Exploring the teaching mode about clinical laboratory diagnostic pathway for chronic hepatitis B / 中华预防医学杂志

Exploring a new teaching mode of CHB laboratory diagnostics to improve the teaching quality through establishment a teaching model covered the whole process of CHB disease diagnosis and differential diagnosis, treatment, drug selection, the toxicity and side effects prediction, effect monitoring, and prognosis evaluation. According to the CHB clinical diagnosis and treatment guidelines, formulated the laboratory examination and detection strategies related to different stages of CHB, and established CHB clinical laboratory diagnostic pathway. Compared the classroom teaching effect by the questionnaire between the 2016 and 2017 eight-year undergraduates from the First Clinical College of Wuhan University. In this study,the CHB clinical laboratory diagnostic pathway was established and approved by clinicians, which covered the whole process of CHB disease diagnosis and differential diagnosis, treatment, drug selection, the toxicity and side effects prediction, effect monitoring, and prognosis evaluation. The teaching quality evaluation indicators and the scores on the class test had been greatly improved with the clinical diagnostic pathway teaching mode in the classroom teaching of 2017 clinical medicine undergraduates compared with the traditional teaching mode in the 2016 clinical medicine undergraduates. In summary, the medical students not only could realize the organic integration of laboratory diagnostics and clinical medicine, but also improves overall understanding of various laboratory tests in CHB diagnosis and treatment from the teaching model of laboratory diagnostics based on the CHB clinical laboratory diagnostic pathway,and the quality of teaching for CHB has been significantly improved.

Brief communication: comparison the diagnostic performance of four HBsAg ELISA kits.

BACKGROUND: Comparison of diagnostic efficiency of four ELISA kits for determining HBsAg. METHODS: Collecting 348 serum samples from clinical laboratory of Renmin Hospital of Wuhan University without specific gender and age requirements, determining HBsAg by the four ELISA kits, simultaneously. Confirmatory test was carried out when the initial results are positive. RESULTS: 329 out of 348 samples results were consistent (94.5%), 152 out of 329 were positive, and 177 out of 329 were negative, and all the positive results can be confirmed; 19 samples were not consistent (5.5%), and only 1 sample was confirmed by the confirmatory test. After calculation, the diagnostic efficiencies of the four ELISA kits (Beijing Wantai, Xiamen Xinchuang, Zhuhai Lizhu, and Shanghai Kehua) were 98.6%, 98.0%, 99.7%, and 97.4%, respectively, the sensitivities were 100%, 99.4%, 99.4%, and 100%, respectively, the specificities were 97.5%, 96.9%, 100%, and 95.4%, respectively, the false positive rates were 2.5%, 3.1%, 0, and 4.6%, respectively, and the false negative rates were 0, 0.6%, 0.6%, and 0, respectively. All the initial absorbencies of the false positive samples were less than 1.0. CONCLUSION: The diagnostic efficiency of Lizhu is the highest, while Kehua is the lowest. False positive or false negative results would take place in any of the kits, an HBsAg confirmatory test is essential for initially positive samples, especially with absorbance <1.0, because it can exclude most false positives.