Journal Detail Information

1

Cite

Share

CysC specific peptides: bioinformatics analysis and mass spectrometry verification

Lei SHEN ; Huimin WANG ; Huoyan JI ; Pei SHEN ; Jianxin WANG

Chinese Journal of Clinical Laboratory Science.2017;35(6):444-447. doi:10.13602/j.cnki.jcls.2017.06.13

Objective To analyze the specific peptide of cystatin C (CysC) and its characteristics by bioinformatics technology,and verify the predicted results by mass spectrometry.Methods Online software was applied to analyze the physicochemical properties and homology of CysC peptides hydrolyzed by trypsin and predict the associated parameters of ionized fragmentation of specific peptide by mass spectrometry.Precursor ion scan and product ion scan were conducted on the samples of synthetic specific peptide.The recombinant human CysC and serum samples were analyzed by mass spectrometry after trypsin digestion.The results of analysis were compared with the outcomes predicted by bioinformatics.Results T3 (ALDFAVGEYNK) was considered as the specific peptide of CysC by software analysis.When selecting[M + 2H] 2 + for product ion scan,almost all the y and b ions of fragmentation were observed using tandem mass spectrometry (MS/MS),showing consistency with Skyline predictions.Moreover,both the peptides from the human recombinant CysC and serum sample following the trypsin digestion were eluted at the same time with the isotope-labeled T3 * under the fixed conditions.Conclusion Bioinformatics technology could be available for picking out the specific peptides of target protein quickly and efficiently and predicting the ionized fragmentation precisely by mass spectrometry scanning.

2

Cite

Share

Monitoring of antiplatelet therapy and changes of mean platelet volume after percutaneous coronary intervention in the patients with coronary heart disease

Linzi MIAO ; Yao LU ; Chenxue QU ; Yan GONG ; Ran YOU ; Jie GUAN ; Yanjun GONG

Chinese Journal of Clinical Laboratory Science.2017;35(6):439-443. doi:10.13602/j.cnki.jcls.2017.06.12

Objective To compare the consistency of thrombelastography (TEG) and light transmittance aggregometry (LTA) in monitoring the antiplatelet therapy of the patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI),and observe the changes of mean platelet volume (MPV) of the patients treated with aspirin and clopidogrel after PCI.Methods A total of 177 patients undergoing PCI and the treatment of aspirin and clopidogrel in Peking University First Hospital during March 2014 and May 2015 were enrolled in the study.Their adenosine diphosphate (ADP) or arachidonic acid (AA) induced platelet inhibition rates determined by TEG,MPV before and after antiplatelet therapy,and the maximum platelet aggregation rates measured by LTA from 99 patients were retrospectively analyzed.Results There was no any correlation between the maximum aggregation rates measured by LTA and the platelet inhibition rates determined by TEG regardless of using ADP or AA as agonist (all P ＞ 0.05).The detection rates of clopidogrel hyporesponsiveness determined by LTA and TEG were 30.3％ and 45.5％,respectively,while those of aspirin hyporesponsiveness were 19.2％ and 31.3％,respectively.The detection rate of hyporesponsiveness determined by LTA was significant lower than that by TEG (P ＜ 0.05).The MPVs after antiplatelet therapy were significant lower than that before treatment (all P ＜ 0.01) regardless of clopidogrel hyporesponsive or sensitive and aspirin hyporesponsive or sensitive.The MPVs in clopidogrel hyporesponsive group before and after treatment were significantly lower than that in clopidogrel sensitive group (all P ＜ 0.05).The PLT counts in clopidogrel or aspirin hyporesponsive groups after treatment were significantly higher than that before treatment (all P ＜ 0.05).Conclusion There is poor correlation between LTA and TEG.It should be noted that the incidence rate of antiplatelet drug hyporesponsiveness is high in clinical practice.The MPVs of the patients significantly decrease after antiplatelet therapy.The patients with a significant increase of PLT after antiplatelet therapy are more likely to become drug hyporesponsiveness,while the patients with lower MPV are more likely to have clopidogrel hyporesponsiveness.

3

Cite

Share

Design of POCT quality management system based on the Internet of things

Min ZHU ; Xiaoli CHEN ; Lingxiang ZHENG ; Liangjin ZHUANG ; Fuhui ZHANG ; Huiming YE

Chinese Journal of Clinical Laboratory Science.2017;35(6):405-408. doi:10.13602/j.cnki.jcls.2017.06.02

Objective To design a POCT quality management system based on the Internet of things so as to standardize POCT quality management.Methods The existing problems in POCT quality management were analyzed.Taking portable blood glucose meters as an example,the quality management system of POCT-Internet of things was designed based on the all aspects of data acquisition,transmission,server management and storage,etc.Results The POCT quality management system based on the Internet of things and medical cloud technology was designed.The system could implement the management of POCT operators and devices,monitor the realtime quality control data and reports,and facilitate the administrators to analyze the quality problems in the whole process of POCT management.Conclusion The designed POCT quality management system based on the Internet of things has the theory feasibility.

4

Cite

Share

Diagnosis of myeloid neoplasms for three patients with erythroblast more than 50 ％ of bone marrow nucleated cells

Lina ZHOU ; Peng ZHAO ; Hu CHEN ; Jianzhong WANG ; Hongxia SHENG ; Dongge GAO ; Li LIAO ; Bin ZHANG

Chinese Journal of Clinical Laboratory Science.2017;35(6):476-480. doi:10.13602/j.cnki.jcls.2017.06.22

Objective To further understand the diagnosis,clinical features and prognosis of myeloid neoplasms with erythroblast more than 50％ of bone marrow(BM) nucleated cells in the WHO Classification(2016) by analyzing the clinical data,diagnosis and prognosis of 3 patients with myeloid leukemia.Methods The ages,medical histories,symptoms and signs,and laboratory examinations from 3 patients with myeloid neoplasms whose erythroblast cells were more than 50％ of BM nucleated cells when newly diagnosed were collected.Then,they were diagnosed with the WHO Classification criteria(2008) and the WHO Classification criteria(2016),respectively,and their prognosis was evaluated with the revised International Prognostic Scoring System(IPSS-R).Results According to the WHO Classification criteria(2008),all of 3 patients were diagnosed as acute erythroid leukemia(AEL).However,according to the WHO Classification criteria(2016),2 patients were diagnosed as myelodysplastic syndrome with excess blasts-2(MDS-EB-2),and 1 was diagnosed as acute myeloid leukemia(AML) with maturation.Moreover,their prognostic scores were also different.The former two patients were older men with significant dysplasia and complex genetic abnormalities,and had poor prognosis,while the latter was a middle-aged woman with no obvious dysplasia and genetic abnormalities,and had medium prognosis.Conclusion The WHO Classification(2016) is more reasonable than the WHO Classification(2008),which tends to focus more on the different biological characteristics of diseases,and may better distinguish two types of diseases with different clinical features and prognosis.

5

Cite

Share

Investigations on the determination methods of alert thresholds for critical values in clinical laboratories

Min DUAN ; Haijian ZHAO ; Wei WANG ; Zhiguo WANG

Chinese Journal of Clinical Laboratory Science.2017;35(6):470-475. doi:10.13602/j.cnki.jcls.2017.06.21

Objective To retrospectively analyze the literature of alert thresholds for the critical values of clinical biochemistry and hematology tests in adults,and collect the evidence source of these alert thresholds.Methods The literatures during 2006 and 2016 were retrieved,and the evidence sources were evaluated and ranked using the 1999 Stockholm hierarchy for analytical performance specifications in laboratory medicine.Results Thirty most frequently reported laboratory tests with alert thresholds were presented with evidence rankings.Four determination methods of alert thresholds were reported in 92 articles with alert thresholds for critical values.Among them,70％ of alert thresholds were set by individual institutions,18％ by the surveys of clinical laboratories or clinicians,2％ by the recommendation of professional institutions,and 10％ by the evaluation of clinical findings.The sources of these alert thresholds were ranked into level 4,level 3,level 2 and leve 1,respectively.In addition,the alert thresholds of 7 clinical laboratory tests were presented as critical δ values.Conclusion The alert thresholds are set mainly by individual institutions in current clinical laboratoties,followed by the surveys of clinical laboratories or clinicians.Moreover,the general level of evidence source is lower.

6

Cite

Share

Effects of lean management on emergency biochemistry test turnaround time in clinical laboratories

Leijun MENG ; Chenyu QIU ; Qi ZHAO ; Hong ZHANG

Chinese Journal of Clinical Laboratory Science.2017;35(6):461-463. doi:10.13602/j.cnki.jcls.2017.06.18

Objective To investigate the effect of lean management on emergency biochemistry test turnaround time(TAT) in clinical laboratories.Methods Based on the approaches of standardized operations,5S on-site management,the efficiency evaluation of batch processing and one piece flow,and visual management,the median time of each workflow,the qualified rate of emergency biochemistry test TAT,the unqualified rate in a relatively concentrated period of TAT timeout and the unqualified rate of collected samples were compared before and after optimization.Results The median times (interquartile ranges) of each workflow including sample receipt and storage,result audit and sample storage-result report before and after lean management were 30 (35) min,7 (13) min,17 (8) min and 16(19) min,5(9) min,16(7) min,respectively,and there were significant differences in the former two(all P ＜0.01) but not the third (P ＞ 0.05).The median times (interquartile ranges) of TAT before and after lean management were 63 (51) min and 46 (33) min,respectively(P ＜ 0.05).The qualified rate of TAT increased from 86.00％ to 95.37％ after lean management(P ＜ 0.01).The unqualified rates in a relatively concentrated period of TAT timeout and collected samples decreased from 3.42％ to 1.00％ (P ＜0.01) and from 0.24％ to 0.17％ (P ＜ 0.01),respectively.Conclusion Lean management may improve process efficiency,reduce errors,and shorten emergency biochemistry test TAT in clinical laboratories.

7

Cite

Share

Effects of physical and chemical factors in environment for dried blood spot preparation of neonatal screening assay

Kexin FANG ; Shiqiang SHANG ; Jianbin YANG ; Ting ZHANG ; Zhenzhen HU ; Weiwei TANG ; Dingwen WU

Chinese Journal of Clinical Laboratory Science.2017;35(6):429-433. doi:10.13602/j.cnki.jcls.2017.06.09

Objective To investigate the effects of physical and chemical factors in the environment for dried blood sample (DBS) preparation of neonatal screening assay.Methods A total of 60 normal and 120 positive DBS were prepared under control and 10 different conditions.Another 30 normal and 80 positive DBS were prepared under control and 7 different concentration gradients of formaldehyde.The levels of phenylalanine (Phe),glucose-6-phosphate dehydrogenease (G6PD),thyroid stimulating hormone (TSH) and 17α-hydoxyprogesterone (17α-OHP) were tested by time-resolved fluorescence immunoassay or fluorescence assay.Statistical analysis was performed using SPSS 22.0 software.Results Compared with the control group,the results of Phe were not significantly different (P ＞ 0.05) when the samples were dried under the formaldehyde sensitive threshold (4.62 to 6.95 ppm for 18 hours).G6PD levels were significantly lowered when the samples were dried under all the conditions except for fast cold drying (2 to 8 ℃ overnight and formaldehyde condition,0.30 to 0.38 ppm for 4 hours or 0.21 to 0.24 ppm for 18 hours).TSH and 17α-OHP levels were lowered obviously when the samples were dried under the conditions of humidity,UV and formaldehyde condition (TSH:0.32 to 0.52 ppm for 4 hours,0.38 to 0.45 ppm for 18 hours,17α-OHP:4.37 to 4.62 ppm for 4 hours,0.38 to 0.45 ppm for 18 hours).The results of Phe,G6PD,TSH and 17α-OHP were not statistically different with the control group when the samples were dried under the fast cold drying and 2 to 8 ℃ overnight.Conclusion The physical and chemical factors in the environment of DBS preparation should be related to the accuracy of neonatal disease screening closely.The necessary control factors including formaldehyde,ethanol,glacial acetic acid,ultraviolet irradiation,heat,humidity and decoration pollution may exhibit significant effects on the preparation of DBS.Fast cold drying and overnight at 2 to 8 ℃ could be available for DBS preparation.

8

Cite

Share

Construction and operation of automatic warning program in medical laboratory center

Ran TAO ; Bo LI ; Luguang NI ; Zhishan ZHENG ; Jinquan YANG ; Hong GAO ; Na LI ; Jun HE ; Zhaohui HU

Chinese Journal of Clinical Laboratory Science.2017;35(6):423-426. doi:10.13602/j.cnki.jcls.2017.06.07

Objective To establish an automatic warning program which accommodates to the test procedures in medical laboratory centerand and to put into operation.Methods Based on laboratory information management system (LIS),automatic warning program was established,which composed of maintenance of warning rules,feedback of vulnerabilities in rules,solutions of feedback targets and evaluation of ride-effectiveness.The results of performance were assessed after operation for six months in Guangzhou Kingmed Medical Laboratory Center.Results An automatic warning program containing 13 kinds of rule templates was successfully established.The multi-point warning program via asynchronous structure for six specialized testing procedures was realized.A total of 1 523 warning rules were included in the rule bank and 24 000 reports were verified on average each day.The average passing rate of reports was 70.2％ and the passing rate of single test was 83.9％.The approval time for reports was reduced by 10 to 40 minutes compared with that without using the automatic warning program.The efficiency for report approval was improved by 25 percent.Conclusion Automatic warning program may ensure the high quality of test reports,ease pressure on staff and improve work efficiency.

9

Cite

Share

Design and application of the ISO15189 management information middleware based on LIS

Heqiang FENG ; Caihong ZHANG ; Yufen LI ; Guoxi YANG

Chinese Journal of Clinical Laboratory Science.2017;35(6):419-422. doi:10.13602/j.cnki.jcls.2017.06.06

Objective To design the ISO15189 management information middleware based on laboratory information management system (LIS) and evaluate its application.Methods The ISO15189 management information middleware was designed based on LIS and the middleware technology as underlaying platform,and the multifunction management of LIS was implemented by the data warehouse technology and the data cleaning and extraction technology.Results The designed middleware made LIS implement the functions such as data exchange and transmission,data sharing,and data intelligence processing ISO15189 management information across multiple systems.It constructed a data warehouse by extracting,transforming,and loading useful data from multiple profession systems in laboratories,and flexibly presented data to the users by operating multidimensional data set from various aspects.Conclusion The ISO15189 management information middleware based on LIS has high value in the management of ISO15189 accredit,which may make the management work more standard,efficiency,and intelligence.

10

Cite

Share

Establishment and application of networked information management system for clinical laboratories in community of Suzhou City

Zhaohua CHEN ; Yuanjian WU

Chinese Journal of Clinical Laboratory Science.2017;35(6):415-418. doi:10.13602/j.cnki.jcls.2017.06.05

Objective To establish a networked information management system for clinical laboratories in community of Suzhou and evaluate its clinical application.Methods Based on dedicated network of public health information in Suzhou City,laboratory information management system (LIS) and hospital information management system (HIS),the management for centralized detections of clinical samples from the health institutions of intra-regional community were performed as the key mission,and a regional,networked and informationized management system was designed for the clinical laboratories of community.Results The informationized management of whole process including test application,specimen collection,delivery and receiving,report releasing and payment,etc.was achieved on line.The information of clinical laboratories among the communities was transferred and shared in whole Suzhou City.Conclusion The established system should be safe,convenient and efficient online network-based information management system between the Suzhou clinical laboratory center and the laboratories in each local community,by which the centralized detections in the clinical laboratories of community could be performed readily.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share