To provide an effective approach to select, develop, interpret and apply well-designed quality indicators. Then to promote the continual improvement of laboratory quality and to assure patient safety. We focused on the quality cycle of selecting, development, implementation and processing for quality indicators. And some examples for essential activities in the development and use of quality indicators were shown. Through the presentation of process and examples, we put forward an organized approach that provides the laboratory with a plan to structure its development of quality indicators to gather useful information. Quality indicators are important. However, they should be integrated with internal review plan, External Quality Assessment (EQA) and the process of activities in plan. Only then can we really promote the continual improvement of quality.

Objective To promote worldwide standardization of methods to determine creatinine by tracing to reference measurement for achieving universal accuracy measurement of creatinine.Methods The results of external laboratory assessment (EQA) survey in China and CAP were compared and analyzed. Results There was significant difference among different measurement methods and assay systems.Conclusion It should promote worldwide standardization of determine creatinine, which makes it trace to reference measurement liquid chromatography-isotope dilution mass spectrometry (LC-IDMS).

It was pointed out in this paper that the nature of values was invisible knowledge by analyzing the rela-tion between values and invisible knowledge,and the measures were put forward for constructing the values in medi-cal staff in view of their value construction process and its influencing factors.

Acquired growth hormone resistance(AGHR) in critical illness may be defined as the combination of a raised serum growth hormone concentration,low serum insulin-like growth factor-1 concentration and a reduced anabolic response to exogenous GH.GH given to reverse catabolism in critical illness increased mortality.Therefore,it has the theoretical significance and clinical value for better understanding of the mechanism of AGHR.The mechanism of AGHR and its prevention and cure are reviewed.

Objective: To assess the effect of preoperative carbohydrate fluid intake on immediate postoperative insulin resistance. Methods: 32 patients for elective colorectal cancer resection were recruited to this randomized controlled study. These patients were randomly assigned to control group and test group. Control group were fasted before surgery, while test group were given oral carbohydrate 3 h before surgery. Patient's wellbeing scores on a visual analogue scale(VAS) were recorded at 3 PM the day before operation and 2 h after consuming carbohydrate fluid respectively. Blood sample were collected to measure the level of blood glucose and the serum concentrations of insulin 4 h before surgery and immediately after surgery, respectively. Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance (HOMA-IR), basic function of pancreatic ? cell (HOMA-? cell) and insulin sensitivity index (ISI). Results: Patients consumed carbohydrate-rich beverage before surgery reduced thirst, hunger and anxiety compared with fasting before surgery. Whole body insulin sensitivity decreased by 33% in the test group vs. 38% in the control group(P

ObjectiveTo investigate the early diagnosis and treatment of pleuropulmonary blastoma in children. Meth-ods The progress of pleuropulmonary blastoma from type 1 to type 3 was retrospectively analyzed.Results The male infant had no obvious abnormality in chest X-ray at 18 days. At one year old, X-ray iflm of the chest showed cystic lesions near hilum of the left lung (about 5 cm × 4 cm × 4 cm). The congenital cystic adenomatoid malformation was considered and an operation resection was suggested. However, it had been rejected by his parents. At 3 years and 2 months old, chest X-ray and CT showed left lung had a solid cystic lesion, the volume was signiifcantly enlarged, the back side was solid and the upper part had a large gas cavity. Two months later, the patient had asthmatic suffocation. The chest CT showed the tumor was completely solid. Pleuropulmonary blastoma type 3 was considered. The patient received the conventional chemotherapy after operation excision, and was followed up for 1 year. No recurrence was observed after the treatment.Conclusions Type 1 pleuropulmonary blastoma and congenital cystic adenomatoid malformation are hard to be differentially diagnosed. Early diagnosis and treatment of type 1 pleuropulmo-nary blastoma can improve the prognosis.

It was proved that Phenolic alkaloids from Menisphermum dauricum (PAMD) has extensive pharmacological effects, manifested as affecting electrophysiology of the heart, resisting cardiac arrhythmia, inhibiting myocardial infarction, protecting nverves in cerebral ischemia, exerting resisting action in thrombogenesis, dementia, and tumor, and improving learning disorder, and so on. We made an overall sum up of researching progress on PAMD pharmaceutical actions in this article.

Precision controls monitor assay random error (reproducibility),accuracy controls assess total error,both random error and systematic error,and trueness (bias)of an assay represents systematic error.A trueness control should be metro-logical traceable,ideally with a target value determined by use of a reference material or a reference method,without metro-logical traceable to a reference measurement system,patient test results for the same patient from different laboratories may not be comparable.A trueness control should be commutable and its analytical response to a reference method and a routine field method should be equivalent to that of a patient sample.And trueness control values should generally be set at medical decision levels and be prepared by the providers of reference materials and manufactured in the same fashion as a calibrator.

External quality assessment (EQA)as an effective tool for quality control can help clinical laboratories to discover quality problems during testing process and prompt clinical laboratories to improve their testing quality.Samples used for traditional EQA frequently have matrix effects which assign the target value by grouping.Ideal samples for EQA are com-mutable which have the same numeric relationship between different measurement procedures as that expected for patients’ samples.And they can assess accuracy against a reference measurement procedure or a designated comparison method.When analyzing,robust statistical method can be used to reflect the variability of testing results between laboratories more truly. And the evaluation standards should be desirable.If unsatisfactory results appear,we should investigate every aspect of tes-ting process,find the root cause,and take corrective action.On condition that no official EQA scheme is launched for some analytes,it is necessary for us to evaluate the performance of analytes by alternative evaluation procedures.

The right internal quality control rules are really important for improving the quality of patient results report in clinical laboratory.In order to look for faster and simpler tools that will help laboratories select the right internal quality con-trol rules for their own applications,recently Westgard introduced a newer tool “Westgard Sigma Rules”which is quicker and easier to use than previous tools.And it is very easy to figure out the right internal quality control rules by using West-gard Sigma Rules.This article introduced the characteristics and usage of original Westgard Rules and sigma metrics graph, and focusing on the application methods and practices of Westgard Sigma Rules which is the combination of original West-gard Rules and sigma metrics graph.Once the sigma quality of the tests and methods in laboratories are calculated,the West-gard Sigma Rules diagram can make it easy to select the right control rules and the right number of control measurements.