XN-9000多功能自动血液分析仪性能评价

目的：对Sysmex公司最新推出的Sysmex XN-9000多功能自动血液分析仪的主要性能进行初步评价,以证实其检测效果。方法按美国临床实验室标准化协会指南文件EP15-A2、EP6-A2的要求对Sysmex XN-9000血液分析仪进行精密度、携带污染率、线性范围和正确度进行验证,以Backman LH750比对结果作为评估依据,结果与厂商声明的性能或公认的质量标准进行比较。结果 XN-9000血液分析仪测定白细胞（WBC）、红细胞（RBC）、血红蛋白（HGB）、红细胞压积（HCT）和血小板（PLT）主要参数的批内变异系数（CV%）为0.11%-2.32%,批间CV%为0.12%-2.46%,线性相关性分析r为0.99990-0.99997,携带污染率为0-0.37%,对比相关性分析,各项指标r均〉0.999,准确度验证各项指标的偏倚为-0.67-0.96。结论 XN-9000仪测定主要参数的精密度、线性、携带污染率、准确性等主要评估指标均符合要求,检测结果可用于临床。     

贝克曼LX-20生化分析仪的性能验证

目的 评价美国Beckman-coulter公司LX-20生化分析仪检测系统的主要性能.方法 按美国CLSI的仪器性能验证文件EP5-A、EP6-A、EP10-A的方法 ,选定4个项目(ALT、BUN、GLU、K),对LX-20牛化分析仪的精密度、携带污染率、准确度和可报告范围进行验证.结果 LX-20全自动生化分析仪测定ALT、BUN、GLU、K各项目质控血清的批内不精密度、总不精密度测定、CV值均小于厂商声明的CV%;准确度实验结果 偏倚,低于1/4CLIA'88TEa;携带污染率<0.5%,可报告范围试验测定值结果 与厂商声明范围接近.结论 Beckman-coulter公司LX-20生化分析仪在精密度、准确度、携带污染率、可报告范围四个方面性能验证合格.     

Sysmex CS5100全自动凝血分析仪性能验证

目的验证Sysmex CS5100全自动凝血仪的性能。方法从批内精密度及批间精密度、准确度、携带污染率、FDP线性范围共四个方面对Sysmex CS5100全自动凝血分析仪系统性能进行验证。结果精密度最大CV为6.55%;准确度最大偏倚为XXXX%;携带污染率最大值为-1.06%;FDP线性范围为0.954~5.967 g/L,相关系数为r为0.9992。结论 Sysmex CS5100全自动凝血分析仪具有较高精密度和准确度,携带污染率低,FDP线性范围宽,结果稳定、准确、可靠。     

BC-5800全自动五分类血液分析仪性能评价

目的:对BC-5800全自动五分类血液分析仪进行性能评价。方法:依照国际血液学标准委员会(ICSH)和美国实验室标准委员会(NCCLS)的标准对BC-5800的精密度、线性范围、携带污染率和可比性进行评价。结果:精密度、线性范围、携带污染率和可比性;全血细胞数(CBC)参数有较好的批内批间精密度(CV%)WBC<2.4%、RBC<0.7%、Hb<0.7%、PLT<2.4%,其他个参数均<1%;线性试验WBC、RBC、Hb、PLT有良好的线性r>0.9960,携带污染率<0.4%,与SysmexSE-9000对比WBC、RBC、Hb、PLT的相关系数r>0.9960;仪器白细胞分类与人工分类比较中性粒细胞、淋巴细胞、单核细胞、嗜酸细胞及嗜碱细胞相关系数(r)分别为0.9217、0.9320、0.6143、0.935、0.4341。结论:BC-5800五分类全自动血液分析仪性能良好与SysmexSE-9000及人工分类有较好的可比性。     

BECKMAN COULTER Gen.S全自动血液分析仪分析性能评价

目的：对BECKMAN COULTER Gen.S全自动血液分析仪的性能进行系统评价。方法：利用Westgard方法评价决策图判断WBC,RBC,HGB,PLT和Hct方法性能的可接受性;利用国际血液学标准化委员会（ICSH）、美国临床和实验室标准协会（CLSI）制定的评价标准对其线性和携带污染率进行评价;利用室内质控变异系数的平均值以及卫生部全血细胞分析能力验证回报结果的相对偏差的平均值简易评价仪器的精密度和准确度。结果：BECKMAN COULTER Gen.S全自动血液分析仪各项指标性能全为优良;在给定的线性范围内线性良好（r＆gt;0.998）;各参数的携带污染率低,均小于1%;精密度和准确度良好。结论：BECKMAN COULTER Gen.S全自动血液分析仪各方面性能良好,符合实验室性能标准。     

ADVIA2120血液分析仪对动物血细胞的分析性能评价

目的 对ADVIA 2120血细胞分析仪的动物血细胞分析性能进行评价。方法 对该仪器的准确度、精密度、线性和携带污染率进行评价,并与Hemavet 950FS动物血细胞分析仪测定结果及人工白细胞分类镜检结果进行比较。结果 该仪器的准确度、批内和批间精密度、携带污染率和线性均在允许范围内;与Hemavet 950FS动物血细胞分析仪测定结果相关性白细胞（WBC）、红细胞（RBC）、血红蛋白（HGB）、血小板（PLT）较好,红细胞压积（HCT）较差;白细胞分类测定结果与人工显微镜分类比较,中性粒细胞、淋巴细胞、嗜酸粒细胞相关性较好,单核细胞、嗜碱粒细胞相关性较差。结论 ADVIA 2120全自动血细胞分析仪在测定动物全血样本时准确度、精密度、线性较好,携带污染率低,有较强的筛选能力,是一台性能良好的全自动血细胞分析仪,可以满足药物安全性评价课题动物血液样本分析的需要。     

血液细胞分析仪红细胞碎片参数检测性能评价

  目的  红细胞碎片（fragmented red cells,FRC）是全自动血液细胞分析仪提供的一项新的检测参数,其与血栓性微血管病等多种疾病密切相关,因此对血液细胞分析仪红细胞碎片的检测性能进行评价。  方法  通过携带污染率、精密度、线性、正确度、灵敏度、特异度等指标,对SYSMEX XN系列全自动血液细胞分析仪红细胞碎片的检测性能进行评价。所有数据采用 SPSS 19.0软件进行分析整理。  结果  SYSMEX XN系列全自动血细胞分析仪检测红细胞碎片的携带污染率为0.11%;批内精密度:各实验浓度下其变异系数（coefficient of variation,CV）分别为8.75%（FRC:42.15×109/L）、6.38%（FRC:83.42×109/L ）、4.57%（FRC:228.74×109/L）、5.31%（FRC:796.89×109/L）;线性验证:线性回归方程为Y = 1.0001X + 9.3288,相关系数为r = 0.9936;正确度验证:以人工镜检为标准,仪器法与其比较,差异无统计学意义（P > 0.05）,其相关系数为r = 0.82,灵敏度为92%,特异度为82%。  结论  SYSMEX XN系列全自动血液细胞分析仪检测红细胞碎片快速、简便,携带污染率低,精密度尚佳,线性范围满足要求,与人工镜检法相比具有较好的相关性,特异度和敏感度也较高。血液细胞分析仪可作为外周血红细胞碎片的快速筛查手段,但其检测的精密度仍需进一步提高,且由于方法的局限性,阳性标本需要在显微镜下进行确认。     

全自动凝血分析仪更换加样针后的性能评价

目的评价全自动凝血分析仪进行更换加样针后的具体性能。方法评估验证更换加样针后全自动凝血仪的精密度、检测限、准确性、携带污染率等。结果通过精密度、准确度、检测限、线性及携带污染率验证后,其批内精密度、批间精密度、检测限最大CV值、准确度的最大偏倚、FIB的相关系数及携带污染率最大值的验证结果均符合要求及相关应用规定。结论全自动凝血分析仪经加样针更换后,其检测系统的性能得以优化,其精密度、准确度得以显著提升,其携带污染率明显下降,可广泛应用于临床中。     

XE-2100全自动血液分析仪检测网织红细胞的性能评估

目的对Sysmex XE-2100全自动血液分析仪测定网织红细胞(Ret)的性能进行评估。方法用XE-2100全自动血液分析仪检测Ret来评估其精密度、稳定性、线性范围及携带污染率,并与人工显微镜法做相关性分析。结果XE-2100血液分析仪测定Ret的精密度、线性范围均在允许的范围内,携带污染率小,稳定性在48 h内无论在4℃还是20℃下均较好;XE-2100全自动血液分析仪检测Ret结果与人工显微镜法检测结果比较差异无统计学意义(P>0.05),相关性良好(r=0.996)。结论 XE-2100测定Ret准确度高、重复性好、线性范围较广、携带污染率低,与人工显微镜法相关性好,符合相关要求,满足临床和科研要求。     

应用NCCLS EP5-A2文件对AU5811全自动生化仪进行精密度性能评价

目的对AU5811全自动生化仪进行精密度性能评价,以确定其是否满足临床需要。方法利用配套试剂的校准品和质控品,根据NCCLS EP5-A2文件的要求对AU5811全自动生化仪测定糖化血红蛋白的项目进行精密度性能评价。结果 AU5811全自动生化仪测定糖化血红蛋白的项目的高值和正常水平校准品的批内精密度CV%分别是0.83%、1.1%;批间精密度CV%分别是1.25%、2.19%;日间精密度CV%分别是1.5%、2.74%;总精密度CV%分别是1.66%、3.29%。结论所有精密度CV%均在可接受范围内,AU5811全自动生化仪精密度性能可满足临床需要。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.