Purpose To explore the effects of ploidy analysis on thoracic neoplasms based on DNA image cytometry (DNA-ICM), and to look for a meaningful novel diagnostic assay for tumor patients. Methods 4 402 patients who were diagnosed with thoracic disease were recruited in 2 years. By the DNA-ICM analysis, all the specimens were diagnosed as three types——positive, equivocal and negative ones. The results of701 specimens were compared with biopsy and clinical followup. Results DNA aneuploidy detected by DNA-ICM were65％ in confirmed malignant samples, 64％ in equivocal malignancy, and 8％ in non-malignant diseases. The comprehensive performance of DNA-ICM in malignancy was 73％, 93％, 71％, 94％ respectively for sensitivity, specificity, positive predictive value and negative predictive value. OR analysis found that the risk ratio of aneuploidy in malignancy was 23.236 compared to non-malignancy. Conclusion DNA-ICM can be applied in thoracic malignancy and have more potential values to be explored in oncology.

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.

Objective To analyze the related pathogenicity gene mutations in a sudden death of hypertrophic cardiomyopathy (HCM) on whole exome level.Methods Whole exome sequencing (WES) was been performed on a sudden death case sample with pathological features of HCM by Illumina(R) Hiseq 2500 platform.Using hgl9 as the reference sequences,the sequencing data were analyzed.Suspicious single nucleotide variants (SNV) were screened,and the conservatism and function were analyzed by the software such as PhyloP,PolyPhen-2,SIFT,etc.Results After screening,a heterozygous mutation C719R was finally identified in the gene MYBPC3 of this case.Conclusion The molecular anatomy on whole exome level by second generation sequencing technology can help to define the molecular mechanism of HCM and provide a new mothed and thought for analysis of death cause.

Objective To investigate the metabolic effects of glucose dependent insulinotropic peptide receptor antagomst pro3 (GIP) in induced diabetes mice about blood glucose,triglyceride,cholesterol,leptin and fatty issue.Methods 27 C57 mice were randomly divided into normal group and diabetes mice group,and the mice in diabetes group were fed with high fat food and intraperitoneal injected streptozocin.Then 1 mouse that random blood giucose lower than 16.9 mmol/L was deleted in diabetes group.The rest mice in diabetes group were divided into two groups,diabetes control group,pro3 (GIP) group.Pro3 (GIP) group was given drug pro3 (GIP).The bloodglucose and glucose tolerance were measured.After treatment for 6 weeks,all mice were sacrificed and fatty tissues were collected.Results After 6 weeks,the blood glucose of the pro3 (GIP) group was obviously lower than diabetes control group (t=8.43,P＜0.01),and insulin levers in 0,30,60 and 120 min were obviously lower than diabetes control group (t =3.90,2.60,6.88 and 3.33,P＜0.05).There was significant difference between pro3 (GIP) group and diabetes control group about inflammatory cells.Moreover,leptin in pro3 (GIP) group was obviously lower than in diabetes control group (t =5.04,P＜0.01),but triglyceride,cholesterol,and adiponectin had no significant difference between two groups.Conclusion Pro3 (GIP) can significantly reduce blood glucose,insulin level,leptin of diabetes mice,and attenuate the inflammatory cells infiltration in fatty issue.

Objective To investigate the antibacterial resistance in nationwide's tietiary hospitals and understand the trend of antimicrobial resistance.Methods All the clinical isolates were collected from 18 hospitals and the minimal inhibitory concentrations (MICs) were tested using agar dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The susceptibilities of isolates to antimicrobial agents were determined by using CLSI or European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2017 guideline.Results A total of 4333 pathogenic isolates from 18 tertiary hospitals in 18 cities nationwide over the period from July 2015 to June 2016 were studied.Based on the MIC results,Escherichia coli and Klebsiella pneumoniae showed extended spectrum β-lactamase (ESBLs) phenotype rates of 59.4％ and 27.5％,respectively;decreased by 7 to 10 percentage points comparing the last time.Carbapenems,amikacin,moxalactam,β-lactam/β-lactamase inhibitor combinations,tigecycline,and fosfomycin displayed desirable antibacterial activity against Enterbacteriaceae,but a significant increasing of carbapenems resistance Klebsiella pneumoniae were noted.For non-fermenting Gram-negative isolates,resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannnii to imipennnem were 29.5％ and 69.8％ and multidrug-resistant (MDR) detection rate were 35.6％ and 78.3％,extensively drug-resistant (XDR) were 10.2％ and 72.5％,respectively.Klebsiella pneumoniae isolated from children were more resistant to β-lactam than those from adults and the old people,so bacterial resistance in children is an important problem in China.Conclusion Though the decline of ESBLs detection rate,carbapenem non-susceptible Klebsiella pneumoniae rates continued to increase,which should be paid more attention.

Objective To investigate the gram-positive coccus resistance in nationwide's tietiary hospitals and understand the trend of antimicrobial resistance.Methods All the clinical isolates were collected from 18 hospitals and the minimal inhibitory concentrations (MICs) were tested using agar/broth dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The susceptibilities of isolates to antimicrobial agents were determined by using CLSI or European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2017 guideline.Results A total of 2301 Gram-positive cocci isolated from 18 hospitals in 18 cities nationwide were studied.Based on the MIC results,the prevalence of methicillin resistant Stapylococcus aureus (MRSA) and methicillin resistant Stapylococcus epidermidis (MRSE) were 39.9％ and 86.6％ respectively.No vancomycin insensitive Staphylococcus was detected.Staphylococcus aureus were 100％ susceptibile to linezolid and teicoplanin,but resistant or insensitive for drugs other than vancomycin were observed among Coagulase Negative Staphylococci (CoNS).Antibiotic resistance rate of Enterococcus faecalis and Enterococcusfaecium to ampicillin were 4.5％ and 85.1％.The detectation rate of vancomycin resistant Enterococcus(VRE) was 2.1％.Nonsusceptibility rate of Enterococcus faecalis to linezolid was 7.8％,showing slight increase than last time.The prevalence of penicillin nonsusceptible Streptococcus pneumoniae (PNSSP) was 6.6％ based on non-meningitis and parenteral administration criterion;while for cases of oral penicillin,the rate was 70.0％,was as flat as last time.There were no significant differenees of resistance rates of Stapylococcus aureus,Stapylococcus epidermidis Enterococcus faecalis and Enterococcus faecium among various groups such as different department,age,or specimen source.Conclusion Compared with past surveillance result,VRE detection ratio was steady,while MRSA detection ratio decreased.The emergence of resistance and non-susceptible strains to new antibiotics such as linezolid,tigecycline and daptomycin should be payed more attention.

Objective To study the effect of propofol intravenous on myocardial damage degree and cardiac function for 2 diabetes patients before and after coronary artery bypass grafting.Methods Seventy-six patients with type 2 diabetes in our hospital was selected from April 2014 to October 2015.The patients were divided into treatment group and control group,according to the method of random numbers,38 cases in each group.Patients in two groups were taken general anesthesia induction,treatment group were infused 1-2 μg · kg-1 · mL-1 propofol after anesthesia induction to maintain anesthesia,continuous intravenous infusion of 0.2-0.4 μg · kg-1 · min-1 fentanyl.Patients in control group isoflurane inhalation and intravenous 0.2-0.4 μg · kg-1 · min-1 fentanyl.Before surgery and postoperative 12 h,the level of the malondialdehyde (MDA),superoxide dismutase (SOD),ischemia modified albumin (IMA),troponin I (cardiac troponin I,cTnI) in two groups were measured by spectrophotometer.Results Before the operation,the level of MDA,SOD,IMA,cTnI in the treatment group were (3.69 ±0.43) nmol · L-1,(73.24 ±6.13) nmol · L-1,(77.29 ± 3.94)ABSU · mL-1,(0.08 ± 0.02) μg · L-1,respectively while in control group were (3.62 ± 0.37) nmol · L-1,(72.36 ±8.22)nmol · L-1,(77.61 ± 3.74) ABSU · mL-1,(0.07 ± 0.01) μg · L-1 with no significant difference (P＞0.05).After 12 h of operation,the level of MDA,IMA,cTnI in treatment group were (4.42 ±0.82) nmol · L-1,(70.52 ± 2.62) ABSU · mL-1,(3.70 ± 0.28) μg · L-1,significantly lower than control group with (7.14 ±1.01)nmol · L-1,(73.63 ±4.12) ABSU · mL-1,(4.79 ±0.29)μg · L-1.But SOD in treatment group was (68.74 ± 6.82) nmol · L-1,significantly higher than the control group with (64.O1 ± 5.88) nmol · L-1,the difference between two groups above factors had statistical significance (all P ＜ 0.05).Conclusion Patients with type 2 diabetes using CABG surgery,the use of intravenous propofol,compared with isoflurane,can effectively reduce the degree of myocardial injury and effectively protect the cardiac function in patients.

Purpose To compare coronary plaque burden,composition,distribution and the degree of coronary artery stenosis in invasive coronary angiography (ICA) diagnosed coronary artery disease (CAD)patients with or without metabolic syndrome (MetS).Methods From January 2008 to June 2011,consecutive patients underwent both coronary computed tomography angiography (CCTA) and ICA within three months were enrolled.Patients with history of previous percutaneous coronary interventions (PCI) and coronary artery bypass grafting (CABG) were excluded.Plaque characteristics and maximal luminal diameter stenosis were analyzed on a 16-segment basis as suggested by the American Heart Association classification.Results The study population consisted of 872 patients [age (60.2 ± 10.0) years,72.70％ males] including 377 patients with MetS and 495 patients without MetS.The median coronary artery calcium score (CACS) was higher in MetS patients than in non-MetS patients [102(10,410) vs.58(0,274),P ＜ 0.01].Percentage of patients with no coronary artery calcium was significantly lower in MetS group than in non-MetS group [19.63％ (74/377) vs.30.71％ (152/495),P ＜ 0.01],while percentage of patients with severe coronary calcium (CACS ≥ 1000) were significantly higher in MetS than non-MetS group [8.22％ (31/377) vs.4.65％ (23/495),P =0.03].The proportion of patients with 1-vessel disease was lower [23.61％ (89/377) vs.36.77％ (182/495),P ＜ 0.01],2-vessel [29.71 ％ (112/377) vs.22.83 ％ (113/ 495),P ＜ 0.05] and 3-vessel disease [35.54％ (134/377) vs.24.44％ (121/495),P ＜ 0.01] were higher in MetS group than in non-NetS group.Calcified plaque of LM and the middle and distal coronary artery were significantly higher in MetS group than in non-MetS group(all P ＜ 0.05).Conclusions CAD patients with MetS are associated with severer coronary artery calcium deposition and higher percentage of calcified plaque in the middle and distal coronary arteries and severer obstructive coronary vessels.

Objective To investigate the involvement of heme oxygenase (HO-1) in PM2.5 induced toxic responses in human umbilical vein endothelial cells (HUVECs).Methods The experiment groups are as follows:(1) control group; (2) PM2.5 groups:the cells were cultured with various concentrations of PM2.5 (200,400,800 μg/ml) for 24 h and 400 μg/ml was chosen for the main study; (3) PM2.5 + Trion group:the cells were pre-treated by 10 μmol/L Trion [a scavenger of reactive oxygen species(ROS)] for 1 h before PM2.5 (400 μg/ml) treatment for 24 h; (4) PM2.5 +ZnPP group:the cells were pretreated by HO-1 inhibitor ZnPP (10 μmol/L) for 1 h before treatment with PM2.5 (400 μg/ml) for 24 h.MTT assay was used to detect cell viability.Reverse transcription polymerase chain reaction (RT-PCR) and indirect immunofluorescence assay were used to determine the mRNA and protein expressions of HO-1.Fluorescence labeling probe method was used to measure intracellular ROS level and flow cytometry was used for cell apoptosis.Colorimetric assay was used to detect intracellular caspase-3 activity.Results Compared with control,PM2.5 significantly decreased cell viability,increased intracellular ROS,cell apoptosis and caspase-3 activity (all P ＜ 0.05),these effects were significantly attenuated in PM2.5 + Tiron group while enhanced in PM2.5 + ZnPP group (all P ＜ 0.05 vs.PM2.5 group).PM2.5 upregulated HO-1 mRNA and protein expressions in HUVECs which was downregulated in both PM2.5 + Tiron group and PM2.5 + ZnPP group.Conclusion PM2.5 could induce oxidative injury through increasing ROS production via modulating HO-1 mRNA and protein expressions,the injury could be aggravated with inhibition of the activity of HO-1 suggesting a potential protective role of HO-1 against PM2.5 induced oxidative stress in HUVECs.

Objective To investigate the oncolytic effect of E1B mutant adenovirus (d11520) on human malignant gliomas. Methods Ad-βgal vector was used to investigate the infectibility of dl1520.U251,Hep3B (positive control) and T24 (negative control) cell lines were infected with dl1520respectively at 50,5,0.5,0.005 and 0 pfu of multiplicity of infection (MOI).The replication efficiency of d11520 in host cells was assessed by plaque assay.The cytopathic effect (CPE) was assessed by crystal violet staining in a panel of tumor cells. Results Crystal violet staining showed the Hep3B cell line was the most sensitive to dl1520 and had the fastest CPE,followed by the U251 cell line,while the T24cell line had no CEP.The replication and infection rates ofdl1520 in the U251 cell line were lower than in the Hep3B cell line but significantly higher than in the T24 cell line (P＜0.05). Conclusion The E1B mutant adenovirus (dl1520) has a significant oncolytic effect on human malignant gliomas.