Commutability evaluation of candidate reference materials and ERM-DA470k/IFCC for immunoglobulin M using two international approaches.

BACKGROUND: This study aimed to assess the commutability of frozen pooled human serum (PHS), high concentration of Immunoglobulin M (IgM) pure diluted materials (HPDM), commercialized pure materials (CPM), and dilutions of ERM-DA470k/IFCC in IgM detection using the CLSI and IFCC approaches, to support standardization or harmonization of IgM measurement. METHODS: Twenty-four serum samples, relevant reference materials (PHS, HPDM, CPM), and different ERM-DA470k/IFCC dilutions were analyzed in triplicate using six routine methods. The commutability of the relevant reference materials was carried out following CLSI EP30-A and IFCC bias analysis. RESULTS: According to the CLSI approach, low, medium, and high concentrations of PHS, HPDM, and CPM were commutable on 10, 13, 15, 13, and 8 of 15 assay combinations, respectively. Using the IFCC approach, low, medium, and high concentrations of PHS, HPDM, and CPM were commutable on 10, 11, 9, 15, and 10 of 15 assay combinations, respectively. The ERM-DA470k/IFCC dilutions with D-PBS and RPMI-1640 Medium were commutable on 13 of 15 assay combinations according to CLSI and were commutable on all 15 assay combinations using IFCC approach. CONCLUSIONS: High concentration of PHS were commutable on all six detection systems using the CLSI approach. Low and medium concentration of PHS showed unsatisfied commutability. HPDM, not CPM have good commutability, has the potential to become reference materials. ERM-DA470k/IFCC diluted with different medium showed different commutability.

The Effect of Endogenous PARP-1 in Different Phases of IL-1ß-Induced Chondrocyte Degeneration.

Objective: Poly (ADP-ribose) polymerase-1 (PARP-1) is a regulatory enzyme involved in DNA damage repair, gene transcription, cell growth, death and apoptosis. In our study, we aimed to explore the dynamic role of PARP-1 in chondrocyte (CH) degeneration in vitro. Methods: We used the primary CHs and treated them with interleukin-1 beta for up to 5 days. (IL-1ß) to induce degeneration. Meanwhile, we used AG-14361 (AG) to inhibit endogenous PARP-1 expression. Cell survival and collagen II expression were used to define the cell function of CHs. In addition, other metabolic indicators were measured containing the reactive oxygen species (ROS) level, 8-Hydroxy-2'-deoxyguanosine (8-OH-dG), IL-1ß, tumor necrosis factor alpha (TNF-α) and caspase 3/9 expression. Results: With IL-1ß treatment, the PARP1 expression of CHs was gradually increased from day 1 to day 5, accompanied by a reduction in cell survival and collagen II expression, and an increase in ROS, 8-OH-dG, IL-1ß, TNF-α and caspase 3/9 levels. We suppressed PARP1 expression on the first day of IL-1ß stimulation and found severe destruction of cell survival and collagen II content with a higher expression of caspase 3/9. However, when we cultured the CHs with AG from day 3 of the 5-day IL-1ß stimulation, cell survival and collagen II expression were rescued, and the ROS, 8-OH-dG, IL-1ß, TNF-α, and caspase 3/9 were downregulated. Conclusions: On day 1 of degeneration, increased PARP-1 played a protective role in CHs. However, from days 3 to 5 of degeneration, the accumulated PARP-1 presented a more destructive function in CHs.

An indirect approach for reference intervals establishment of immunoglobulin A, G and M: the combination of laboratory database and statistics.

Immunoglobulins are affected by sex, age and region, so it is necessary to establish suitable reference intervals (RIs) for clinical diagnosis. Various statistical methods were used to calculate RIs, but there has been a lack of comparison among the methods. Research based on immunoglobulin RIs establishment with various methods would provide a methodological basis for further research. A total of 16,525 individuals were enrolled in the study. Individuals were selected in the medical examination center of First Hospital of Jilin University from 2014 to 2020. The lambda-mu-sigma (LMS) method was performed to evaluate the dynamic changes in analytes. RIs were calculated by parametric, non-parametric, Hoffman method and Bhattacharya method. Sex and age partitions were found for immunoglobulins G and immunoglobulin M. The levels of IgM showed no difference with age in males, but showed differences after 50 years of age in females. Circulating immunoglobulin A concentrations showed an increasing trend with age, and immunoglobulin M showed a fluctuating trend with age. Obvious difference (>5%) was commonly found among the four methods, however, the RIs established by the four methods all passed the verification with a high passing rate. Sex and age differences should be considered for immunoglobulins G and immunoglobulin M in clinical practice. The feasibility of the four indirect methods was proven, which would provides a methodological reference for further studies and benefit the application of clinical data.

Fast parallel implementation for total variation constrained algebraic reconstruction technique.

In computed tomography (CT), the total variation (TV) constrained algebraic reconstruction technique (ART) can obtain better reconstruction quality when the projection data are sparse and noisy. However, the ART-TV algorithm remains time-consuming since it requires large numbers of iterations, especially for the reconstruction of high-resolution images. In this work, we propose a fast algorithm to calculate the system matrix for line intersection model and apply this algorithm to perform the forward-projection and back-projection operations of the ART. Then, we utilize the parallel computing techniques of multithreading and graphics processing units (GPU) to accelerate the ART iteration and the TV minimization, respectively. Numerical experiments show that our proposed parallel implementation approach is very efficient and accurate. For the reconstruction of a 2048 × 2048 image from 180 projection views of 2048 detector bins, it takes about 2.2 seconds to perform one iteration of the ART-TV algorithm using our proposed approach on a ten-core platform. Experimental results demonstrate that our new approach achieves a speedup of 23 times over the conventional single-threaded CPU implementation that using the Siddon algorithm.

Homogeneity and Stability Evaluation of External Quality Assessment Control Materials for Four Coagulation Tests.

BACKGROUND: This study assessed the homogeneity and stability of control materials used in external quality assessment (EQA) of four coagulation tests, aiming to verify that these materials meet clinical testing requirements and to provide an evidence base for future improvement of laboratory coagulation test quality. METHODS: The homogeneity and stability of control materials were assessed according to the relevant guidance. Homogeneity assessment involved 10 vials of samples obtained from 2 batches (each vial tested twice). The homogeneity of control materials in four coagulation tests was assessed using one-way analysis of variance, with standard deviation of uniformity (Ss) 0.3 σ as an assessment criterion. Stability assessment involved two vials of sam-ples obtained from two batches (each vial tested twice). The stability of control materials was assessed at cold storage, room temperature, temperature of 37°C. Reconstitution stability of control materials placed in cold storage and at room temperature, and long-term stability of reconstituted control materials stored frozen (-20°C and -80°C) were observed. Linear regression analysis was performed to assess long-term stability. RESULTS: The Ss values of EQA control materials for four coagulation tests were PT L1 Ss = 0.084, PT L2 Ss = 0.889, APTT L1 Ss = 0.164, APTT L2 Ss = 0.223, Fbg L1 Ss = 6.256, Fbg L2 Ss = 2.251, TT L1 Ss = 0.552, TT L2 Ss = 0.3111. PT, APTT, Fbg, and TT were associated with the standard deviation of uniformity values of 0.3 σ. Non-reconstituted samples were observed at 37°C for 2 hours and 4 hours, and at room temperature for 1 day. Reconstituted samples were observed when stored at 4°C for 4 hours and 8 hours, at room temperature for 4 hours, and at -20°C and -80°C for 6 months. Instability of reconstituted samples was observed in PT and APTT tests at 4°C for 8 hours and at -20°C for 5 months. CONCLUSIONS: EQA control materials presented with satisfactory homogeneity in four coagulation tests. Non-reconstituted samples presented with satisfactory stability at 37°C for 2 hours and 4 hours and at room temperature for 1 day, while reconstituted samples presented with satisfactory stability when refrigerated at 4°C for 4 hours, when kept at room temperature for 4 hours, and when frozen at -80°C for 6 months.

Trueness assessment of routine electrolytes measuring systems using the candidate reference method by ion chromatography.

Electrolytes for sodium, potassium, magnesium, and calcium are important serum ions that are frequently assayed in clinical laboratories. In this study, we assessed the trueness of routine analytical systems for four cations using an inexpensive candidate reference method aimed to promote the standardization of serum electrolyte detection. An ion chromatography (IC) method with Cesium as an internal standard was developed and evaluated. The residual clinical serum samples at Chaoyang Hospital were collected and prepared into three human serum pools of electrolytes, which were used for the trueness evaluation of five routine analytical systems. Furthermore, the agreement between routine methods and the IC method was verified using 40 individual human samples. The recovery rates of sodium, potassium, magnesium and calcium were 99.69%, 100.34%, 100.43% and 99.89%, respectively. The intra-batch standard deviation and intra-laboratory precision of NIST SRM 956c were all less than 1% for the four ions. The certified values were within the validation range, and the deviation between the results and the certified values were less than 0.5%. The three serum pools were homogeneous and stable. All routine systems aligned with the IC method for four cations and achieved the analytical quality specifications for potassium and magnesium at 3 different concentrations. The developed IC method is simple, practical, accurate, and precise, which can be used as a candidate reference method for serum electrolytes measurement. Five routine analytical systems for electrolytes measurement had the acceptable bias for potassium and magnesium and their results showed good concordance.

EQA/PT scheme to improve the equivalence of enzymatic results between mutual recognition laboratories in Beijing.

BACKGROUND: To utilize the external quality assessment (EQA)/proficiency testing (PT) scheme to evaluate the equivalence of different clinical enzymatic measuring systems in Beijing. METHODS: The Beijing Center for Clinical Laboratory (BCCL) distributed three investigation samples to mutual recognition clinical laboratories in Beijing including alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), creatine kinase (CK), and lactate dehydrogenase (LDH). These samples were derived from serum pools with values assigned by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) enzymatic reference measurement procedures (RMPs). Each laboratory performed duplicate tests of the samples. Then, the samples at level 1 were used to recalibrate individual measuring systems for repeating the tests. BCCL collected data for evaluation of their analytical quality. RESULTS: Before recalibration, the biases of ALT and AST tests were not traceable to the IFCC RMPs, and the bias pass rates of GGT, CK, and LDH tests were only 51.2%, 55.7%, and 48.6% respectively. After recalibration, the pass rates of ALT, AST, GGT, CK, and LDH increased to 95.1%, 82.9%, 95.1%, 97.1%, and 70.0% respectively. The EQA/PT also showed that after recalibration, more than 95% of laboratories met the optimum level specifications of the biological variation for ALT, AST, GGT, and CK tests and the desirable for LDH tests. CONCLUSION: The enzymatic tests in Beijing need to be further standardized by category 1 or 2 EQA/PT scheme for mutual recognition between clinical laboratories. The criteria of biological variation are more relevant for determining the equivalence of clinical enzymatic tests.

Establishment of Multiple Myeloma Diagnostic Model Based on Logistic Regression in Clinical Laboratory.

BACKGROUND: Due to the insidious onset of multiple myeloma (MM), missed diagnosis and misdiagnosis have a serious impact on the health of MM patients. Simple, rapid, and valid laboratory screening is critical for MM clinical diagnosis. METHODS: We used routine laboratory tests to establish a simple, inexpensive, and non-invasive diagnostic model for MM based on logistic regression. In the retrospective analysis, a total of 273 newly diagnosed MM inpatients and 288 non-MM participants, from January 2016 to December 2018 in Beijing Chaoyang hospital, Capital Medical University, were divided into training set and validation set. Age, gender, and the related routine laboratory tests for MM, including albumin (ALB), globulin (GLB), lactate dehydrogenase (LDH), creatinine (Cr), calcium (Ca2+), hemoglobin (Hb) and platelet (PLT), were analyzed by multivariate logistic regression to develop a diagnostic model. RESULTS: A diagnostic model was calculated using the formula MM index=-((-18×gender-3×ALB-Hb)/10), based on the logistic regression. The MM index [22 (20 - 25)] of MM patients was significantly lower than that of non-MM [30 (29 - 31)] in the training set (p < 0.001). It showed an excellent diagnostic performance in diagnosing MM through a receiver operating characteristic (ROC) curve, and its corresponding sensitivity, specificity, and area under the curve (AUC) were 95.6%, 96.7%, and 0.982 (0.968, 0.997), respectively. At a diagnostic risk threshold of 28, the model identified MM with a sensitivity of 95.6% and a specificity of 98.1% by using independent validation data. There was a significant positive correlation (r = 0.845, p < 0.001) between the DS grading and the MM index among all the participants. CONCLUSIONS: The established diagnostic model of MM index can successfully identify newly diagnosed MM from healthy controls. The diagnostic model of MM index may also act as a predictor of the severity of MM without therapy.

Commutability of external quality assessment materials for point-of-care glucose testing using the Clinical and Laboratory Standards Institute and International Federation of Clinical Chemistry approaches.

OBJECTIVES: The aim of this study was to assess the commutability of three external quality assessment (EQA) materials for point-of-care (POC) glucose testing using two approaches, to identify suitable EQA materials to evaluate and monitor the quality of POC testing. METHODS: Commercial control materials (CCMs), pooled human serum samples (PHSs), and homemade human whole-blood samples (HWBs) were measured along with 33 individual clinical samples using five POC instruments and a Hitachi 7600 analyzer. Data were analyzed by Deming regression analysis with a 95% prediction interval as described in Clinical and Laboratory Standards Institute (CLSI) EP30-A, and by difference in bias analysis as described by the International Federation of Clinical Chemistry (IFCC) Working Group on Commutability. RESULTS: Using the CLSI approach, HWBs, CCMs, and PHSs were commutable with five, one, and two instruments, respectively. With the IFCC approach, HWBs were commutable with two instruments, while CCMs and PHSs were largely inconclusive or non-commutable on five instruments. CONCLUSIONS: HWBs were commutable on all instruments by the CLSI approach and may be a suitable EQA material for POC testing. Although some results differed between the IFCC and CLSI approaches, both indicated that HWBs were far superior to CCMs and PHSs in commutability.

Algicoccus marinus gen. nov. sp. nov., a marine bacterium isolated from the surface of brown seaweed Laminaria japonica.

A Gram-staining-negative, strictly aerobic, non-motile, ovoid- to rod-shaped bacterium, designated as HZ20T, was isolated from the surface of a brown seaweed (Laminaria japonica) sample collected from the East China Sea. Colonies are 1.0-2.0 mm in diameter, smooth, circular, convex and yellow after grown on MA at 28 °C for 72 h. The strain was found to grow at 4-50 °C (optimum, 37 °C), pH 5.0-9.5 (optimum, pH 7.0-7.5) and with 0-10% (w/v) NaCl (optimum, 1.0-1.5%). Chemotaxonomic analysis showed ubiquinone-8 as the only quinone, C17:0 cyclo, C16:0, summed feature 8 (C18:1ω7c and/or C18:1ω6c) and summed feature 2 (C12:0 aldehyde/unknown 10.9525/C16:1 iso I/C14:0 3OH) as the major fatty acids (> 5%), and diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, one unidentified amino phospholipid, two unidentified phospholipids, five unidentified glycolipid and two unidentified lipids as the polar lipids. The DNA G + C content was 55.5 mol %. 16S rRNA gene sequences of the isolate showed highest similarities to Bordetella flabilis AU10664T (97.1%), Parapusillimonas granuli Ch07T (97.1%), Paracandidimonas soli IMT-305T (97.1%), Kerstersia gyiorum LMG5906T (97.0%) and Bordetella sputigena LMG 28641T (97.0%). The phylogenetic trees using 16S rRNA gene and genome sequences both showed that the strain HZ20T formed a deep branch separated from other related genera, indicating that it represents a novel species of a novel genus. The calculated average nucleotide identity (ANI) and percent of conserved proteins (POCP) values using genome sequences of strain HZ20T and related strains also support this conclusion. Based on the phenotypic properties and phylogenetic distinctiveness, we propose strain HZ20T (= MCCC 1K03465T = KCTC 62330T) to represent a novel species of a novel genus with the name Algicoccus marinus gen. nov. sp. nov.

Loganin Attenuates Osteoarthritis in Rats by Inhibiting IL-1ß-Induced Catabolism and Apoptosis in Chondrocytes Via Regulation of Phosphatidylinositol 3-Kinases (PI3K)/Akt.

BACKGROUND Chondrocyte apoptosis and catabolism are 2 major factors that contribute to the progression of osteoarthritis (OA). Loganin, an iridoid glycoside present in several herbs, including Flos lonicerae, Cornus mas L, and Strychnos nux vomica, is a valuable medication with anti-inflammatory and anti-apoptotic effects. Our study examines these effects and explores the potential benefits of loganin in the OA treatment. MATERIAL AND METHODS To clarify the roles of loganin in OA and its specific signaling pathway, chondrocytes were administrated with IL-1ß and supplemented with or without LY294002 (a classic PI3K/Akt inhibitor). The apoptotic level, catabolic factors (MMP-3 and MMP-13 and ADAMTS-4 and ADAMTS-5), extracellular matrix (ECM) degradation, and activation of the PI3K/Akt pathway were evaluated using western blotting, PCR, and an immunofluorescent assay. The degenerative condition of the cartilage was evaluated using the Safranin O assay in vivo. The expression of cleaved-caspase-3 (C-caspase-3) was measured using immunochemistry. RESULTS The data suggested that loganin suppressed the apoptotic level, reduced the release of catabolic enzymes, and decreased the ECM degradation of IL-1ß-induced chondrocytes. However, suppressing PI3K/Akt signaling using LY294002 alleviated the therapeutic effects of loganin in chondrocytes. Our in vivo experiment showed that loganin partially attenuated cartilage degradation while inhibiting the apoptotic level. CONCLUSIONS This work revealed that loganin treatment attenuated IL-1ß-treated apoptosis and ECM catabolism in rat chondrocytes via regulation of the PI3K/Akt signaling, revealing that loganin is a potentially useful treatment for OA.

Ginsenoside Rh2 inhibits proliferation and migration of medulloblastoma Daoy by down-regulation of microRNA-31.

This study aimed to investigate the effects of ginsenoside Rh2 on proliferation, apoptosis, and migration of the human medulloblastoma cell line Daoy, as well as to explore the potential mechanisms of the effects. The human medulloblastoma cell line Daoy was cultured in vitro and treated with or without ginsenoside Rh2. CCK-8 assay was performed to investigate the effect of Rh2 on cell survival using a cell counting Kit-8. Cell proliferation was assessed by BrdU assay. Cell apoptosis was determined using flow cytometry analysis. Cell migration was detected using a modified two-chamber migration assay. MiR-31 mimic and the NC control were transfected into Daoy cells and detected by qRT-PCR. The expression of Wnt3a, Wnt5a, and ß-catein was detected by Western blot analysis. Rh2 efficiently suppressed the proliferation and migration, and promoted the apoptosis of Daoy cells. Additionally, Rh2 could down-regulate miR-31. miR-31 overexpression reversed the effects of Rh2 on proliferation, apoptosis and migration of Daoy cells, and activated the Wnt/ß-catein signaling pathways in Daoy cells. Rh2 could inhibit the proliferation and migration, and induce apoptosis of Daoy medulloblastoma cells through down-regulation of miR-31 to inactivate the Wnt/ß-catein signaling pathway. Therefore, Rh2 may have a utility in clinical applications for the treatment of medulloblastoma.

Uncertainty evaluation in clinical chemistry, immunoassay, hematology and coagulation analytes using only external quality assessment data.

BACKGROUND: Measurement uncertainty (MU) is a parameter associated with the result of a measurement that characterizes its dispersion. We report results for estimating MU following the application of a top-down procedure using only proficiency test data to establish uncertainty levels for various analytes. METHODS: Data were obtained from 142 laboratories participating in the Beijing Center for Clinical Laboratory (BCCL) proficiency testing/external quality assessment (PT/EQA) schemes. The 24-month study included six selected PT shipments to obtain estimates for 50th percentile (median) and 90th percentile MUs and to compare those estimates to usual analytic goals. The number of laboratory participants varied for each trial. The expanded uncertainty (U) was calculated using a cover factor of k=2 for a confidence interval of 95%. All reproducibility, method and laboratory biases came from the PT/EQA data. RESULTS: The median U (k=2) ranged from 3.2% (plasma sodium, indirect ion selective electrode) to 32.8% (triglycerides, free glycerol blanking) for clinical chemistry analyte means from participants in the same method group. Immunoassay analyte median U results ranged from 11.3% (CA125 tumor marker, Roche) to 33.8% (prostate-specific antigen [PSA], Abbott). The range for median U was 3.5% (red blood cell [RBC], Abx) to 30.3% (fibrinogen [FBG], other) for hematology and coagulation analytes. The MUs for most analytes satisfied quality requirements. CONCLUSIONS: The use of PT/EQA data, when available, provides an effective means for estimating uncertainties associated with quantitative measurements. Thus, medical laboratories can calculate their own MUs. Proficiency testing organizers can provide participants with an additional MU estimate using only EQA data, which may be updated at the end of each survey.

Preparation of Commutable Frozen Human Serum Candidate Reference Materials for Standardization of Sodium Measurements.

BACKGROUND: The measurement of serum sodium is important in the diagnosis of diseases. However, the accuracy and comparability of results in clinical laboratories are not ideal. The aim of this study was to prepare the candidate reference materials (RMs) to standardize serum sodium measurements. METHODS: Fresh sera without hemolysis, lipemia, and choloplania were collected and packed in the cryovials. According to ISO Guide 35, the homogeneity and stability were tested. The value was assigned by transfer from the National Institute of Standards and Technology (NIST) SRM919b using the reference method of ion chromatography (IC) and uncertainty was calculated. The commutability of candidate RMs were observed between the reference method and the two analyzed systems and then distributed to 47 laboratories to apply in routine assays. RESULTS: The F values of the homogeneity test were less than F0.05; stability can last at least 12 months, 30 days, 15 days, and 7 days at -80°C, 2 - 8°C, room temperature (20 - 24°C), and 37°C, respectively. The results of three levels of candidate RMs for sodium were (159.00 ± 2.70), (139.16 ± 2.57), and (124.71 ± 3.12) mmol/L; coordinate dots of candidate RMs were all within the 95% confidence interval range of a 25-serum regression line. More than 76.6% of laboratories were within a bias of ± 1.5% from the target values. CONCLUSIONS: The homogeneity, stability, and commutability of candidate RMs all meet the requirement, and the target values are assigned accurately. These new RMs of sodium in the human serum pool can be used to set up the traceability chain to improve the comparability of measurement results.

Application of Commutable ERM-DA474/IFCC for Harmonization of C-reactive Protein Measurement Using Five Analytical Assays.

BACKGROUND: ERM-DA474/IFCC has been used as a reference material for C-reactive protein (CRP) since 2012. However, the commutabilities and the capacity for harmonizing CRP results of the material and its dilutions have not yet been reported. In this study, we aimed to evaluate the harmonization of CRP results using commutable ERM-DA474/IFCC. METHODS: Twenty-one serum samples were collected and split into five vials. The samples were then analyzed using five popular assays (Siemens BN II, Beckman Immage 800, Roche, Diasys, and Leadman). ERM-DA474/IFCC and four dilutions of healthy human serum containing low levels of CRP were also analyzed using the five assays described above. Commutability was assessed using the Roche, Diasys, and Leadman assays. Clinical sample results from assays were recalibrated based on ERM-DA474/IFCC and its dilutions. RESULTS: There were significant variations among the five assays for CRP measurement. The slopes ranged from 0.60 to 1.60, and the BN II and Leadman assays showed significant negative and positive systemic biases, respectively. ERM-DA474/IFCC and its dilutions exhibited commutability among the three assays. After recalibration, the slope was reduced to 0.76 - 1.27. CONCLUSIONS: Harmonization was not ideal for CRP measurement. ERM-DA474/IFCC may play a role in improving harmonization for CRP measurement.

3D cost aggregation with multiple minimum spanning trees for stereo matching.

Cost aggregation is one of the key steps in the stereo matching problem. In order to improve aggregation accuracy, we propose a cost-aggregation method that can embed minimum spanning tree (MST)-based support region filtering into PatchMatch 3D label search rather than aggregating on fixed size patches. However, directly combining PatchMatch label search and MST filtering is not straightforward, due to the extremely high complexity. Thus, we develop multiple MST structures for cost aggregation on plenty of 3D labels, and design the tree-level random search strategy to find possible 3D labels of each pixel. Extensive experiments show that our method reaches higher accuracy than the other existing cost-aggregation and global-optimization methods such as the 1D MST, the PatchMatch and the PatchMatch Filter, and currently ranks first on the Middlebury 3.0 benchmark.

A case of Galen vein thrombosis occurring after bilateral acetabular fractures in the Tibet plateau - what can we learn?

Hypoxia leads to increased red blood cells and blood viscosity at high altitude while moderate trauma increases coagulation in blood. Under the above-mentioned conditions, venous sinus thrombosis is more likely to occur. A patient suffering bilateral acetabular fractures together with the gradual disturbance of consciousness was admitted to our hospital. Though computed tomography arteriogram (CTA) of the brain displayed normal blood vessels; bilateral thalamus and brainstem infarction were found on head computed tomography (CT) and Galen vein thrombosis on cerebral computed tomography venography (CTV). Dehydration and tracheotomy were immediately conducted with antiplatelet, anticoagulant and neurotrophic medicine administered to the patient. After three days' treatment, the patient's consciousness gradually improved and eventually became clear enough to leave the hospital. On follow-up, no dysfunction was documented.

A concise and practical stereoselective synthesis of ipragliflozin L-proline.

A concise and practical stereoselective synthesis of ipragliflozin L-proline was presented starting from 2-[(5-iodo-2-fluorophenyl)methyl]-1-benzothiophene and 2,3,4,6-tetra-O-pivaloyl-α-D-glucopyranosyl bromide without catalyst via iodine-lithium-zinc exchange. The overall yield was 52% in three steps and the product purity was excellent. Two key diastereomers were prepared with efficient and direct access to the α-C-arylglucoside.

Greenhouse gas emissions from sludge treatment reed beds.

Sludge treatment reed bed systems (STRBs) are considered as an alternative technology for surplus sludge treatment. Organic matter is decomposed by various microbial reactions, resulting in gases such as CO2and CH4emitting into the atmosphere. The aim of this study is to investigate gas emission from STRBs. The static transparent chamber was adopted to measure gas emission; it allows sunlight to enter and plants to photosynthesise. The comparison of total solids and volatile solids showed STRBs have a higher efficiency in dewatering and mineralization than a conventional unplanted sludge drying bed (USDB). The CO2emission ranged from 28.68 to 100.42 g CO2m⁻² d(-1) in USDB, from 16.48 to 65.18 g CO2m⁻² d⁻¹ in STRBs; CH4emission ranged from 0.26 to 0.99 g CH4 m⁻² d⁻¹ in USDB, from 0.43 to 1.95 g CH4m⁻² d⁻¹ in STRBs. Both gas fluxes decreased towards the end of vegetation and reached the highest rates during the hot and dry summer. After the system was loaded by sludge, the fluxes of CO2and CH4significantly decreased in the USDB, whereas they increased in STRBs. In terms of CO2equivalent, the global warming potential of CH4was 13.13 g CO2eq m⁻² d⁻¹ and 15.02 g CO2eq m⁻² d⁻¹ in USDB and STRBs, respectively.

Comparable analysis of six immunoassays for carcinoembryonic antigen detection.

Objective: This study aimed to assess the current status of carcinoembryonic antigen (CEA) detection. We evaluated the correlation, consistency, and comparability of CEA results among six automated immunoassays, and combined with the results of CEA trueness verification of the Beijing Center for Clinical Laboratories (BCCL) for further analysis. Methods: Abbott Architect i2000, Beckman DxI800, Roche Cobas E601, Diasorin Liaison XL, Maccura IS1200, and Autolumo A2000 were used to detect 40 individual serum CEA samples. Taking the optimal analytical quality specifications calculated from data on biological variation as the evaluation criterion. Passing-Bablok regression and Bland-Altman analysis were performed between each assay and all-assays median values to evaluate the correlation and relative difference. The concordance correlation coefficient (CCC) was used for consistency analysis. Additionally, the trueness verification program used samples at three concentration levels to assess the bias, coefficient of variation (CV), and total error (TE) between the average measured values and the target value. Results: The Spearman's rank correlation coefficient (rs) was ≥0.996 and the CCC ranged between 0.9448 and 0.9990 for each assay vs. all-assays median. Considering the all-assays median value of each sample as a reference, there were proportional and systematic differences according to the Passing-bablok regression analysis. The relative difference of the four assays (Abbott Architect i2000, Autolumo A2000, Diasorin Liaison XL, and Maccura IS1200) met the optimal analytical quality specifications. On the other hand, Beckman DxI800 (13.2 %) and Roche Cobas E601 (-9.0 %) were only able to fulfill the desirable analytical quality specifications. The average pass rates for bias, CV, and TE of the trueness verification program were 80 %, 98 %, and 96 %, respectively. Conclusions: The six automated immunoassays vs. all-assays median have a good correlation in CEA detection. However, there is a lack of comparability of CEA results. Further improvements are needed in harmonization among CEA detections.