Base on the situations of urine analysis at home and abroad and the wrong tendency of neglecting the urine formed elements in routine test, the authors describe the clinical value and standard test protocol according to the national guideline, references, personal clinical practice and research findings. The authors also make comments on the advantages and disadvantages of microscopic analysis with a variety of instruments, and provide suggestions on how to strengthen the quality management of urine analysis in our couutry.

Objective To investigate the epidemiology of 10 000 patients with mammary gland disease.Methods 10 000 mammary gland disease cages during 1987～2006 in Yangquan Tumor Institute were collected,all patients had integrity case files and were diagnosed by molybdenum target radiography,near infrared ray,sonography,aspiration-needle biopsy or polyrrhea smear examination.Results In 8919 outpatient treated cases,7493 suffered cyclomastopathy(84%).1081 cases were inpatient cared(11%),the top five mammary gland disease are:breast cancer 342 cases,cyclomastopathy 252 cases,adenofibroma 104 cases,intraductal papilloma 86 cases and ductal ectasia 76 cages.For breast cancer patients,there were 125 cases during 1987～1996,3 were 21～30 years old and 23 were 31～40 years old.The number during 1997～2006 was 217,24 were 21～30 years old and 69 were 31～40 years old.Conclusion In 10000 cases,there are 7745 cyclomastopathy patients(77.45%)which takes the first place.Especially for 342(3.42%)breast cancer cases,the incidence grew up and patients age was much younger.

Endoscopic retrograde cholangiopancreatonraphy (ERCP) is the main treatment modality for common bile duct stone.Biliary hemorrhage easily occurred in patients suffering from cirrhosis during and after ERCP.From May 2012 to May 2016,8 cases diagnosed with cirrhosis and common bile duct stones who developed post-ERCP refractory biliary hemorrhage were treated with full-covered self-expanding removable metal stents (FCSERMS),including 5 cases with perioperative hemorrhage of ERCP and 3 cases with delayed onset of biliary hemorrhage post ERCP.All the patients were successfully implanted with FCSERMS.Seven patients had successful hemostasis,and the other one case with ineffective hemostasis was treated with interventional arterial embolization later.Four stents were removed within 4 weeks and one in 8 months after ERCP.No evidence of biliary hemorrhage,intestinal fistula and other complications was observed during removal procedures.Spontaneous stent dislodgment occurred in one patient in postoperative 4 weeks,one patient died of liver failure in postoperative 6 months and one patient carried FCSERMS for 23 months.

Objective To study the biocompatibility of carboxymethyl chitosan (CMCS) membrane with melanocytes from healthy human skin,and to investigate the feasibility to transport and carry melanocytes by using CMCS membrane.Methods CMCS membrane was prepared by a casting method combined with a glutaraldehydebased cross-linking method.Melanocytes were isolated from the foreskin of healthy men,and subjected to primary culture and subculture.The third-passage melanocytes were classified into two groups to be cultured on the CMCS membrane (test group) or traditional culture plates (control group).Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferative activity of melanocytes,and a sodium hydroxide-based lysis method to determine melanin content.HMB45 staining was conducted,and tyrosinase activity was estimated for melanocytes.Results Inverted microscopy showed that melanocytes were evenly distributed on the CMCS membrane with a normal shape.The melanocytes adherent to the CMCS membrane stained positive for anti-HMB45 monoclonal antibody.The growth curve of the melanocytes on the CMCS membrane,which was obtained from MTT assay,demonstrated that CMCS membrane could support the normal growth of melanocytes.No significant difference was observed between the test group and control group in melanin content (0.083 ± 0.015 vs.0.066 ± 0.008,t =2.38,P ＞ 0.01) or tyrosinase activity (0.234 ± 0.083 vs.0.241 ± 0.061,t =0.23,P ＞ 0.05).Conclusion CMCS membrane can maintain the normal biological activity of melanocytes and have good biocompatibility with skin melanocytes.

Objective To compare the value of ERCP plus EST and laparotomy in the treatment of common bile duct stones.Methods 56 cases of common bile duct stones were treated with ERCP and EST in our hospital from June 2012 to June 2013 (endoscopy group),78 cases were treated with laparotomy and common bile duct exploration (laparotomy group).The two groups were compared on success rate of stone removal,operation time,intraoperative bleeding volume,incidence of infection and pancreatitis and hyperamylasemia,common bile duct stone recurrence rate,hospital stays,hospital costs.Results Operation time,intraoperative bleeding volume and infection rate in endoscopic group was lower than the laparotomy group,the incidence of hyperamylasemia,hospital costs in the endoscopic group was higher than laparotomy group.The success rate of stone removal and the recurrence rate of common bile duct stone in the endoscopic group was lower than the laparotomy group,incidence of pancreatitis in the endoscopic group was higher than the laparotomy group,though the differences were not statistically significant.Conclusions ERCP and EST is a time saving procedure fast relieving the bile duct obstruction,less traumative,spelling lower infection rate,less hospital stays,though causing higher incidence of hyperamylasemia and hospital costs.

Objective To determine the biological reference interval of urinary conductivity in healthy people and to study the relationship between urine conductivity and other parameters as well as its clinical feasibility.Methods Conductivities of midstream urine specimen from healthy people (n=10119,5074 males and 5045 females,aged under 96 years) or patients with different diseases (n=3449) were determined.Among them the following parameters:conductivity,osmolality,specific gravity,creatinine,urea,uric acid,sodium,potassium and chloride of 250 random urine specimens were simultaneously determined.Results The urinary conductivities in healthy people exhibited normal distribution and significant differences were found in the subjects with different age and sex.The reference range of urinary conductivity was between 10.42?4.61 mS/ch and 24.10?6.81 mS/ch in healthy people and between 7.95 mS/ch?2.40 and 18.01?5.90 mS/ch in the patients with different diseases.Conductivity determined was positively correlated with osmolality (r:0.894),specific gravity (r:0.727),sodium (r:0.698),potassium (r:0.563),chloride (r:758),uric acid (r:0.521),urea (r:0.556) and creatinine (r:0.495).Conclusions Urine conductivity,which determination is simple and rapid,may reflect the conductive capacity of electrolytes in urine and positively correlated with osmolality,so it can be used as a new parameter for urinalysis to diagnose renal concentrative function in routine laboratory.

Objective To evaluate the accuracy and sensitivity of three techniques in the diagnosis of renal diseases following multiple myeloma. Methods 41 serum samples from the kidney-damaged patients with multiple myeloma and 36 from the control group with general renal diseases were detected by quantitative analysis of immunoglobulins, serum protein electrophoresis and serum Immunofixation Electrophoresis. The accuracy and sensitivity of the three techniques were analysed by Two-way ANOVA and Multiple Comparisons of the check-out rate of monoclonal immunoglobulin. Results No monoclonal components were checked out by quantitative analysis of immunoglobulins. The checkout rate of IgG and IgM myelomas were 100% by serum protein electrophoresis, which had application limit on other types of myelomas. Whereas all secretarial myelomas could be diagnosed and typied by Immunofixation Electrophoresis, the sensitivity and accuracy was 100%, there was no false positive in the control group. Comparing with quantitative analysis of immunoglobulins and serum protein electrophoresis, serum Immunofixation electrophoresis had higher sensitivity and accuracy in diagnosis of renal diseases following multiple myeloma ( P

This paper introduces the background, implication and construction of the county health services community (County medical alliance) model in Anhui Province under the background of new medical reform,and briefly introduces the relationship between medical insurance, enhancing the ability to upgrade and standardize services and medical treatment integration of the typical experience.It also analyses the challenges faced in the construction of medical syndicate, such as the mechanism of regional environmental restriction, compensation and assessment mechanisms which have not been established yet, and the sustainable development of information technology that has lagged behind, and put forward the policy suggestion to improve the construction of medical community, with a view to providing reference for the next work.

ObjectiveTo establish the proper review rules for the microscopic screening of urine samples tested by automatic urinalysis work station which is composed of LabUMat urine dry chemical analyzer and Urised urine sedimental analyzer.Methods The paired comparison was used to analyze the results tested by microscopy and Urised.A total of 2015 random urine samples were enrolled to establish and validate review rules.All the samples were collected from the inpatients and ontpatients of General Hospital of the People's Liberation Army from May to November 2011 and tested by urinalysis work station.2015 urine samples were firstly tested by urinalysis work station,including both urine dry chemical analyzer and urine sediments analyzer.Then each urine sample was examined microscopically by two technicians-in-charge using double-blind method.The average results from the two technicians were used as review results.Compared with review results,we set up the review rules and evaluated the Irue positive rate,false positive rate,true negative rate,false negative rate (omission diagnostic rate) and review rate.According to different test methods by automatic urinalysis work station,four microscopic review protocols were defined:( 1 ) Protocol 1:based on chemistry results only,microscopy review was performed when any of WBC,RBC,PRO and NIT was positive; (2) Protocol 2:based on urine sedimental analysis only,microscopy review was performed when any of WBC,RBC and CAST count was over upper limit of the reference range ; (3) Protocol 3:if any of BLD vs.RBC,LEU vs.WBC was different between two systems,or quantitative results had two or more than two gradient differences,microscopy review was performed; (4) Protocol 4:if any of BLD vs.RBC,LEU vs.WBC was different between two systems,or CAST was over upper limit of the reference range,or alam appeared,microscopic review was performed.300 randomly selected urine samples were tested to validate the review rules.Omission diagnostic rate and review rate were used to evaluate the rules.Results According to our review rules,the positive samples rate was 41.14％ (829/2015) and the negative rate was 58.86％ ( 1186/2015 ) ; Positive samples were composed of RBC (50.30％),WBC (53.32％) and CAST (3.74％).The review rates of four protocols were 42.93％ (865/2015),39.70％ (810/2015),29.58％(596/2015),18.91％ (381/2015 ),respectively.The false negative rates (omission diagnostic rates) were 6.36％ (128/2015),4.42％ (89/2015),1.34％ (27/2015)and 1.04％ (21/2015)respectively.Protocol 4 was selected as an ideal plan.Additional 300 urine samples were tested using protocol 4 in order to confirm the review rule.The review rate,consistency rate,true positive rate,false positive rate,true negative rate,omission diagnostic rate were 19.67％ (59/300),91.67％ (275/300),35.67％ (107/300),7.67％(23/300),56.00％ (168/300),0.67％ (2/300),respectively.After image review revised,the review rate was 8.67％ (26/300).ConclusionThe review rules established by our research for Urinalysis Work Station can find the abnormal urine samples effectively and exactly and can reduce the workload significantly.(Chin J Lab Med,2012,35:810-814)

Objective To establish L4 vertebrae burst fractures and take a biomechanical test of different internal fixations so as to discuss the significance of internal fixation using short-segment plus Index-level screws in treatment of low lumbar burst fractures.Methods Ten fresh human lumbosacral vertebrae specimens were used to establish models of L4 vertebrae burst fractures by corpectomy and partial removal of ligament.Thereafter,the biomechanical test was performed in order as below:longsegment fixation,short-segment fixation and short-segment construction plus Index-level screw fixation.Differences of range of motion (ROM) of the lumbar after three different internal fixations were compared.Results Compared with short-segment fixation,short-segment plus Index-level screw fixation showed that ROM of the lumbar was decreased in front flexion,axial rotation and lateral bending (P ＜ 0.05),but stability was improved and ROM of lumbar was decreased by 32.7％ in back extension (P ＞ 0.05).Conclusions Compared with short-segment fixation,the short-segment plus Index-level screw fixation can increase initial lumbar stability by average 32.5％ in treatment of low lumbar burst fractures.In the meantime,short-segment plus Index-level screw fixation provides larger ROM of the lumbar than the long-segment fixation.