The Proposal for the Standardization of Urinary Sediments Examination and the expert consensus have provided effective and timely instruction on urinalysis normalization,but there are still some puzzles about the methods and requirements on quality improvement for urinalysis normalization.This paper is discussing about some issues referring to American and European urinalysis guidelines,which include establishment of examination procedure,specifications and methods of testing system evaluation,specimen stability,the influence of sample centrifugation,the usage of sample staining,confirmation tests,requirements on result reporting,internal quality control and external quality assessment.These discussions will contribute to the quality improvement of urinalysis in clinical laboratories.

BACKGROUND: There are different reports on the comorbidity rates of anxiety and depression. In the pathopsychology of depression, it is unclear for the relationship between coping styles and personality in depressive patient accompanied with anxiety disorders.OBJECTIVE: To analyze the relationship between coping styles and personality in depressive patient with anxious disorders.DESIGN: A case-control study.SETTTNG: Second Xiangya Hospital of Central South University; Hunan Brain Hospital.PARTICIPANTS: Eighty-eight patients with depression were selected from the Second Xiangya Hospital of Central South University and Hunan Brain Hospital from June 2002 to January 2003. Ninety subjects were selected as normal control group from the employees or their family members, health volunteers in the Second Xiangya Hospital of Central South University and Sun Yat-sen University.METHODS: All the subjects were surveyed with self-rating depression scale (SDS), self-rating anxiety scale (SAS), coping style questionnaire and Eysenck personality questionnaire (EPQ).MATN OUTCOME MEASURES: ① Comparison of the scores of SDS, SAS, coping styles questionnaire and EPQ between the depressive group and normal control group; ② Comparison of the scores of SDS, SAS, coping styles questionnaire and EPQ between the depressive patients with and without anxious symptoms. ③ Pearson correlation analysis and stepwise regression analysis of all the indexes in the depressive group.RESULTS: ① All the 178 subjects were involved in the final analysis of results. ① The total scores of SDS and SAS, the scores of psychoticism and neuroticism of EPQ in the depressive group were significantly higher than those in the normal control group, but the score of introversion-extraversion of EPQ and passive coping style were lower than those in the control group. ② The total scores of SDS and SAS, the scores of psychoticism and neuroticism of EPQ were obviously higher but the score of active coping style was lower in the depressive patients with anxious symptoms than in those without anxious symptoms. ③ The correlation analysis and stepwise regression analysis suggested that the severity of depressive symptom was significantly related with SAS, introversion-extraversion dimension of EPQ and passive coping style.CONCLUSION: ① Depressive patients suffer from obvious depressive and anxious symptoms and psychoticism, and they inclined to introversion and emotional instability, and adopt less active coping style. ② Depressive patients with anxious symptoms suffer from more serious depressive symptoms, psychoticism and neuroticism, and they adopt active passive coping style. ③ Less adoption of active coping style can be brought into the dimension of introversion-extraversion in personality trait.

Objective To prepare and evaluate the reference materials for plasma von Willebrand Factor antigen testing with fresh frozen plasma.Methods The candidates were prepared by low temperature centrifugation in 5 different concentration levels.The homogeneity and stability of the preparation was evaluated according to the ISO Guide35 and CNAS-GL03.The comparability between STAGO and IL system was evaluated according to the WS/T 356-2011.Then the preparations were characterized by six laboratories with the Secondary Coagulation Standard established by NIBSC(SSCLOT4).Results Homogeneity evaluation of the preparation showed that there was no statistically significant difference between the groups (P >0.05),the F values of factor analysis of variance were 0.317~0.844,the uncertainty range was 1.01% ~2.06%.A linear regression based on stability evaluation indicated that the linear trend (within 24 weeks)was insignificant (P >0.05). The uncertainty range of long-term (within 24 weeks)stability was 0.79% ~ 1.20%.The results of the preparations on STAGO and IL system were comparable.The certificated values of the candidates were range from 12.2% to 138.9% with uncertainties were 0.06%~0.09%,respectively.The range of combined standard uncertainty was 0.03% ~ 0.16% while the expanded uncertainty was 2.2%~6.7%.Conclusion The reference materials for von Willebrand Factor antigen testing were stable and homogenous with comparability between STAGO and IL.The method of characterization was accurate and reliable.

Objective To investigate current status and problems of coagulation factor Ⅷ and Ⅸ assay in domestic laboratories so as to provide the reference for implementing the standardization and quality improvement.Methods A questionnaire survey was carried out in 76 laboratories,and quality control materials were distributed to 54 laboratories for activity assay.The questionnaire information was analyzed statistically.Test results of quality control materials were classified into three groups according to the reagents and the ranked grading analysis were used to evaluate the performance.Results This research was investigative study.The amount of sample was less than 30 per month in 72％ (52/72)of laboratories.The frequencies of calibration were different,and 33％ (24/72) of laboratories did not perform calibration in a different assay batch.39％ (28/72)of laboratories did not run internal quality control,and about 21％ (15/ 72) of laboratories just performed the normal level quality control.Individual laboratories showed a high cumulative CV (＞ 30％) of intemal quality control.For normal FⅧ and FⅨ control materials,the CV of results were 11.3％-18.2％ and 11.3％-17.9％ respectively as well as 15.3％-20.3％ and 19.5％-21％ for abnormal.Of the three groups,the proportions of laboratories which the FⅧ test results out with consensus were18％,24％ and 22％ as well as 20％,24％ and 28％ for FⅨ.Conclusions The key requirements for quality control of coagulation factors active assay remain to be addressed and implemented.The repeatability and comparability in some laboratories are not satisfactory to meet the clinical needs.With the purpose of promoting quality improvement,we need to develop guidelines,organize related training and establish a national external quality assessment scheme.

Objective To explore teaching effect of comprehensive teaching mode of PBL combined with CBL in ophthalmologic cataract clinical teaching.Methods 2008 grade clinical majors (n =80) in class 1 as experimental group were taught by comprehensive teaching mode of PBL combined with CBL while those (n =83) in class 2 as control group were taught by traditional LBL teaching mode.After the courses,the teaching effects of two methods were compared.SPSS 11.5 software was used for statistical analysis,x2 test for satisfaction survey and t-test for theoretical examination scores.The test level is α =0.05.Results There were significant differences between experimental group and control group in improving comprehensive quality and developing clinical thinking.Scores of understanding knowledge,case analysis and total scores of experimental group were higher than those of control group (all P ＜ 0.05).Conclusions Comprehensive teaching mode may improve the teaching effect of cataract clinical teaching,but it need to be explored and improved continually in practice.

Objective:To explore the relation among depression, anxiety, coping styles and personality in patients with major depression.Method:88 patients with major depression were assessed on admission. The assessments included Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale(SAS),Eysenck Personality Questionnaire and Coping Styles Questionnaire. Nighty normal controls were assessed with the same instruments too.Results:The patients were found having higher scores in Neuroticism and Psychoticism, and lower scores in Extroversion and positive coping styles than normal controls.Higher scores in SDS, SAS, Neuroticism, and Psychoticism, and lower scores in positive coping styles, were found in the patients with anxiety. Significant relationship was found among depression, SAS, Extroversion, and positive coping styles.The last three accounted for 52.0% of the variance of depression.Conclusion:The patients with major depression have high scores in Neuroticism and Psychoticism, and low in Extroversion and positive coping styles.Those with anxiety scored even higher in SDS, SAS, Neuroticism, and Psychoticism, and lower in positive coping styles.The application of little positwe coping styles moy be a part of Extrovision in major depresion.

Objective Study cisplatin intraperitoneal hot perfusion chemotherapy for colorectal cancer effect a radical cure the prognosis of the patients and the influence of immune function.Methods120 patients who underwent radical resection of colorectal cancer patients, divided into observation group and control group, 60 cases in each group.The observation group were treated with cisplatin in postoperative continuous hyperthermic perfusion chemotherapy (chemotherapy for 200mg/m2 solution to cisplatin and injected with 1L), once a week, continuous treatment three weeks.The control group was treated with mFOLFOX6 intravenous chemotherapy (oxaliplatin 100mg/m2 fluorouracil leucovorin 400mg/m2, 400mg/m2), once every two weeks, 12 times of treatment.After the treatment, observation and analysis of two groups of patients before and after treatment of tumor markers (CEA, cancer antigen 19-9, cancer antigen 242), immune function (CD3+ cells, CD4+ cells, CD8+ cells, CD4+ cell ratio/CD8+ cell natural killer cells), quality of life, and the incidence of recurrence and metastasis.ResultsAfter treatment, the quality of life of patients in the observation group the total effective rate was 91.67%, significantly higher than the control group 70.00% (P<0.05), the recurrence rate is 8.33%, the metastasis rate of 10.00% was significantly higher than the control group 28.33% and 25.00% (P<0.05).The observation group of patients with carcinoembryonic antigen, cancer antigen 19-9, cancer antigen 242 level respectively (3.4±1.1)% and (17.5±7.1)% and (4.7±1.9)% was significantly lower than the control group (10.2±2.8)% and (30.1±10.3)% and (20.3±4.5)% (P<0.05), the observation of immune function effect is improved significantly better than the control group, significant differences (P<0.05).ConclusionChemotherapy after radical resection of colorectal cancer patients using cisplatin intraperitoneal hyperthermic perfusion, can significantly reduce the recurrence rate and metastasis rate, improve immune function, reduce the level of tumor markers, so as to improve the quality of life of patients.

Objective To investigate the pathological features and prognostic analysis in endoscopic strip-ping microflap excision of vocal cords leukoplakia.Methods A total of 186 cases with vocal cord leukoplakia and treated by endoscopic stripping microflap excision were retrospectively analyzed,calculated the ratios of recurrence and malignant transformation on keratosis without dysplasia,mild dysplasia,moderate dysplasia and severe dysplasia and carcinoma in situ.Then,the association of histopathological classification with recurrence and malignant transformation in vocal cord leukoplakia were evaluated.Results 87 cases of all 186 patients with vocal cord leukoplakia were kera-tosis without dysplasia,17 cases were recurrenced and 3 cases were developed to carcinoma;64 cases were mild dysplasia,15 cases were recurrenced and 7 cases were developed to carcinoma;29 cases were moderate dysplasia, 13 cases were recurrenced and 10 cases were developed to carcinoma;6 cases were severe dysplasia and carcinoma in situ,all 6 cases were recurrenced and 5 cases were developed to carcinoma.Conclusion The histopathological classi-fication is predictive factor for the risk of recurrence and malignant transformation in vocal cord leukoplakia.

Objective To verify the reference interval for D-dimer assay and analyze the influence of age and gender on the ref-erence interval.Methods Inclusion criteria for reference individuals were established.60 healthy males and 63 females were enrolled and divided to three groups by age,including 20 to 39 years old group (20 males and 20 females),40 to 59 years old group (20 males and 23 females)and above 60 years old group (20 males and 20 females).Blood samples were drawn in cit-rate sodium anticoagulated tubes and D-dimer concentration was determined by three different coagulation analyzers using o-riginal reagents.According to CLSI guideline C-28-A3,the reference interval for each measurement system from reagent manufacturer was verified and the difference of D-dimer concentration between different age-group and sex-group was ana-lyzed using non-parameters tests.Results All reference intervals were verified for people under age 40,while one reference interval cannot be verified for people from 40 to 59 years old as same as one for people above 60 years old.D-dimer concen-tration increased with age and there was significantly different between 20~39 years old group and 40~59 years old group or above 60 years old group(P<0.05).There was only a significant difference between sex-group for people under age 60(P<0.05).Conclusion D-dimer concentration was associated with age and sex.For people under age 40,the reference inter-val from reagent manufacture can be verified and directly used in laboratory,while for people above age 60,the reference in-terval from reagent manufacture cannot be verified.The cause should be investigated and a new reference interval should be established separately when necessary.

Objective The study was to evaluate the behavioral differences in learning and memory abilities among three ani -mal models of Alzheimer′s disease. Methods Three SD rat models(n=20) were used in this study.The first SD rat model was es-tablished by intracerebral injection of Aβ25-35 into the bilateral hippocampus , the second mouse model was induced by intraperitoneal in-jection of scopolamine and the third was a senescence accelerated mouse model .Morris Water maze test was performed to investigate behavioral differences by comparison to corresponding blank control groups ( sham operation group , blank group and P8 group ) . Results The learning and memory abilities of senescence accelerated rats and scopolamine -treated rats were worse than those of the corresponding control groups, especially the scopolamine-treated rat ([35.47 ±3.78]s vs [50.61 ±3.94]s, P<0.01).There was no significant difference between Aβrats and sham-operated rats(P>0.05). Conclusion The model of Alzheimer′s disease in-duced by intraperitoneal injection of scopolamine represents more distinct changes in learning and memory abilities .Morris water maze test can be used to well evaluate whether the scopolamine-induced model is successfully established or not .