP in inflammation of air passage and of 6-eto-GF 1 and TXB2 were obviously improved (P＜0.05). Conclusion: The herbal application on the acupoints is effective and positively influential to the improvement of the symptoms in the asthma patients and to ECP, 6-keto-PGF 1, and TXB2 remarkably.