1.Analysis of Animal Models of Allergic Asthma Based on Data Mining
Han WU ; Zhixiang HU ; Meiqi JI ; Hao YIN ; Yu'e LYU ; Chuntao ZHAI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):211-217
ObjectiveTo provide a basis for the establishment of an ideal animal model of allergic asthma by statistically analyzing the modeling characteristics and the selection of indicators of the available models. MethodsWe retrieved the relevant articles from China National Knowledge Infrastructure(CNKI), VIP, Wanfang Data, SinoMed, and PubMed with "allergic asthma" as the keyword and the time interval from January 2019 to January 2024. Through integrating the literature and extracting data, we used Excel 2021 to create a personal database and sorted out the animal strains, genders, allergenic substances, modeling routes, and test indicators and methods. Excel 2021, Cytoscape 3.10.2, and SPSS Modeler 18.0 were then used to analyze the relevant characteristics of the animal models. ResultsA total of 418 articles were included in the database, and the comparative analysis showed that the most frequently used animal strain for modeling was BALB/c mice, and female animals were mostly used. The main modeling method was sensitization by intraperitoneal injection of ovalbumin (OVA), which was combined with intranasal inhalation. The test indicators mainly included appearance signs, cellular analysis, lung histopathology, lung function indicators, and protein and gene expression in the lung. The test methods mainly involved pathological staining, enzyme-linked immunosorbent assay, immunohistochemistry, immunofluorescence, Western blot, and polymerase chain reaction(PCR) assays. ConclusionThere is no recognized modeling method or evaluation standard for the animal models of allergic asthma. Based on the results of data analysis, the OVA-induced allergic asthma model in BALB/c mice is recommended. The main criteria for evaluating the success of modeling are the general behavioral changes, the morphological changes of the airway and inflammatory cell infiltration in the lung tissue, the changes of pro-inflammatory and anti-inflammatory cytokines in the serum, and the alterations of inflammatory cells in the bronchoalveolar lavage fluid.
2.Screening of biomarkers for fibromyalgia syndrome and analysis of immune infiltration
Yani LIU ; Jinghuan YANG ; Huihui LU ; Yufang YI ; Zhixiang LI ; Yangfu OU ; Jingli WU ; Bing WEI
Chinese Journal of Tissue Engineering Research 2025;29(5):1091-1100
BACKGROUND:Fibromyalgia syndrome,as a common rheumatic disease,is related to central sensitization and immune abnormalities.However,the specific mechanism has not been elucidated,and there is a lack of specific diagnostic markers.Exploring the possible pathogenesis of this disease has important clinical significance. OBJECTIVE:To screen the potential diagnostic marker genes of fibromyalgia syndrome and analyze the possible immune infiltration characteristics based on bioinformatics methods,such as weighted gene co-expression network analysis(WGCNA),and machine learning. METHODS:Gene expression profiles in peripheral serum of fibromyalgia syndrome patients and healthy controls were obtained from the gene expression omnibus(GEO)database.The differentially co-expressed genes were screened in the expression profile by differential analysis and WGCNA analysis.Least absolute shrinkage and selection operator(LASSO)and support vector machine-recursive feature elimination(SVM-RFE)machine learning algorithm were further used to identify hub biomarkers,and draw receiver operating characteristic curve(ROC)to evaluate the accuracy of diagnosing fibromyalgia syndrome.Finally,single sample gene set enrichment analysis(ssGSEA)and gene set enrichment analysis(GSEA)were used to evaluate the immune cell infiltration and pathway enrichment in patients with fibromyalgia syndrome. RESULTS AND CONCLUSION:Eight down-regulated differentially expressed genes(DEGs)were obtained after differential analysis of the GSE67311 dataset according to the conditions of log2|(FC)|>0 and P<0.05.After WGCNA analysis,497 genes were included in the module(MEdarkviolet)with the highest positive correlation(r=0.22,P=0.04),and 19 genes were included in the module(MEsalmon2)with the highest negative correlation(r=-0.41,P=6×10-5).After intersecting DEGs and the module genes of WGCNA,seven genes were obtained.Four genes were screened out by LASSO regression algorithm and five genes were screened out by SVM-RFE machine learning algorithm.After the intersection of the two,three core genes were identified,which were germinal center associated signaling and motility like,integrin beta-8,and carboxypeptidase A3.The areas under the ROC curve of the three core genes were 0.744,0.739,and 0.734,respectively,indicating that they have good diagnostic value and can be used as biomarkers for fibromyalgia syndrome.The results of immune infiltration analysis showed that memory B cells,CD56 bright NK cells,and mast cells were significantly down-regulated in patients with fibromyalgia syndrome compared with the control group(P<0.05),and were significantly positively correlated with the above three biomarkers(P<0.05).The enrichment analysis suggested that there were nine fibromyalgia syndrome enrichment pathways,mainly related to olfactory transduction pathway,neuroactive ligand-receptor interaction,and infection pathway.The above results showed that the occurrence and development of fibromyalgia syndrome are related to the involvement of multiple genes,abnormal immune regulation,and multiple pathways imbalance.However,the interactions between these genes and immune cells,as well as their relationships with various pathways need to be further investigated.
3.Effect of thrombocytosis on prognosis of hepatocellular carcinoma after TACE
Tingsong YING ; Hao XU ; Zichen WU ; Zhixiang FAN ; Wang LIU
Chinese Journal of Hepatobiliary Surgery 2024;30(1):15-20
Objective:To analyze the prognosis of hepatocellular carcinoma (HCC) patients with thrombocytosis (platelet count ≥350×10 9) after transcatheter arterial chemoembolization (TACE), and the effect of thrombocytosis on the prognosis of patients with HCC after TACE. Methods:Clinical data of 867 patients with HCC admitted to the Department of Interventional Radiology, the Affiliated Hospital of Xuzhou Medical University from January 2013 to May 2018 were retrospectively analyzed. After propensity score matching, 99 patients were enrolled, including 70 males and 29 females, aged (60.1±12.1) years. Patients were divided into the groups with thrombocytosis ( n=33) and without thrombocytosis ( n=66). The gender, maximum tumor diameter, Barcelona clinical liver cancer (BCLC) stage, and total bilirubin were compared between the two groups. The association of thrombocytosis with the prognosis of HCC after TACE treatment were analyzed using univariate and multivariate Cox regression. Results:After propensity score matching, the male proportion, maximum tumor diameter, BCLC stage, and serum level of total bilirubin were comparable between the groups (all P>0.05). Before TACE treatment, the platelet count of patients with thrombocytosis was (394.4±54.5)×10 9/L, which was higher than that after TACE [(278.2±86.4)×10 9/L, t=7.63, P<0.001]. The progression-free survival rates after TACE in without thrombocytosis group were 83.3%, 24.2%, and 7.6% at 3, 6 and 9 months, respectively, better than those in thrombocytosis group (51.5%, 3.0%, and 3.0%, respectively; χ2=31.24, P<0.001). The overall survival rates after TACE in without thrombocytosis group were 81.8%, 30.3%, and 4.5% at 1, 2 and 3 years, respectively, better than those in thrombocytosis group (15.2%, 9.1%, and 3.0%, respectively; χ2=27.89, P<0.001). Multivariate Cox regression analysis showed that patients of HCC with thrombocytosis had an increased risk of tumor progression ( HR=5.785, 95% CI: 3.291-10.168, P<0.001) and increased risk of death ( HR=4.090, 95% CI: 2.482-6.740, P<0.001) after TACE. Conclusion:The prognosis of TACE for HCC might be worse in patients with thrombocytosis. Thrombocytosis is a risk factor for cumulative survival and progression-free survival of HCC patients after TACE.
4.The Porous SilMA Hydrogel Scaffolds Carrying Dual-Sensitive Paclitaxel Nanoparticles Promote Neuronal Differentiation for Spinal Cord Injury Repair
Zhixiang LI ; Tao ZHOU ; Zhengqi BAO ; Min WU ; Yingji MAO
Tissue Engineering and Regenerative Medicine 2024;21(6):809-827
BACKGROUND:
In the intricate pathological milieu post-spinal cord injury (SCI), neural stem cells (NSCs) frequently differentiate into astrocytes rather than neurons, significantly limiting nerve repair. Hence, the utilization of biocompatible hydrogel scaffolds in conjunction with exogenous factors to foster the differentiation of NSCs into neurons has the potential for SCI repair.
METHODS:
In this study, we engineered a 3D-printed porous SilMA hydrogel scaffold (SM) supplemented with pH-/ temperature-responsive paclitaxel nanoparticles (PTX-NPs). We analyzed the biocompatibility of a specific concentration of PTX-NPs and its effect on NSC differentiation. We also established an SCI model to explore the ability of composite scaffolds for in vivo nerve repair.
RESULTS:
The physical adsorption of an optimal PTX-NPs dosage can simultaneously achieve pH/temperature-responsive release and commendable biocompatibility, primarily reflected in cell viability, morphology, and proliferation.An appropriate PTX-NPs concentration can steer NSC differentiation towards neurons over astrocytes, a phenomenon that is also efficacious in simulated injury settings. Immunoblotting analysis confirmed that PTX-NPs-induced NSC differentiation occurred via the MAPK/ERK signaling cascade. The repair of hemisected SCI in rats demonstrated that the composite scaffold augmented neuronal regeneration at the injury site, curtailed astrocyte and fibrotic scar production, and enhanced motor function recovery in rat hind limbs.
CONCLUSION
The scaffold’s porous architecture serves as a cellular and drug carrier, providing a favorable microenvironment for nerve regeneration. These findings corroborate that this strategy amplifies neuronal expression within the injury milieu, significantly aiding in SCI repair.
5.Transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium in liver transplantation for Budd-Chiari syndrome complicated with liver cancer: a case report with surgical video
Zhenghui YE ; Hongchuan ZHAO ; Xiaoping GENG ; Fan HUANG ; Guobin WANG ; Wei WANG ; Xiaojun YU ; Ruolin WU ; Liujin HOU ; Xinghua ZHANG ; Zhixiang HE
Organ Transplantation 2023;14(6):855-860
Objective To summarize clinical experience of transabdominal pericardial anastomosis of suprahepatic vena cava of the donor and right atrium of the recipient in liver transplantation for Budd-Chiari syndrome (BCS) complicated with liver cancer. Methods Clinical data of a BCS patient complicated with liver cancer undergoing transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium in liver transplantation were retrospectively analyzed. Results The hepatic vein and suprahepatic vena cava were partially occluded in the patient. Liver transplantation was completed by transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium with beating-heart. In addition, due to pathological changes of the recipient's hepatic artery, splenic artery of the recipient was cut off, distal ligation was performed, and the proximal end was reversed and anastomosed with the common hepatic artery of the donor liver, and the reconstruction of hepatic artery was completed. The surgery was successfully performed. At approximately postoperative 1 week, the function of the liver allograft was gradually restored to normal, and no major complications occurred. The patient was discharged at postoperative 25 d. No signs of BCS recurrence was reported after 8-month follow-up. Conclusions It is safe and feasible to treat BCS by liver transplantation with transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium. BCS patients complicated with liver cancer obtain favorable prognosis.
6.Effectiveness of transcutaneous lower eyelid blepharoplasty with a skin flap reserving the pretarsal fullness
Jianwu CHEN ; Yuzhi WANG ; Xiaoyu CHENG ; Liming ZHANG ; Qi LI ; Zhixiang CHEN ; Yanhong WU
Chinese Journal of Plastic Surgery 2023;39(10):1088-1093
Objective:To evaluate the effectiveness of transcutaneous lower eyelid blepharoplasty with a skin flap reserving the pretarsal fullness.Methods:From November 2017 to April 2022, a retrospective analysis was performed to assess the reserving of pretarsal fullness after the transcutaneous lower blepharoplasty with a skin flap in the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA. A subciliary incision was made below the ciliary margin and a skin flap was elevated at the surface of pretarsal orbicularis. The muscle was partially split at the position of pretarsal crease, leaving the pretarsal orbicularis oculi muscle and the pretarsal crease intact. Preseptal dissection was proceeded down to the level of arcus marginalis, exposing the orbital fat pads. For patient with tear trough deformity or volume deficiency in the medial cheek, retaining ligament laxity and fat repositioning were routinely performed. The muscle wound was closed edge to edge and the excess skin was excised conservatively. Postoperative complications were recorded. Face-Q scale was used for surgical decision and postoperative satisfaction evaluation. The scores range from 0 to 100, with higher scores indicating less regret the operation or greater satisfaction. The preoperative and postoperative digital photographs were used to evaluate the change of pretarsal fullness.Results:256 patients were included, of whom 233 cases were women and 23 cases were men. The age was (43.0±10.2) years. 24 cases had concomitant lateral canthoplasty due to hypotonia of lower eyelid, 22 had concomitant upper blepharoplasty, and 21 cases had brow lift surgery to correct upper eyelid relaxation. All patients had follow-up for (3.7±4.1) months, most patients were satisfied with the operation results. A total of 211 patients maintained a natural pretarsal fullness postoperatively, with the rate of 82.4%. The Face-Q satisfaction score was (75.8±18.6) and the surgical decision score was (80.3±15.4), indicating that most patients did not regret the operation. Postoperative complications included 8 cases of eyelid bags undercorrection, of whom 4 patients underwent secondary resection. 7 patients experienced infraorbital bulge for the uneven placement of the fat pad, 2 of them required revision surgery. Hematoma occurred in 4 cases and was resolved by hematoma clearance. Other complications included 3 cases of ectropion and 2 cases of minimal tear trough correction. Lower eyelid ectropion was corrected in one case.Conclusion:Reserving the pretarsal fullness in transcutaneous lower eyelid blepharoplasty with a skin flap provides excellent aesthetic results and high patient satisfaction. This technique is simple and effective.
7.Effectiveness of transcutaneous lower eyelid blepharoplasty with a skin flap reserving the pretarsal fullness
Jianwu CHEN ; Yuzhi WANG ; Xiaoyu CHENG ; Liming ZHANG ; Qi LI ; Zhixiang CHEN ; Yanhong WU
Chinese Journal of Plastic Surgery 2023;39(10):1088-1093
Objective:To evaluate the effectiveness of transcutaneous lower eyelid blepharoplasty with a skin flap reserving the pretarsal fullness.Methods:From November 2017 to April 2022, a retrospective analysis was performed to assess the reserving of pretarsal fullness after the transcutaneous lower blepharoplasty with a skin flap in the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA. A subciliary incision was made below the ciliary margin and a skin flap was elevated at the surface of pretarsal orbicularis. The muscle was partially split at the position of pretarsal crease, leaving the pretarsal orbicularis oculi muscle and the pretarsal crease intact. Preseptal dissection was proceeded down to the level of arcus marginalis, exposing the orbital fat pads. For patient with tear trough deformity or volume deficiency in the medial cheek, retaining ligament laxity and fat repositioning were routinely performed. The muscle wound was closed edge to edge and the excess skin was excised conservatively. Postoperative complications were recorded. Face-Q scale was used for surgical decision and postoperative satisfaction evaluation. The scores range from 0 to 100, with higher scores indicating less regret the operation or greater satisfaction. The preoperative and postoperative digital photographs were used to evaluate the change of pretarsal fullness.Results:256 patients were included, of whom 233 cases were women and 23 cases were men. The age was (43.0±10.2) years. 24 cases had concomitant lateral canthoplasty due to hypotonia of lower eyelid, 22 had concomitant upper blepharoplasty, and 21 cases had brow lift surgery to correct upper eyelid relaxation. All patients had follow-up for (3.7±4.1) months, most patients were satisfied with the operation results. A total of 211 patients maintained a natural pretarsal fullness postoperatively, with the rate of 82.4%. The Face-Q satisfaction score was (75.8±18.6) and the surgical decision score was (80.3±15.4), indicating that most patients did not regret the operation. Postoperative complications included 8 cases of eyelid bags undercorrection, of whom 4 patients underwent secondary resection. 7 patients experienced infraorbital bulge for the uneven placement of the fat pad, 2 of them required revision surgery. Hematoma occurred in 4 cases and was resolved by hematoma clearance. Other complications included 3 cases of ectropion and 2 cases of minimal tear trough correction. Lower eyelid ectropion was corrected in one case.Conclusion:Reserving the pretarsal fullness in transcutaneous lower eyelid blepharoplasty with a skin flap provides excellent aesthetic results and high patient satisfaction. This technique is simple and effective.
8.Effects of vaccination status on the disease severity of patients with coronavirus disease 2019
Xiaoyan WU ; Zhixiang YANG ; Yishan ZHENG ; Wei HAN ; Jiangquan YU ; Jun ZHAO ; Ruiqiang ZHENG
Chinese Critical Care Medicine 2022;34(9):915-920
Objective:To evaluate the effect of 2019 novel coronavirus inactivated vaccine on the disease severity of patients with Delta variant of coronavirus disease 2019.Methods:A retrospective analysis was performed on 704 patients with coronavirus disease 2019 infected with Delta variant who were older than 18 years old and admitted in the coronavirus disease 2019 designated hospital of Yangzhou (Subei Hospital New Area Branch) from July 2021 to September 2021. They were divided into severe (severe, critical) group and non-severe (light, ordinary) group according to the clinical characteristics of patients. According to the vaccination status, they were divided into 0-dose group, 1-dose group and 2-dose group. We evaluated the effects of vaccination on the severity of the disease and the production of antibodies, and analyzed the influencing factors leading to the severe group of coronavirus disease 2019.Results:The proportion of severe group in the 2-dose vaccinated group was significantly lower than that in the 1-dose vaccinated group and 0-dose vaccinated group [3.02% (7/232) vs. 9.48% (22/232), 15.83% (38/240), P < 0.05]. The time from onset to admission (day: 1.97±1.66 vs. 2.66±2.70), age (years: 45.3±12.2 vs. 63.6±17.0), direct bilirubin [DBil (μmol/L): 3.70±1.83 vs. 5.30±5.13], lactate dehydrogenase [LDH (U/L): 240.69±74.29 vs. 256.30±85.18], creatinine [SCr (μmol/L): 63.38±19.86 vs. 70.23±25.43], interleukin-6 [IL-6 (ng/L): 7.32 (1.54, 17.40) vs. 18.38 (8.83, 33.43)], creatine kinase [CK (U/L): 66.00 (43.00, 99.75) vs. 78.00 (54.50, 144.00)] and D-dimer [mg/L: 0.30 (0.08, 0.49) vs. 0.41 (0.23, 0.69)] of patients in the 2-dose group were significantly lower than those in the 0-dose group (all P < 0.05), while platelet [PLT (×10 9/L): 176.69±60.25 vs. 149.25±59.07], white blood cell count [WBC (×10 9/L): 5.43±1.77 vs. 5.03±1.88] and lymphocyte [LYM (×10 9/L): 1.34±0.88 vs. 1.17±0.50] were significantly higher than those in the 0-dose group (all P < 0.05). The titer of immunoglobulin G (IgG) in the 2-dose group was significantly higher than those in the 1-dose group and 0-dose group on the 10th day after admission [U/L: 130.94 (92.23, 326.31), 113.18 (17.62, 136.20), 117.85 (33.52, 156.73), both P < 0.05], and higher than 0-dose group on the 16th day [U/L: 156.12 (120.32, 167.76) vs. 126.52 (61.34, 149.57), P < 0.05]. The proportion of complete 2-dose vaccination [10.45% (7/67) vs. 35.32% (225/637)], LYM (×10 9/L: 1.09±0.32 vs. 1.25±0.56) and PLT (×10 9/L: 138.55±68.03 vs. 166.93±59.70) in the severe group were significantly lower than those in the non-severe group ( P < 0.05), while the time from onset to admission (day: 3.01±2.99 vs. 2.25±2.09), the length of hospital stay (day: 28±18 vs. 16±6), male proportion [77.61% (52/67) vs. 34.54% (220/637)], age (years: 69.13±12.63 vs. 52.28±16.53), DBil [μmol/L: 4.20 (3.18, 6.65) vs. 3.60 (2.80, 4.90], LDH (U/L: 310.61±98.33 vs. 238.19±72.14), SCr (μmol/L: 85.67±38.25 vs. 65.98±18.57), C-reactive protein [CRP (μmol/L): 28.12 (11.32, 42.23) vs. 8.49 (2.61, 17.58)], IL-6 [ng/L: 38.38 (24.67, 81.50) vs. 11.40 (4.60, 22.07)], CK [U/L: 140.00 (66.00, 274.00) vs. 72.80 (53.00, 11.00)] and the D-dimer [mg/L: 0.46 (0.29, 0.67) vs. 0.35 (0.19, 0.57)] in the severe group were significantly higher than those in the non-severe group (all P < 0.05). Multivariate regression analysis showed that the odds ratio ( OR) of severe group was 0.430 ( P = 0.010) in the 1-dose group and the 2-dose group compared with the 0-dose group. However, the risk of severe group was 0.381-fold in the 2-dose group compared with the 0-dose group [ OR = 0.381, 95% confidence interval (95% CI) was 0.121-1.199] which was not statistically significant, when the age was included in the regression analysis ( P > 0.05). PLT ( OR = 0.992, 95% CI was 0.986-0.998) were protective factors, but older than 60 years old ( OR = 3.681, 95% CI was 1.637-8.278), CK ( OR = 1.001, 95% CI was 1.000-1.001), IL-6 ( OR = 1.006, 95% CI was 1.002-1.010), SCr ( OR = 1.020, 95% CI was 1.007-1.033) were risk factors for severe group (all P < 0.05). Conclusions:Compared with the 0-dose vaccinated patients, the coronavirus disease 2019 patients infected with delta variant and fully vaccinated with 2-dose 2019 novel coronavirus inactivated vaccine had lower level of IL-6, SCr, CK and D-dimer, and higher PLT, LYM and IgG titer, who were not easy to develop into the severe condition.
9.Analysis of clinical features of rosacea and rediscussion of a Chinese diagnostic criterion for rosacea
Ben WANG ; Zhixiang ZHAO ; Dan JIAN ; Wei SHI ; Fangfen LIU ; Hui LIU ; Bin YU ; Jianxin XIA ; Jie YANG ; Lin WU ; Qiang JU ; Ji LI ; Hongfu XIE
Chinese Journal of Dermatology 2020;53(9):675-679
Objective:To propose a Chinese diagnostic criterion for rosacea on the basis of clinical feature analysis of rosacea, and to assess its sensitivity and specificity.Methods:A total of 3 350 Chinese patients with newly diagnosed rosacea were collected from Department of Dermatology, Xiangya Hospital, Central South University between December 2017 and July 2018, their phenotypes and clinical features were retrospectively analyzed, and a Chinese modified diagnostic criterion for rosacea was put forward. A national multi-center clinical observational trial, which included 2 269 patients with rosacea and 2 408 patients with other facial skin diseases from 28 centers, was conducted to verify this diagnostic criterion. Then, the sensitivity and specificity of the modified diagnostic criterion were evaluated by comparing with the 2017 standard classification of rosacea developed by the National Rosacea Society Expert Committee (NRSEC) .Results:Fixed centrofacial erythema occurred in 3 350 (100%) patients with rosacea. Flushing occurred before or simultaneously with fixed erythema in 1 850 (99.4%) of the 1 861 patients with erythema on the cheeks; among the 1 489 patients with erythema on the nose or perioral area, only 52 (3.5%) had flushing; all the 342 patients presenting with phymatous changes had fixed erythema before phymatous changes. Based on the above clinical findings, it was proposed that patients with periodically aggravated fixed erythema on the cheeks accompanied with flushing could be diagnosed with rosacea; patients with fixed erythema on the nose and perioral area accompanied with at least one of selective phenotypes (flushing, telangiectasia, papules and pustules, phymatous changes, or ocular manifestations) could be diagnosed with rosacea. The national multi-center clinical observational trial revealed that the sensitivity of the Chinese modified diagnostic criterion for rosacea was 99.6%, which was close to the sensitivity (100%) of the NRSEC standard, and its specificity was 91.9%, higher than the specificity (73.3%) of the NRSEC standard.Conclusion:The Chinese modified diagnostic criterion for rosacea has good sensitivity and specificity, and can facilitate the early diagnosis of phymatous rosacea.
10.Analysis of the Development Status of Neuropsychiatric Therapeutic Drug Monitoring in Terms of the External Quality Evaluation
Shaochuan ZHANG ; Zhixiang CHEN ; Qiuyan HUANG ; Siqi WU ; Chunxia YANG
China Pharmacy 2019;30(1):136-140
OBJECTIVE: To analyze the development status of neuropsychotropic therapeutic drug monitoring (TDM), and to provide reference for improving the quality of TDM in neuropsychiatry department. METHODS: The laboratory data of neuropsychotropic TDM external quality assessment (EQA) were collected from Website of Clinical Laboratory Center of Ministry of Health (http://www.clinet.com.cn) during 2008-2017, and then analyzed statistically in respects of TDM project, the number of involved laboratory, monitoring method, etc. RESULTS: By the end of 2017, the Clinical Laboratory Center of the Ministry of Health had conducted 5 neuropsychiatric TDM projects involving 4 drugs, including 3 items of serum TDM (carbamazepine, valproic acid, phenytoin), lithium ion monitoring (lithium carbonate) in biochemical routine and newly added pharmacokinetic laboratory biological sample monitoring (carbamazepine) in 2014. From 2008 to 2017, the number of involved laboratories increased from 209 to 603, with carbamazepine (serum, plasma) and valproic acid showing good annual growth trend, exceeding 200 and phenytoin 107, but only 27 in lithium carbonate until 2017. Among all monitoring methods of involved laboratories, the number of laboratories which adopted fluorescence polarization immunoassay (FPIA) decreased year by year. By the end of 2017, there were fewer than 10 laboratories. The number of laboratories using acridinium direct chemiluminescence, enzyme-multiplied immunoassay technique (EMIT), and high performance liquid chromatography (HPLC) had steadily increased. By the end of 2017, acridinium direct chemiluminescence was the most used in laboratory, followed by EMIT and HPLC. CONCLUSIONS: Due to the increasing number of participating laboratories, it can be seen that the consciousness of quality control of laboratory personnel is increasing day by day; but the complexity of TDM monitoring methods limits the types of drugs used in external quality evaluation. It is suggested to formulate guidelines, quality control standards and operation rules as soon as possible, so as to ensure the accuracy of test results.

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