Objective To investigate the role of pancreatic β cell on pancreatic regeneration following experimental acute pancreatitis.Methods Eighty-seven SD male rats were randomly divided into four groups:control group ( n =15 ),STZ group ( n =24),L-Arg group ( n =24 ),STZ + Arg group ( n =24).60 mg/kg of STZ was administrated by intraperitoneal injection to induce the diabetes model.2.5 g/kg body weight of LArg was administrated by intraperitoneal injection to induce the acute pancreatitis model.The rats were sacrificed 1,3,5,7 d later and the serum levels of amylase and glucose were measured.Relative pancreatic weight (pancreatic weight/body weight) were measured.Pancreatic tissue underwent routine pathologic examination,and the percentage of area of necrosis and tissue transformation was calculated.The expression of Reg4 and insulin was performed by immunofluorescence.Results Serum level of glucose significantly increased after STZ injection.After L-Arg injection,serum level of amylase significantly increased,and there was pancreatic tissue edema,necrosis,infiltration of inflammatory cells,which suggested the successful model induction.The percentage of area of necrosis in STZ + L-Arg group was (71.6 ± 6.0) ％ at the 3rd day,which were significantly higher than (42.3 ± 4.0 ) ％ in L-Arg group; the percentage of area of transformation was (45.6 ± 5.4) ％,which were significantly lower than (78.5 ± 6.4) ％ in L-Arg group.Expression of Reg4 in pancreatic islets of STZ + L-Arg group was significantly lower than those in L-Arg group.Conclusions STZ impairs pancreatic β cells,aggravates pancreatic damage following L-arginine induced pancreatitis and inhibits pancreatic regeneration.

Objective To study the applicability of a new analytical specification defined in WS/T 403-2012 in the external quality assessment schemes and the external comparision of internal quality control .Methods It was a quality management method study.Total error allowable criterions listed in WS/T 403-2012 and GB/T 20470-2006 were selected to assess the results of 23 analytes in the 1st challenge of 2013 routine chemistry external quality assessment.The acceptable rate of 23 analytes were calculated with the two specifications.Criterions of imprecision derived from the two standards were applied to assess the coefficient of variation with internal quality control data.Results With the specification based on WS/T 403-2012, the ratio of laboratories that all five samples were passed in the 1st challenge for 23 analytes ranged from 55.5%to 94.7%.The ratio of laboratories with 80%or more samples passed in 2013 EQA ranged from 73.9%to 98.5%.While ratios of two kinds described above evaluated based on GB /T 20470-2006 ranged from 63.0%to 99.2%, and from 90.0% to 99.7%, respectively.The acceptable rate of CV according to the two criterions ranged from 55.5% to 94.7% and 63.0% to 99.2%, respectively.Conclusions As evaluation criterions of external quality assessment allowable total error and internal quality control imprecision in routine chemistry , the specification in WS/T 403-2012 can be used to assess the analytical performance of clinical laboratory more objectively and comprehensively.It can help laboratories to identify the latent problems for further quality improvement.

?AIM:To observe the values and changing rules of angle Kappa in corneal refractive surgery under light and dark conditions.?METHODS:Two hundred and thirty-four eyes of 118 patients for corneal refractive surgery were enrolled for this study.Pupil diameters and angle Kappa values under light and dark conditions were measured by Keratron Scout corneal topography.?RESULTS: There were significant differences in pupil diameters between light and dark conditions (P<0.01). More angle Kappa of both eyes distributed in the superior nasal quadrant under light conditions, and more angle Kappa distributed in the superior temporal quadrant under dark conditions.The differences of horizontal and vertical offsets of angle Kappa under two conditions were statistically significant (P<0.01).?CONCLUSION: The changes of pupil diameters in light and dark conditions could affect angle Kappa and then affect the accuracy of corneal refractive surgery centered on angle Kappa.

External quality assessments play important roles in quality improvement in clinical laboratories, but most laboratories focused on the unsatisfied data only.With appropriate quality controls, laboratories can detect not only the error sourses of unsatisfied data but the potential error sourse of satisfied data as well.

Objective To evaluate the commutability of certified reference material IRMM ERM-DA 471/IFCC for cystatin C measurement among 8 methods.Methods 46 individual samples used for the commutability study were residual serum samples collected from clinical laboratories.The individual samples interspersedwith pooled sera and the certified reference material IRMM ERM-DA 471/IFCC and the whole set of samples was divided into 2 subsets for measurements in 2 days.The measurements were performed by8 different methods o.The samples were measured in duplicate order.Calibration was performed every day. Passing-Bablok regression was performed to compare the slopes and intercepts of mean values of the serum samples derived from different methods. Pearson correlation cofficient was also calculated. Deming regeression and 95%confidence intervals were calculated to evaluate the statistics commutability of ERM-DA 471/IFCC.The minimal specification of bias derived from biological variations was calculated to evaluate the clinical commutability.Results The within-laboratory CVs of pool sera ranged from 0.5% to 4.0%.The Passing-Bablok slope ranged from 0.765 to 1.311 and intercepts ranged from -0.04 to 0.241.The determination coefficient of Pearson regression ranged from 0.988 to 0.999.Deming regeression and 95%confidence intervals demonstrated commutability of ERM-DA 471/IFCC in 4/28 (14.3%) methods pairs. The minimal specfication bias ( 5.12%) demonstrated commutability of ERM-DA 471/IFCC in15/28 (53.6%) methods pairs.Conclusions The ERM-DA 471/IFCC domonstrated poor commutability between some methods pairs. The commutability of ERM-DA 471/IFCC should be evaluated before used as calibrators.

Objective To describe and compare the roles of 3 external quality assessment programs in assessment of analytical quality of serum creatinine and urea.Methods Research in quality management methods.Sixty-five laboratories those enrolled in the Natonal Center for Clinical Laboratories′programs of routine chemistry external quality assessment ( EQA ) , trueness verification ( TV ) for small molecular metabolites and external comparison of internal quality control ( IQC) simultaneously in 2013 were selected , the performances of those laboratories of serum creatinine (crea) and urea in terms of total errors(TE), bias and CV were obtained by using the above 3 programs, and these performance were assessed against the criterion listed in the analytical quality specifications for routine analysis in clinical biochemistry ( WS/T 403-2012).The failure ratio of 65 laboratories on each performance was calculated , the sensitivity of 3 external quality assessment programs in detection of analytical quality deficiency among clinical laboratories were compared.Results Only 1 laboratory failed in the 1st routine chemistry EQA in terms of TE of creatinine , failure ratio is 1.5%(1/65).Three laboratories failed in the 2nd EQA and caused a failure ratio of 4.6%(3/65).For serum urea, 3 laboratories failed in the 1st routine chemistry EQA with a failure ratio of 4.6%(3/65).Two laboratories failed in the 2nd EQA with a failure ratio of 3.1%(2/65).The failure ratios of creatinine determination in two samples in TV were 41.5%(24/65) and 21.5%(14/65) respectively, and the failure ratio of urea determination were 53.8%( 36/65 ) and 32.3%( 21/65 ) respectively.In the program of external comparison of IQC , the CVs of creatinine and urea determination ranged from 0.7% to 6.2%and from 1.0%to 7.2%respectively, their respective failure ratio range were 15.4%(10/65) and 40.0%(26/65).The failure ratio in routine EQA were much less than those in the other two programs , the laboratories failed in routine EQA program were all failed in trueness verification or /and the comparison of IQC programs, but not vice versa.Conclusions By participating in the programs of routine EQA , TV and comparison of IQC laboratories could assess the performances of inaccuracy , bias and imprecision.Laboratories should participate in different external quality assurance programs to detect their quality issues and get improved.

Objective To study the auditory perception and speech ability outcomes after cochlear implantation in prelingually deaf children with extremely severe neurosensory hearing loss and comorbid leukoencephalopathy.Methods Our study included 14 prelingually deaf children with leukoencephalopathy (confirmed by preoperative MRI scanning) who were treated with cochlear implantation in the Department of Otorhinolaryngology Head and Neck Surgery of Hainan Provincial People''s Hospital, including 8 males and 6 females of 1~6 yr with a mean age of 3.8 yr.Sixteen synchronous prelingually deaf children without central nervous system (CNS) diseases were also included as the control group, including 11 males and 5 females of 1~6 yr with a mean age of 4.4 yr.All the patients underwent pre-surgical assessments of audiology, radiology, speech ability and intelligence before cochlear implantation via transmastoid facial nerve recess approach was done, after which rehabilitation was provided at the Hainan Rehabilitation Center for Deaf Children.Categories of auditory performance (CAP) and speech intelligibility rate (SIR) were employed as the assessment criteria for the outcome of surgery, the scores of which at different timepoints after surgery were statistically compared through paired t-test between the two groups.Results All the patients gained post-surgical hearing and speech abilities to different degrees, whereas CAP and SIR scores both chronologically improved in the both groups.No statistical difference was revealed either in CAP or in SIR scores between the two groups at 6, 12 and 24 months after surgery (P>0.05).Conclusion Children with extremely severe neurosensory hearing loss can be reated with cochlear implantation even if they have comorbid leukoencephalopathy.The effects of auditory and speech rehabilitation for the same age patients with leukoencephalopathy are similar to those without leukoencephalopathy in 2 years after surgery.

Objective To investigate and analyze the reasons of fa0ilure in external quality assessment(EQA) for routine chemistry and provide the basis for the corrective and preventive actions.Methods Based on the network system of NCCL EQA the reasons of failure in 2013 national routine chemistry external quality assessment program were investigated,among which the reasons were classified and analyzed with seven sources of problems which were clerical errors,methodological problems,equipment problems,technical problems,EQA materials problems,EQA Evaluation problems and unable to explain after investigation.Results The return rate of this root cause investigation for each analyte ranged from 33.3％ to 80.0％.The major reason for unacceptable analyte included clerical errors (6.5％) (decimal point position error:70.1％;unit error:20.8％;instrument or method coding error:8.1％),methodological problems (45.1％)(calibration:54.2％;reagent:38.0％;EQA material:7.8％),equipment problems (28.5％) (no regular maintenance:98.0％;pipeline error:2.0％),technical problems (8.2％) (do not follow SOP:80.4％;EQA material redissolve error:10.6％;placing order error:9.0％) and unable to explain (11.7％) (system error:68.2％;random error:31.8％).There were no EQA materials problems or EQA Evaluation problems in this survey.Analysis systems' grouping statistics were implemented for seven analytes including sodium,chlorine,phosphorus,direct bilirubin,total iron binding capacity,copper,and zinc.Unsatisfied EQA proportions of mating system were lower than nonmatching ones for the majority of analytes.Conclutions Further work on EQA should be undertaken by clinical laboratories.Laboratories should use reagents with high quality as well as improve the operation technology and sense of responsibility.Only in this way,can the accuracy and reliability of testing results be guaranteed.

Objective The aim of this study was to analyze the effect of gender and age on shoulder and hip range of motion (ROM) and to determine the differences of ROM of normal side shoulder and hip joints between the data we collected and the published standards (Guideline of Examination for Body Impairment in Clinical Forensic Medicine SF/ZJD0103003-2011) in China. Methods We collected cases with unilateral injury of shoulder or hip from clinical forensic medicine. The differences of ROM of normal side joint between the data we collected and the published standards were studied. Descriptive statistics was calculated between male and female subjects in ifve age groups including 0~25, 26~40, 41~50, 51~60 and >60 years, and the ROM changes with age were also studied. Results The data collected in this study was signiifcantly different from the published standard. With age growth, the ROM of shoulder and hip were decreased and a significant difference between genders in partial activity direction of shoulder and hip was found in the individuals who were over 50 years. Conclusion Gender and age appear to be inlfuential factors to determine the normal ROM of the shoulder and hip joint, and there is signiifcantly difference of ROM of normal side shoulder and hip joints between the data we collected and the published standards (Guideline of Examination for Body Impairment in Clinical Forensic Medicine SF/ZJD0103003-2011).

Objective The purpose of this study was to study the correlation between dental fluorosis, saliva and plaque fluoride levels and urinary fluoride values in adolescents dental fluorosis. Methods A middle school was chosen as a survey point in the study. Two hundred adolescents were examined the degree of dental fluorosis by Dean's method. These adolescents were divided into four groups according to the severity of fluorosis (n = 52, 40, 28 and 80). Fluoride ion specific electrode was used to measure the fluoride levels in dental plaque, saliva, urinary and drinking water. The differences were analyzed b y ANOVA. Correlation of the fluoride levels between dental plaque, saliva, urine and the degree of dental fluorosis were analyzed by the method of multiple linear regression. Results The average fluoride content of drinking water was (2.20 ± 0.40) mg/L. Compared with controls, the fluoride concentrations in dental plaque, saliva and urine were higher in light, medium and severe dental fluorosis groups [(1.55 ± 0.88), (1.94 ± 0.77), (2.74 ± 0.83) than (0.32 ± 0.20) mg/L; (4.44 ± 1.62), (8.09 ± 0.93), (10.72 ± 0.99) than (0.02 ± 0.01) mg/L;(31.77 ± 6.09), (57.98 ± 1.83), (65.98 ± 2.78) than (13.06 ± 2.11) μg/g, all P<0.05]. Urinary fluoride was correlated with fluoride in saliva and dental plaque (r=0.245, 0.440, all P<0.05). Saliva fluoride was correlated with fluoride in dental plaque (r=0.849, P<0.01). The degree of dental fluorosis was correlated with fluoride in urine and saliva (r = 0.497, 0.896, 0.924, all P< 0.01). The multiple linear regression equation between fluoride in urine and the degree of dent al fluorosis, fluoride in dental plaque and saliva was as follow: y = 1.357 + 1.618x1 + 0.001x2 - 0.331x3 ± 0.69. Conclusions The metabolism of fluoride in body is related with oral fluoride repository in adolescents dental fluorosis. Fluoride in urine is influenced by plaque fluoride level, saliva fluoride concentration and the degree of dental fluorosis.