Objective To discuss the application of allowable total error (Tea) and allowable imprecision derived from biological variation in routine chemistry external quality assessment ( EQA) and internal quality control (IQC) and set up quality specifications of routine chemistry in our country.Methods Data of test items including K,Na,CI,Ca,P,Glu,Urea,UA,Cre,Alb,TP,TC,TG,AST,ALT,Tbil,ALP,AMY,CK,LDH,Fe,Mg,Cu,Zn and GGT was collected and evaluated by a nationwide EQA.At the same time the coefficients of variation (CVs) of these test items during the month were acquired from the IQC reports of each laboratory and then the results were analyzed.Results Percent of pass was different in these test items based on Tea derived from biological variation in EQA results.Except for items of CI,Mg,Cu and Zn,about 80％ of participant laboratories could achieve the minimum performance of biological variation.About 80％ of participant laboratories could achieve the desired performance of biological variation for K,P,Glu,Urea,UA,Cre,TC,TG,ALT,AST,Tbil,AMY,CK,LDH,Fe and GGT.About 80％ of participant laboratories could achieve the optimum performance of biological variation for Urea,UA,TC,TG,ALT,AST,Tbil,C K,and GGT.And the IQC results showed that acceptable percents of different items based on three allowable imprecision were different.More than 80％ of participant laboratories could achieve the minimum allowable imprecision for K,P,Glu,Urea,UA,TC,TG,ALT,AST,Tbil,AMY,CK,LDH,Dbil,Fe,GGT,the desirable imprecision for P,Urea,UA,TG,ALT,AST,Tbil,CK,Dbil,Fe,GGT and the optimum imprecision for TG,ALT,CK,Dbil,Fe.Conclusions The quality specifications derived from biological variation can be as evaluation criteria for EQA and IQC in order to know the detection ability of each laboratory more completely and objectively,set up quality specifications derived from allowable total error and allowable imprecision in routine chemistry and to provide basis for mutual recognition of routine chemistry test results.

Breast Neoplasms ; therapy ; Consensus ; Female ; Humans ; Neoadjuvant Therapy

OBJECTIVE:To observe the efficacy and safety of Compound yimucao oral liquid combined with oxytocin in the prevention of postpartum hemorrhage and promotion of uterine involution for puerpera of vaginal delivery. METHODS:240 preg-nants with natural childbirth of vaginal delivery were randomly divided into control group and observation group. Control group was injected oxytocin 20 U in buttock after delivery. Observation group was additionally treated with Compound yimucao oral liquid 20 ml,tid for consecutive 2 weeks. Postpartum vaginal bleeding,uterine involution and incidence of adverse reactions in 2 groups were observed. RESULTS:Compared with control group,postpartum hemorrhage volume after delivery 2-24 h,incidence of post-partum hemorrhage,uterus size,uterine hemorrhage and lochia duration in postpartum 42 d in observation group were significantly better than control group,the differences were statistically significant(P<0.05);there were no significant differences in the hemor-rhage postpartum volume after delivery 1 h and 1-2 h and fundal height in postpartum 42 d in 2 groups(P>0.05). There were no fever,rash,nausea and other obvious adverse reactions in 2 groups. CONCLUSIONS:Compound yimucao oral liquid combined with oxytocin can obviously decrease the postpartum bleeding and promote uterine involution,with good safety.

Objective To evaluate the clinical effect of transcatheter closure with Amplatzer duct occluder offers in infants with patent ductus arteriosus(PDA).Methods Thirty-seven PDA infants underwent transcatheter closure of PDA at(8.7 ? 3.3)months and weight of(8.6 ? 3.5)kg.A lateral view aortogram was made to determine the morphology and the narrowest diameter of the ductus and selected the size of the device.Occluder was implanted using the anterograde venous approach.Follow-up evaluations were made with chest X-ray and echocardiogram at 24 hours and 1,6 and 12 months after implantation.Results The narrowest diameter of the ducts measured by angiographically was(3.3 ? 1.5)mm.Ninteen patients(54.29%) achieved immediate complete occlusion.On color Doppler the closure rates at 1 month after implant were 34 cases(97.14%).No residual shunt exsisted in all implanted patients at 6 and 12 months follow-up.Procedure time at(57 ? 43)minutes and fluoroscopy time(23.0?14.9)minutes.Conclusions Percutaneous PDA closure with the Amplatzer duct occluder decice is an safety and effective method for the treatment of PDA in infants,but caution shall be exercised to the anatomic characteristics in the infant age group in solving clinical complications.

Objective To explore the effects of nerve growth factor (NGF) and low frequency electricity stimulus on the configurations of skeletal muscle cells and the change of muscle fibre types in the denervated skeletal muscle separately.Methods The denervated rat model was established and model animals were injected with the NGF and given the stimulus (frequency=2 Hz) about 30 days. The configurations and the change of muscle fibre types were observed by immunohistochemistry and image analysis.Results The muscle fibre was in chaos and the boundary was not obvious among cells in the denervated rats; the muscle fibre of the denervated rats with NGF injection and low frequency electricity stimulus was more regular and the boundary of cells was clearer, the cells number was more than those of the denervated rats. Compared to normal rats, the proportion of Ⅰ muscle fibre in the denervated rats increased ( P<0.05), whereas the proportion of Ⅱ muscle fibre decreased ( P<0.05); it had no significant differences of the two types of muscle fibre between the denervated rats with NGF injection, low frequency electricity stimulus and the denervated rats ( P<0.05).Conclusion NGF injection and low frequency electricity stimulus can make the configurations of denervated muscle to better.

To probe into psycho-social factors related to relap se of heroin addict and to find main factor of effect on relapse． 186 cases of heroin addict had been devised into first and relapse group． Addict condition, family condition, motive of drug abuse and MMPI of addict had been studied． The results showed that relapse group were early and long time user, most of them with intravenous, the times per day of use, dosage and fee more then first drug abuse group． The motivation of relapse was strong dependent． Psychological dependent and release of depression and adolescence are high danger factor of relapse． Rehabilitation measure must be personal depend on cause of relapse of Individual．

Objective To understand the correlations between HIV-1 subtypes and changes in CD4+T cell count over time in patients with different subtypes of HIV-1 infection.Methods A total of 94 patients who were diagnosed with HIV-1 infection in Nanjing and received at least twice CD4+T cell counting test before antiretroviral therapy (ART) were recruited in this study.Descriptive analysis was used to present the rates of CD4+T cell decline for different HIV-1 subtypes.Logistic regression analysis and nonparametric test were conducted to investigate the factors responsible for CD4+T cell decline and to analyze the correlations between the rates of CD4+T cell decline and HIV-1 subtypes.Results The median monthly rate of CD4+T cell decline was-2.20 [interquartile range (IQR):-11.36-2.13] cell/μl.Of all patients,25.5% (24/94) had a significant decline (≥30%) in CD4+T cell count.Compared with the patients infected with CRF01_AE,those infected with CRF07_BC (OR=0.28,95%CI: 1.7-6.5) or other subtypes (OR=0.16,95%CI: 1.0-2.9) had a lower risk of significant decline in CD4+T cell count.In addition,results of the nonparametric test showed that the patients infected with CRF01_AE (M=-21.54,IQR:-30.97——11.92 cell/μl) had a faster CD4+T cell loss than those infected with CRF07_BC (M=-11.26,IQR:-14.06——5.63 cell/μl) (P=0.033).Conclusion HIV-1 subtype is associated with the rate of CD4+T cell decline.It is important to monitor the changes in CD4+T cell count in patients infected with CRF01_AE and to carry out timely ART.

ObjectiveTo describe upper and lower limits and their sources of reference intervals in routine chemistry assays and to make a comparison between routine and dry chemistry in these aspects.MethodsThe data of reference intervals were collected,which come from the third run of 2010 External Quality Assessment (EQA) programs in routine and dry chemistry performed by National Center for Clinical Laboratories(NCCL).All data from maternal and child care service center,children's hospital and corporations were excluded.Then all the abnormal values and errors (for instance,the lower limit was higher than the upper one or the upper limit was as the same as the lower one,etc.) were eliminated,either.Data statistics was performed by SPSS 13.0 referring to upper and lower limits of reference intervals and sources of 24 routine chemistry assays ( including serum potassium and serum sodium,etc).Comparison was made between routine and dry chemistry in these aspects in 23 assays.Data from adult men were reported when gender difference was present.ResultsThe three main sources of reference intervals were National Guide to Clinical LaboratoryProcedures, instructions of reagent manufacturesanddetermined by their own laboratory.In comparison of reference intervals between routine and dry chemistry,6 assays had statistical significant difference in both upper limits and lower ones while,4 assays in one-sided limits and 13 assays were not statistically significant in both limits.Conclusions The reference intervals of routine chemistry have big differences among institutions and the sources of them are various.Only a few assays have statistical significant difference in routine and dry chemistry among medical institutions,it might be discussed in further study whether the statistical results have clinical values.In order to achieve the result agreement among clinical assays,all the laboratories must share the common reference intervals on the basis of standardization.

Objective To investigate the value of new microvascular pattern of contrast-enhanced ultrasonography (CEUS) in the diagnosis of peripheral lung lesion.Methods A total of 72 peripheral lung lesions which had been proved by clinical and pathology results underwent conventional ultrasound,CEUS and new microvascular pattern examination.Two independent readers (Reader 1 and Reader 2) blindly and retrospectively analysised and classified the characteristic of microvascular patterns respectively,and Kappa test was used for evaluating the concordance between the two readers.The diagnosis accuracy of CEUS was calculated,and the CEUS diagnostic scores were compared with conventional ultrasound.Results 16 benign lesions and 56 malignant lesions were enrolled in this study.The microvascular patterns in benign lesions included branch enhancement(43.8 ％,31.3％),point and patchy enhancement (18.8％,25.0％) and rim-like enhancement (18.8％,18.8％).The microvascular patterns in malignant lesions included vascular enhancement (46.4％,57.1％),cotton enhancement (26.8％,25.0％) and dead wood enhancement (19.6％,8.9％).There was significant difference between benign and malignant lesions.Kappa result showed that the two readers had a good diagnosis concordance(Kappa=0.759,P =0.000).According to the different types of microvascular pattern,the diagnostic accuracy,sensitivity,and specificity rates of two readers were 92.9％,91.1％;81.3％,75.0％ and 90.3％,87.5％,respectively.Before CEUS,59.7％ and 68.1％ of lesions were diagnosed as 3 by two readers respectively,while only 1.4％ and 6.9％ of lesions were diagnosed as 3 after CEUS.Further analysis demonstrated that there was significant difference in the microvascular pattern between squamous carcinoma and adenocarcinoma,and also between squamous carcinoma and small cell lung carcinoma.Conclusions Contrast-enhanced ultrasound could significantly increase the differential diagnosis of peripheral lung lesions.New microvascular pattern helped to display patterns of vascular perfusion.of peripheral lung lesions,and provide new diagnostic clue for differential diagnosis.

OBJECTIVETo set up a mathematic model for determining individual risk and population risk of gastric carcinoma.

METHODSBased on principles and methods of probability and fuzzy mathematics, a case-control study was quantified and a mathematic model for the screening of gastric carcinoma was set up. Using two different calculation methods of weight coefficients, the thresholds were identified as 0.20 and 0.17, respectively. This mathematic model was then used to examine 63 cases and 693 normal persons.

RESULTSThe sensitivities and specificities were 69% and 63%. The different calculative methods of weight coefficients did not affect the results of the identification.

CONCLUSIONThe sensitivities and specificities were satisfactory indicating that it was convenient, feasible, economic and could meet the contented screening rate. It could be used to determinate the risk for gastric carcinoma both on individual and on population.

Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Male ; Mass Screening ; methods ; Models, Theoretical ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; Stomach Neoplasms ; epidemiology ; etiology ; prevention & control ; Surveys and Questionnaires