Objective:To establish a candidate reference procedure for the enumeration of cell particles in urine and applied to the multi-center performance evaluation of an automated urine formed elements analyzer.Methods:According to the standardized mannual microscopic examination of fresh non-centrifuged urine samples and the recommended reference method for enumeration of cell particles in urine published by ISLH, we established a candidate reference procedure for the enumeration of cell particles in urine. From four class A tertiary hospitals′ clinical laboratories, three rigorous trained technicians per hospital tested the same specimen respectively using the reference procedure. Each specimen was repeatedly counted 5 times, obtaining the quantitative results of cell particles were obtained in urine. Four hospitals used the established candidate reference measurement procedure and the automated urine formed elements analyzer to detect 40 to 60 urine specimens from September 2020 to January 2021, and evaluate the established reference method, meanwhile evaluate the accuracy and consistency of the each count from automated urinalysis analyzer.Results:Using the candidate reference measurement procedures, the coefficient of variation of results derived from three trained technicians per hospital was less than 6.98% (red blood cells), 6.99% (white blood cells), 13.94% (epithelial cells) and met the quality requirements. The performance evaluation results of automated urine formed elements analyzer showed that the accuracy of red blood cells, white blood cells and epithelial cells met the requirements (bias≤4.98%) and was well consistent with the reference measurement procedure ( R2≥0.989). Conclusions:A candidate reference measurement procedure for the enumeration of urine cell particles was successfully established with satisfactory precision and accuracy. This procedure was applied to multicenter performance evaluation of an automated urine formed elements analyzer with good accuracy and consistency.

OBJECTIVE: To detect potential variant in an ethical Han Chinese pedigree affected with breast cancer. METHODS: The proband and her relatives were subjected to next-generation sequencing using a target capture sequencing kit containing 121 cancer-related genes. Candidate variants were selected by analysis of their type, frequency in population, and segregation with the phenotype. Candidate variant was verified by Sanger sequencing and TA cloning. RESULTS: A c.2013_2014ins GT variant was detected in the BRCA1 gene among all breast cancer patients from this pedigree but not among healthy females. The variant was not recorded in the 1000 Genome Project database or the Exome Aggregation Consortium (ExAC) database. The frameshifting insertion was predicted to form an premature stop codon in gene transcript and can give rise to a truncated protein. CONCLUSION The BRCA1 c.2013_2014ins GT variant probably underlies the pathogenesis of breast cancer in this Chinese pedigree.
Asian Continental Ancestry Group ; BRCA1 Protein ; genetics ; Breast Neoplasms ; genetics ; Exome ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Pedigree ; Phenotype

Objective: To investigate the potential improvement of sample quality by automatic pre-analysis sample checking system, comparing to visual inspection for coagulation tests routinely. Methods: Thirty samples with hemolysis, Icteric and lipemia in different levels were prepared and issued to 13 technicians for visual check, to evaluate the consistency individually. 2 949 blood samples with order for coagulation test were collected in Beijing Chaoyang Hospital in April and May 2018, the quality of all samples was evaluated by both visual check and automatic sample quality checking system before analysis, performance of two measurements detecting hemolysis, lipid, icteric or clot was compared. Results: Significant differences were found in visual check among operators. The Kappa coefficients in three randomly selected groups were 0.32, 0.26 and 0.38 respectively, indicating that the consistency of visual check was poor. Among all investigated samples, 3 samples with unacceptable interference were detected visually, including 2 samples with hemolysis and another one with lipemia. On the other hand, 19 unqualified samples were identified by automatic checking system. Five types of interference of unqualified samples were detected as icteric (26.32%,5/19), clot (21.05%,4/19) hemolysis (5.26%,1/19),lipemia (36.84%, 7/19), and hemolysis with lipemia (10.53%,2/19) respectively by automatic checking system. But one case of hemolysis sample rejected by visual check was not rejected by automatic sample quality checking system.7 samples were merely affected on D-dimer by lipemia, which level did not influence the results of prothrombin time(PT) and activated partial thromboplastin time (APTT). Notably, other two samples were interfered with not only tests of PT, APTT and fibrinogen by hemolysis, but also D-dimer by the considerable level of lipemia, which showed the superiority of test-specific quality checking features. Conclusions The automatic pre-analysis sample quality checking system can improve the detection rate of unqualified samples and improve the efficiency of routine, helping realization of total quality management.

Objective? To establish a standardization training indicator system for newly admitted nurses in orthopedics based on the theory of post competence. Methods? Indicators at different levels were defined by literature analysis and focal group interview from August 2017 to April 2018. Totally 15 experts were consulted by correspondence for two rounds using Delphi method. The standardization training indicator system for newly admitted nurses in orthopedics was finally built. Results? The standardization training indicator system for newly admitted nurses in orthopedics included 5 primary indicators, 12 secondary indicators and 59 tertiary indicators. Conclusions? The experts' response to correspondence consultation is active and their authority coefficient and coordination is satisfactory. The standardization training indicator system for newly admitted nurses in orthopedics built in this study is scientific, proper and clinically practical, which provides a reference for nurse training.

Objective To compare and study the two kinds of quality control methodologies related to intelligent quality management system ( iQM) and traditional quality control , and the quality control performance of iQM equivalent to traditional quality control were evaluated , ensuring the accuracy of the results of blood gas testing.Methods Beijing Chaoyang Hospital of Capital Medical University , Beijing Tiantan Hospital of Capital Medical University , Shanghai Longhua Hospital of Shanghai University of Chinese Medicine, and Sichuan Provincial People′s Hospital, these 4 medical institutions were selected to implement this study.During the period from June 2016 to December 2016, in the routine detection of total 3 712 specimen, the iQM and traditional quality control modes were used simultaneously to calculate the mean values of all blood gas parameters quality controls , SD, CV (%) and Sigma values, to evaluate the quality control performance and difference of the two quality control modes .Results During the process of testing blood gas samples from 3 712 specimen in 4 hospitals, iQM process control solution ( PCS) A, B, C ran 1 089, 7 678 and 154 quality control samples respectively , and 732 external quality control samples were run by traditional quality control mode .Considering the most sensitive parameters of blood gas testing pO 2, iQM PCS A, B, C′s Sigma value are higher than 8, however, the traditional quality control′s Sigma value are less than 6; For parameters pCO2, pO2and Na+, there exists significant difference between two quality control methods (P＝0.004 8,P＝0.000 1,P＝0.004 4,P＜0.01), other parameters pH, K+, Ca ++, Glu, Lac and Hct, there exists no significant difference between two quality control methods (P＝0.250 6, P＝0.062 3,P＝0.034 0,P＝0.346 9,P＝0.186 3,P＝0.823 1,P＞0.01).Totally 22 errors detected by iQM, includes 14 micro-clots and 8 interferences samples, which were not detected by traditional quality control .Conclusions The error in blood gas analysis mainly comes from the pre-analytical phase.iQM enhanced specimen inspection capabilities and make up for the inability of traditional quality control to monitor the quality of specimens , enabling full-scale, real-time, and dynamic monitoring of each specimen , powerful error detection capabilities , and automatic error correction capabilities . Besides, automatic documentation saves staff much time.The system can effectively ensure the accuracy of blood gas test results, meet the quality requirements of related laws and regulations and related industry standards , and also can meet the clinical intended use , providing new ideas for POCT quality management and improvement.

Objective:To investigate the improvement effects of duodenal-jejunal bypass (DJB)on the blood glucose homeostasis,insulin resistance and inflammation of the obese type 2 diabetic (T2DM)ZDF rats,and to discuss its possible mechanism.Methods:A total of 20 ZDF rats were randomly divided into DJB operation group and sham operation group (n = 10).There were 8 rats survived in each group after operation.The level of blood glucose (FBG)was detected by Roche glucose meter at 1 week before operation,2 weeks,4 weeks and 6 weeks after operation;the fasting serum insulin level of the rats was measured by ELISA kit;the insulin sensitivity index (HOMA-ISI)and insulin resistance index (HOMA-IR)were calculated.The rats were executed 6 weeks after operation.HE staining was used to observe the morphology of the inflammatory cells in BP limb of the rats;the expression levels of AMPK and pAMPK in BP lamb of the rats were observed by immunohistochemical staining;the expression levels of interleukin 1β(IL-1β),interleukin 6 (IL-6),tumor necrosis factorα(TNF-α),nuclear factorκB (NF-κB),and interleukin 10 (IL-10)mRNA of the rats were detected by QRT-PCR method.Results:From the 2nd week after operation,compared with before operation,the FBG levels of the rats in DJB operation group were decreased (t=3.798,P <0.05);compared with sham operation group,the FBG level of the rats in DJB operation group was decreased (t=3.205,P <0.05).Six weeks after operation,compared with sham operation group,the HOMA-IR of the rats in DJB operation group was significantly decreased (t=4.441,P <0.05)and the HOMA-ISI was significantly increased (t=-8.65,P < 0.05).The HE staining results showed that compared with sham operation group,the morphology of the inflammatory cells in BP limb of the rats in DJB operation group was significantly improved.The QRT-PCR results showed that the expression levels of IL-1β,IL-6,TNF-αand NF-κB of the rats in DJB operation group was significantly decreased compared with sham operation group (P < 0.05), while the expression level of IL-10 was significantly increased (P < 0.05).The immunohistochemical test results showed that the expression levels of AMPK and pAMPK in BP lamb of the rats in DJB operation group were increased compared with sham operation group.Conclusion:DJB can significantly improve the blood glucose homeostasis and insulin resistance in the T2DM rats,and its mechanism may be related to the decreased expressions of inflammatory factors and the activation of AMPK molecules in BP lamb of the T2DM rats.

Objective To investigate the distribution of critical values of adults in Beijing, to provide the evidence for the formulation of the Standardized Management Guideline in Critical Values, in order to promote the accurate management of critical values.Methods A total of 110 398 data of critical values from the tertiary and above medical institutions during January 1 to May 31 in 2015 in Beijing were collected by the way of on-site inspection, covering the disciplines of hematology, clinical chemistry, coagulation and blood gas analysis.Fristly, the selected critical values were classified by the factor of admission departments and disease types,then were analyzed by using Kruskal-Wallis test, to compare the differences in each group.Secondly,the combined groups were classified by the factor of gender then were analyzed by using Mann-Whithey U test, to compare the differences in each group.Finally, the stratification thresholds of critical values were established.Results Except for the upper limits of Ca, pH, pCO2, Hb and the lower limits of Glu, pH, the rest of thresholds of critical values had significant differences due to different admission departments and disease types and/or gender.Conclusion Depending on the different admission departmentsces disease types and/or gender, hierarchical limit values on each critical value were formulated.

Alzheimer's disease (AD) is a neurodegenerative disorder associated with progressive memory loss and neuronal cell death. Although numerous previous studies have been focused on disease progression or reverse pathological symptoms, therapeutic strategies for AD are limited. Alternatively, the identification of traditional herbal medicines or their active compounds has received much attention. The aims of the present study were to characterize the ameliorating effects of spinosin, a C-glucosylflavone isolated from Zizyphus jujuba var. spinosa, on memory impairment or the pathological changes induced through amyloid-beta1-42 oligomer (AbetaO) in mice. Memory impairment was induced by intracerebroventricular injection of AbetaO (50 muM) and spinosin (5, 10, and 20 mg/kg) was administered for 7 days. In the behavioral tasks, the subchronic administration of spinosin (20 mg/kg, p.o.) significantly ameliorated AbetaO-induced cognitive impairment in the passive avoidance task or the Y-maze task. To identify the effects of spinosin on the pathological changes induced through AbetaO, immunohistochemistry and Western blot analyses were performed. Spinosin treatment also reduced the number of activated microglia and astrocytes observed after AbetaO injection. In addition, spinosin rescued the AbetaO-induced decrease in choline acetyltransferase expression levels. These results suggest that spinosin ameliorated memory impairment induced through AbetaO, and these effects were regulated, in part, through neuroprotective activity via the anti-inflammatory effects of spinosin. Therefore, spinosin might be a useful agent against the amyloid b protein-induced cognitive dysfunction observed in AD patients.
Alzheimer Disease ; Amyloid ; Animals ; Astrocytes ; Blotting, Western ; Cell Death ; Choline O-Acetyltransferase ; Disease Progression ; Humans ; Immunohistochemistry ; Memory Disorders ; Memory* ; Mice* ; Microglia ; Neurodegenerative Diseases ; Neurons ; Ziziphus*

Objective To investigate the effects of penehyclidine hydrochloride on Fas/FasL expression during acute lung injury induced by blunt chest trauma-hemorrhagic shock and resuscitation (HSR) in rats.Methods Thirty male SPF Sprague-Dawley rats, aged 8 weeks, weighing 245-275 g, were randomly assigned into 3 equal groups using a random number table: sham operation group (group Sham) , blunt chest trauma-HSR group (group THSR) and penehyclidine hydrochloric group (group PHCD).The model of acute lung injury induced by blunt chest trauma-HSR was induced by dropping a 300 g weight onto a precordium in anesthetized rats.Blood was withdrawn via the femoral artery 5 min later until mean arterial pressure was decreased to 35-45 mmHg within 15 min, and maintained at this level for 60 min, followed by resuscitation.In PHCD group, PHCD 2 mg/kg was injected intravenously at 60 min after hemorrhagic shock.At 6 h after the model was established, the rats were sacrificed, the lungs were then removed for microscopic examination of pathologic changes and for determination of Fas, FasL and caspase-8 expression, and interleukin-6 (IL-6) and IL-1β contents in lung tissues.Apoptotic index was calculated.Results Compared with group Sham, the expression of Fas, FasL and caspase-8 was significantly up-regulated, and AI and contents of IL-6 and IL-1β were increased in THSR and PHCD groups (P＜O.05).Compared with group THSR, the expression of Fas, FasL and caspase-8 was significantly down-regulated,and AI and contents of IL-6 and IL-1β were decreased in group PHCD (P＜0.05).The pathologic changes of lungs were significantly reduced in group PHCD compared with group THSR.Conclusion The mechanism by which penehyclidine hydrochloride inhibits lung cell apoptosis induced by blunt chest trauma-HSR is associated with inhibition of Fas/FasL expression in rats.

Objective To establish a new traceability pathway of point-of-care testing ( POCT ) of HBA1c by using commutable quality controls, in order to improve the accuracy of POCT HBA1c and the harmonization of testing results with those of central laboratories.Methods The study was about measurement traceability. Human frozen whole blood samples with IFCC assigned values were used to calibrate the G8 HBA1c Variant in June, 2013.According to the CLSI EP9-A2-IR guideline, 50 patient samples and 2-level commercial QC samples were then analyzed by G8 system and DCA Ventage system.The best fitting curves for fresh patient samples and the commercial QC materials were established separately. The patient results tested on the DCA Ventage were modified and verified.Paired t-test and Passing Bablok linear regression were used.Results The linear equation of DCA/G8 before calibration was Y=0.899 5X+0.389 1(R2 =0.991 0).Calibration by fresh patient samples reduced the mean bias of DCA/G8 from -0.40%±0.34%to 0.00%±0.29%.Calibration by QCs reduced the mean bias to 0.15%±0.29%.The linear correlation established by quality controls was stable, which made the bias was lower between DCA and G8 in the consequent six runs.Conclusions The accuracy and the traceability of POC testing could be realized by using commutable QC materials traceable to IFCC assigned values.Through this method, POC testing can become more comparable to the results of clinical laboratory HBA1c instruments.