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 endoscropic assist in rat orotracheal intubation.Methods 40 rats were randomly divided into two groups.The procedure time, total time, intubation frequency,the success rate of the first intubation and the survival rate in 24h were compared between the conventional group and the endoscropic group.Results The total time in two groups were nearly the same.But the procedure time and frequency of intubation were significantly less in the endoscropic group than those in the conventional group.The success rate of the first intubation in the endoscropic group was obviously higher than that of the conventional group.There was no obviously difference between the survival rate after extubation in 24h between groups.Conclusion Endoscropic assist is superior to the conventional method and worth promoting.

Objective To investigate the relationship between the leptin level and neonatal weight and the expression of leptin in placenta. Methods The concentrations of leptin in 100 maternal blood and umbilical blood of the term pregnant women were examined by radioimmunoassay (RIA). According to the neonatal weight to divide into the large for gestational age (LGA) group 19 cases, the appropriate for gestational age (AGA) group 65 cases, the small for gestational age (SGA) 16 cases. The level of leptin mRNA in 41 placental tissue was examined by Reverse transcription polymerase chain reaction (RT PCR). Results (1) The expression level of leptin mRNA in placenta was 0 97?0 04, which was positively related to the neonatal weight significantly ( r =0 43, P 0 05).(3)The concentration of leptin in umbilical blood was (7 58? 5 15) ?g/L, which was positively related to the neonatal weight ( r =0 57, P

In type 2 diabetes mellitus,the levels of leptin were higher in female and obese subjects compared with male and non-obese subjects.There was negative relationship in female between leptin and HbA_1c,and negative relationship between leptin and HDL-C in male.Gender and obesity had no effect on TNF-? and NP Y.

Objective To observe the impact of DPP4 inhibitor Saxagliptin on body weight of type 2 diabetes patients. Methods In this randomized and parallel study,50 patients were given either Saxagliptin(n=25)or Glimepiride(n=24). The changes of body weight, HbA1c and hypoglycemic events were observated in 12 weeks. Results There were no significant difference in gender,age and body weight between 2 groups(P>0. 05). After 12 weeks treatment,body weight has significant changed in both group,and the weight changes were sig-nificant differet in two groups:an average of 0. 4 kg weight was increased in Glimepiride group and 0. 4 kg weight was decreased in Saxagliptin group (P<0. 05). The change of HbA1c level has no statistical difference in two groups (P>0. 05). Hypoglycemia event was happened four times in Glimepiride group,while no hypoglycemia event was happened in Saxagliptin group. Conclusion Compared with Glimepiride,Saxa-gliptin provides similar hypoglycemic action with less hypoglycemia,at the same time,Saxagliptin yields better results in lowering weight.

BACKGROUND: Cigarette smoking has been recognized as one of the high risk factors in carcinogenesis of lung cancer. Early diagnosis of lung cancer may be of clinical therapy value.OBJECTIVE: To explore the mutation of K-ras oncogene in bronchoalveolar lavage fluid(BALF) in order to reveal its relationship with cigarette smoking in lung cancer patients.DESIGN: Randomized controlled trial based on the patients.SETTING: Department of Toxicology, College of Radiology and Public Health of a university, and Department of Respiratory Medicine of a university hospital.PARTICIPANTS: The out-patients and inpatients in the Second Affiliated Hospital of Soochow University between June 1999 and September 2001 were included. The patients were confirmed to have lung cancer or innocuous diseases by fiber bronchoscopy through bronchoalveolar lavage(BAL) and cytological or pathological examination.METHODS: BALF samples were obtained from 37 smoking patients with lung cancer and 25 nonsmoking patients with lung cancer, and 20 with benign pulmonary diseases in the Second Affiliated Hospital of Soochow University. They were detected for K-ras codon 12 mutations using polymerase chain reaction with restriction fragment length polymorphism(PCR-RFLP).MAIN OUTCOME MEASURES: Codon 12 mutations of K-ras gene.RESULTS: K-ras mutation in patients with lung cancer was found to have an average frequency of 36% (22/62)but no K-ras gene mutation was detected in patients with benign pulmonary diseases. The mutation frequency in heavy smokers(69% ) was higher than that in moderate smokers(31%), mild smokers (25%) and nonsmokers (20%). The mutation was related to age and history of smoking, but not to sex and TNM classification.CONCLUSION: Cigarette smoking may be correlated with the mutation of K-ras gene. Early detection of K-ras mutation in BALF may be of clinical value, which helps the identification and diagnosis of smoking-related lung cancer.

Objective • To investigate the effects of bisphenol A (BPA) on the development and neurobehavior of zebrafish. Methods • The zebrafish fertilized eggs that developed to 4 hpf (hours post-fertilization) were treated with different concentrations of BPA (0, 2.5, 25, 250, and 2 500 μg/L). Survival rates, malformation rates, hatching rates, 24 hpf autonomic movement, and 48 hpf heart rates in the groups were observed and recorded. And the neurobehavioral test of larval zebrafish that developed to 144 hpf was performed. Results • The BPA exposure did not affect the survival rates, malformation rates and hatching rates of zebrafish. Compared with the control group, the autonomic movement in 24 hpf and heart rate in 48 hpf of zebrafish embryos that exposed to 2 500 μg/L BPA decreased (P=0.000), and the total distance and average speed of larval zebrafish that developed to 144 hpf also decreased (P=0.000). The behavior of larval zebrafish exposed to 250 μg/L and 2 500 μg/L BPA changed on light-evoked startle escape response activity, mainly including the decrease of total distance under strong light stimulation (P<0.05). Conclusion • BPA exposure during embryonic phase has developmental toxicity and neurotoxicity on zebrafish.

Objective To review the experiences of diagnosis and treatment of pneumatosis cystoides intestinalis (PCI), and study the clinical characteristics of the disease in order to improve the diagnosis and treatment. Methods Clinical data from 20 patients with endoscopically confirmed PCI were retrospectively analyzed. They were admitted to the Chinese PLA General Hospital from June 1995 to June 2015. Results Among the patients 16 of them were male, and the other four were female. The main clinical manifestations were abdominal distention, diarrhea, abdominal pain and mucous bloody stool. The diagnosis relied mainly on colonoscopy and pathological examination. Laparoscopy assisted colorectal cancer resection was performed in 1 patient, laparostomy and repair of sigmoid colon perforation in 1, endoscopic treatment in 5 cases, drug administration and hyperbaric oxygen therapy in 2, drug treatment alone in 7, and no treatment in 4. Conclusions The final diagnosis depends on endoscopic findings. No treatment is recommended to patients with no symptoms. The management of patients with PCI includes antibiotics, oxygen therapy, endoscopic therapy, surgery, and appropriate therapy related to the underlying cause of PCI. The prognosis is good.

This paper summarized the nursing experience of one infant with right lower limb ischemia caused by amniotic band syndrome. The nursing key points included:careful observation of the infant condition,exposing the wound,raising the affected limb,wound disinfection,and removing necrotic tissues at the surface skin,applying topical drugs for promoting tissue growth and antibiotics,selecting appropriate dressing to provide suitable environment for tissue regeneration;debridement of inguinal skin,dressing change,assessing pain and providing corresponding care during debridement;infection prevention. After 29 days of treatment and careful nursing care,the skin damage was repaired on the right lower limb,swelling subsided,the necrotic tissues at right inguinal region were completely cleared,granulation tissue was formed,and the infant was discharged smoothly.

A 880 bp cDNA localized to the putative NS5 region of HGV genome was expressed in E.coli BL21(DE3). The cDNA fragment was inserted into a plasmid pGEX-5X-1,at the downstream of the DNA sequence encoding Schistosoma japonicum glutathione S- transferase(GST),in the same reading frame with the gene of GST. A 60KD GST-NS53 fusion protein was expressed at 37℃ in a form of inclusion bodies amounting to 30 percent of total host protein whereas at 20℃ mainly in a form of soluble protein . The fusion protein was extracted and purified to homologue. The purified GST-NS53 fusion protein could be specifically recognized with either the sera from the patient infected by HGV or the antisera directed against GST.