1.Evaluation of the effects of calibration modes and sample reconstitution on the analytic precision of 26 clinical chemistry analytes using system measurement procedure
Huiying SUN ; Yan SHAO ; Shuming LIU ; Bin HU ; Baorong CHEN
Chinese Journal of Laboratory Medicine 2018;41(2):149-154
Objective To evaluate the system measurement procedure effects on the analytic precision of clinical chemistry analytes.Methods In June 2009, June 2010 and September 2010 respectively,the National Center for Clinical Laboratories of China and the Organization of Five Hospitals in Fukuoka Japan organized comparison activities of 26 clinical chemistry analytes which were ALT,AST,GGT, ALP,CK,LDH,AMY,ChE,TG,TC,HDL-C,LDL-C,Glu,Cr,BUN,UA,K,Na,Cl,Ca,TP,Alb,TBil,DBil, P,Fe.In this paper, we investigated 26 analytes of three sets in Beijing Aerospace General Hospital as follows.(1)The precision of different reconstitution methods was observed by using three kinds of pipetting tools, such as measuring pipette, pipette and dispenser.(2)The experiments were carried out in three stages by testing the dried powder control samples of two concentration levels(101-Ⅰ,101-Ⅱ)provided by Hitachi Japan.They were measured on 28 consecutive days at each stage in order to observe the precision of 26 clinical chemistry analytes.In the first stage,we used the former measurement procedure to measure the control samples;in the second stage we added three conditions of the measurement procedure.The first was two calibration modes,which were once-a--day calibration and twice-a--day calibration.The second was the calibration standard and the last was the conditions of the freeze-thaw samples.In the third stage, we used the twice-a-day calibration only for GGT,ALP,ChE,TG,Cr,Na,K,CL,ALB.(3)JSCC and Health Industry Standard quality objectives were implemented to evaluate whether the precision of the improved measurement procedure met the requirements.(4)Paired T test were used to compare the precision of measurement between the second stage and the first stage, and between the third stage and the second stage of the measurement procedure.Results (1)The precision of three kinds of pipetting tools were 0.56%,0.10%, 0.01%.(2)The ranges of precision of ALT,AST,GGT,ALP,CK,LDH,AMY,ChE,TG,TC,HDL-C,LDL-C,Glu,Cr,BUN,UA,K,Na,Cl,Ca,TP,Alb,TBil,DBil,P,Fe were 0.99%-10.5% about 101-Ⅰ and 0.91%-7.03%about 101-Ⅱin the first stage.The ranges of precision were 0.66%-8.81%of 101-Ⅰand 0.66%-4.28%of 101-Ⅱin the second stage.The ranges of precisions were 0.60%-3.91%of 101-Ⅰand 0.73%-3.39%of 101-Ⅱin the third stage.(3)73%/80%of the samples met the standard of JSCC about 101-Ⅰand 101-Ⅱand 80%/88%of the samples met the standard of Health Industry Standard in the first stage.88%/100% of the samples met the standard of JSCC about 101-Ⅰand 101-Ⅱ and 100%/100%samples met the standard of Health Industry Standard in the second stage.The ratio of samples meeting the standard of JSCC about 101-Ⅰand 101-Ⅱwere 96%/100% and that of Health Industry Standard were 100%/100%in the third stage.(4)Precision of 101-Ⅰand 101-Ⅱwas statistically significant between the measurement procedures of second stage and the first stage,and there was no significant difference between the third stage and the second stage.Conclusion (1)The precision of samples using dispenser to reconstitute is higher than that of the other two pipetting methods.(2)Improving the calibration mode and reconstitution of samples increase the precision of 26 clinical chemistry analytes by over 50%.
2.Effect of reproduction on maternal and infant outcomes in female patients with systemic lupus erythematosus
Shuming SHAO ; Yimin ZHANG ; Xiaorui ZHANG ; Jie LIU ; Chaomei ZENG
Chinese Journal of Applied Clinical Pediatrics 2021;36(18):1403-1406
Objective:To investigate the effect of reproduction on maternal and infant outcomes in female patients with systemic lupus erythematosus (SLE).Methods:Clinical data of SLE patients complicated with pregnancy admitted in the Peking University People′s Hospital from July 2015 to December 2019 were analyzed retrospectively.According to the history of live birth, SLE patients complicated with pregnancy were divided into primiparity group (94 cases) and reproduction group (32 cases). Maternal and infant outcomes of the 2 groups were analyzed.Results:A total of 126 SLE patients complicated with pregnancy were included in the present study.The proportion of using immunosuppressants was significantly lower in reproduction group than that of primiparity group [3 cases (9.38%) vs.27 cases (28.72%)] ( χ2=4.927, P=0.026). Complications like lupus nephritis, thyroid disease and postpartum hemorrhage significantly increased in the reproduction group (all P<0.05), and the adverse neonatal outcomes like preterm infants, low birth weight infants and small for gestational age infants in the reproduction group were lower than those in primiparity group, but no significant differences were detected(all P>0.05). There were no significant diffe-rences in the results of the first blood routine examination of newborns and the incidence of neonatal pathological jaundice between the 2 groups (all P>0.05). Conclusions:For SLE patients complicated with reproductive pregnancy, although the incidence of some pregnancy complications increases, the incidence of adverse neonatal outcomes decreases.In addition, reducing the use of immunosuppressants may have positive implications on neonatal outcomes.
3.The effect of oral glucocorticoid dose on maternal and infant outcomes in women with systemic lupus erythematosus
Shuming SHAO ; Yimin ZHANG ; Xiaorui ZHANG ; Jie LIU ; Chaomei ZENG
Chinese Journal of Applied Clinical Pediatrics 2022;37(5):358-361
Objective:To investigate the effect of oral glucocorticoid dose on maternal and infant outcomes in female patients with systemic lupus erythematosus(SLE), thus providing reference for clinical work.Methods:Clinical data of pregnant women with SLE admitted to Department of Obstetrics, Peking University People′s Hospital from July 2015 to June 2020 were retrospectively analyzed.According to the daily oral glucocorticoid dose during pregnancy(equivalent converted to Prednisone), pregnant women were divided into 2 groups: ≤7.5 mg group(67 cases) and >7.5 mg group(74 cases). The maternal and fetal outcomes of the 2 groups were analyzed by t-test or χ2 test or Fisher′ s exact probability method. Results:The neonatal birth weight, birth length, white blood cell count and platelet count in ≤7.5 mg group were significantly higher than those in >7.5 mg group[(2 990.69±532.20) g vs.(2 734.57±608.35) g, (48.97±2.34) cm vs.(47.43±3.38) cm, (17.69±6.16)×10 9/L vs.(15.11±6.00)×10 9/L, (276.92±74.51)×10 9/L vs.(240.05±69.29)×10 9/L], while the incidence of low birth weight and neonatal transfer rate were significantly lower(13.85% vs.30.43%, 12.31% vs.33.33%) ( t/ χ2=2.587, 3.068, 2.354, 2.841, 5.301, 8.321, all P<0.05). Meanwhile, the incidence of maternal complications like hypertension disorders in pregnancy and gestational diabetes mellitus in the ≤7.5 mg group were lower than those in the >7.5 mg group, but the incidence of anemia and postpartum hemorrhage increased, although no significant differences were detected (all P>0.05). Conclusions:The overall maternal and fetal outcomes of patients with SLE with oral Prednisone ≤7.5 mg/d were better those medicated >7.5 mg/d, but the incidence of anemia during pregnancy and postpartum hemorrhage was higher.An individual monitoring and treatment should be concerned to improve the maternal and infant outcomes.
4.The effect of artificial oocyte activation on the short- and long-term development of offspring
Shuming SHAO ; Yimin ZHANG ; Xiaorui ZHANG ; Fang FANG ; Qun LU ; Jie LIU ; Chaomei ZENG
Chinese Journal of Applied Clinical Pediatrics 2022;37(17):1355-1357
Intracytoplasmic sperm injection (ICSI) is an important treatment option for male infertility at pre-sent.However, a few patients still suffer from repeated ICSI fertilization failure because their sperm is unable to activate oocytes.Artificial oocyte activation (AOA) technology can improve the fertilization rate, pregnancy rate, live birth rate, etc., but it remains unknown whether AOA has short- and long-term effect on offspring.In this article, recent literature about the effect of AOA technology on perinatal outcomes, genetics, physical development and neurological development of offspring was summarized.This paper aims to provide reference for reproductive medicine workers and pediatricians in clinical practice.