Serum TBA and GCA Levels Across Pregnancy and the Gestational Age-Specific Reference Intervals for Pregnant Chinese.

BACKGROUND: Reference intervals of clinical laboratory indexes are the basis of interpretation of test results. While intrahepatic cholestasis of pregnancy (ICP) could severely threaten maternal and fetal health, reference intervals of the biomarkers serum total bile acids (TBA) and glycocholic acid (GCA) are unsatisfactory. The purpose of this study was to derive gestational age-specific reference intervals for serum TBA and GCA in a Chinese population to promote early diagnosis of ICP. METHODS: A total of 416 healthy pregnant Chinese were recruited and divided into three groups by gestational age: 140 in the first trimester (1 - 13 weeks) group, 136 in the second trimester (14 - 27 weeks) group, and 140 in the third trimester (≥ 28 weeks) group. Serum TBA and GCA levels were measured respectively by cyclic enzymatic method and latex enhanced immune turbidimetry. Reference intervals were calculated with non-parametric method. RESULTS: The reference intervals of serum TBA are 0.90 - 6.60 µmol/L, 1.20 - 9.10 µmol/L, and 1.50 - 8.90 µmol/L respectively in the first, second, and third trimester. The reference intervals of serum GCA are 0.24 - 1.14 µg/mL in the first and second trimesters (combined) and 0.00 - 2.04 µg/mL in the third trimester. CONCLUSIONS: Gestational age-specific reference intervals of serum TBA and GCA for pregnant Chinese were derived in strict accordance with CLSI C28-A3 guidelines, which will be valuable for early diagnosis of ICP.

Reference intervals for serum bilirubin, urea, and uric acid in healthy Chinese geriatric population.

OBJECTIVES: The study aims to establish the reference intervals (RIs) for total bilirubin (TBIL), direct bilirubin (DBIL), urea (UR), and uric acid (UA) in healthy Chinese geriatric population. METHODS: Eight hundred and twenty cases from six representative geographical regions in China (including male 413 cases and female 407 cases) of apparently healthy individuals aged 60-96 years were recruited. Serum TBIL, DBIL, UR, and UA were analyzed by automatic biochemical analyzer and RIs were determined following CLSI C28-A3 guidelines using a non-parametric method. RESULTS: In apparently healthy Chinese geriatric population of China, the RIs of TBIL, DBIL, UR, and UA were 6.6~21.8 µmol/L, 1.9~8.0 µmol/L, 3.60~9.51 mmol/L, 179.2~460.9 µmol/L in males and 6.1~20.0 µmol/L, 1.8~7.1 µmol/L,3.35~8.89 mmol/L, 130.2~443.4 µmol/L in females, respectively. CONCLUSIONS: The RIs of TBIL, DBIL, UR, and UA were established within apparently healthy geriatric Chinese population according to CLSIC28-A3 document, providing a reference for the clinical.

Screening and evaluating the mimic peptides as a useful serum biomarker of ankylosing spondylitis using a phage display technique.

To screen specific serum biomarker for ankylosing spondylitis (AS) using a phage random peptide library. A phage random peptide library of random peptide 12-mers was immunoscreened with purified immunoglobulin (Ig) G from sera of AS patients. Positive clones obtained after three rounds of biopanning were detected with ELISA and sequenced. Reaction of the screened positive clones with sera from AS patients, systemic lupus erythematosus (SLE) patients, rheumatoid arthritis (RA) patients, osteoarthritis (OA) patients and healthy controls was detected using phage ELISA. Correlation among erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and the absorbance value of the positive clone in phage ELISA was examined in AS patients. Seventeen out of twenty randomly selected phage clones exhibited specific reaction with purified sera IgG from AS patients, among them seven coming from the same clone whose inserted peptide sequence was LALPPLAPNHHH (named "AS1"). Phage ELISA results showed that the positive reaction rate of the AS1 clone was 92.0% with AS patients, significantly different (P < 0.01) from those with SLE patients (56.7%), RA patients (50.0%), OA patients (13.3%), and healthy controls (14.0%). Absorbance value of the AS1 clone in phage ELISA was significantly higher than those in the other groups (P < 0.05). In addition, the absorbance value of the AS1 clone showed no statistically significant correlation with ESR and CRP in AS patients, suggesting that AS1 detects AS patients through a unique mechanism other than inflammation. The short peptide AS1 obtained through screening of a phage random peptide library with purified serum IgG from AS patients can specifically react with the sera of AS patients, and thereby may be a candidate of AS-specific serum biomarkers.

[Gene Detection Analysis of Thalassemia in 2 494 Cases of Childbearing Couples in Haikou City].

OBJECTIVE: To observe the genotypes and composition ratio of thalassemia in couples of reproductive age, and provide a reference for the prevention and control of thalassemia in Haikou. METHODS: Gene diagnosis was performed in 2 494 subjects who were screened for thalassemia before marriage or prenatal by cross-breakpoint PCR, PCR-reverse dot hybridization, and PCR-electrophoresis. RESULTS: A total of 1 037 thalassemia gene carriers were detected in 2 494 samples, with a detection rate of 41.57%, of which 75.02% was α-thalassemia, 18.61% was ß-thalassemia, and 6.36% was α-ß complex thalassemia. There were 778 cases of α-thalassemia, mainly of deletion type, accounting for 76.99% (599/778). Twenty genotypes were detected, the highest three was --SEA/αα (33.42%, 260/778), -α3.7/αα(23.91%, 186/778), and -α4.2/αα(19.02%, 148/778), respectively. A rare HKαα/-α3.7 was detected, who immigrated from other province. There were 193 cases of ß-thalassemia, all of them were light (ß0/ßA or ß+/ßA). Eight genotypes were detected, the highest two was 41-42M/N (74.61%, 144/193) and 654M/N (10.36%, 20/193), respectively. There were 66 cases of α-ß compound type of thalassemia, 15 genotypes were detected, the highest three was ααWS/αα complex 41-42M/N (28.79%, 19/66), -α3.7/αα complex 41-42M/N, and -α4.2/αα complex 41-42M/N (16.67%, 11/66 for both). CONCLUSION: In Haikou city, the gene carrying rate of thalassemia is very high, and the genotype distribution is different from other cities in Hainan Province, attention should be paid to the impact of population inflow on the frequency spectrum change of local thalassemia gene.

A self-consistent investigation of the topological state in the Ising superconductors.

By self-consistently solving the Bogoliubov-de Gennes equations, we investigate the superconductivity, the magnetization and the local density-of-state (DOS) of the Ising superconductor. The calculations show that the Ising spin orbital coupling is responsible for the anisotropic behaviors of the Ising superconductor in response to the external magnetic field. In the absence of the magnetic impurities, only opposite spin triplet superconducting (SC) pairing correlations can be induced from the intrinsic on-site singlet SC pairing. The equal spin triplet SC correlations can be induced when a magnetic impurity chain with in-plane spin direction is deposited on the Ising superconductor. The chain could support a pair of Majorana Fermions, which are originated from the induced 1-dimensional equal spin triplet SC pairing correlations. The local DOS for the Majorana Fermion states exhibits an excellent agreement with the experimental observations. The low energy spectrum as a function of the exchange coupling strength forms two hourglass shapes. The waist of the hourglass may serves as a boundary to separate the zero energy crossings of the two lowest energy levels into topologically trivial and non-trivial quantum states. These results not only account for the experimental observations in a realistic way, but also clarify several important questions in the studies of the Ising superconductors.

Changes of serum homocysteine levels during pregnancy and the establishment of reference intervals in pregnant Chinese women.

BACKGROUD: Reference intervals (RIs) of clinical laboratory indexes are important basis for interpretation of corresponding test results. While elevated homocysteine (HCY) level is a risk factor of some severe gestational diseases, HCY RIs for pregnant women have not been reported so far. The current use of HCY RIs established for general population in pregnant women may challenge clinicians' judgment. This study aims to investigate the changes of serum HCY levels during pregnancy and establish the RIs of serum HCY in healthy pregnant Chinese women to provide valuable data to clinicians and enable the provision of more appropriate therapy. METHODS: 354 healthy pregnant Chinese women were randomly selected and divided into three groups according to gestational age: 114 in first trimester (1-13 week), 120 in second trimester (14-27 week) and 120 in third trimester (≥28 week). 120 healthy non-pregnant Chinese women were randomly selected as the non-pregnant control group. Serum HCY levels were determined on automatic biochemical analyzer with enzymatic cycling method. The RIs of serum HCY for healthy pregnant women were established using a nonparametric method. RESULTS: the RIs of serum HCY for healthy pregnant women is 5.79-11.86 µmol/L in first and second trimester (combined) and 6.13-16.75 µmol/L in third trimester. Besides, the RIs of serum HCY for healthy non-pregnant women is 8.25-22.92 µmol/L. CONCLUSIONS: Rigorously according to CLSI C28-A3 guidelines, the authoritative document of RIs establishment, the RIs of serum HCY for healthy pregnant Chinese women were established, which will provide a valuable reference for clinical work and laboratory researches.

Reference intervals for serum progastrin-releasing peptide in healthy Chinese adults with electrochemiluminescence immunoassay.

BACKGROUND: Reliable reference intervals for serum progastrin-releasing peptide (ProGRP) in healthy Chinese adults with electrochemiluminescence immunoassay (ECLIA) are still lacking in the Chinese population. OBJECTIVES: The study aims to establish reference intervals for ProGRP with ECLIA in apparently healthy Chinese adults. METHODS: A total of 384 apparently healthy individuals from six representative geographical regions in China were enrolled: 200 males and 184 females with a mean age of 43.4±12.2 years, and an age range from 21 to 85 years. Serum ProGRP levels were analyzed on Cobas e601 automatic immunoassay analyzer with ECLIA. Reference intervals for serum ProGRP with ECLIA were determined following CLSI C28-A3 guidelines using a nonparametric method. RESULTS: In an apparently healthy Chinese population, the reference intervals for serum ProGRP with ECLIA were ⩽53.92 ng/L for adults aged 21-70 years and ⩽75.69 ng/L for adults aged >70 years, respectively. CONCLUSIONS: The reference values for serum ProGRP with ECLIA in an apparently healthy Chinese population were established according to the CLSI C28-A3 document, providing a reference for the clinical work.

A self-consistent determination of the RVB and SC gaps in the YRZ ansatz.

A correct understanding of the origin of the pseudogap in high temperature (high-T c) cuprate superconductors is considered to be a peripheral breakthrough in the understanding of the microscopic mechanism of the high-T c superconductivity. Yang-Rice-Zhang (YRZ) ansatz is an important phenomenological theory to describe the phenomenon of pseudogap. However, in the framework of YRZ, the pseudogap (resonant valence bond (RVB) gap) and the superconducting (SC) gap are unable to have a self-consistent determination at different doping concentrations, and this severely limits the application of the YRZ ansatz. Based on the YRZ ansatz, this study develops a technical method to determine the RVB and SC gaps in a self-consistent manner. It is revealed that the self-consistent calculations of the doping dependence of RVB, SC gaps and spectral function are not only consistent with the empirical gap formula in the YRZ framework, but also consistent with the doping evolution of the Fermi surface observed in the angle-resolved photoemission spectroscopy (ARPES) experiments. Our method will greatly extend the applications of the YRZ ansatz, and will deepen our understanding of the origin of pseudogap as well as the mechanism of high-T c superconductivity.

Pretreatment neutrophil-lymphocyte count ratio may associate with gastric cancer presence.

BACKGROUND: Inflammation plays a pivotal role in cancer development and progression. Neutrophil-lymphocyte count ratio (NLR) is an indicator of systemic inflammatory response which is supposedly associated with gastric cancer (GC) development and progression. Since this parameter can be easily obtained from routine blood examination, it will be a great economic relief to gastric patients if we can bring it into clinical application. OBJECTIVE: The current study aims to evaluate the pretreatment NLR in gastric cancer patients through retrospectively reviewing the medical records. METHODS: A total of 327 patients hospitalized on a tertiary care hospital were retrospectively investigated and divided into two groups. Gastric cancer group were composed of patients with newly diagnosed, pathologically confirmed GC and the control group were patients with gastric polyp or benign gastric stromal tumor. The value of NLR in the presence and stage of gastric cancer was investigated in the entire gastric cancer group. RESULTS: Our study showed levels of NLR were significantly higher in gastric cancer cohort (2.17 (1.63-3.09) versus 1.62 (0.85-2.32), p< 0.001). After all the known confounders were excluded, NLR was an independent predicator of GC (OR = 1.446, 95%CI (1.121-1.866), and P= 0.005). Area under ROC curve (AUC) of NLR was 0.694. In addition, the results of Spearman's correlation showed NLR may have a positive correlation with size of tumor, N-stage, distant metastasis, and overall stage (r = 0.256, 0.256, 0.161 and 0.171, resp., all p < 0.05). CONCLUSIONS: The current study demonstrated that pre-treatment NLR may be a useful biomarker in the health care of gastric cancer patients.

Role of quality control circle in sustained improvement of hand hygiene compliance: an observational study in a stomatology hospital in Shandong, China.

BACKGROUND: Hand hygiene is an important element of the WHO multimodal strategy for healthcare-associated infection control, whereas compliance of hand hygiene among healthcare workers (HCWs) remains a challenge to sustain. In order to increase the hand hygiene compliance of HCWs, a quality control circle (QCC) program was carried out in our hospital, and the plan-do-check-act (PDCA) method was applied for 12 months. FINDINGS: Hand hygiene compliance rates improved over time, with significant improvement between preintervention (60.1%) and postintervention (97.2%) periods (P < 0.001). Nurses (88.3%) exhibited higher compliance than dentists (87.3%), and female (88.4%) HCWs were more likely to perform hand hygiene than males (85.6%), both P < 0.001. Overall hand hygiene compliance and observance of the five indications exhibited significant linear increases over time (P < 0.005). CONCLUSION: This study highlights the success of a multifaceted intervention, conducted by QCC program and PDCA method, which led to a significant improvement of hand hygiene compliance. Though training is the most basic intervention element, surveillance, evaluation and feedback should be explored as additional interventions to ensure that hand hygiene compliance is achieved and sustained at high levels.

Application of failure mode and effects analysis in a clinical chemistry laboratory.

BACKGROUND: Timely delivery of correct results has long been considered as the goal of quality management in clinical laboratory. With increasing workload as well as complexities of laboratory testing and patient care, the traditional technical adopted like internal quality control (IQC) and external quality assessment (EQA) may not enough to cope with quality management problems for clinical laboratories. We applied failure mode and effects analysis (FMEA), a proactive tool, to reduce errors associated with the process beginning with sample collection and ending with a test report in a clinical chemistry laboratory. Our main objection was to investigate the feasibility of FMEA in a real-world situation, namely the working environment of hospital. METHODS: A team of 8 people (3 laboratory workers, 2 couriers, 2 nurses, and 1 physician) from different departments who were involved in the testing process were recruited and trained. Their main responsibility was to analyze and score all possible clinical chemistry laboratory failures based on three aspects: the severity of the outcome (S), the likeliness of occurrence (O), and the probability of being detected (D). These three parameters were multiplied to calculate risk priority numbers (RPNs), which were used to prioritize remedial measures. Failure modes with RPN≥200 were deemed as high risk, meaning that they needed immediate corrective action. After modifications that were put, we compared the resulting RPN with the previous one. RESULTS: A total of 33 failure modes were identified. Many of the failure modes, including the one with the highest RPN (specimen hemolysis) appeared in the pre-analytic phase, whereas no high-risk failure modes (RPN≥200) were found during the analytic phase. High-priority risks were "sample hemolysis" (RPN, 336), "sample delivery delay" (RPN, 225), "sample volume error" (RPN, 210), "failure to release results in a timely manner" (RPN, 210), and "failure to identify or report critical results" (RPN, 200). The corrective measures that we took allowed a decrease in the RPN, especially for the high-priority risks. The maximum reduction was approximately 70%, as observed for the failure mode "sample hemolysis". CONCLUSIONS: FMEA can effectively reduce errors in clinical chemistry laboratories.

Doping dependence of the nonmagnetic impurity resonance in cuprate superconductors.

Motivated by the observation that the nonmagnetic impurity induced resonance strength is reduced with underdoping in Bi(2)Sr(2)Ca(Cu(1-y)Zn(y))(2)O(8+x), we study the doping dependence of the nonmagnetic impurity induced resonance in cuprates from the viewpoint of resonating valence bond (RVB) spin liquid theory. It is revealed that the pseudogap state in the Yang, Rice and Zhang ansatz (Yang et al 2006 Phys. Rev. B 73 174501; Rice et al 2012 Rep. Prog. Phys. 75 016502) does not support an impurity resonance state due to the overdamping of the quasiparticle. In the coexistence of the d-wave superconductivity and the RVB gap, our theory provides an alternative but consistent explanation for the reduction of the resonance strength with underdoping, as well as the absence of the resonance in the large gap region.

Discontinued drugs in 2012: cardiovascular drugs.

The continued high rate of cardiovascular morbidity and mortality has attracted wide concern and great attention of pharmaceutical industry. In order to reduce the attrition of cardiovascular drug R&D, it might be helpful recapitulating previous failures and identifying the potential factors to success. This perspective mainly analyses the 30 cardiovascular drugs dropped from clinical development in 2012. Reasons causing the termination of the cardiovascular drugs in the past 5 years are also tabulated and analysed. The analysis shows that the attrition is highest in Phase II trials and financial and strategic factors and lack of clinical efficacy are the principal reasons for these disappointments. To solve the four problems (The 'better than the Beatles' problem, the 'cautious regulator' problem, the 'throw money at it' tendency and the 'basic researchbrute force' bias) is recommended as the main measure to increase the number and quality of approvable products.

Theory of the interplay between the superconductivity and the blocked antiferromagnetic order in A(y)Fe(2-x)Se2.

Based on an effective two-orbital tight-binding model, we examine the possible superconducting states in iron-vacancy-ordered A(y)Fe(2-x)Se(2). In the presence of ordered vacancies and blocked antiferromagnetic order, it is shown that the emergent SC pairing is the nodeless next-nearest-neighbor (NNN)-pairing due to the dominant antiferromagnetic (AFM) interaction between the inter-block NNN sites. In particular, we show that due to the ordered vacancies and the associated blocked AFM order, the interplay between the superconducting and AFM states results in three distinct states in the phase diagram as doping is varied. The divergent experimental observations can be accounted for by considering the different charge carrier concentrations in their respective compounds.

Discontinued drugs in 2011: cardiovascular drugs.

This perspective is part of an annual series of papers discussing drugs dropped from development in the previous year. Specifically, this paper focuses on the 19 cardiovascular drugs discontinued in 2011 after reaching preclinical or Phase I - III clinical trials. Information for this perspective is mainly derived from a search of Pharmaprojects.

Coexistence of the antiferromagnetic and superconducting order and its effect on spin dynamics in electron-doped high-T(c) cuprates.

In the framework of the slave-boson approach to the t-t'-t''-J model, it is found that for electron-doped high- T(c) cuprates, the staggered antiferromagnetic (AF) order coexists with the superconducting (SC) order in a wide doping level ranged from underdoped to nearly optimally doped at the mean-field level. In the coexisting phase, it is revealed that the spin response is commensurate in a substantial frequency range below a crossover frequency ω(c) for all dopings considered, and it switches to the incommensurate structure when the frequency is higher than ω(c). This result is in agreement with the experimental measurements. Comparison of the spin response between the coexisting phase and the pure SC phase with a d(x(2)-y(2))-wave pairing plus a higher harmonics term (DP+HH) suggests that the inclusion of the two-band effect is important to consistently account for both the dispersion of the spin response and the non-monotonic gap behavior in the electron-doped cuprates.

Spectral and optical properties in the antiphase stripe phase of the cuprate superconductors.

We investigate the superconducting order parameter, the spectral and optical properties in a stripe model with spin-(charge-) domain-derived scattering potential V(s) (V(c)). We show that the charge-domain-derived scattering is less effective than the spin scattering on the suppression of superconductivity. For [Formula: see text], the spectral weight concentrates on the (π,0) antinodal region and a finite energy peak appears in the optical conductivity with the disappearance of the Drude peak. But for V(s)≈V(c), the spectral weight concentrates on the (π/2,π/2) nodal region and a residual Drude peak exists in the optical conductivity without the finite energy peak. These results consistently account for the divergent observations in the ARPES and optical conductivity experiments in several high- T(c) cuprates and suggest that the 'insulating' and 'metallic' properties are intrinsic to the stripe state, depending on the relative strength of the spin- and charge-domain-derived scattering potentials.

[Twin test in the determination of alanine aminotransferase and aspartate aminotransferase in the serum].

OBJECTIVE: To explore a method which can simultaneously determine alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the serum. METHODS: Using the self-prepared twin test reagent, ALT and AST in the serum were detected simultaneously. RESULTS: There was a good correlation between the twin test's method and the traditional method in the detection of ALT and AST (All r = 0.999). The precision of the method was good, and the coefficient variation (CV) was below 5%. Hemolysis, jaundice, and lipohemia serum were found to be interference-free. The time of the detection was two times of the traditional method. CONCLUSION: The twin test method can both exert the capability of the automatic analyzer and shorten the time of detection. It is a method worthy to be popularized.