Definiting the workflow and key link of the risk management in medical laboratory by FMEA.Identifying risk factors of the workflow and key link of blood coagulation test by the criteria for laboratory accreditation , such as ISO15189 recognition criteria and CAP laboratory accreditation inspection . Through the evaluation of the blood coagulation test , effective corrective actions and examining performance data periodically , the quality of the blood coagulation test can be improved continuously.

Objective To evaluate the advantages and disadvantages of Narcotrend(NT)in monitoring the depth of anesthesia when compared with the bispectral index.Methods Eighty ASA Ⅰ or Ⅱ patients of both sexes,aged 19-60 yr,undergoing elective surgery,were enrolled in this clinical study.Propofol was given by target-controlled infusion(TCI).After the initial target plasma concentration of 2.1 μg/ml was achieved,the concentration was increased by 0.3 μg/ml every 30 s until the patients lost consciousness.Then the effect-site concentralion of propofol was increased by 0.5μg/ml to maintain anesthesia and rocuronium 0.8 mg /kg was injected intravenously 30 s later.Tracheal intubation was performed 3 min after rocuronium injection.Mean arterial pressure (MAP),HR,NT value and BIS value were measured before TCI of propofol(baseline),al loss of consciousness,immediately before rocuronium administration,2 min after rocuronium administration,during intubation,and at 1 and 3 min after intubation.Results NT and BIS values were significantly decreased at loss of consciousness as compared with the baseline value(P ＜ 0.01).NT and BIS values were significantly lower at 2 min after rcuronium administration than before rocuronium administration(P ＜ 0.05).Compared with that before intubalion,HR and MAP were significantly increased during intuhation,and at 1 and 3 min after intubation,while no significant change was found in NT and BIS values(P ＞ 0.05).Conctusion NT can monitor the sedative effecl induced with TCI of propofol accuralely,the myoelectric activity exerts an obvious effect,and the accuracy of NT for monitoring the analgesic effect is lower.NT and BIS are comparable with respect to the advantages and disadvantages.

Objective To study the operative methods and surgical technique of arthroscopical meniscal suture in treatment of meniscal tears under local anesthesia. Methods From February 1999 to November 2003, we cure 32 patients (22 males and 10 females) with this method. The patients' average age is 29. Results All of the patients accept the operation through arthroscopy under local anesthesia. The procedure last 50 minutes on an average. 92% of the patients gain good results, no severe complications. Conclusion This method has the advantages of less pain, time saving(save time), quick recovery and less complications.

Objective To assess the diagnostic value of dynamic contrast enhanced MR imaging in predicting the efficacy of distinguishing benign from malignant soft tissue tumor Methods Dynamic contrast enhanced MR imaging was performed in 30 patients with pathologically confirmed soft tissue tumors The MR signal intensity of the ROI was plotted The slope value of the time intensity curve was analyzed Results There was significant difference between the slope value of benign and malignant lesions Based on the slope value of half minute, differentiation of benign from malignant lesions was possible with 90 9% of the sensitivity, 89 4% of the specificity, 83 3% of the positive predictive value and 94 4% of the negative predictive value Conclusion Dynamic contrast enhance MR imaging can correctly predict benignity or malignance of soft tissue tumors

Objective To clone human autoimmune antigen SSA/Ro60 and to purify its expression to provide the material basis for the assisted diagnosis of human autoimmune diseases .Methods The SSA/Ro60 gene was cloned by RT‐PCR and directionally inserted into expression vector pPICZ .The recombinant plasmid was transformed into Pichia SMD1168 .The obtained recombinant protein was identified by SDS‐PAGE and Western blotting .Results The amplified full‐length sequence was about 1 .5 kb in size . The pPICZ‐SSA positive clone produced a 60 × 103 recombinant protein which had natural immunogenicity of human autoimmune antigen SSA/Ro60 by SDS‐PAGE and Western blot .Conclusion Human autoimmune antigen SSA/Ro60 is successfully cloned and expressed ,which lays a foundation for diagnosing autoimmune diseases .

Objective To study the influence of different routes of keyhole limpet hemocyanin ( KLH) immuniza-tion on the T-cell-dependent antibody response in mice.Methods SPF Kunming mice were divided into four groups: the intravenous injection group, subcutaneous injection group, intraperitoneal injection group and control group.Each mouse was injected 200 μg KLH intravenously, subcutaneously or intraperitoneally daily for consecutive 10 days, respectively. Mice in the control group were given solvent injection only.Serum concentration of IgG stimulated by KLH antigen was measured 7 days after the last dosing.Spleen was isolated to calculate the organ coefficient and examined by pathology u-sing hematoxylin and eosin staining.Results Intravenously, subcutaneously and intraperitoneally administered KLH stimu-lated the generation of secondary lymphoid follicles and germinal center to varying degrees, B cell apoptosis, increased a-mount of cells in the marginal zone and other pathological changes were observed in the spleen.Intravenous and intraperito-neal administration of KLH led to more pronounced pathological changes compared with that in the subcutaneous injection group.All of the three administration routes of KLH induced generation of IgG antibody, significantly higher than that in the control group (P<0.05).Intravenous injection of KLH generated the highest concentration of IgG and organ coefficient among the three administration routes ( P<0.05) .Conclusions Different immunization routes do affect the production of IgG antibody, organ coefficient and pathological changes in the spleen, and these differences should be taken into consider-ation when analyzing the T cell dependent antibody response in mice.

Objective To investigate inhibitory effect of Telmisartan on carotid arterial intima-media thickness in patients with essential hypertension. Methods 104 patients with mild or mid essential hypertension were randomly divided into three groups, which include telmisartan group( telmisartan 80 mg/d PO), ramipril group( ramipril 5 mg/d PO), and control group( other anti-hypertension agents). Blood pressure was monitored during treatment. Carotid arterial intima-media thickness(CIMT) were measured in all patients at beginning and patients who had the 12 months course. Results There were 91 patients who had the 12 months course,which include telmisartan group33 cases,ramipril group28 cases, and control 30 cases. The CIMT was significantly decreased in telmisartan group and ramipril group ( all P < 0. 05 ), and not changed in control while blood pressure fall effectively. In ramipril, group5 cases were ceased the course because of severe cough. Conclusion Both telmisartan and ramipril could decrease blood pressure and CIMT effectively, and there were less side effects in telmisartan group.

Objective:To investigate the effects of IL-18BP blockade on apoptosis of synovial cell in IL-18 induced Collagen-induced-arthritis(CIA) in mice and its possible mechanism.Methods: CIA mice were established by freund′s complete adjuvant,and divided into 5 groups:normal group,CIA model group,IL-18-CIA group,MTX group and IL-18BP group,each for 10,total 50 mice.The expression of Fas and FasL in the synovial tissue of the left posterior ankle joint taken from each group were detected by immunohistochemistry analysis.Results: IL-18BP group compared with the model group,the mice of joint swelling was inhibited,the expression level of Fas and FasL increased significantly,the difference was statistically significant (P<0.01);IL-18BP group has a significant curative effect and basically recovered to normal level(P<0.05).Conclusion: IL-18BP can promote the apoptosis of synoviocytes by regulating the expression of apoptosis genes Fas and FasL,which is helpful for the treatment of rheumatoid arthritis.

Objective To research the 50% effective anesthetic volume ( EAV50) of 0.5% ropivacaine in nerve stimulator-guided vertical infraclavicular brachial plexus block. Methods Thirty patients scheduled for forearm or hand surgery were blocked using 0. 5% ropivacaine in nerve stimulator-guided vertical infraclavicular brachial plexus block. The EAV50, which is the anesthetic volume corresponding to 50% success and 50% failure was determined by up-and-down sequential test. The starting dose of 0. 5% ropivacaine was 0. 55ml/kg. Block failure resulted in a dose increase 110% , and block success in a reduction 110%. The sensory and motor blockade were accessed at 5- min intervals (up to 60 min). Results In nerve stimulator-guided vertical infraclavicular brachial plexus block, EAV50 for 0.5% ropivacaine was 0.417ml/kg. In up-and-down sequential test, there were significantly different in the block success rates of lateral, medial and posterior cord ( P <0.01). Conclusion In nerve stimulator-guided vertical infraclavicular brachial plexus block, enough anesthetic volume must be given to increase block success rates of all the cords of brachial plexus, and EAV50 for 0. 5% ropivacaine was 0.417ml/kg.

Objective To observe the influence of Shenkang injection with Irbesartan on urinary albumin excretion rate(UAER)in 24 hours,serum lipid and blood rheology in early diabetic nephropathy.Methods One hundred and fifty normotensive early diabetic nephmpathy were randomly divided into control group,Shenkang injection group and Shenkang injection with Irbesartan group.Three groups were treated with diabetic education,dietary regimen,suitable physical activity and oral anti-hyperglycemic agents till their fasting blood glucose(FBG)was less than 7.0 mmol/L and postprandial blood glucose(PBG)was less than 10.0 mmol/L.The control group was treated with oral anti-hyperglycemic agents or/and insulin.Shenkang injection group was additionally treated with Shenkang solution.Shenkang solution was mixed by Shenkang injection 100 ml,5% glucose 250 ml and insulin 2-3 U.Shenkang solution was intravenously guttaed once a day.Shenkang injection with Irbesartan group was additionally treated with Irbesartan 0.15 g,once a day,taken orally.A course was taken for 3 weeks.The levels of UAER,serum lipid and blood rheology were detected immediately and 9 weeks after treatment.Results In the Shenkang injection group,compared with those before treatment,them were significant difference in UAER (87.44 ±10.06)μg/min vs.(116.55 ± 33.42)μg/min),serum lipid( (4.22 ± 0.70)mmol/L vs.(4.88 ± 0.69 )mmol/L)and blood rheology( (5.77 ±0.53)mPa·s vs.(7.38 ± 0.41)mPa·s)(P ＜ 0.05).In the Shenkang injection with Irbesartan group,compared to those before treatment,there were also significant difference in UAER ( (61.90 ±28.02)μg/min vs.(123.37 ± 29.98)μg/min),serum lipid( (4.00 ± 0.14)mmol/L vs.(4.90 ± 0.12)mmol/L)and blood rheology( (5.11 ±0.41)mPa·s vs.(7.27 ± 0.44)mpa·s)(P ＜ 0.05).Whearas in the control group,no significant difference were found compared with those before treatment.Furthermore,the improvements in the Shenkang injection with Irbesartan group were better than those in the Shenkang injection group(P ＜ 0.05).Conclusions Shenkang injection can reduce UAER,decrease serum lipid and improve renal blood rheology.Iteffectively prevents diabetic nephropathy in earlier period and maybe have synergy with Irbesartan.