Objective To investigate the detection results of GHB with different instruments, and to provide reliable basis for improving the accuracy of GHB detection. Methods ADVIA 1650 biochemical analyzer and HA-8160 glycosylated hemoglobin analyzer were used. The accurate detection of glycosylated hemoglobin in 100 healthy people was carried out, and the related data were recorded and analyzed statistically. Attention should be paid to this group according to glycosylated hemoglobin detection value, that is, within 6.5％ for A group, 6.5％-10.0％ for B group, more than 10％ for C group, and compare the above-mentioned different grouping of corresponding instrument glycosylated hemoglobin detection value. Results The analysis showed that there was no significant difference between the two groups of C instrument glycosylated hemoglobin levels, but the level of glycosylated hemoglobin detected by A in group HA-8160 and group B was significantly higher than that of ADVIA 1650(P<0.05). Conclusion Different instruments have some differences in the detection value of glycosylated hemoglobin. Clinicians should judge the disease comprehensively according to the actual situation and other indicators.

Objective To analyze the factors related to the disqualification of urine routine and stool routine, and to formulate corresponding solutions. Methods In April 2014 to April 2017 our collected 600 cases of hospitalized patients, urine and stool samples for routine detection, made clear that cause unqualified samples related factors, and develop effective solution strategy. Results 600 cases in the selected routine urine, excrement and urine routine test specimens, the unqualified samples of total 110 cases, fraction defective is 18.33%, 490 qualified samples, percent of pass is 81.67%, the difference was statistically significant (P<0.05).There are a number of factors that cause the sample to fail, such as the contamination of the sample, the length of storage, the operation and the preparation. Conclusion In the process of actual diagnosis of disease, clinical result in urine, feces routine test specimen unqualified often appear, the reason is to a great extent, and the related nursing staff in urine and stool samples of patients before the lack of relevant guidance and so on, and nursing staff after the complete collection of specimens does not usually in accordance with the relevant standard of serious check, to avoid the sample inspection is unqualified, hospitals need to develop scientific inspection process, nurses in practice need to strict adherence to the process, and through intensive training, promote nursing staff awareness test, can to improve the qualification rate of sample test provide strong guarantee.

Objective To evaluate the semi-quantitative parameters of dynamic contrast enhanced MRI (DCE MRI) with double echo in the diagnosis of breast tumors.Methods Thirty eight patients suspected of breast tumour underwent DCE MRI with double echo examination by using 3.0 T whole-body MR scanner with a sixteen-channel phased-array breast coil.Semi-quantitation of both pharmacokinetic and perfusion parameters were performed including peak enhancement ratio (PER),time from contrast agent arrive to peak enhancement (Tmax),and maximum signal intensity loss (MSIL).The mean PER,Tmax and MSIL of the breast cancer,fibroma and other benign lesions were calculated.One-way ANOVA and receiver operating characteristic curve (ROC) analysis were used to compare the differences between malignant and benign lesions.Results The mean PER,Tmax and MSIL of the lesions were as follows:0.61 ± 0.09,(164.9 ± 20.5) s,and 0.31 ± 0.03 for breast cancers (n =20) ; 0.46 ± 0.07,(183.2 ± 13.7) s,and 0.17± 0.03 for fibromas (n =10) ; 0.23 ± 0.06,(139.4 ± 23.6) s,and 0.24 ± 0.07 other benign lesions (n =8),respectively.There were significant differences among 3 groups in all semi-quantitative parameters (F =4.319,4.154,4.752,respectively.P ＜ 0.05).The areas under the ROC curve of PER,Tmax and MSIL for the diagnosis of malignant lesions were 0.513,0.794 and 0.769,respectively.The sensitivity of PER,Tmax,and MSIL were 60.0％,80.0％ and 62.5％ and the specificity were,62.5％,75.0％ and 90.0％,respectively,with the maximum Youden'index as cut off value.When combining the 3 semi-quantitative parameters,the sensitivity,specificity and accuracy for differential diagnosis of breast tumors were 95.0％ (19/20),83.3％ (15/18),and 89.4％ (34/38),respectively.Conclusion The semi-quantitation of pharmacokinetic parameters (PER,Tmax) and perfusion data (MSIL) can be simultaneously estimated in a dynamic contrast enhanced MRI with double echo in breast lesions.The Accuracy for differential diagnosis of breast tumors can be improved when judge by combination of PER,Tmax and MSIL.

Objective To investigate the radiological features of granulomatous mastitis (GM) in dynamic contrast enhanced MRI (DCE-MRI) and DWI and to differentiate it from the breast cancer in diagnose.Methods Forty five cases of GM and 64 cases of breast cancer confirmed by surgical histopathology or biopsy were retrospectively analyzed in the study.All of the patients were examined preoperatively by DCE-MRI and DWI.Including lesion type,location,enhancement pattern,nipple retraction,supplying arteries,skin thickening and axillary adenopathy in the two groups were evaluated and analyzed by using x2 test.One-way ANOVA was employed to compare the ADC values between the abscess area of GM and non-abscess area,and the difference among the breast cancer lesion area.Dynamic enhancement MR pharmacokinetic parameters were used to measure including early-phase enhancement rate (EER),peak enhancement ratio(Emax),and time to peak ehhancement(Tmax).The statistical differences of EER,Emax and Tmax between the two groups were calculated by using Wilcoxon test.Results In 45 cases of GM,DCE MR images showed nonmass-like lesions (43 patients) and mass-like lesions (2 patients); the nipple involved(16 patients) and segment involved (29 patients);rim-like with heterogeneous enhancement (40 patients) and heterogeneous enhancement (5 patients); nipple retraction (24 patients) supplying arteries dilatation (42 patients),skin thickening (29 patients),and axillary adenopathy (17 patients).Corresponding to the radiological features above,in the 64 breast cancer cases,it showed 54,10,5,59,30,34,16,51,12 and 20,respectively.There were statistical significance between GM and breast cancer in lesion type,location,enhancement pattern,and nipple retraction (x2=67.574,13.075,20.297,20.398 and 23.510,respectively,all P＜0.01).But no differences were existed between 2 groups in supplying arteries and axillary adenopathy(x2=3.928 and 0.502,P＞0.05).EER,Emax and Tmaxin GM were 146.58％,191.13％,195.00 s in GM and 118.13％,159.43％,183.33 s in breast cancer,respectively.Significant statistic differences between GM and breast cancer were found in EER and Emax(Z values were-2.271 and-2.948,P＜0.01).But it did not show significant difference in Tmax (Z =-0.548,P＞0.05).The ADC values of GM on abscess area,non-abscess area,and breast cancer lesion area were (8.0±2.6) × 10-3,(11.3± 1.7) × 10-3 and (8.2± 1.1) × 10-3mm2/s,respectively.There were significant differences in the groups (F=52.167,P＜0.01).Conclusions The characteristic of radiological findings can be found in GM by using advanced MR imaging techniques.DCE-MRI combined with DWI is useful in the differential diagnosis between GM and breast cancer.

Objective To investigate the basic status and the 15 quality indicators in clinical laboratory of medical institutionin in Qinghai provinces, and to understand the quality status.Methods Clinet-EQA system was applied by Qinghai Center for Clinical Laboratories to provide the electronic questionnaire for the clinical laboratory of 106 medical institutions in April 2016 and report related results online.The software of Clinet-EQA system and SPSS13.0 were used for 15 quality indicators for statiatical analysis,13 indicators expressed in rate were further evaluated with sigma scales.Results Totally 102 laboratories returned questionnaires, the rate was of 96.2%.8/13 quality indicators of the overall sigma levels were all >3.The average level of 4 quality indicators such as the sample type error rate was slightly lower than the national.Comparison of the 4 quality indicators of each grade hospital in Qinghai and the same grade hospital in the national, secondary hospital in clinical chemistry, immunology, clinical examination,microbiology in the four major performed better than tertiary hospital.In routine examination, pre-analytical TAT average level of clinical chemistry and immunology was about 50 min,and of blood,urine and stool was 45 min.Pre-analytical TAT in emergency examination for all four disciplines were about 15 min.Intra-analytical TAT for clinical chemistry was the longest,which was 120 min for routine examination and 40 min for emergency examination,respectiely.The average level of the median TAT of blood,urine and stool in routine examination of Intra-analytical in Qinghai was longer than the national.For example of clinical chemistry, routine examination both in pre-analytical TAT and in Intra-analytical TAT was statistically significant in different scales of laboratories,and emergency examination in pre-analytical TAT and in Intra-analytical TAT was not statistically significant.Conclusions 4/13 quality indicators which expressed in rate in the average level in Qinghai province were lower than the national,the average level of the median TAT of blood,urine and stool in routine examination of Intra-analytical in Qinghai was longer than the national.The laboratory should focus on the weak links and continue improvement.

UDP-glucuronosyltransferase 1A1 (UGT1A1) plays a key role in detoxification of many potentially harmful compounds and drugs. UGT1A1 inhibition may bring risks of drug-drug interactions (DDIs), hyperbilirubinemia and drug-induced liver injury. This study aimed to investigate and compare the inhibitory effects of icotinib and erlotinib against UGT1A1, as well as to evaluate their potential DDI risksUGT1A1 inhibition. The results demonstrated that both icotinib and erlotinib are UGT1A1 inhibitors, but the inhibitory effect of icotinib on UGT1A1 is weaker than that of erlotinib. The ICvalues of icotinib and erlotinib against UGT1A1-mediated NCHN--glucuronidation in human liver microsomes (HLMs) were 5.15 and 0.68 μmol/L, respectively. Inhibition kinetic analyses demonstrated that both icotinib and erlotinib were non-competitive inhibitors against UGT1A1-mediated glucuronidation of NCHN in HLMs, with thevalues of 8.55 and 1.23 μmol/L, respectively. Furthermore, their potential DDI risksUGT1A1 inhibition were quantitatively predicted by the ratio of the areas under the concentration-time curve (AUC) of NCHN. These findings are helpful for the medicinal chemists to design and develop next generation tyrosine kinase inhibitors with improved safety, as well as to guide reasonable applications of icotinib and erlotinib in clinic, especially for avoiding their potential DDI risksUGT1A1 inhibition.

OBJECTIVETo summarize the 2491 acupuncture inpatient consultations in Qilu Hospital of Shandong University during 2014, and analyze the application of acupuncture in comprehensive hospital, hoping to provide direction and methods for clinical practice and scientific research of acupuncture.

METHODSThe consultation record and hospitalization information during 2014 in Department of Acupuncture-Moxibustion and Tuina, Qilu Hospital of Shandong University, were collected and summarized through Inpatient Information Management System. The distribution of consultation discipline and disease were analyzed.

RESULTSAmong all the consultations, 15 second-class disciplines were involved, and the number of neurology and surgery was 1399, accounting for 59.00% of all consultation. 111 types of diseases were found in consultation, mainly postoperative complications, cerebrovascular disease and arthropathy. The primary disease of consultations involved all the systems, mainly nervous system disease, musculoskeletal system disease, connective tissue diseases and genitourinary system diseases, accounting for 73.89% of all consultations. .

CONCLUSIONAcupuncture is closely related with clinical disciplines of neurology and surgery. The cooperation between acupuncture and pediatrics and oncology should be strengthened. Acupuncture has an advantage over treating postoperative complications and neuromuscular diseases.