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.

Aged ; Aged, 80 and over ; Cross Infection ; etiology ; Diabetes Mellitus, Type 2 ; complications ; microbiology ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; microbiology ; Retrospective Studies

ObjectiveTo investigate the long term effect of different antihypertensive agents on renal hemodynamics with ultrasound Doppler.Methods52 essential hypertensive patients were divided into three groups according to the antihypertensive agent they took: angiotensin-converting-enzyme inhibitor (ACEI), calcium channel blocker (CCB) and β-adrenoceptor blocker (βB). The blood pressures of right upper arms were measured with mercury column blood pressure gauge using Korotkoff method. Renal hemodynamics were examined with ultrasound Doppler before and after treatment with agents. ResultsSystolic blood pressure (SBP) and diastolic blood pressure (DBP) of all patients were decreased significantly. An significant correlation was found between the deceases of blood pressure and the betterment of renal homodynamic parameters in ACEI and CCB groups, but not in βB group. ConclusionTo a degree, the betterment of renal hemodynamics is correlation with the reduction of systemic blood pressure and mechanism of action of antihypertensive agents.

Objective To establish a new traceability pathway of point-of-care testing ( POCT ) of HBA1c by using commutable quality controls, in order to improve the accuracy of POCT HBA1c and the harmonization of testing results with those of central laboratories.Methods The study was about measurement traceability. Human frozen whole blood samples with IFCC assigned values were used to calibrate the G8 HBA1c Variant in June, 2013.According to the CLSI EP9-A2-IR guideline, 50 patient samples and 2-level commercial QC samples were then analyzed by G8 system and DCA Ventage system.The best fitting curves for fresh patient samples and the commercial QC materials were established separately. The patient results tested on the DCA Ventage were modified and verified.Paired t-test and Passing Bablok linear regression were used.Results The linear equation of DCA/G8 before calibration was Y=0.899 5X+0.389 1(R2 =0.991 0).Calibration by fresh patient samples reduced the mean bias of DCA/G8 from -0.40%±0.34%to 0.00%±0.29%.Calibration by QCs reduced the mean bias to 0.15%±0.29%.The linear correlation established by quality controls was stable, which made the bias was lower between DCA and G8 in the consequent six runs.Conclusions The accuracy and the traceability of POC testing could be realized by using commutable QC materials traceable to IFCC assigned values.Through this method, POC testing can become more comparable to the results of clinical laboratory HBA1c instruments.

Objective To explore the correlation between-173G/C gene polymorphism of macrophage migration inhibitory factor(MIF) and Henoch-Schonlein purpura(HSP),Henoch-Schonlein purpura nephritis(HSPN) in children in Jiangxi Province.Methods One hundred and thirty-one ethnic Han children with HSP were enrolled,including 80 children with concurrent nephritis(HSPN group) and 51 children without nephritis(HSP without nephritis group).One hundred and five healthy children were used as the healthy control group.Germline DNA was extracted from peripheral blood by Promega blood genomic DNA kit.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) was used for genotyping the-173G/C polymorphism of MIF.Genotype distribution and allele frequencies were obtained by direct counting.Statistical analysis was performed by using SPSS 11.5 software.Allele and genotype distribution were compared by using the chi-square test.The relative risk of allele was described by odds ratios(OR) and 95% confidence intervals(95%CI).Results Three genotypes(GG,GC,CC) were detected in MIF-173 G/C.GG,GC genotypes were detected in HSP without nephritis and healthy control group.GG,GC and CC genotypes were detected in HSPN group.Mutant genotype(37.5%) and C allele frequency(20.0%) in HSPN group were significantly higher than those in healthy control group(20.0% and 10.0%,respectively)(?2=6.964,7.400,Pa

Objective To evaluate the influence of self-etch adhesive,total-etch adhesive and glass ionomer cement on the marginal microleakage of class II restorations. Methods Thirty human premolars were randomly divided into 3 groups(n=10),and cuboid class II cavities(4.0 mm?3.5 mm?2.5 mm) were prepared.Restoration was performed using self-etch adhesive+nano-resin(self-etch group),total-etch adhesive + nano-resin(total-etch group) or glass ionomer cement(glass ionomer group).Half of each group underwent 200 thermocyclings and the other half underwent 500 thermocyclings.The specimens were immersed in 0.5% basic fuchsin for staining.Each tooth was then evaluated the microleakage at the axial wall and the gingival wall section by section under a stereomicroscope.The data were statistically analyzed. ResultsSelf-etch group had significantly more miroleakage than total-etch group and glass ionomer group after 200 and 500 thermocyclings(P

Objective To explore the changes of pathogens and antibiotic susceptibility in a respiratory ward.Methods All pathogens isolated from patients in a respiratory ward from 2001 to 2005 and the drug susceptibility results were retrospectively analyzed.For patients with more than 1 isolates of the same species, only the first strain of pathogen was included for analysis. The isolation and identification procedure was based on guidelines for national clinical laboratories.The susceptibility test was performed by disk diffusion method.WHONET 5.3 software was used for statistical analysis.Results A total of 876 strains were analyzed.The majority was gram negative bacteria.MRSA prevalence was 72.4% and showed a trend of increase.No vancomycin resistant Staphylococcus aureus or Enterococcus was detected.Streptococcus pneumoniae was highly resistant to macrolides.The non-sensitivity rate to penicillin was 25.5%-66.7% over years.The resistance rate to levofloxacin was 22.2%-27.3%.Enterobacter and Acinetobacter baumannii showed stable susceptibility to imipenem.ESBLs-producing Esche- richia coli and Klebsiella pneumoniae accounted for 33.3%-38.9% and 14.3%-19.2% respectively.P.aeruginosa strains were relatively susceptible to ceftazidime, amikaein, cefoperazone-sulbactam, imipenem, piperacillin-tazobactam and cefepime. The sensitivity rate was 87%, 82.6%, 78.3%, 73.9%, 73.9% and 71.4% respectively in 2005.Conclusions The changes of pathogens and antibiotic resistance in the respiratory ward were consistent with the surveillance data in this country, which were influenced by underlying diseases, severity of illness and antibiotic use.Our data are useful for the guidance of rational use of antibiotics.

Objective:To design an intra-abdominal pressure measuring device applied to children on peritoneal dialysis (PD), and evaluate the feasibility and safety of the application of the device.Methods:The device consisted of a three-way stopcock with extension tubing, a three-way stopcock, a manometer tube, and a "Y" system peritoneal dialysis bag. The intraperitoneal pressure of different fill volumes was measured when a child was supine and relaxed in a horizontal position. The subjects of the study were children who received PD at the Pediatric Hospital of Fudan University from May 2019 to February 2020 and had PD dialysis age of>1 month. The children's demographic and clinical information were collected. During the measurement, the child’s complaints of pain, bloating, vital signs, and catheter-related contamination were recorded. Additionally, the occurrence of dialysis-related infections and complications during the hospitalization and outcomes of PD after three months of the measurement were tracked. A scatter plot and Pearson correlation test were used to explore the correlation between fill volumes and the intraperitoneal pressure.Results:Nine PD children were included in our study. The age of the children was (8.4±4.7) years old. The body surface area is (0.84±0.29) m 2. The intraperitoneal pressure was (12.6±1.9) cmH 2O at the fill volume of 1 000 ml/m 2 and (13.8±1.9) cmH 2O at the fill volume of 1 200 ml/m 2. The measurement was smoothly and safely taken without any case of contamination and dialysis-related infections during the hospitalization. After three months of the measurement, one child was transferred to temporary hemodialysis due to the aggravation of the umbilical hernia. Conclusions:The intraperitoneal pressure measuring device is feasible and safe to perform among children with PD. It can achieve non-invasive and continuous measurement of intra-abdominal pressure, and has guiding significance for the dialysis prescription of children with PD.

OBJECTIVETo investigate the role of transcript factor SCL/TAL-1 gene in the erythroid differentiation through the knockdown of SCL/TAL-1 mRNA by RNA interference.

METHODSThe plasmid of pTRIP-dU3-RNAiTALh-EF1a-GFP with SCL/TAL1 shRNA was transfected into EPO-induced K562 cell line with erythroid differentiation via lentiviral vector system and the expression of SCL/TAL-1 mRNA decreased. The plasmid pTRIP-dU3- RNAiluc-EF1-GFP expressing EGFP gene was as control. The mRNA levels of SCL/TAL-1 and erythroid related RhD, GPA, CD47 in the cell lines were detected by RT-PCR, and erythroid antigen CD71, CD235a were examined by flow cytometry.

RESULTS(1) After 48 h of transfect, more than 95% of K562 cells were GFP positive, indicating the infection rate of the plasmids in the K562 cells more than 95%. (2) The results of RT-PCR showed SCL/TAL-1 mRNA expression in the K562 cell line of knockdown of SCL/TAL-1 was significantly lower than that in the control (P < 0.05). The mRNA levels of CD47 and RhD were also significantly lower, however, GPA decreased slightly in comparison with the control. (3) The expressions of CD71 and CD235a markedly reduced in the K562 cell line of knockdown of SCL/TAL-1 with positive rates as 10.4% and 76.5%, while the positive rates in the control as 94.3% and 83.6%.

CONCLUSIONOur findings suggested that transcription factor SCL/TAL-1 might play an positive role in erythroid differentiation.

Cell Differentiation ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; K562 Cells ; RNA Interference

OBJECTIVETo investigate the anti-leukemia effect of oridonin on Ph(+) acute lymphoblastic leukemia (ALL) cell line SUP-B15.

METHODSHuman Ph(+) ALL cell line was cultured in vitro. The 50% inhibition concentration (IC(50)) of oridonin against SUP-B15 cell line was examined using modified MTT assay. The cellular morphologic changes were observed using a light microscope. The percent of apoptosis of SUP-B15 cell line after drug treatment was evaluated by flow cytometric analysis. The active levels of ABL kinase and its downstream Akt/mTOR, Raf/MEK/ERK, STAT5 signaling pathways and the expression levels of Bcl-2 and BAX were examined by Western blot.

RESULTSOridonin inhibited the growth of SUP-B15 cell line in both time- and dose-dependent manner with the IC(50) of oridonin as (7.08 ± 1.21) µmol/L after 72 h treatment. The cellular membrane of SUP-B15 cell line treated with oridonin became unsharp, some of them disintegrated. Oridonin induced apoptosis in SUP-B15 cell line with the apoptosis rates following 0, 5, 10 µmol/L oridonin treatment for 24 h were (6.67 ± 0.83)%, (18.30 ± 1.79)% and (37.63 ± 7.12)%, respectively. Oridonin inhibited activation of ABL kinase and its downstream Akt/mTOR, Raf/MEK/ERK and STAT5 signaling pathways, which were constitutively activated in SUP-B15 cell line, down-regulated the level of anti- apoptotic protein Bcl-2 and up-regulated the expression of pro-apoptotic protein Bax.

CONCLUSIONOridonin exerted anti-leukemia effect in Ph(+)ALL cell line SUP-B15 by inhibiting the activation of ABL kinase and its downstream Akt/mTOR, Raf/MEK/ERK and STAT5 signaling pathways, down-regulating the expression of Bcl-2 and up-regulating the expression of BAX.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Diterpenes, Kaurane ; pharmacology ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; pathology ; Signal Transduction