Objective To evaluate the testing capabilities of laboratories,analyze existing issues,and improve testing quality,through carrying out the external quality assessment(EQA)of clinical laboratories for human papillomavirus(HPV)type 6 and 11 nucleic acid detection.Methods EQA plan was carried out twice a year.Each panel contains 4 positive samples,including one strong positive sample and one weak positive sample of HPV6 and HPV11,made from cervical secretions from patients with clinical manifestations of condyloma acuminata(CA)and positive for HPV6 or HPV11(from Shanghai First Maternity and Infant Hospital).One negative sample was cultured from the C-33A cell line(from Chinese Academy of Sciences).Samples were sent to participating laboratories by cold chain,and laboratories were required to detect test samples and upload their results within the specified time.Shanghai Center for Clinical Laboratory(SCCL)calculated the scores of each laboratory based on the return results.Results A total of 163 sample panels were sent out in the 6 rounds of EQA plan and 140 valid reports were received.The laboratory qualification rate was 96.43%(135/140)and the sample compliance rate was 97.86%(685/700).There were 13 false negative results and 2 false positive results,with weakly positive samples accounting for 76.92%(10/13)of the false negative results.Conclusion The detection accuracy of HPV6/11 nucleic acid in each laboratory was relatively high,and the detection ability of weak positive samples in individual laboratories may need to be improved.The laboratory could discover problems and improve its quality management by participating in EQA.

Objective:To investigate the effects of different levels of ophthalmic surgical stimulation on blood glucose in patients with type 2 diabetes mellitus(T2DM).Methods:From Mar to Oct 2021,236 patients with T2DM who underwent ophthalmic surgery in our hospital were enrolled,including 71 cases of secondary surgery,89 cases of tertiary surgery,and 76 cases of quaternary surgery.According to the operation time,the 236 patients were divided into groups A(＜60 min),B(60-120 min)and C(＞120 min).The preoperative and postoperative blood glucose levels were compared in patients with different levels of surgery,and in groups A,B and C.Results:The postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery,and it was higher than that before surgery in quaternary surgery(P＜0.05).The fluctuation value of blood glucose in secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In groups A,B and C,the postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery(P＜0.05).In group A,there was no significant difference in the blood glucose before and after surgery in quaternary surgery(P＞0.05),and in groups B and C,the postoperative blood glucose was higher than that before surgery in quaternary surgery(P＜0.05).In group A,there was no difference in the fluctuation value of blood glucose at different levels of surgery(P＞0.05).In group B,the fluctuation value of blood glucose in patients with secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In group C,the fluctuation value of blood glucose in patients with tertiary and quaternary surgery was higher than that in patients with secondary surgery(P＜0.05).Conclusions:For ophthalmic surgery patients with T2DM,the postoperative blood glucose values of patients undergoing secondary and tertiary surgery generally show a downward trend,while the postoperative blood glucose value of patients undergoing quaternary surgery generally shows an upward trend.It is suggested that clinical workers should actively manage the perioperative blood glucose of patients with high-level surgery.

ObjectiveTo explore the effect of repetitive peripheral magnetic stimulation on upper limb motor function rehabilitation of stroke patients after contralateral seventh cervical nerve transfer (CC7). MethodsFrom May, 2020, to May, 2022, 34 stroke patients with hemiplegia underwent CC7 in Jing'an District Centre Hospital of Shanghai were randomly divided into control group (n = 17) and observation group (n = 17). Both groups received conventional rehabilitation. The observation group accepted repetitive peripheral magnetic stimulation, and the control group received sham stimulation, for eight weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Hua-Shan Grading of Upper Extremity (H-S grading) before and after treatment. ResultsTwo cases dropped down in each group. There was difference in gender between two groups (χ² = 6.136, P < 0.05). After treatment, the scores of FMA-UE and H-S grading significantly improved in both groups (t > 4.000, P < 0.01), and the improvement was better in the observation group than in the control group (t > 2.362, P < 0.05). ConclusionRepetitive peripheral magnetic stimulation could improve the motor function of upper limb and hand of stroke patients with hemiplegia after CC7.

Objective To explore the effects of triclosan (TCS) on the immune function of mice. Methods Forty male and female Kunming mice (25±2 g) were selected. The animals were divided into 5 groups according to body weight ratio, including a blank control (saline solution) group, dimethyl sulfoxide (DMSO) group, and three triclosan solution groups (59.375 mg/kg, 118.75 mg/kg, and 237.5 mg/kg, respectively). There were 8 mice in each group, half male and half female. Animals were treated with TCS by intragastric administration once a day for two weeks. Upon the completion of the treatment, animals were sacrificed, the spleen, thymus and other tissues were collected, and the ratios of their weight to body weigh were calculated. The peripheral blood was taken by eye-ball removal method, and the half hemolysis value was determined. Results Compared with the positive control group, the spleen index of male mice in the medium dose group and high dose group increased significantly (P < 0.05), and the spleen index of female mice in the high dose group showed significant difference (P < 0.05). Compared with the positive control group, the thymus index of male high dose group was significantly different (P < 0.05). The thymus indexes of female high, medium, and low dose groups all were significantly different compared to the control group (P < 0.05). HC50 results showed that the HC50 of both male and female mice decreased (P < 0.05). Conclusion High concentration of triclosan can inhibit the immune function of Kunming mice.

Objective To evaluate the clinical value of holographic image navigation in urological laparoscopic and robotic surgery.Methods The data of patients were reviewed retrospectively for whom accepted holographic image navigation laparoscopic and robotic surgery from Jan.2019 to Dec.2019 in Beijing United Family Hospital and other 18 medical centers,including 78 cases of renal tumor,2 cases of bladder cancer,2 cases of adrenal gland tumor,1 cases of renal cyst,1 case of prostate cancer,1 case of sweat gland carcinoma with lymph node metastasis,1 case of pelvic metastasis after radical cystectomy.All the patients underwent operations.In the laparoscopic surgery group,there were 27 cases of partial nephrectomy,1 case of radical prostatectomy,2 cases of radical cystectomy and 2 cases of adrenalectomy.In the da Vinci robotic surgery group of 54 cases,there were 51 cases of partial nephrectomy,1 case of retroperitoneal lymph node dissection,1 case of retroperitoneal bilateral renal cyst deroofing and 1 case of resection of pelvic metastasis.There were 41 partial nephrectomy patients with available clinical data for statistic,with a median age of 53.5 years (range 24-76),including 26 males and 15 females.The median R.E.N.A.L score was 7.8 (range 4-11).Before the operation,the engineers established the holographic image based on the contrast CT images and reports.The surgeon applied the holographic image for preoperative planning.During the operation,the navigation was achieved by real time fusing holographic images with the laparoscopic surgery images in the screen.Results All the procedures had been complete uneventfully.The holographic images helped surgeon in understanding the visual three-dimension structure and relation of vessels supplying tumor or resection tissue,lymph nodes and nerves.By manipulating the holographic images extracorporeally,the fused image guide surgeons about location vessel,lymph node and other important structure and then facilitate the delicate dissection.For the 41 cases with available clinical data including 23 cases of robotic-assisted partial nephrectomy and 18 cases of laparoscopic nephrectomy,the median operation time was 140 (range 50-225) min,the median warm ischemia time was 23 (range 14-60) min,the median blood loss was 80(range 5-1 200) ml.In the robotic surgery group,the median operation time was 140 (range 50-215)min,the median warm i schemia time was 21 (range 17-40)min,the median blood loss was 150(range 30-1 200)ml.In the laparoscopic surgery group,the median operation time was 160(range 80-225)min,the median warm ischemia time was 25 (range 14-60)min,the median blood loss was 50 (range 5-1 200) ml.All the patients had no adjacent organ injury during operation.There were 2 cases with Clavien Ⅱ complications.One required transfusion and the other one suffered hematoma post-operation.However,the tumors were located in the renal hilus for these 2 cases and the R.E.N.A.L scores were both 11.Conclusions Holographic image navigation can help location and recognize important anatomic structures during the surgical procedures..This technique will reduce the tissue injury,decrease the complications and improve the success rate of surgery.

Objective: To evaluate the external quality assessment (EQA) program for genotyping results of tacrolimus metabolism-related cytochrome P450 family 3 subfamily A member 5 ( CYP3A5 )using plasmid DNA constructed in vitro as quality control samples, discuss the problems in clinical laboratories enrolled in the program and improve the detection quality of CYP3A5 gene. Methods: Recombinant plasmid carrying CYP3A5 *3 (rs776746) AA locus sequence was constructed as wild type sample and plasmid with CYP3A5 *3 GG mutation as mutant type sample. Heterozygous mutant samples were obtained by mixing the two plasmids with equal proportion. Recombinant plasmids DNA were used as the sample panel for EQA scheme. Participating laboratories were asked to test the samples using their routine methods and report the results before deadlines. The scores of each laboratory were calculated based on their results and the overall coincidence of different samples as well as the sensitivity and specificity of different methods. Results: CYP3A5 *3 locus genotypes of the constructed plasmid were verified by Sanger sequencing. The results of 15 and 17 valid laboratories were received respectively in the two EQA programs. The total percentage of 93.33% (14/15) and 100% (17/17) of the laboratories submitted correct results for all the samples. The overall coincidence rates were 96% (72/75) and 100% (85/85) respectively. All the laboratories using digital FISH got full marks in two EQA schemes, while the coincidence rates were 90% (27/30) and 100% (40/40) for Sanger sequencing. Conclusion The recombinant plasmid DNA constructed in this study could effectively detect the performance of reagents with good clinical applicability. The results of EQA programs suggested that the overall accuracy rate of enrolled laboratories was high enough, while the performances in some laboratories still need to be improved. Quality controls in clinical laboratories were essential to assure the accuracy of results.

A male patient, with diagnose of Madelung disease, was admitted in September 2009. He has been a heavy drinker for decades before onset of the disease. This patient was characterized by the large amount of symmetrical deposits of adipose tissue in the subcutaneous layer around neck, and without obesity on other sites. The excessive adipose tissue was surgically removed by three steps. Appearance almost returned to normal. No recurrence happened after 8 years of follow-up.

Objective To evaluate the performance of MTHFR 677 genotyping external quality assessment ( EQA) program using plasmid DNA constructed in vitro as quality control samples and discuss the problems in clinical laboratories enrolled in the program .Methods Recombinant plasmid carrying MTHFR 677C locus sequence was constructed as wild type sample and plasmid with MTHFR 677T mutation was generated with site-directed mutagenesis as mutant type sample .Heterozygous mutant samples were obtained after equal proportion of the two plasmids .EQA scheme were held twice a year in 2016 and 2017, and sample panels contained 5 different samples using recombinant plasmid DNA containing all types of MTHFR 677 locus genotypes.Participating laboratories were asked to test samples using their routine methods and report the results before deadlines .26, 28, 52 and 56 effective reports were received respectively in the four EQA schemes .The scores of each lab were calculated based on their results and the overall compliance of different samples as well as the sensitivity and specificity of different methods were calculated using Microsoft Excel .Results MTHFR 677 locus genotypes of the constructed plasmid were verified by Sanger sequencing and there was no failure of sample detection in the four EQA schemes , which suggest that the plasmid has good clinical applicability .About 96.15％( 25/26 ) ,100％( 28/28 ) ,96.15％ (50/52)and 98.21％(55/56) of the laboratories submitted correct results for all samples in the four EQA schemes.The overall compliance rate were 99.23％ ( 129/130 ) , 100％( 140/140 ) ,96.92％ ( 252/260 ) and 98.93％(277/280) respectively.All laboratories using digital FISH and microarrays got full marks in four EQA schemes.The compliance rates for fluorescent PCR were 97.5％ ( 39/40 ) , 100％ ( 45/45 ) , 94.29％(66/70) and 100％ (95/95) respectively, while the rates were 100％ (20/20), 100％ (15/15), 90％(36/40) and 92.5％(37/40) for Sanger sequencing.Conclusions The recombinant plasmid DNA constructed in this study can effectively detect the performance of reagents with good clinical applicability.The results of EQA programs suggested that the overall accuracy rate of laboratories enrolled was high enough , while some laboratories′performance still needs to be improved .Quality controls in clinical laboratories were essential to assure the accuracy of results .

Objective Comparative study of gastric tube implantation at different times in patients with invasive mechanical ventilation. Methods Random sampling was used to divide 160 patients who were incubated with mechanical ventilation at the hospital into two groups,There were 80 patients in each group. Two groups of patients were routinely placed gastric tube by a stationary nurse.The observation group was treated with ordinary silica gel stomach tube at early stage(immediately)after trachea cannula, the control group still used the ordinary silica gel stomach tube after the trachea cannula late (24 hours later).The one-time successful rate,the total successful rate,the operation time and the result of the two Methods were observed in the two groups. Results The observation group Placing stomach tube one-time successful rate and the total successful rate was 75% (60/80), 97.5% (78/80), significantly higher than the control group 27.5%(22/80),72.5%(58/80),the difference was statistically significant(χ2=36.12, 19.61,P<0.01).The operation time of gastric tube in observation group was(1.49 ± 0.45)min,which was significantly lower than that of control group(3.07 ± 0.32)min,the difference was statistically significant (t=25.48,P<0.01).The observation group only heard gurgling not pumped to the gastric juice of 10 cases (12.50%), only smoke into the gastric juice does not hear the gurgling in 0 cases, both in 70 cases (87.50%),both in 0 cases,the control group were 37 cases(46.25%),0 cases,40 cases(50.00%),3 cases (3.75%). There were significant differences between the 2 groups in determining the success of gastric tube placement,and the difference was statistically significant(χ2=39.36,P<0.01). Conclusions After the trachea cannula,the ordinary silica gel gastric tube was placed in the early stage(immediately),which improved the successful rate of gastric tube placement in the mechanical ventilation patients, Shortened the operation time,improved the work efficiency and alleviated the patient's pain.

Objective To develop a set of high-frequency ultrasound grayscale blood flow imaging system based on field programmable gate array (FPGA) to execute simultaneous imaging of superficial blood flow and tissues.Methods This system was mainly composed of an ultrasonic transducer,an ultrasonic transmission and receiving modules,imaging software in host computer and peripheral equipment.A PVDF transducer with the frequency between 20 and 50 MHz was used for the ultrasonic transducer.In transmission and receiving modules,the radio frequency echo signals were digitized by high-speed A/D.Then the digital signals were transmitted,added,filtered,demodulated,log amplified,double sampled,and lastly transferred to the host computer by USB interface for real-time display.Results A vascular 1 mm far form the surface of the hand skin was examined by this system.Four blood flow images were obtained in corresponding with four transmission frequencies.Conclusion Real-time superficial organ blood flow imaging is realized by this system.The solution has the architecture concise and clear,and lays an experimental foundationfor high-frequency ultrasound gray-scale blood flow imaging.