The pre-examination process is the first key step in the total testing process of clinical laboratories.Specimen acceptability is an important indicator to measure the quality of pre-examination.In order to identify the risks and the root causes in the process , establishment and monitoring of quality indicators about specimen will effectively control the risks , enhance the acceptability of specimens , promote the improvement of pre-examination quality and finally get the aim of assuring patients′safety.

Through analysis of the anatomic and physiological characteristics and the pathophysiological changes of 84 obstructive sleep apnea syndrome (OSAS) patients,the risks and key points of nursing care during general anesthesia were summarized,such as careful assessment of the patient situation,preparations of first aid materials and drugs,close observation and cooperation with the procedure of anesthesia,timely detecting and dealing with the abnormal changes during anesthesia.

The paper conducts a case study of Yangzhou No.1 People′s Hospital, introduces the practice of outpatient process opti-mization based on informatization support platform, analyzes the operation status of self-service outpatient service platform and existing problems.Based on the M/M/s model in queuing theory, the queuing model of payment for outpatient service in the hospital is construc-ted, the characteristics of queuing payment problems for outpatient service are revealed, the relationship between the sharing rate of self-service terminals and the average length of the queue in service windows, the average waiting time of patients.

The pre-analytical process is the first key step in the total testing process of clinical laboratories,which will directly influence the accuracy and timeliness of testing results.Efficient preanalytical quality assurance system consists of scientific personnel structure,regular training and monitoring,bright and comfortable phlebotomy environment,advanced comprehensive phlebotomy facilities,strict biosafety practice in each procedure and harmonious relationship between clinicians/patients and laboratory.Besides,the application and monitoring of sound quality indicators in pre-analytical process will promote the improvement of quality and finally get the aim of assuring patients' safety.

Objective To determine the added clinical applications of MR virtual endoscopy (MRVE) plus MRCP in cholangiopancreatography. Methods In 14 month, 44 patients with obstructive jaundice and symptomatic bile trace were assessed by MRVE in biliary tract.The 2D data of heavily T 2 weighted images with FSE(non breath hold, respiratory trigger) and SSFSE(breath hold, multi slice single shot fast spin echo) sequence were transferred to the computer workstation. Navigator software (GEMS) was used to display intraluminal views of the pancreaticobiliary tract with a surface rendering technique. Results Patients suffered from neoplasm ( n =18), bile stone (17), postoperative complications of cholecystectomy( n =3), and other disease of biliary tract( n =6). MRVE could clearly demonstrate the anatomical structures in biliary tract, extended pancreas tract,biliary meatus narrowing and obstruction, bile duct stones, duct branches, and the inner wall of pathological obstruction.The main limitation of virtual endoscopy was inability to evaluate mucosa and lack of histological diagnosis. Sensitivity for detection of bile duct dilatation and site of obstruction was: 2D FSE 91 7%, and SSFSE 97 9%. Conclusion MRVE provided noninvasively endoscope like display of biliary tract.Its display ability was a supplement to image biliary trace. MRVE effect of multi slice SSFSE sequence was better than that of fast spin echo.

Objective To discuss the application value of the combination detection of serum cystatin C(CysC),serum amyloid A (SAA)and urinary microalbumin(malb)for the early diagnosis of diabetic nephropathy(DN).Methods 112 cases of diabetic melli-tus(DM)were selected and divided into the non-DN group(malb<25 mg/L)and the early DN group(malb 30-299 mg/L)according to the urinary microalbumin level.50 cases of healthy subjects were selected as the control group.The levels of serum CysC and malb were measured by immuno-scatter turbidmetry and SAA was measured by enzyme-linked immunosorbent assays(ELISA).At the same time,the biochemical indexes of GLU,Cr,HbA1C were detected too.Results The levels of CysC,SAA and malb in the DM two groups were significantly higher than those in the healthy control group with statistical differences(P <0.05 ),moreover which were increased with the renal damage aggravation;the levels in the early DN group were significantly higher than those in the non-DN group with statistical differences(P <0.05).The levels of GLU and HbA1C in the DM two groups had statistically signifi-cant differences compared with the healthy control group(P <0.05).Conclusion The levels of serum CysC and SAA in the DM pa-tients are increased with the urinary malb level increase.The combined detection of CysC,SAA and malb could increase the diagnos-tic rate of the renal damage in early DN.

Objective To study the development of neural stem cells from human fetal brains at different developmental stages. Methods A total of 100 cases of embryos at 16-32 gestational weeks by induction of labor with water bag were collected for the determination of the distribution, forms, existing modes, and the number of neural stem cells in the hippocampus by SABC immunohistochemical method and light microscopy. Results Neural stem cells were found in the hippocampus at different fetal ages and located in the polymorphic layer, pyramidal, granular and molecular layers of hippocampus, mainly in polymorphic layer, pyramidal layer, and granular layer. Neural stem cells in hippocampus were round, ellipse, triangle, and stellate, particularly round and ellipse. No obvious enation was found. Neural stem cells had plenty of cytoplasm. The nuclei were round and ellipse with rare chromatin and nucleoli from 2 to 6. Most of neural stem cells were distributed among other neurons, and symmetric cleavage was found in some of them, but some neural stem cells were distributed in cluster and nest. The number of neural stem cells in hippocampus were different between groups and gradually decreased with the increasing gestational age. Conclusion Neural stem cells exist widely in the hippocampus at different gestational ages. There are differences in distribution, forms, existing modes, and number of neural stem cells in hippocampus at different gestational ages. Hippocampus may be the new originating region of neural stem cells.

Objective To evaluate the value of low-dose lung screening with 16-slice CT scanner in physical examination.Methods Lung screening was performed in 114 cases with a 16-slice spiral CT scanner.The scan parameters were 120KV,20~50mA.The reconstructive modes were standard mode and lung mode.Results 41 cases with lung diseases were detected with low-dose 16-slice spiral CT.Conclusion Low-dose 16-slice spiral CT is good for lung scanning in physical examination.

Objective:To analyze the immune function regulation and clinical effect of dust mite drops desensitization treatment on children with allergic rhinitis.Methods:80 patients with allergic rhinitis and adenoid hypertrophy treated in our department from January 2012 to June 2014 were selected and randomly divided into experimental group and control group.Control group was treated with ebastine and levocabastine treatment, the experimental group was treated with sublingual containing Dermatophagoides Farinae Drops on the basis of control group.The level of IL-2,IL-6,house dust mite specific IgE (sIgE),dust mite IgE (T-IgE),house dust mite specific IgG4 ( sIgE in) ,blood addicted eosinophile cells ( EOS) ,and induced sputum EOS level were compared between the two groups before treatment and after 2 years treatment.Results:The level of IL-2 in the two groups was significantly higher than that before treatment,the level of IL-6 was significantly lower than that before treatment ( P<0.05 ) .After treatment, the level of IL-2 in the experimental group was significantly higher than that in the control group, the level of IL-6 was significantly lower than that in the control group( P<0.05 ).After treatment, the level of sIgE, T-IgE, blood EOS and induced sputum EOS in the two groups were significantly lower than before treatment,the level of sIgG4 were significantly higher than those before treatment (P<0.05).After the treatment,the level of sIgE, T-IgE, blood EOS and induced sputum EOS in experimental group were significantly lower than control group,and the level of sIgG4 was significantly higher than that in control group ( P<0.05).After treatment,the asthma symptom scores and nasal symptom scores of the two groups were significantly lower than before treatment (P<0.05),and those index of experimental group after treatment were significantly lower than control group ( P<0.05 ).Conclusion: Combine the basis of conventional therapy plus with Dermatophagoides Farinae Drops in the treatment of allergic rhinitis and adenoid hypertrophy children can effectively regulate the immune function of the patients,has good clinical efficacy.

BACKGROUND:Under mitomycin C treatment, feeder cells appear to have restricted proliferation, but they are stil able to secret different cytokines. Non-mesenchymal stem cells from the bone marrow and secreted factors in plasma maintain the micro-environment suitable for the growth of mesenchymal stem cells that can improve the yield of mesenchymal stem cells.
OBJECTIVE:To study the biological characteristics of C57 mouse bone marrow mesenchymal stem cells isolated using a whole bone marrow adherent culture technique.
METHODS:Using the whole bone marrow adherent culture technique, purified and amplified C57 mouse bone marrow mesenchymal stem cells were harvested. cellproliferation kinetics, immune cellsurface markers, multiple differentiation potential and cellcycle were detected.
RESULTS AND CONCLUSION:Using the whole bone marrow culture, mouse bone marrow mesenchymal stem cells were harvested and capable of adhering to the plastic culture vessel. The obtained cells expressed CD45, CD105 and Sca-1, but were negative for CD34, CD33 and C-kit. The doubling time was (57.11±1.5) hours. The cells could be induced to differentiate into osteoblasts, adipocytes and chondrocytes. The cellcycle analysis showed that 64%of cells were in G 0-G 1 phase. These indicates that C57 mouse bone marrow mesenchymal stem cells isolated using a whole bone marrow adherent culture technique have biological characteristics of mesenchymal stem cells.