Objective:To investigate the application value of intelligent laboratory construction in the laboratory.Methods:All samples sent to the Department of Clinical Laboratory from all the clinical departments at the Eighth Affiliated Hospital of Sun Yat-Sen University from January 2018 to June 2024 were collected. Full-process intelligentization building was achieved by the use of logistics transmission system, automatic sampling system, automatic quality control system, automatic audit system, intelligent monitoring system, critical value monitoring system, and intelligent DxlabReport operation management system, et al. The normal distribution data were analyzed by two independent samples t-test, and the skew distribution data were analyzed by Mann-Whitney U test. Results:After the implementation of the pneumatic logistics transmission system, the turn-around time (TAT) from sample transmission to receiving decreased significantly from 51.5 (37.7, 73.0) min to 18.1 (14.4, 31.0) min ( U=0, P<0.001). After adopting the automatic sampling system, the TAT from receiving to sampling decreased from 41.0 (38.0, 45.0) min to 10.0 (5.0, 11.0) min ( U=0, P<0.001). The introduction of automatic quality control advanced the median time for the first batch of samples entering the biochemical testing pipeline from 9∶03 to 8∶27 and increased the reporting rate within 3 hours from 27.71%±1.39% to 36.90%±2.30% ( t=3.423, P<0.001). The intelligent monitoring system enabled module positioning monitoring, sample turn-around time reminder, instrument load rate monitoring, remaining reagent monitoring, and patient-based real-time quality control, resulting in improved instrument running efficiency and result accuracy. Followed by the introduction of the automatic audit function, the overall pass rate was 28.19%(10 006/35 500), including 37.17% (7 738/20 818) for biochemical reports, 31.57% (1 251/3 963) for chemiluminescence reports, and 9.49% (1 017/10 719) for biochemical immunity reports. The laboratory TAT decreased from (207.3±6.0) min to (169.8±5.9) min ( t=4.426, P<0.001). After the implementation of the critical value monitoring system, the timely reporting rate reached 99.52% (99.32%, 99.89%). After using quality digital management, outpatient biochemical immunity process was optimized to a decrease in laboratory TAT from 222 (201, 233) min to 145 (119, 195) min ( U=0, P=0.004), while the pass rate increased from 86.88% (85.91%, 87.81%) to 96.32% (95.86%, 96.96%) ( U=0, P=0.004). Conclusion:The establishment of an intelligent laboratory can optimize workflow, significantly improve the work efficiency and accuracy of sample processing, and minimize error.

Objective:To investigate the application value of intelligent laboratory construction in the laboratory.Methods:All samples sent to the Department of Clinical Laboratory from all the clinical departments at the Eighth Affiliated Hospital of Sun Yat-Sen University from January 2018 to June 2024 were collected. Full-process intelligentization building was achieved by the use of logistics transmission system, automatic sampling system, automatic quality control system, automatic audit system, intelligent monitoring system, critical value monitoring system, and intelligent DxlabReport operation management system, et al. The normal distribution data were analyzed by two independent samples t-test, and the skew distribution data were analyzed by Mann-Whitney U test. Results:After the implementation of the pneumatic logistics transmission system, the turn-around time (TAT) from sample transmission to receiving decreased significantly from 51.5 (37.7, 73.0) min to 18.1 (14.4, 31.0) min ( U=0, P<0.001). After adopting the automatic sampling system, the TAT from receiving to sampling decreased from 41.0 (38.0, 45.0) min to 10.0 (5.0, 11.0) min ( U=0, P<0.001). The introduction of automatic quality control advanced the median time for the first batch of samples entering the biochemical testing pipeline from 9∶03 to 8∶27 and increased the reporting rate within 3 hours from 27.71%±1.39% to 36.90%±2.30% ( t=3.423, P<0.001). The intelligent monitoring system enabled module positioning monitoring, sample turn-around time reminder, instrument load rate monitoring, remaining reagent monitoring, and patient-based real-time quality control, resulting in improved instrument running efficiency and result accuracy. Followed by the introduction of the automatic audit function, the overall pass rate was 28.19%(10 006/35 500), including 37.17% (7 738/20 818) for biochemical reports, 31.57% (1 251/3 963) for chemiluminescence reports, and 9.49% (1 017/10 719) for biochemical immunity reports. The laboratory TAT decreased from (207.3±6.0) min to (169.8±5.9) min ( t=4.426, P<0.001). After the implementation of the critical value monitoring system, the timely reporting rate reached 99.52% (99.32%, 99.89%). After using quality digital management, outpatient biochemical immunity process was optimized to a decrease in laboratory TAT from 222 (201, 233) min to 145 (119, 195) min ( U=0, P=0.004), while the pass rate increased from 86.88% (85.91%, 87.81%) to 96.32% (95.86%, 96.96%) ( U=0, P=0.004). Conclusion:The establishment of an intelligent laboratory can optimize workflow, significantly improve the work efficiency and accuracy of sample processing, and minimize error.

Objective To investigate the clinical efficacy of neoadjuvant chemotherapy (oxaliplatin +capecitabine,XELOX) for the resectable locally advanced adenocarcinoma of esophageal-gastric junction (AEG).Methods The prospective study was conducted.The clinicopathological data of 106 locally advanced AEG patients who were admitted to the Cancer Hospital of Shantou University Medical College from January 2011 to December 2014 were collected.All the patients were divided into the treatment group and control group by single blind,randomized,controlled random number table.Patients underwent preoperative neoadjuvant chemotherapy (XELOX) + surgery + postoperative adjuvant chemotherapy (XELOX) in the treatment group and surgery + postoperative adjuvant chemotherapy (XELOX) in the control group.Total gastrectomy + Roux-en-Y esophagojejunostomy + D2 lymphadenectomy were applied to patients by the same team of doctors.Observation indicators:(1) treatment situations;(2) results of postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination was performed to detect the postoperative tumor recurrence or metastasis and patients' survival up to February 2017.Measurement data with normal distribution were represented as (-x)±s,and comparisons between groups were evaluated with the t test.Measurement data with skewed distribution were described as M (range) and analyzed by the nonparametric test.Comparisons of count data were analyzed using the chi-square test.The ordinal data were compared using the nonparametric test.Survival rate and curve were respectively calculated and drawn by the Kaplan-Meier method and survivals were compared using the Long-rank method.Results One hundred and six patients were screened for eligibility,including 54 in the treatment group and 52 in the control group.(1) Treatment situations:① preoperative neoadjuvant chemotherapy:54 in the treatment group received 2-4 cycle neoadjuvant chemotherapy.During the chemotherapy,gastrointestinal reaction,grade 1-2 granulocytopenia,elevated alanine transaminase (ALT) and grade 3 granulocytopenia were detected in 21,17,8,1 patients,and 7 patients had no adverse reaction.The complete response(CR),partial response (PR),stable disease (SD) and progressive disease (PD) of neoadjuvant chemotherapy in the treatment group were detected in 4,27,20 and 3 patients,respectively.Of 54 patients in the treatment group,4,13,25 and 12 were in grade 0,1,2 and 3 of response to preoperative chemotherapy,respectively.② Surgical situations:preoperative carcinoembryonic antigen (CEA) in the treatment and control groups were respectively 4.71 μg/L (range,0.20-36.19 μg/L) and 14.09 μg/L (range,0.71-178.20 μg/L),with a statistically significant difference between groups (Z =-1.92,P＜ 0.05).All patients underwent total gastrectomy + Roux-en-Y esophagojejunostomy + D2 lymphadenectomy.Operation time in the treatment and control groups were respectively (210± 31) minutes and (195 ±26) minutes,with a statistically significant difference between groups (t =-2.45,P ＜ 0.05).Volume of intraoperative blood loss,cases with intraoperative blood transfusion,time to postoperative anal exsufflation,time to defecation,time for initial diet intake,cases with postoperative complications and duration of hospital stay were respectively (216± 172) mL,6,(4.3± 1.0) days,(4.5±0.8)days,(3.1±0.5)days,11,(15.0±5.0)days in the treatment group and (174±108)mL,4,(4.2± 1.0) days,(4.4± 0.8) days,(3.1 ± 0.5) days,15,(15.0± 5.0) days,with no statistically significant difference between groups (t=-1.01,x2 =0.36,t=-0.31,-0.88,-0.36,x2 =1.03,t=-0.38,P＞0.05).③Postoperative adjuvant chemotherapy:all the patients completed the postoperative adjuvant chemotherapy.The granulocytopenia,elevated ALT and gastrointestinal reaction occurred in 25,5,28 patients in the treatment group and 21,7,30 patients in the control group,respectively,with no statistically significant difference between groups (x2 =0.38,0.47,0.36,P＞0.05).Some of the patients were merged with multiple adverse reactions.(2) Results of postoperative pathological examination:maximum tumor dimension,cases with lymphovascular invasion,perineural invasion,T0,T2,T3,T4 (T stage),stage 0,Ⅰ,Ⅱ and Ⅲ1 (TNM stage) were respectively (3.6±1.4)cm,5,10,4,10,20,20,4,7,15,28 in the treatment group and (4.5±1.7)cm,24,30,0,2,13,37,0,1,12,39 in the control group,with statistically significant differences between groups (t=-2.88,x2 =18.14,17.30,Z=14.74,8.13,P＜0.05).(3) Follow-up and survival situations:of 54 patients in the treatment group,52 were followed up for 4-72 months,with a median time of 32 months;of 52 patients in the control group,49 were followed up for 5-71 months,with a median time of 36 months.The postoperative diseasefree survival time,1-,3-and 5-year tumor-free survival rates,postoperative overall survival time and 1-,3-and 5-year overall survival rates were respectively 26 months (range,3-72 months),79.5％,64.7％,61.3％,27 months (range,5-72 months),88.3％,69.2％ and 62.1％ in the treatment group.Seventeen patients had tumor recurrence,including 2 with intraperitoneal local recurrence and 15 with distant metastasis.The postoperative disease-free survival time,1-,3-and 5-year tumor-free survival rates,postoperative overall survival time and 1-,3-and 5-year overall survival rates were respectively 33 months (range,2-71 months),89.7％,55.4％,55.4％,33 months (range,5-71 months),91.8％,72.1％ and 59.7％ in the control group.Nineteen patients had tumor recurrence,including 8 with intraperitoneal local recurrence and 11 with distant metastasis.There was no statistically significant difference in disease-free survival and overall survival between groups (x2 =0.018,0.596,P＞0.05).There was a statistically significant difference in cases with local recurrence between groups (x2=4.41,P＜ 0.05) The tumor-free survival time and overall survival time in the treatment group were respectively 29 months (range,8-72 months),38 months (range,10-72 months) in 31 patients with CR and PR and 11 months (range,3-68 months),18 months (range,4-68 months) in 23 patients with SD and PD,showing statistically significant differences in tumor-free and overall survival times (x2=5.27,7.72,P＜0.05).Concluslon Neoadjuvant chemotherapy with oxaliplatin and capecitabine is safe and effective for patients with the resectable locally advanced AEG,it can also decrease tumor stage and reduce local recurrence,but fail to demonstrate a survival benefit.

Objective To analyze the clinical pathology features of light-chain amyloidosis associated renal disease,and investigate the survival influential factors. Method From January 1998 to March 2009,25 patients with light-chain amyloidosis associated renal disease were reviewed and followed up.Results Of the 25 patients with light-chain amyloidosis associated renal disease,median age was 57(37-69) years old and lamda light-chain predominated (88% ,22/25). Heavy proteinuria and nephrotic syndrome with peripheral edema were typical clinical presentations. Renal biopsy showed that amyloid deposition of light-chain amyloidosis associated renal disease involved the glomeruh mostly, with mesangial area widening. Median survival of all patients was 24.4 months after diagnosis. The estimated 1,2,3 year survival rate was (65 ± 10 )%, (46 ± 12 )% and (15 ± 12 )% respectively. There was significant difference in median survival between the two groups (24.7 months in the group of 14 patients with isolated kidney affected,16.4 months in the group of 11 patients with kidney and other organs involved,P = 0.03). By univariate analysis, kidney associated with other organs amyloidosis and renal dysfunction were relevant to prognosis (P ＜ 0.05) and heart involvement was probably relevant (P = 0.06),whereas sex,age,plasma cell ratio,serum albumin level and hemoglobin level had no relation(P＞ 0.05 ). Multivariate analysis revealed that renal dysfunction at the time of diagnosis was a significant and independent prognostic factor for survival (P ＜0.05). Conclusions Renal dysfunction at the time of diagnosis is the best predictor of survival. The presence of amyloidosis in organs other than the kidney, such as advanced cardiac amyloidosis, predicts a poor survival.

Objective To investigate the differences of clinicopathologic characteristics and prognosis between young and old age patients with rectal cancer. Methods From January 1996 to January 2006, 85 young patients(age≤40 years) and 155 older patients(age≥65 years)with rectal cancer were surgically treated. The clinicopathological and follow-up data of them were retrospectively analyzed and compared by survival analysis and COX regression multivariate analysis. Results Rectal cancer under peritoneal in young group were higher than that in older group (69.41 % vs 52.90 %, P =0.013). The young group had significantly higher frequencies of pooly differentiated carcinoma (31.76 % vs 18.71 %, P =0.023) and more mucinous adenocarcinoma as well as signet-ring cell carcinoma (22.35 % vs 8.39 %, P =0.007), There were more lymphatic metastasis in young group than that in old group (N_1+N_2: 63.53 % vs 47.10 %, P =0.015). The overall 5-year survival rates were 48.2 % and 55.7 % in young and old patients respectively, which was not significantly different (P =0.176). COX regression showed that radical operation, tumor infiltration depth,lymph node metastasis and TNM stage were independent prognostic factors. Conclusion As compared to the old age patients, more malignancy and more advanced stage are common in young patients with rectal cancer.However the efficacy of young patients is similar to the older counters by early detection and radical operation combined radiotherapy as well as chemotherapy.