Introduction to the content design, selection and implementation method of the simulation exercise test method for work quality of clinical laboratories,and a comparison with traditional control method.It is held that the method is advantageous in artificial impact factors as necessary and whole-process tracing,and it tests not only the outcomes,but also all steps in the workflow,and can avoid man-made interference.

A new solid-phase BA-ELISA-spot assay is described for detection and enumera-tion of antigen specific antibody secreting cells.Spleen cells from immunized mice areincubated in plstic wells precoated with specific an tigen.After removal of the cells,immobilized antibodies at the point of release from single cell are demonstrated bymeans of an immunenzyme procedure in which.enzyme-substrate(HRP-TMB)reactionsare performed.Blue spots are thus produced and counted with naked eye.

Objective To explore the mRNA expressions of NLRP1 (NOD-like receptor 1 ) and NLRP3 inflammasomescomponents and related pro-inflammation cytokines in peripheral blood mononuclear cells (PBMCs).Methods A total of 21 septic patients,20 non-infectious SIRS patients and 20 health subjects were enrolled in this study.The mRNA expressions of inflammasomes components and related proinflammation cytokines were measured by using RT-PCR,and serum levels of IL-1β and IL-18 were measured using ELISA.One-way ANOVA was usedd to compare the data of all three groups,and SNK-q was employed to compare thedata among different groups.Spearman correlation analysis was used to analyze the correlation between these biomarkers and the severity of septic patients.Results ①The mRNA expression of NLRP1 in PBMCs of septic patients in early stage and non-infectious SIRS patients was down-regulated in comparison with healthy subjects (P ＜0.01 ).The expression of NLRP3 in septic patients was not differentfrom that in healthy subjects ( P ＞ 0.05 ),but NLRP3 mRNA expression in non-infectious SIRS patients was significantly higher than that in septic patients and in healthy subjects ( P ＜ 0.01 ).ASC ( apoptosis associated speck like protein containing a CARD) and caspase-1 mRNA expressions in septic patients and non-infectious SIRS patients were higher than those in healthy subjects ( P ＜ 0.01 ).There was no difference in level of IL-1β found among all groups.IL-18 mRNA expression in septic patients and non-infectious SIRS patients was higher than that in healthy subjects ( P ＜ 0.01 ),and that in non-infectious SIRS patients was highest.②)Serum protein level of IL-1β in septic patients was lower than that in healthy subjects (P ＜0.05 ),and serum level of IL-18 in septic patients was significantly higher than that in non-infectious SIRS patients and in healthy subjects ( P ＜ 0.01 ).③NLRP1 was negatively related to SOFA ( sepsis-related organ failure assessment) score (r =-0.44,P ＜ 0.05 ) and negatively related to APACHE Ⅱ score as well ( r =- 0.52,P ＜ 0.05 ).Conclusions NLRP1 mRNA expression was down regulated in patients with early sepsis and its expression was negatively correlated to the severity of septic patients,indicating the lower NLRP1 mRNA expression the severer illness.

Malignant tumors are the most common lethal diseases in China.Because of complexity of etiology and pathogenesis , and the lack of specific markers for early diagnosis , delayed diagnosis and treatment of cancer , the fatality rate is high.With the development of basic research , more and more early specific markers were found , but the current detection mostly depend on the professional laboratories , time-consuming , high price and have a number of inconveniences to patients on time and money.Meanwhile , it′s difficult to extend to zoon of medicine resources deficient.Recently, point-of-care testing (POCT) has been rapidly developed , because of its portability , getting results quickly , can be operated in basic medical units and economic backward areas , so it′s benefit to cancer screening in human.By the application in tumor markers, POCT can be done for the cancer early detection , early diagnosis and early treatment , so then cuts the death rate.

Objective To investigate the apoptotic effect induced by sulfur mustard on the lymphocytes of the rat spleen,and define the role of caspase-3 during the process.Methods Sulfur mustard was given by intraperitoneal injection in a dose of 3.5mg/kg.The animals were anesthetized and the spleens were harvested at different timepoints after intoxication.The histopathogy of spleen was studied with hematoxylin-eosin staining.Caspase-3 mRNA was detected with RT-PCR.Protein expression of caspase-3 was assayed with Western blotting,lymphocytes of rat spleen were isolated and cultured in vitro and they were challenged with sulfur mustard(100?mol/L).The effect of Ac-DEVD-CHO(a specific inhibitor of caspase-3)on sulfur mustard-induced apoptosis of the lymphocytes cultured in vitro was evaluated.Fluorescent probe labeled with Rhodamine 123 was used to study mitochondrial potential.Results The histology of rat spleen was affected after sulfur mustard intoxication,as evidenced by apoptosis of a part of lymphocytes.Protein and mRNA expressions of caspase-3 were increased significantly in the spleens of intoxicated rats as compared with that in control group.DNA ladder and 'sub-G1' peak of lymphocytes which were treated with sulfur mustard in vitro were partially improved by Ac-DEVD-CHO(the specific inhibitor of caspase-3).In addition,mitochondrial potential decreased in a time-dependent manner in the lymphocytes intoxicated by sulfur mustard in vitro compared with that in the control group.Conclusions The spleen is injured in the rat which is intoxicated by sulfur mustard.Lymphocyte apoptosis is one of the mechanisms splenic injury.Caspase-3 may be involved in the process of lymphocyte apoptosis induced by sulfur mustard.

Objective To study the toxic effects of Rotenone on glutamate transporter and glutamine synthetase in rat brain.Methods The glutamate levels in the striatum of SD rats were detected by high performance liquid chromatography(HPLC),the expression of glutamate tansporter mRNA and proteins were detected by RT-PCR and Western blotting and the activity of glutamine synthetase was determined by using GS detect kit.Results Rotenone was shown to increase the release of glutamate in rat striatum,the expression of glutamate/aspartate transporter(GLAST)mRNA and protein decreased significantly in 0.6 mg/kg and 1.2 mg/kg Rotenone intoxicated groups,but the expression of GLT-1 and the activity of GS enhanced obviously.Conclusion Down-regulation of GLAST may be responsible for increased Glu level in rat brain induced by Rotenone,but the increased expression of GLT-1 and GS activity may represent a protective mechanism of the brain cells by limiting the neurotoxicity of Glu.

Correctly grasping the International Classification of Diseases ICD-10 and surgical classification ICD-9-CM-3 encoding method to improve coding accuracy and professional level is increasingly important to the current hospital information management.Through systematic continuing education training,the relevant personnel should be familiar with ICD-10 and ICD-9-CM-3 encoding rules,and continue to accumulate the appropriate clinical knowledge to improve their own coding levels.Coders should be a basis,six fits,that is based on the international classification of diseases and operation classification coding rules,coders should rcad more medical records,have more communication with clinicians,understand clinical medical knowledge,do more book search query for [CD code,sum up coding experience and multiply track the latest development of medicine and ICD coding.

In recent years,stem cell transplantation for the treatment of ischemic stroke has become a hot topic.However,since embryonic stem cells (ESCs) transplantation is limited by the ethics and law,stem cell research was once in trouble.Induced pluripotent stem cells (iPSCs) are a class of cells by introducing the specific transcription factors into somatic cells,which have the similar characteristics with ESCs,and also avoid the ethical issues and immunological rejection,making them become the most ideal replacer of ESCs.Although the current research on iPSCs has made some progress,their induction efficiency and safety issues remain to be resolved.This article reviews the status quo,mechanisms,and problems faced in clinical practice for iPSCs transplantation in the treatment of ischemic stroke.

Objective To investigate the expression of STAT3 signaling pathway genes including Survivin and COX-2 in cholangiocarcinoma,as well as the relationship between expression of these genes and prognosis of patients with cholangiocarcinoma.Methods The tumor and normal tissue samples were respectively collected from 43 patients with cholangiocarcinoma and 12 patients with intra-and extrahepatic bile duct stones or hepatic duct injury in the Affiliated Provincial Hospital of Anhui Medical University from September 2007 to July 2012.The expression of STAT3,phosphorylated-STAT3 (p-STAT3),Survivin and COX-2 were examined using immunohistochemistry,and the relationship between the expression of these genes and the clinical pathological features and prognosis of patients with cholangiocarcinoma was analyzed.Patients were followed-up through outpatient examination and telephone interview until March 2014.Categorical data were analyzed using the chi-square test.Correlation analysis was done by Spearman's method.The survival curve was generated using the Kaplan-Meier method,and the survival analysis was conducted using the log-rank test.Results The positive expression rates of STAT3,p-STAT3,Survivin and COX-2 in the tumor samples were 69.8％ (30/43),65.1％ (28/43),72.1％ (31/43),79.1％ (34/43),respectively,which were compared with 41.7％ (5/12),8.3％ (1/12),16.7％ (2/12) and 41.7％ (5/12) in the normal tissue samples,showing a significant difference for the last 3 indexes (x2=12.136,9.811,4.679,P ＜ 0.05).Overexpression of p-STAT3,Survivin and COX-2 protein was correlated with lymph node metastasis (x2 =14.700,5.959,4.075,P ＜ 0.05).Overexpression of p-STAT3 was also related to neural invasion (x2=10.384,P ＜ 0.05).Expression of Survival and COX-2 protein was not associated with lymph invasion (x2=2.718,3.024,P ＞ 0.05).Expression of p-STAT3,Survivin and COX-2 was however not associated with gender,age and tumor location,differentiation and diameter (x2=0.148,0.720,1.835,1.040,0.236 ; 0.001,0.009,0.029,1.863,0.197 ; 0.433,0.686,0.002,2.974,0.029,P ＞ 0.05).Expression of Survivin and COX-2 protein was positively correlated to p-STAT3 protein (r =0.524,0.583,P ＜ 0.05).All the 43 patients were followed up for 6-60 months.Among the 17 patients with hilar cholangiocarcinoma,the median survival time was 7,9,9 months for patients with positive expression of p-STAT3,Survivin and COX-2 protein,compared with 18,11 and 11 months for patients with negative expression of these proteins.The survival rates of the patients with positive and negative expression of p-STAT3 protein were 33.3％ and 68.6％,respectively,with a statistical significance for p-STAT3 protein (x2=12.916,P ＜ 0.05).Of the remaining 26 patients with common bile duct carcinoma,the median survival time was 9,10 and 9 months for patients with positive expression of p-STAT3,Survivin and COX-2 protein,compared with 20,20 and 20 months for patients with negative expression of these proteins.The survival rates of the patients with positive expression of p-STAT3,Survivin and COX-2 protein were 20.8％,9.4％ and 8.5％,which were lower than 37.5％,37.5％ and 50.0％ of patients with the negative expression of these proteins,with a statically significance for all the 3 proteins (x2=12.787,6.245,11.161,P ＜ 0.05).Conclusions The p-STAT3,Survivin,COX-2 proteins are highly expressed in the cholangiocarcinoma and the expression levels of these proteins are positively correlated.The survivin and COX-2 may be the downstream genes of STAT signaling pathway,which are involved in the progression and prognosis of cholangiocarcinoma.

Objective To investigate the feasibility of mean wave intensity (MWI), W1 and W2 in assessing the function of common carotid artery (CCA) before and after cold presser test with wave intensity analysis. Methods Twenty-four healthy subjects were enrolled. The W1, W2, and other parameters of blood flow in resting, before and after cold presser test of CCA, the inner diameter different rate and MWI of blood flow were calculated respectively. The receiver operation characteristic (ROC) curves were drawn, and of the effectiveness of MWI, W1 and W2 was compared. Results The different rate of diameters and W1 decreased significantly when subjects underwent cold presser test (P＜0.05), but MWI and W2 increased significantly (P＜0.05). The area under ROC curves was 0.858, 0.731 and 0.698, corresponding to MWI, W1 and W2 (P＞0.05). Conclusion The function of CCA can be evaluated with MWI calculated from conventional parameters.