Design of internal quality control program for specific protein testing based on patient risk / 中华检验医学杂志

Objective:Patient risk-based statistical quality control (SQC) program was designed for 9 specific protein projects using Westgard sigma rules with run length.Methods:The cumulative coefficient of variation of immunoglobulin (Ig)G, IgA, IgM, C3, C4, rheumatoid factor (RF), antistreptolysin O (ASO), transferrin (TRF) and prealbumin (PA) from the laboratory department of Beijing Tongren Hospital between December 2018 to May 2019 were used as the estimated value of imprecision. The mean of the absolute value of the percentage difference of 10 batches in the laboratory, which was derived from the results of participating the external quality assessment (EQA), was used as the estimated value of bias. The National Center for Clinical Laboratories EQA evaluation criteria was used as an allowable total error (TEa), and the sigma value of each project (σ) was calculated. Westgard Sigma rule with run length was used to design appropriate SQC program for each project, including quality control rules, number of control measurements (N) and frequency of quality control.Results:The sigma value was larger than 6 for SQC procedure of IgG, IgA, IgM, C4 and TRF. SQC could be established with the use of 1 3s rule, number of control measurements (N)=2, number of runs (R)=1, and a run length of 1 000 patient samples. Combined with the average daily workload, internal quality control could be conducted once every 10 days for IgG, IgA, IgM and C4, every 50 days for TRF. The σ was 5.86 for C3, SQC program could be established with run length of 450 using 1 3S/2 2S/R 4s rule (N=2, R=1), combined with average daily workload, internal quality control could be conducted every 4.5 days. σ was between 3 and 4 for RF, ASO and PA. With the use of 1 3S/2 2S/R 4s/4 1s/6 X rule (N=6, R=1), SQC program with a run length of 45 and higher frequency internal quality control activities. Conclusion:It is feasible to use Westgard sigma rules with run length for the laboratories design of personalized risk-based SQC procedures, the method is very simple and intuitive. This tool is valued to be recommended to be actively applied by all clinical laboratories.

The sequencing and characterization of chloroplast genome of Geranium sibiricum Linne.

The complete chloroplast genome of Geranium sibiricum Linne. was sequenced, assembled and annotated. It is a circular form of 150,656 bp in length, which was separated into four distinct regions, a large single copy (LSC) of 73,862 bp, a small single copy region (SSC) of 52,666 bp, two inverted repeats (IR) of 12,064bp. A total of 124 genes were predicted, of which, 87 encode proteins, 4 rRNA, 33 tRNA. The evolutionary history was inferred using Maximum Likelihood method, and the result indicates that G. sibiricum was grouped within Geraniaceae, and comprised a clade with Geranium palmatum under 100% Bootstrap value.

Application of branchedspongiosum repair in duckett surgery for hypospadias / 中华泌尿外科杂志

Objective To explore the effect of reducing complication in branched spongiosum repair for hypospadias Duckett surgery.Methods Retrospective analysis was performed for the clinical data of 140 surgical infants with hypospadias Duckett surgery from January 2016 to April 2018.According to different covering materials on newly formed urethra,the experimental group (68 cases) cut dysplasia,branched spongiosum and lateral Buck's fascia from tunica albuginea to coronary groove and then sutured over newly formed urethra,and the control group (72 cases) used Dartos fascia or subcutaneous fascia.The operative age,penile curvature,length of urethral defect,operation time,added value of coronary groove before and after operation,maximum urinary flow rate and complication rate of postoperative follow-up were compared between the two groups,and the therapeutic effect was analyzed.Results There was no statistically significant difference between two groups in operating time [(135 ± 49) min vs.(135 ± 45) min,P =0.580] and the value added of coronary sulcus [(0.1 ± 0.2) cm vs.(0.1 ± 0.1) cm,P =0.167].In experimental group,there were 8 cases of urethra percutaneous fistula (11.8％) (coronary groove fistula in 3 cases,4.4％) and 6 cases of urethral stenosis (8.8％) without urethral dehiscence.In control group,there were 18 cases of urethra percutaneous fistula (25.0％) (coronary groove fistula in 11 cases,15.3％),10 cases of urethral stenosis (13.9％),and 2 cases of urethral dehiscence (2.8％).The incidence of postoperative urinary fistula and total complications in experimental group was lower than that in the control group,and the difference was statistically significant (P ＜ 0.05),while the incidence of urethral stenosis was not statistically different between two groups (P ＞ 0.05).The maximum urine flow rate of experimental group at 6 months after surgery was significantly higher than control group [(9.5 ± 3.8) ml/s vs.(6.8 ± 2.8) ml/s],and the difference was statistically significant (P ＜ 0.001).Conclusions Urethral cavernosum reconstruction can significantly reduce the incidence of postoperative coronary groove fistula of hypospadias Duckett surgery and improve the postoperative urine flow rate.

Research progress on internal statistical quality control procedures for quantitative tests in clinical laboratories / 中华检验医学杂志

The laboratory medicine is aimed to support clinical decisions and patient health by providing accurate results. The internal statistical quality control (SQC) can help laboratories detecting the instability of the analytical system and preventing laboratories from reporting the patient results with medically important errors, so it is essential to ensure the quality of testing results and patient safety. The traditional methods of designing SQC strategy are based on the probability of error detection (Ped) and the probability of false rejection (Pfr). With the introduction of risk management concepts, the design of SQC strategy began to be based on the patient risk parameter [MaxE(Nuf)] proposed by Parvin, which means the maximum increase in the number of unacceptable patient results reported compared to the in-control condition during the existence of an undetected out-of control error condition. MaxE(Nuf) is related to the SQC frequency and patient risk, which is very essential for optimizing the SQC frequency and designing a risk-based SQC strategy.

Research progress on internal statistical quality control procedures for quantitative tests in clinical laboratories / 中华检验医学杂志

The laboratory medicine is aimed to support clinical decisions and patient health by providing accurate results. The internal statistical quality control (SQC) can help laboratories detecting the instability of the analytical system and preventing laboratories from reporting the patient results with medically important errors, so it is essential to ensure the quality of testing results and patient safety. The traditional methods of designing SQC strategy are based on the probability of error detection (Ped) and the probability of false rejection (Pfr). With the introduction of risk management concepts, the design of SQC strategy began to be based on the patient risk parameter [MaxE(Nuf)] proposed by Parvin, which means the maximum increase in the number of unacceptable patient results reported compared to the in-control condition during the existence of an undetected out-of control error condition. MaxE(Nuf) is related to the SQC frequency and patient risk, which is very essential for optimizing the SQC frequency and designing a risk-based SQC strategy.

Application of branchedspongiosum repair in duckett surgery for hypospadias / 中华泌尿外科杂志

Objective@#To explore the effect of reducing complication in branched spongiosum repair for hypospadias Duckett surgery.@*Methods@#Retrospective analysis was performed for the clinical data of 140 surgical infants with hypospadias Duckett surgery from January 2016 to April 2018. According to different covering materials on newly formed urethra, the experimental group (68 cases) cut dysplasia, branched spongiosum and lateral Buck′s fascia from tunica albuginea to coronary groove and then sutured over newly formed urethra, and the control group (72 cases) used Dartos fascia or subcutaneous fascia. The operative age, penile curvature, length of urethral defect, operation time, added value of coronary groove before and after operation, maximum urinary flow rate and complication rate of postoperative follow-up were compared between the two groups, and the therapeutic effect was analyzed.@*Results@#There was no statistically significant difference between two groups in operating time[(135±49)min vs.(135±45)min, P=0.580] and the value added of coronary sulcus[(0.1±0.2)cm vs.(0.1±0.1)cm, P=0.167]. In experimental group, there were 8 cases of urethra percutaneous fistula (11.8%) (coronary groove fistula in 3 cases, 4.4%)and 6 cases of urethral stenosis (8.8%) without urethral dehiscence. In control group, there were 18 cases of urethra percutaneous fistula (25.0%)(coronary groove fistula in 11 cases, 15.3%), 10 cases of urethral stenosis (13.9%), and 2 cases of urethral dehiscence (2.8%). The incidence of postoperative urinary fistula and total complications in experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05), while the incidence of urethral stenosis was not statistically different between two groups (P>0.05). The maximum urine flow rate of experimental group at 6 months after surgery was significantly higher than control group[(9.5±3.8)ml/s vs.(6.8±2.8)ml/s], and the difference was statistically significant (P<0.001).@*Conclusions@#Urethral cavernosum reconstruction can significantly reduce the incidence of postoperative coronary groove fistula of hypospadias Duckett surgery and improve the postoperative urine flow rate.

Short-term outcome of Kelly procedure for bladder exstrophy- epispadias complex / 中华泌尿外科杂志

Objective To evaluate the short-term outcome of the Kelly procedure for bladder exstrophy-epispadias complex.Methods Kelly procedure was performed in 5 cases from December 2015 in our institute. Retrospective analysis was done including the surgery and follow up.Results Two bladder exstrophy boys had histories of primary bladder closure without bladder neck reconstruction during the neonatal period. Another three epispadias boys had sever urethral defects with full incontinence. All cases undertook Kelly procedure and were followed up for 7.8 months (2-12 months). No severe complications such as glanular necrosis, urethral stricture and urethrocutaneous fistula was observed. Four cases were fully continent and one epispadias case had stress incontinence.Conclusions Kelly procedure produced satisfactory urinary continence and phallic cosmetics in bladder exstrophy-epispadias complex in children. Proper identification of the pudendal neurovascular bundle and repair of the external sphincter by levatorplasty help improve the outcome.

Preliminary results of robotic-assisted laparoscopic pyeloplasty in children / 中华泌尿外科杂志

Objective To evaluate the feasibility and outcomes of robotic-assisted laparoscopic pyeloplasty in children .Methods A retrospective study was performed in patients who underwent robotic-assisted laparoscopic pyeloplasty ( Anderson-Hynes ) at our institution between January 2014 to August 2014.Totally 6 boys were diagnosed as left ureteropelvic junction obstruction depending on the symptoms and radiographic studies .The mean age was 9 years ( range 4 -12 years ) .Results The procedure was performed successfully without conversion to open surgery in all of the cases .Mean operative time was 216 min (range 175-269 min), with a mean robotic anastomosis time of 45 min (range 30-60 min).Mean estimated blood loss was less than 15 ml.The mean hospitalization was 4.5 days.Mean follow-up period was 10 months ( range 7 -14 months ) .There were no perioperative complications , and recovery was uncomplicated (without recurrence, pyelonephritis, nephrarctia) in all of the patients.Conclusion Robotic-assisted laparoscopic pyeloplasty can be safely performed in children older than 4-year-old with ureteropelvic junction obstruction .

The Effect of Erhuang Decoction on Transforming Growth Factor-β1 of Lung Tissues and the Expression of Leukotriene-33 in Asthmatic Rats / 天津医药

Objective To investigate the effect of Erhuang decoction on TGF-β1 expression of lung tiusses and the concentrations of IL-33 in asthmatic rats. Methods Fifty Sprague-Dawley rats were randomly divided into five groups equally:Control group, Asthmatic group, Budesonide aerosol group, High-dose Erhuang decoction group ( 68 g/kg)and Low-dose Erhuang decoction group(17 g/kg). The model of asthma was established by ovalbumin (OVA) sensitizing and challeng-ing. Then Erhuang decoction and budesonide aerosol was used respectively for intervention therapy. Histologic HE staining were used to observe the general pathologic alteration and to analyze the total bronchial wall area (Wat) and the muscle wall area(Wam). The protein expressions of TGF-β1 in the lung tissues were detected by immunohistochemistry. The concentra-tions serum IL-33 and BALF were tested by sandwich ELISA. Results There was significant reduction in the infiltrated inflammatory cells in all drug intervention groups compared with asthma group;The Wat and Wam in asthmatic group was significantly higher in than those in Budesonide aerosol group,High-dose Erhuang decoction group and Low-dose Erhuang decoction group ( Watμm2/μm:54.99±8.82, 52.28±7.61, 58.53±7.63 vs 79.50±5.64, P＜0.05;Wamμm2/μm:22.74±2.73, 20.63±1.72, 21.20±4.50 vs 30.16±1.68, P＜0.05);Compared with control group, BALF and serum IL-33 concentration were significantly higher in asthmatic group. Compared with asthmatic group, all the indicators were significantly decrease in the treatment groups after drug intervention (P＜0.05). Andthere was no significant difference between the treatment groups in all the indicators. TGF-β1 expression in lung tissues in asthmatic group were significantly higher than that in control group (12.60 ± 2.25 vs 1.67 ± 0.17). Compared with asthmatic group, there was significantly reduction of TGF-β1 expression in the Budesonide aerosol group (5.51±2.48), High-dose Erhuang decoction group (5.22±2.52) and Low-dose Erhuang decoction group (6.92 ±2.18) (P＜0.05). There were no significant difference between the treatment groups. TGF-β1 expression and se-rum IL-33 concentration in asthmatic rats were positively correlated with Wat and Wam. Conclusion The effects of Er-huang decotion on ameliorating the progression of airway remodeling about asthmatic rats may be partially by regulating TGF-β1 and IL-33.

Mechanistic study of pancreatic cancer cell radioresistance conferred by Aurora-A / 中国癌症杂志

Background and purpose:Aurora-A is a member of serine/threonine kinase family. The abnormal expression of Aurora-A induces tumorigenesis and radioresistance. This study was aimed to investigate the association of Aurora-A with radioresistance. Methods: Capan-1 cells were treated with Aurora-A kinase inhibitor, and then used to test cell proliferation, anchorage independent assay, cell cycle, and cell cycle regulatory proteins. Treated cells were also used to detect cell apoptosis afterγ-irradiation. Results:Cell growth and colony number in soft agar were decreased after treatment with Aurora-A inhibitor. Treatment of cells with Aurora-A inhibitor also down-regulated the expression of Cyclin D1, CDK2 and CDK6 to induce cell cycle arrest at G1/S and G2/M phases, but promoted cell apoptosis afterγ-irradiation. Conclusion:Treatment of pancreatic cancer cells with Aurora-A kinase inhibitor blocks cell proliferation and cell cycle progression, and promotes sensitivity of cells to radiation. Thus, Aurora-A may be used as one of therapeutic targets to increase the sensitivity of pancreatic cancer radiotherapy.

Low-Field-MRI in Assessing the Vessels Surrounding Pancreas Involved by Pancreatic Carcinoma / 实用放射学杂志

Objective To study the accuracy,clinical value and limit in assessing the vessels surrounding pancreas involved by pancneutic carcinoma with low field MRI.Methods MRI scanning was performed in 55 patients with pancreatic carcinoma.We prospectively evaluated the MRI findings of vascular involvement by pancreatic carcinoma,and compared with the surgical results.Results Of total 55 cases,50(91%)cases were correctly diagnosed on MRI .MRI carries an accuracy of 86% for prediction of resectility,and accuracy of 93% for unresectility.Conclusion Low field MRI can accurately assess the peripancreative vessels ,but it has limited value in the patients with pancreatic carinomaⅠa orⅠb.

OBSERVATIONS ON THE MORPHOLOGICAL CHANGES OF EPIDERMAL LANGERHANS CELLS IN REPEATED SKIN IRRITATION TEST WITH BENZALKONIUM BROMIDE AND DINITROCHLOROBENZENE / 解剖学报

The kinetic changes in morphology and cellular density of epidermal Langerhanscells (LC) in the guinea pig were observed by ATPase cytochemical staining techniqueafter repeated skin application of 5%,3% and 1% of benzalkonium bromide (BB,primary irritant) and 0.05% dinitrochlorobenzene (DNCB,allergen) respectively.We have found that there was a significant difference in the density and morpho-logical change of LC between BB and DNCB application.Treatment with 5% BBcould induce a reversible decline in LC density and changes in cell processes,andwith 0.05% DNCB,the number of LC was decreased and the ATPase activity wasweakened only in the late stage of treatment.The significance of using the kineticchanges in morphology and cellular density of LC as the criteria for the safetyevaluation of weak allergens and weak primary irritants as well as cosmetics wasdiscussed.