Blood samples were detected by 24 blood-glucose meters using glucose oxidase and another 18 glucose meters using glucose dehydrogenase. The plasma glucose was detected by the auto-chemistry analyzer as control. According to ISO1 5197 and EF9-A2, the bias of results from both glucose meters 100% fall in the range of ±0. 56 mmol/L( ＜4. 2 mmol/L) and ≥99. 7% in the range of ±20% ( ≥4. 2 mmol/L), predicted bias were all less than the true bias(Bc). As κ＞0. 6, the results from both glucose meters were in accordance with the results from autochemistry analyzer in judging hyperglycemia ( ＞6. 11 mmol/L) and hypoglycemia ( ＜ 3.89 mmol/L). Between the results from the two blood-glucose meters, κ＜0. 6. The accuracy of both glucose-meters are accepted for the purpose of clinical diagnosis and treatment.

Corresponding author: SONG Guang yao Human umbilical venous endothelial cells (HUVEC) were incubated with free fatty acids (FFAs) of various degrees of saturation. C18:1 and C18:2 inhibited the synthesis of nitric oxide (NO) and endothelin (ET) in HUVEC, and ET synthesis was inhibited much more than NO synthesis, and C18:0 increased ET synthesis in HUVEC, suggesting that the effects of FFAs on HUVEC were related to their degree of saturation.

Objective:To describe clinical characteristics, genetic mutation and therapeutic response of a family diagnosed as slow-channel congenital myasthenia syndrome (SCCMS) and analyze the factors of the efficacy of channel blockers therapy.Methods:Clinical data and therapeutic response in three patients from a family of SCCMS from Department of Neurology, Xuanwu Hospital, Capital Medical University in May 2017 were collected. The clinical data, mutations and response to therapy of all literature SCCMS cases in the English database of Pubmed and Chinese database of Wanfang until December 31, 2018 were analyzed statistically.Results:The proband was a 48-year-old female who referred to Xuanwu Hospital for limb weakness for 40 years. The proband′s elder daughter presented with onset of the birth and delayed motor milestones, scoliosis and difficulty in walking. The younger daughter was born healthy with normal motor milestones, while fatigue and weakness gradually appeared. The antibodies of myasthenia gravis were negative. No repetitive compound muscle action potentials (CMAP) were detected in three patients. Repetitive nerve stimulation showed decrements. Gene test revealed heterozygous mutation of CHRNE p.εV279F, a known pathogenic mutation of SCCMS. Seventeen SCCMS cases were reported in literature. A total of 20 patients with SCCMS were described in terms of clinical manifestation, mutation, drug therapy and efficacy in detail. According to the literature description, they were divided into significant benefit group and mild to modest benefit group to channel blocker therapy. The age of onset in 10 patients with significant benefit was 1.50 (0.75, 28.25) years from birth to 43 years, and that in 10 patients with mild to modest benefit was 2.50 (0, 6.25) years from birth to 11 years. There was no significant difference between the two groups. The age at the initial channel blocker therapy in the group with significant benefit was (23.40±13.29) years from 12 to 43 years, whereas that in the group with mild to modest benefit was (34.10±13.43) years from 20 to 62 years, and there was no significant difference between the two groups. The delay time of treatment (age at the beginning of treatment with channel blockers-age of onset) in patients with significant benefit was 13.0 (10.25, 15.00) years, which was 32.50 (19.25, 38.00) years in patients with mild to modest benefit ( Z=-3.374, P=0.000). According to the response of cholinesterase inhibitor, eight patients were in the effective group, 10 patients were in the ineffective group and two patients were without cholinesterase inhibitor. The age of onset in the effective group was 0 (0, 4.75) years, while that in the ineffective group was 6.50 (1.00, 28.25) years ( Z=-2.315, P=0.021).The age of treatment with channel blockers was (27.90±12.99) years in the effective group and (32.00±13.21) years in the ineffective group, and there was no significant difference between the two groups. The delay time of channel blocker treatment in effective group was (30.25±11.07) years, while that in ineffective group was (14.30±9.60) years ( t=-3.274, P=0.005). Conclusions:In SCCMS, the effect of channel blockers was related to the delay time of treatment. Channel blocker was more effective the sooner it was started after the onset of symptoms. The average age of onset of SCCMS patients with positive responses to cholinesterase inhibitor was younger, but the delay time of channel blocker therapy was longer, resulting in poor therapeutic effect.

Objective: To study the learning curve of laparoscopic pacreaticoduodenectomy (LPD) with a view to find an appropriate way to develop LPD step by step. Methods: 112 consecutive patients who completely underwent LPD in a single surgery center at the First People’s Hospital of Changzhou from December 2015 to February 2018 were retrospectively reviewed. By using both the cumulative sum (CUSUM) and the risk-adjusted CUSUM (RA-CUSUM) methods to analyze the perioperative data of these patients, the learning curve of LPD was studied in a more scientific way. Results: The learning curve could be divided into three phases: Phase 1, the initial period (the initial 45 patients); Phase 2, the enhancement period (the subsequent 31 patients); Phase 3, the maturation period (the remaining patients). For these 3 phases, the corresponding operative times were (448.4±75.0), (381.3±74.3), and (336.2±52.1) min, respectively (P<0.05). The intraoperative blood losses were (373.3±250.1), (332.3±211.6), and (265.3±253.2) ml, respectively (P<0.05). The times to oral intake were 6.0(5.0, 8.0), 5.0(3.0, 6.0), and 3.0(3.0, 5.0) days, respectively (P<0.05). The number of lymph nodes harvested were (10.0±7.0), (8.8±4.3), and (13.3±6.2), respectively (P<0.05). All these showed significant improvement through the 3 phases. On the other hand, the postoperative stays, the postoperative pancreatic fistula rates were also decreased. But these failed to reach statistical significance. Vascular reconstruction was carried out in the 48th patient in phase 2 of the study. Conclusions The initial phase of LPD passed after LPD for 46 patients, but the maturation phase occurred after LPD on 76 patients. Vascular reconstruction should be considered as passing through the learning phase rather than reaching the maturity phase. Adjustments made in the enhancement phase helped to get through the maturation phase earlier.

Objective:To summarize the clinical and genetic characteristics in patients with transthyretin familial amyloid polyneuropathy (TTR-FAP).Methods:Fourteen unrelated TTR-FAP patients diagnosed at Xuanwu Hospital, Capital Medical University from September 2014 to February 2022 were retrospectively reviewed. The clinical manifestation, electrophysiology, cardiac function, biopsy and gene mutation were analyzed.Results:In the 14 patients (13 males, 1 female) diagnosed as TTR-FAP, the mean age at onset was 53.9 years (range: 33.0-71.0 years), with a mean course from symptom-onset to diagnosis of 4.1 years. The late-onset type occurred in 9 cases. Seven patients had a family history of TTR-FAP. Distal paresthesia of lower limbs was the commonest initial symptom (8 cases), with sensorimotor neuropathy and autonomic dysfunction seen initially in 4 and 2 cases, respectively. Cardiac involvement occurred in 6/8 of the patients. Nerve conduction studies indicated extremely axonal impairment with demyelinating features. Sural nerve biopsies showed moderate to severe axonal loss of myelinated fibers and the positive rate of Congo red staining was 8/14. Of 8 different TTR mutations detected, V50M was the most common (appearing in 5 cases). No obvious neuropathy progression was seen in the 5 patients who received tafamidis and 2 patients died of dyscrasia. Conclusions:TTR-FAP is more common in males, with sensorimotor axonal polyneuropathy, autonomic dysfunction and cardiac subclinical damage as the predominant symptoms. V50M is the commonest mutation. Tafamidis can delay the progression of disability.

Objective Photoelectric volumetric tracing(PPG)exhibits high sensitivity and specificity in flap monitoring.Deep learning(DL)is capable of automatically and robustly extracting features from raw data.In this study,we propose combining PPG with 1D convolutional neural networks(1D-CNN)to preliminarily explore the method's ability to distinguish the degree of embolism and to localize the embolic site in skin flap arteries.Methods Data were collected under normal conditions and various embolic scenarios by creating vascular emboli in a dermatome artery model and a rabbit dermatome model.These datasets were then trained,validated,and tested using 1D-CNN.Results As the degree of arterial embolization increased,the PPG amplitude upstream of the embolization site progressively increased,while the downstream amplitude progressively decreased,and the gap between the upstream and downstream amplitudes at the embolization site progressively widened.1D-CNN was evaluated in the skin flap arterial model and rabbit skin flap model,achieving average accuracies of 98.36%and 95.90%,respectively.Conclusion The combined monitoring approach of DL and PPG can effectively identify the degree of embolism and locate the embolic site within the skin flap artery.

Objective:To evaluate the performance of key performance indicator (KPI) lean teaching management system in clinical medical laboratory.Methods:Combining lean teaching management in universities with KPI system of enterprises, an innovative KPI lean teaching management system was developed and applied in Clinical Medical Laboratory of Guangdong Provincial People′s Hospital (GDPH). A total of 106 teachers, who had worked from January 2021 to December 2022 in GDPH, joined this study. Teachers were divided into 8 professional groups. Firstly, we quantified the teaching workload by class hours, evaluated the teaching outcomes base on national, provincial, school, and college levels to assign different teaching points, and linked the teaching KPI scores to the evaluation, salary, and professional title of teachers. Then, we analyzed the overall teaching points and teaching points for each professional group (2021-2022). Finally, we asked teaching managers, teachers, and colleagues to evaluate the KPI lean teaching management system and compared the effects before and after the implementation of this system.Results:Compared with 2021, the teaching scores of 106 teachers increased significantly from 1.0 (0.2, 2.7) to 3.8 (2.3, 6.0) in 2022 ( Z=8.1, P<0.01). The teaching scores of clinical molecules, clinical coagulation, clinical immunology, clinical microbiology, Huifu laboratory, and clinical biochemistry group were significantly higher in 2022 than the scores they got in 2021 (all P<0.05). Compared with 2021, there were 3 new set up of educational reform projects, 2 submitted teaching articles, 3 new competition awards, 7 outstanding teachers, and 5 outstanding students in 2022. After application of KPI lean teaching management, the evaluation scores of teaching work by teaching managers, teachers, and colleagues are all significantly improved ( P<0.05). Conclusion:KPI lean teaching management system could effectively enhance teachers′ work initiative, improve teaching efficiency and outcome, and promote the teaching quality. Therefore, based on the performance of KPI lean teaching management system in our study, it is possible to realize its potential in terms of lean management in clinical medical laboratory.

OBJECTIVE: To investigate the effect of dexmedetomidine (DEX) on renal function after laparoscopic radical nephrectomy. METHODS: We reviewed the clinical data of 282 patients with renal cell carcinoma (RCC), who underwent laparoscopic radical nephrectomy (LRN) in the Department of Urology, Third Medical Center of PLA General Hospital from November, 2020 and June, 2022.According to whether DEX was used during the operation, the patients were divided into DEX group and control group, and after propensity score matching, 99 patients were finally enrolled in each group.The incidence of acute kidney injuries were compared between the two groups.Serum creatinine (sCr) data within 3 months to 1 year after the operation were available in 51 patients, including 26 in DEX group and 25 in the control group, and the incidence of chronic kidney disease (CKD) was compared between the two groups. RESULTS: After propensity score matching and adjustment for significant covariates, there were no significant differences in postoperative levels of sCr, cystatin C (CysC), β2-microglobulin (β2-MG), hemoglobin (Hb), or C-reactive protein (CRP), extubation time, incidence of AKI, or length of hospital stay between the two groups (P>0.05).The intraoperative urine volume was significantly higher in DEX group than in the control group (P < 0.05).A significant correlation between AKI and CKD was noted in the patients (P < 0.05).The incidence of CKD did not differ significantly between the two groups (P>0.05). CONCLUSION DEX can not reduce the incidence of AKI or CKD after LRN.
Humans ; Dexmedetomidine ; Incidence ; Propensity Score ; Renal Insufficiency, Chronic/epidemiology* ; Kidney Neoplasms/surgery* ; Nephrectomy/adverse effects* ; Laparoscopy/adverse effects* ; Acute Kidney Injury/prevention & control* ; Retrospective Studies