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.

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.

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.

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.

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 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 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.

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 observe the clinical efficacy of Chinese medicine inunction wet dressing therapy and helium neon laser in the treatment of rheumatoid arthritis.METHODS:Both groups received Methotrexate tablets,Salazosulfapyridine tablets,Loxoprofen tablets.Observation group were additionally treated with Chinese medicine inunction wet dressing therapy and helium neon laser with a treatment course of 30 days.RESULTS:The effective rate was 70.00% for control group and 93.55% for observation group,there was significant difference between two groups(P

Objective To differentiate benign from malignant breast lesions by analyzing qualitative and quantitative MR characteristics.Methods The dynamic contrast-enhanced MR imaging of the breast was performed using a double breast coil at 1.5T.The correlation between qualitative and quantitative characteristics of lesions on MRI,the data system(BI-RADS) category scores and histology was comparatively analysed.Results Some qualitative characteristics (shape, margin type, relative T 2-weighted signal intensity, rim enhancement, the later heterogeneous enhancement, and time-signal intensity curve type) were statistically significantly correlated with malignancy, P