Objective:To assess the applicability of fully automatic pipeline automated testing for internal quality control (automated quality control).Methods:Stability, assay efficiency and implementation costs of 18 biochemical tests, 5 immunoturbidimetric tests and 11 chemical illuminescent tests in the Department of Laboratory Medicine of Peking Union Hospital from January 2019 to July 2022 were evaluated using automated quality control implementation methods. The detailed method is as follows: quality control materials for biochemical, immunoturbidimetric and chemiluminescent tests were stored in the refrigerator in the pipeline which was controlled by the intermediate software, and were automatically retrieved and tested as pre-set followed by documenting and storing. The quality control setup for the biochemical tests included refreshing quality control materials daily and weekly,both of which were paralleled for 3 months. The on-line storage stability of quality control materials in the pipeline was evaluated by comparing the coefficients of variation ( CV) of the quality control results between the two patterns. Effect of automated quality control application was evaluated using 6 indicators, including the results′ variation of automatically performed and manually performed quality controls, the out-of-controlled rate, the consumption of quality control materials, the change of staff workload, the impact on the testing time of the first sample, and the failure rate of automated quality control. Results:(1) Storage stability of quality control materials in the pipeline: under the pattern of weekly refresh of the biochemical quality control materials, except for total carbon dioxide (TCO 2) (the CVs of low and high level quality control were respectively 20.24% and 21.82%) and sodium (the CV of low level quality control was 1.51%) that were greater than the allowable variation set by the laboratory, the CVs of the rest tests meet the lab requirements on the allowable variations. (2) The results′ variation of quality control in automatically performed and manually performed control patterns: in the patterns of daily refresh of biochemical quality control materials and weekly refresh of immunoturbidimetric and chemiluminescent quality control materials, the CVs of both low and high levels of quality control were lower in the automatically performed control pattern than that in manually performed pattern for 8 chemiluminescent items of dehydroepiandrosterone sulfate, estradiol, follicle stimulating hormone, luteinizing hormone, serum ferritin, serum folic acid, vitamin B12 and testosterone, 3 immunologic items of complement 3, C reactive protein and immunoglobulin G, and 10 biochemical items of alkaline phosphatase, glucose, calcium, chloride, potassium, lactate dehydrogenase, sodium, urea, low density lipoprotein cholesterol, and adenosine deaminase. The out-of-control rates of biochemistry, immunoturbidimetric and chemiluminescence tests in both quality control patterns conformed with the clinical routine work requirements. (3) Comparison of quality control materials′ consumption: compared with manually performed quality control, weekly consumption of automatically performed chemiluminescent quality control materials decreased 37.5% (from 8 ml to 5 ml); weekly consumption of automatically performed immunoturbidimetric quality control materials decreased 33.3% (from 3 ml to 2 ml). (4)Comparison of staff workload and first sample testing time: compared with manually performed quality control, automatical quality control reduced manual work by about 156 steps per week, and the daily initial testing time was earlier by 15 min on average. The failure rate was 54.5% (37/64) during the early-stage application of the automated quality control which dropped to 10.2% (13/128) in the late-stage. Conclusion:The results of automated quality control detected in the pipeline system meet the quality indicators′ requirements of the laboratory, and the application of automated quality control can improve the quality control, save costs, reduce workload, and improve work efficiency.

Objective:To investigate the effects of laparoscopic surgery versus open surgery on acute appendicitis in children. Methods:We retrospectively analyzed the data of 50 children with acute appendicitis who underwent surgery in Zhoushan Women and Children Hospital from December 2016 to December 2019. They were randomly divided into observation ( n = 27) and control ( n = 23) groups. The observation group underwent three-port laparoscopy. The control group underwent open surgery. Operation-related indicators, postoperative recovery, parental satisfaction, and complications were compared between the two groups. Results:Operative time was significantly longer in the observation group than in the control group [(56.57 ± 5.35) minutes vs. (40.23 ± 6.31) minutes, t = 9.78, P < 0.001). Intraoperative blood loss was significantly less in the observation group than in the control group [(10.11 ± 2.36) mL vs. (18.36 ± 3.21) mL, t = 10.45, P < 0.001]. Duration of pain was significantly shorter in the observation group than in the control group [(1.23 ± 0.23) days vs. (2.98 ± 0.87) days, t = 10.06, P < 0.001). Time to postoperative exhaust was significantly shorter in the observation group than in the control group [(21.39 ± 4.35) minutes vs. (39.88 ±5.39) minutes, t = 13.35, P < 0.001]. Time to defection was significantly shorter in the observation group than in the control group [(50.12 ± 3.35) minutes vs. (61.23 ± 4.21) minutes, t = 10.33, P < 0.001]. Time to first diet was significantly shorter in the observation group than in the control group [(13.25 ± 2.56) hours vs. (19.96 ± 2.67) hours, t = 9.07, P < 0.001]. Length of hospital stay in the observation group was significantly shorter in the observation group than in the control group [(4.13 ± 1.12) days vs. (7.98 ± 1.96) days, t = 8.53, P < 0.001). Parental satisfaction was significantly higher in the observation group than in the control group [96.30% vs. 47.83%, χ2 = 13.360, P < 0.001]. The incidence of complications was significantly lower in the observation group than in the control group [7.41% vs. 52.17%, χ2 = 10.58, P < 0.001]. Conclusion:Laparoscopic surgery is superior and safer to open surgery in the treatment of acute appendicitis in children.

Objective:The characteristics of women with false elevated testosterone were analyze and the literature was reviewed to provide reference for clinical laboratory identification of false elevated testosterone.Methods:The characteristics of three patients with false elevated testosterone in Peking Union Medical College Hospital were analyzed retrospectively, and the results of different detection platforms and methods for the determination of testosterone levels were compared. International and domestic literatures related to false elevation of testosterone and detection methods of testosterone were searched for a comprehensive analysis from PUBMED and CNKI.Results:The levels of testosterone in 3 female patients were elevated by immunoassay and normal by mass spectrometry. They were excluded from the diagnosis of hyperandrogenemia. A total of 38 literatures related to testosterone detection were retrieved, of which 9 case reports of pseudohyperandrogenemia, among which 12 cases of pseudohyperandrogenemia were reported in 2 domestic literatures in 2021. All cases were confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Previous studies have clearly indicated that the result of routine immunoassay in clinical laboratory for the determination of female testosterone have poor correlation with the results of LC-MS/MS, with varying degrees of deviation.Conclusions:Immunoassay tests for female testosterone is susceptible to interference and lead to elevated false results. It is suggested that clinical laboratories evaluate the detection methods used and establish a identification program, and confirm samples with suspected pseudoelevated testosterone elevation using other immune platforms or LC-MS/MS.

End-stage liver disease (ESLD) is a serious threat to human health, and liver transplantation is the only effective treatment. However, most of the patients died in the process of waiting for transplantation due to the shortage of liver source. With the rapid development of biological tissue enginee-ring technology, researchers have established the strategy of 'decellularized and recellularized technology’, which has deve-loped into the first choice for construction of important organs such as the liver and opened up new ideas for the treatment of ESLD. At present, scientists are working on the optimization of this technology, in order to construction a functional 'new liver’ for transplantation. The authors review the feasibility and challenges of the application of this technology and its optimization stra-tegy in the field of regenerative surgery.

Objective:To observe the clinical effect of hernia ring filling tension-free hernia repair on adult inguinal hernia.Methods:From March 2016 to March 2019, 100 adult patients with inguinal hernia who received surgical treatment in Zhoushan Maternal and Child Health Hospital were divided into two groups according to the random number table method, with 50 cases in each group.The control group received the chip without tension hernia repair, and the study group received hernia ring filling type without tension hernia repair.The operation time, length of hospital stay, use of analgesic ratio, ratio of postoperative patients with local foreign body sensation, incidence of adverse reactions (incision infection rate, rate of seroma, scrotal edema rate) were compared between the two groups.Results:The operation time [(0.86±0.22)h] and hospital stay [(5.11±1.56)d] in the study group were shorter than those in the control group [(1.44±0.76)h and (9.87±1.33)d] ( t=5.183, 16.418, all P<0.05). And the ratio of use analgesics (20.00%), the ratio of local foreign body sensation (2.00%), the incidence of adverse reactions (incision infection rate: 2.00%, seroma rate: 4.00%, scrotal edema rate: 2.00%) and other indicators in the study group were lower than those in the control group (36.00%, 18.00%, 8.00%, 10.00%, 8.00%)(χ 2=5.183, 16.418, 3.174, 7.111, 5.740, all P<0.05). Conclusion:Application of the hernia ring filling tension-free hernia repair in the treatment of adult inguinal hernia can shorten the operation time, hospital stay and decrease the incidence rate of adverse reactions.

[Abstract] Objective: To investigate the effect of long non-coding RNA (lncRNA)-CCAT2 on the proliferation and cell cycle of cervical cancer cells. Methods: The expression of CCAT2 in 3 cervical cancer cell lines (HeLa, C-33A, and CaSki) was detected by qPCR and the cell line with the highest expression level was selected for subsequent experiments. CCAT2 overexpression and interference vectors were designed and synthesized. After transfection, qPCR was performed to detect the transfection efficiency. The cells were divided into 5 groups: control, sh-EV (empty vector), overExp-EV , sh-CCAT2, and overExp-CCAT2. MTT assay was performed to evaluate cell viability. Flow cytometry was performed to measure cell cycle. WB was performed to detect the expressions of Ki67, cyclin D1, and cyclin dependent kinase 4 (CDK4). Results: Among HeLa, C-33A, and CaSki cells, the highest expression of CCAT2 was found in CaSki cells. CCAT2 overexpression and interference vectors were successfully transfected into the CaSki cells. Compared with the control group, the cells viability and proliferation in the sh-CCAT2 group was significantly decreased (all P<0.01), the proportion of cells in the G1 phase was significantly increased (P<0.01), and the expression levels of Ki67, cyclin D1, and CDK4 were significantly decreased (all P<0.01). However, in the overExp-CCAT2 group, the cell proliferation was enhanced and the expression levels of Ki67, cyclin D1, and CDK4 were significantly increased (all P<0.01). Conclusion: CCAT2 affects proliferation and cell cycle of cervical cancer cells by regulating the expressions of their associated proteins.

Objective To study the feasibility and safety of simultaneous super-selective hepatic arterial and portal vein embolization for staged hepatectomy (ASAPS) in the treatment of patients with hepatocellular carcinoma (HCC) and cirrhosis.Methods The clinical data of 8 patients with HCC who underwent ASAPS at the First Affiliated Hospital of the Army Medical University from December 2016 to January 2018 were retrospectively analyzed.All the patients,including 7 males and 1 female with an average age of 44.3± 9.2,were diagnosed to have cirrhosis with insufficient volume of future liver remnant (FLR).Portal vein embolization (PVE) and super-selective hepatic arterial embolization (SHAE) were performed simultaneously.The patients were then closely monitored for the volumes of FLR.Once the FLR achieved the target volume,a second staged resectional surgery would be performed.The postoperative major complications,laboratory tests and patient long-term survival were studied.Results The ratio of FLR to the average standard liver volume (SLV) increased from (28.5±5) ％ to (49.6±7.3) ％ following the first-stage procedure.All the patients underwent liver resection successfully.The average second-stage operation time was 342.6±92.8 min,and the intraoperative blood loss was 743.8±432.1 ml.Both the postoperative serum alanine amin otransferase (ALT) and aspartate aminotransferase (AST) levels were elevated remarkably and then droppedto the near normal levels.All the patients were discharged home without any severe complications.Among them,3 patients relapsed early in the postoperative period,5 survived without recurrence,and 3 survived for over 1 year.Conclusions The first-stage surgery of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) using ASAPS was minimally invasive.The volume growth rate of the FLR after ASAPS was comparable to that of the conventional first stage of ALPPS.In conclusion,ASAPS is a promising alternative to the traditional ALPPS as the first-line treatment of patients with insufficient FLR.

This article summarized perioperative nursing experience of 6 patients underwent percutaneous microwave or radiofrequency ablation liver partition and portal vein embolization for planned hepatectomy(PALPP).The key points of nursing included:psychological counseling applied throughout the perioperative treatment;personalized preoperative biliary drainage;nursing intervention targeting at Enhanced Recovery After Surgery(ERAS);complication-directed prevention and nursing after microwave or radiofrequency ablation,portal vein embolization,and radical hepatectomy.All 6 patients were recovered and discharged successfully.

Objective To analyze the MSCT manifestations of spontaneous isolated superior mesenteric artery intramural hematoma (SISMAIH) to improve the recognition and diagnosis of this disease.Methods MSCT manifestations of 15 clinically confirmed cases were analyzed retrospectively.Results All the 15 cases showed circular or crescent wall thickening,without tearing intimal flap.Conclusion SISMAIH have some characteristic MSCT manifestations,and MSCT can be used as an important and effective method for the diagnosis of this disease.

Intein is a part of polypeptide in the premature protein with the capability of self-splicing, which is widely applied in protein purification, protein conjuction, cyclopeptide preparation, protein labeling and biosensor. In this review, we summarized the development of intein used in protein purification, discussed intein-mediated chromatographic and non-chromatographic purification systems, and summarized the researches in manipulating intein cleavage reaction. This work is to provide clues for improvement of intein-mediated protein purification.
Chromatography, Affinity ; Inteins ; Protein Splicing ; Proteins ; isolation & purification