Objective To investigate the expression of glioma-associated oncogene 2 (Gli2) in giant cell tumor of bone, and analyze the differential expression in the different classification of imaging and pathology and the recurrent diseases, to discuss its role and significance in the pathogenesis and prognosis of giant cell tumor of bone. Methods 46 cases of giant cell tumor of bone who received the primary treatment in Peking University Peopleˊs Hospital during Jan 2009 and Dec 2012 and had the full data of treatment and could be follow-up were collected. Among which there were 40 benign cases and 6 malignant cases. The expression of Gli2 in the different cases of giant cell tumor of bone were detected by immunohistochemistry and real-time PCR, and its effect on the prognosis of giant cell tumor of bone was analyzed. Results Immunohistochemistry revealed positive expression of Gli2 in giant cell tumor of bone. The positive rate of Gli2 in malignant cases was significantly higher than that in benign cases [100.0 % (6/6) vs 55.0 % (22/40), P=0.035], and only found increasing trend but no significant difference among recurrent cases (P=0.204). Results of real-time PCR indicated that Gli2 highly expressed in giant cell tumor of bone, and the increasing trend of expression in different pathological types, different image classifications and recurrent cases, but no statistical different were found (all P>0.05). The expression correlation analysis showed that the expression of Gli2 and PTHrP, and the expression of RANKL and OPG either had a significant correlation (both P< 0.05). Additionally the expression of PTHrP and RANKL had a moderate correlation (P<0.05). Conclusions The expression level of Gli2 is high in giant cell tumor of bone, and Gli2 may be involved in recurrence,metastasis and malignant transformation. Gli2 may effect the osteolytic process of giant cell tumor of bone by the regulation mechanism of Gli2-PTHrP-RANKL pathway.

Objective To improve the quality of clinical biochemistry laboratory by quality indicators of pre-analytical,analytical,post-analytical phase and the whole process.Methods Analytical Phase:The Sigma values of items were calculated,applying the equation Sigma =(TEa％-Bias％)/CV％.Total allowable error (TEa) is from analyticalal specification defined in WS/T403-2012 of China,Bias％ is from the evaluation results of National Center for Clinical Laboratory (NCCL) trueness verification PT series and CV％ is from internal quality control data during the last 6 months in our lab.Normalized Sigma metrics plot was made to evaluate the analysis performance and the quality control strategies were designed accordingly.The quality goal indexes (QGI) were also calculated to propose improvement measures for items below 6 Sigma.Quality indicators of pre-,post-analytical and whole analytical phase,such as quality of specimen,critical value notification,critical value notification in time,TAT of hs-cTnT,TAT of emergency biochemical items,rewrite of laboratory reports and unacceptable performance in EQA-PT were measured in Sigma metrics too.The Sigma metrics changes before and after taking improvement measures were compared to conform the effectiveness.Results The average Sigma value of 17 biochemical tests was 5.29,of which 8 items (UA,K,ALP,CK,AMY,AST,TG,Na) achieved excellent to world class level (≥ 5 Sigma),6 items (LDH,Cre,TC,ALT,Mg,Glu) achieved marginal to good level (5 ＞ Sigma ≥ 3),BUN performed poorly (3 ＞ Sigma ≥ 2),Ca,TP performed unacceptably (Sigma ＜ 2) with serious quality defects.The Sigma values of unacceptable specimen,critical value notification,critical value notification in time,unacceptable turn around time (TAT) of hs-cTnT,unacceptable turn around time (TAT) of emergency biochemical items,rewrite of laboratory reports,unacceptable performance in EQA-PT were 4.17,3.60,2.75,1.72,3.27,4.52,3.33 respectively,rising to 4.30,4.30,2.90,2.45,3.75,4.80,3.60 accordingly after improvement.Conclusions Sigma metrics is potentially an ideal approach for clinical biochemistry laboratories management,which is helpful to find out problems,put forward improvement measures,and confirm the effectiveness,so as to achieve the purpose of continuous quality improvement.