ISO 15189 standard quality management system developed by the International Organi-zation for Standardization (ISO) embodies the international medical laboratory's latest quality management concept, and puts forward the quality improvement method of the standard. In this research, ISO 15189, as an important content in practice teaching for laboratory medicine, was designed according to the elements of this system. Students were requested to participate in every linkage of laboratory quality management by writing system document, taking part in quality activity, and practicing the key and difficult points of tech-nique in quality system in order not only to cultivate their basic idea of ISO 15189 standard, but also to make them familiar with the basic patterns of laboratory accreditation system and process, which could make them become the backbone of the laboratory quality management quickly in their vocational positions in the future.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Bulbar Palsy, Progressive ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications

Objective To determine whether color doppler ultrasonography (CDU),thyroid function or thyroid autoimmune antibodies could identify Graves' disease in pregnancy(GDP) in pregnant patients with newly diagnosed thyrotoxicosis.Methods It is an observational study.Sixty-eight pregnant patients with newly diagnosed thyrotoxicosis including gestational hyperthyroidism (GHT) subjects (GHT group,n =33) and GDP subjects (GDP group,n =35),and 62 age-and sex-matched healthy subjects (C1 group:pregnant,n =32,C2 group:non-pregnant,n =30) were recruited.Thyroid function,human chorionic gonadotropin(HCG),thyroid autoimmune antibodies were detected.Peak systolic velocity of the superior thyroid artery (STA-PSV) and diastole inner diameter(STA-D) of the superior thyroid artery were measured by CDU.A ROC curve was used to evaluate STA-PSV,STA-D,thyroid function and thyroid autoimmune antibodies for identification of GDP.Results The area under the ROC curve of STA-PSV,STA-D and thyroid stimulating hormone (TSH),free T4 (FT4) for GDP were 0.905,0.887,0.803 and 0.786,respectively.The optimal cut-off points of STA-PSV,STA-D,TSH and FT4 for GDP were 40 cm/s,2.0mm,0.03 mIU/L and 30 pmol/L with the sensitivity of 82.9％,72.1％,81.8％,76.2％ and specificity of 81.8％,87.9％,75.2％,80.3％,respectively.Conclusions Detection of STA-PSV and STA-D by CDU,as well as thyroid function,is useful in screening GDP in pregnant patients with thyrotoxicosis.

Objective:To describe the clinical features and immunological of Uygur systemic lupus erythematosus (SLE) subjects.Methods:Atotal of 484 adult patients (≥18 years) followed in the People's Hospital of the Xinjiang Uygur Autonomous Region were included into this study including 211 Uygur patients with SLE and 273 Han patients with SLE.Results:① Of the 211 Uygur SLE patients, 195 (92.4%) were female and 16(7.6%) were male (female:male=12.2∶1), the mean age at SLE onset was 15-64(35±12) years, mean disease duration was 0.1-228(21±35) months.② Of the 211 Uygur SLE patients, the most prevalent clinical presentationswere renal involvement 56.4%(119/211), hematological 56.4%(119/211), rash 50.2% (106/211), arthralgia/arthritis 49.8%(105/211), weakness 47.9%(101/211). The significant difference observed between the Uygur and Han SLE patients was Raynaud phenomenon( χ2=6.066, P=0.014) .③ The positive rates of antinuclear antibodies were 94.8%(200/211), 54.5%(115/211) for anti-dsDNA antibodies, 47.9% (101/211) for anti-SSA antibodies, 35.1%(74/211) for anti-U 1-RNP antibodies, and 28.4%(60/211) for anti-AHA antibodies. The positivity of anti-AHA antibodies ( χ2=4.952, P=0.026) was higher in Uygur SLE patients than thatin Han SLE patients. More Uygur SLE patients were anemic ( χ2=6.904, P=0.009), with decrease of complement ( χ2=6.330, P=0.012). Conclusion:This study can not find any significant differences between the Uygur SLE patients and Han SLE patients in common clinical manifestations in Xinjiang. The Uygur SLE patients are more likely to have anemia and decrease of complement, which may be related to race and diet habits.

Objective To present clinical results of endovascular treatment of total iliac vein occlusions and to discuss the technique details of this treatment. Methods From Feb 2006 to Aug 2010,15 patients with chronic total occlusive lesions of the iliac vein and adjacent vein segments underwent endovascular treatment. Average age was (62 ±7) years (range 35 to 81 years), the male/female ratio was 12: 3. Clinical score of CEAP was grade 3 in 33. 3%, grade 4 in 40%, grade 5 in 13. 3%, and grade 6 in 13.3%. Venography showed left iliac vein was occluded in all 15 patients, common femoral vein was occluded in 14 patients, and superior femoral vein was occluded in 9 patients, however profounder femoral vein was patent in these patients with superior femoral vein being occluded. Results No postoperative major morbidity or mortality was seen. The technique success rate was 93. 3%. Treatment failure was caused in one case for a wrong selection of the femoral vein approach site. The average length of stent was 18. 4 cm.In 12(80. 0% ) stents crossed the inguinal ligament. The average follow-up time was 11.6 ± 2. 4 months.The primary patency rates of the stents at 6 months were 92. 9%. 10 (66. 7% ) patients were asympotomatic, 3(20% )were improved, 1 (6. 7% ) was unchanged, and 1 (6.7%) was worse, compared to before intervention. Conclusions Endovscular recanalization and stent placement is a safe and effective treatment for chronic total occluded iliac veins, with good patency, significant symptom resolution, and minimal morbidity in the short term follow-up.

OBJECTIVETo detect the effect of genistein on mandible metabolism in ovariectomized rats.

METHODSForty 12 week-old female SD rats were randomly assigned to four groups: (1) sham operated; (2) ovariectomized; (3) ovariectomized and treated with estradiol; (4) ovariectomized and received genistein, 45 mg/kg body weight per day. After 12 weeks, bone mineral density (BMD), serum level of alkaline phosphatase (ALP), acid phosphatase (ACP), osteocalcin, IL-1beta, TNF-alpha, IL-6 and calcitonin (CT) were evaluated. In addition, the serum estradiol and the weight of uteri were also examined to indicate the side effect of genistein to the uteri.

RESULTSOvariectomized animals had a significant decrease in BMD, and increased serum level of ALP, ACP, IL-1beta and osteocalcin compared with sham rats. After treated with genistein, BMD and the serum level of ALP, ACP, osteocalcin increased significantly, while the serum level of IL-1beta and TNF-alpha decreased. Especially, the increase of ALP and osteocalcin was higher than that of estradiol-treated animal. Additionally, the uterus weight index and the serum estradiol in genistein-treated rats were lower significantly than those of estradiol-treated rats.

CONCLUSIONSGenistein can improve the mandible bone metabolism as well as its effect on femur through the promotion of bone formation and the prevention of bone resorption with slight side effect. Genistein provides an additional viable way to therapy for osteoporosis in the jaw bones.

Alkaline Phosphatase ; blood ; Animals ; Bone Density ; drug effects ; Estradiol ; blood ; Female ; Genistein ; pharmacology ; therapeutic use ; Mandible ; drug effects ; metabolism ; Osteocalcin ; blood ; Osteoporosis ; prevention & control ; Ovariectomy ; Ovary ; drug effects ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo detect the expression of RANKL and OPG protein in the giant cell lesions of jaw and to study the mechanism of this lesion.

METHODSRANKL and OPG were detected by immunohistochemistry (SP) in 24 paraffin-embedded and 2 frozen specimens of central giant cell lesion of jaw.

RESULTSRANKL signals were strongly positive in the vascular epithelial cells. They also could be found in fibrous stroma, bone matrix, and stromal spindle cells, even in some cytomembrane of multinucleated giant cells. OPG was detected in multinucleated giant cells and a fraction of round mononuclear cells.

CONCLUSIONSActive vascular epithelial cells are contributed to the formation of multinucleated giant cells through regulating RANKL, and RANKL could play its role by paracrine and autocrine, which might be inhibited by OPG.

Giant Cells ; metabolism ; pathology ; Humans ; Jaw Diseases ; metabolism ; pathology ; Osteoclasts ; metabolism ; Osteoprotegerin ; metabolism ; RANK Ligand ; metabolism

This article explained the character of dental disease and effective facts for dental health utilization, and current situation of basic medical insurance for oral diseases through checking up relative articles. Dental insurance had a positive effect on utilization of dental medical service and public oral health. The PEST tool was used to analyze the environment of dental insurance developing direction and feasibility in this article, and then raise some suggestions and core strategies for developing dental insurance. We believe that the dental insurance can increase the oral health service utilizations and enhance the oral health for Chinese people. Only oral insurance will be developed, Chinese oral health could be geared to international practice.
China ; Humans ; Insurance, Dental ; Oral Health

OBJECTIVETo detect the expression of a disintegrin-like and metalloproteinase (ADAM) 8 and 12 gene in the giant cell lesions of jaw and to study their effects on the histogenesis of cells in these lesions.

METHODSADAM8 and ADAM12 was detected by immunohistochemistry (SP) in 40 paraffin-embedded specimens of central giant cell lesions of jaw, 10 peripheral giant cell lesions, 9 cherubisms, 6 aneurysmal bone cysts.

RESULTSADAM8 and ADAM12 were positive in the cytomembrane and cytoplasm of all multinucleated giant cells and some round mononuclear cells of the lesions; ADAM12 was positive for some spindle mononuclear stromal cells in central and peripheral giant cell lesions.

CONCLUSIONSMultinucleated giant cells probably originated from the fusion of the round mononuclear cells, and ADAM8 and ADAM12 were involved in this process. In addition, ADAM12 might play a role in the maturation of spindle mononuclear stromal cells.

ADAM Proteins ; ADAM12 Protein ; Antigens, CD ; biosynthesis ; genetics ; metabolism ; Giant Cell Tumor of Bone ; enzymology ; genetics ; Humans ; Jaw Neoplasms ; enzymology ; genetics ; Maxillary Neoplasms ; enzymology ; genetics ; Membrane Proteins ; biosynthesis ; genetics ; metabolism ; Metalloendopeptidases ; biosynthesis ; genetics ; metabolism

OBJECTIVETo observe the clinical efficacy of acupuncture at Hegu (LI 4) on central facial nerve paralysis after ischemic stroke, and explore dose-effect relationship among different stimulation intensities of acupuncture at Hegu (LI 4) as well as its optimal treatment plan.

METHODSAccording to different acupuncture stimulation intensities which were based on treatment time and needle insertion direction, fifty patients were randomly divided into a Hegu 1 group, a Hegu 2 group, a Hegu 3 group, a Hegu 4 group and a control group, ten cases in each one. Different stimulation intensities of acupuncture at Hegu (LI 4) combined with facial paralysis acupoints, including Yingxiang (LI 20), Dicang (ST 4), Jiache (ST 6) and Quanliao (SI 18), were applied in Hegu 1 to 4 groups; meanwhile acupuncture at stroke acupoints, including Neiguan (PC 6), Shuigou (GV 26) and Sanyinjiao (SP 6), and medication treatment were adopted. Except acupuncture at Hegu (LI 4), the treatment of the control group was identical as Hegu groups. The treatment duration lasted for 14 days. The House-Brackmann facial never grading systems (H-B), Toronto facial grading system (TFGS), degrees of facial never paralysis (DFNP), facial disability index (FDI) and clinical efficacy were compared among groups.

RESULTS(1) Compared before the treatment, H-B, TFGS, DFNP and physical function score in FDI were all improved significantly in the Hegu 1 to 4 groups (all P < 0.05), but social function score in FDI was not obviously improved (all P > 0.05); all the scores in the control group were not evidently changed (all P > 0.05). (2) Compared with the control group, differences of H-B before and after treatment in the Hegu 1 to 4 groups, differences of TFGS in the Hegu 2 group and differences of DFNP in the Hegu 1 and Hegu 2 group were significantly improved (all P < 0.05). The differences of any scale among Hegu 1 to 4 groups were not significant (all P > 0.05), in which the most evident change was found in Hegu 2 group. (3) The total effective rate was 90.0% (9/10), 100.0% (10/10), 90.0% (9/10) and 80.0% (8/10) in Hegu 1 to 4 groups, which were significantly higher than 60.0% (6/10) in the control group (all P < 0.05).

CONCLUSIONAcupuncture at Hegu (LI 4) has affirmative clinical efficacy on central facial nerve paralysis after ischemic stroke, in which oblique insertion along the opposite direction of meridian for 5 s of twirling manipulation has the best clinical effect.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Facial Paralysis ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications