液态酶法糖化血清白蛋白试剂性能评价

目的对液态酶法糖化血清白蛋白(GSA/GA)试剂盒的性能进行评价。方法参考美国临床和实验室标准化协会(CLSI)文件(EP15-A2,EP6-A,EP28-A3C)及相关文献,对液态酶法GA试剂盒的精密度、准确度、回收试验、线性范围、干扰因素和生物参考区间等进行评价,并将实验结果与制造商提供的分析性能或公认的质量指标进行比较。结果 GA低值和高值样本对应的重复性不精密度变异系数(CV)分别为0.89%和1.38%,实验室内不精密度CV分别为1.28%和1.51%;相对偏倚在-0.70%^-1.54%之间,偏差符合率为100%;平均回收率为98.0%;在8.58%~73.94%范围内线性良好;对于游离胆红素、结合胆红素、乳糜、血红蛋白和葡萄糖等共存物质的抗干扰能力均能够达到或超过厂家声明;生物参考区间验证结果在11.0%~17.0%范围内。结论液态酶法糖化血清白蛋白性能良好,可作为一个糖尿病短期控制的有效指标在临床广泛应用。     

ARCHETECT高敏肌钙蛋白Ⅰ试剂盒性能评价

目的 评价ARCHETECT高敏肌钙蛋白Ⅰ（hs-cTnⅠ）试剂盒性能,以验证其是否符合临床实验室使用要求。方法 参考CLSI的EP15-A2文件和相关文献对ARCHETECT高敏肌钙蛋白Ⅰ试剂盒精密度、正确度进行评价,EP17-A文件和相关文献对空白检测限（LoB）进行评价,EP6-A文件和相关文献对线性范围进行评价,参考NCCLS C28-A2文件,对健康体检者血浆标本分男女验证生物参考区间。结果 实验测得hs-cTnⅠ高值样本（5.702 μg/L）的批内不精密度CV为1.56%,总不精密度CV为1.27%,低值样本（0.003 μg/L）的批内不精密度CV和总的不精密度CV均为0;hs-cTnI的回收率为 97.50%;LoB为0.001 μg/L;在检测范围内,hs-cTnI理论值与测定值的线性方程为Y=1.0006X-0.13136,R2=0.9999;生物参考区间验证结果显示男性100.00%的结果在厂家提供的生物参考区间范围内,女性96.67%的结果在厂家提供的生物参考区间范围内。结论 ARCHETECT高敏肌钙蛋白Ⅰ试剂盒性能通过验证,可为临床提供准确、可靠的hs-cTnⅠ定量检测结果,为临床对心肌损伤的诊断、治疗提供重要信息。     

脂蛋白(a)测定试剂性能评价

目的 评估Lp(a)测定试剂盒的胶乳增强免疫透射比浊法在分析性能方面的表现。方法 采用日立7180全自动生化分析仪,按照CLSI EP文件要求对Lp(a)测定试剂的正确度、精密度、线性和参考区间进行评估。结果 胶乳增强免疫透射比浊法Lp(a)测定试剂盒在正确度、精密度、线性和参考区间方面均符合性能评价标准。具体而言,Lp(a)测定试剂的批内精密度为低浓度1.40%、高浓度1.20%;批间精密度为低浓度1.90%、高浓度1.80%。线性范围良好,相关系数r=0.9999。健康人群的Lp(a)参考范围小于300mg/L。结论 胶乳增强免疫透射比浊法Lp(a)测定试剂盒在正确度、精密度、线性和参考区间等方面均达到性能评价标准,具备临床应用的可行性。     

终点法测定缺血修饰白蛋白(IMA)的评价及其应用研究

目的对终点法测定缺血修饰白蛋白(IMA)试剂盒进行性能评价,判断其分析性能是否满足临床要求。方法应用终点法测定血清中的IMA含量,对试剂盒的线性、精密度和准确度做出评价。结果质控品的日内CV分别为:低值血清CV=2.12%,高值血清CV=0.48%;日间CV分别为:低值血清CV=2.46%,高值血清CV=2.73%。连续10次测定2个水平的定值质控,得到低值和高值质控的准确率分别为99.95%和99.98%。回收率为99.50%～105.70%。线性试验表明IMA(R2=0.9999)有很好的线性范围。干扰试验表明,溶血、乳糜和黄疸等干扰因素对于IMA测定影响不大。危重病组和急性冠脉综合征(ACS)组的IMA显著低于健康对照组(P0.01)。结论该商品化缺血修饰白蛋白(IMA)试剂盒符合实验室性能标准,且灵敏、方便、简单,可批量测定,适用于临床检验。IMA的特异性较好,对于ACS的诊断具有重要意义。     

胶乳免疫比浊法检测CA19-9的性能验证研究

目的 对基于生化分析平台检测CA19-9活性的胶乳免疫比浊试剂盒进行检测性能的验证研究。方法 收集2022年1月至4月期间就诊于中国医学科学院肿瘤医院的肿瘤患者315例及表观健康人43例的血清样本进行性能验证试验。参考CLSI EP15-A方案，用两种水平的质控品验证待测试剂盒的精密度；参考EP6-A方案，评价待测试剂盒的线性范围；验证血清样本的稀释准确性；参考EP7-P方案，用含特定浓度干扰物(胆红素、血红蛋白、乳糜、类风湿因子)的混合血清评价试剂盒的抗干扰能力；使用表观健康人的新鲜血清样本验证待测试剂盒的生物参考区间，使用肿瘤患者的新鲜血清比较待测试剂盒与电化学发光法检测结果的相关性和偏差。结果 精密度验证显示，两种水平质控品的批内CV和批间CV(低浓度：4.08%和4.33%;高浓度：3.01%和3.55%)均小于允许不精密度(批内CV≤6.85%和批间CV≤9.14%)。在21.08～843.21U/mL的检测范围内，检测曲线呈一阶线性分布，理论值与实测值的平均百分偏倚1.57%,线性良好。本试验验证的最大稀释度为1∶64倍稀释，稀释验证样本与原倍血清的相对偏移为9.11%。4...     

血清SCC在非配套免疫检测系统中的性能验证

目的验证上海透景公司生产的化学发光法血清鳞状上皮细胞癌相关抗原(SCC)定量测定试剂盒在非配套免疫检测系统中的性能,并初步评价其临床应用价值。方法参考CLSI EP15-A2及EP9-A2方案,在雅培全自动免疫分析仪i2000SR上验证上海透景化学发光法SCC定量测定试剂盒,主要评价试剂盒的精密度、正确度、线性范围和生物参考区间。采用上海透景公司提供的多项肿瘤标志物质控品进行精密度的评价;同时,收集雅培化学发光法SCC检测结果均匀分布在测量范围内的冻存血清标本进行比对试验和线性范围的评价。另外,选取120例表观健康体检人员的新鲜血清标本进行生物参考区间的评价。将所得的结果与厂家提供的数值进行比较,判断其是否一致。结果测定多项肿瘤标志物质控品,血清SCC低值和高值质控品实验室内CV分别为5.37%和4.02%,均小于厂家提供的数值(≤10%),精密度验证通过。40例标本进行比对试验时,透景与雅培试剂盒SCC检测结果相关性良好,说明二者之间具有一致性。线性范围验证时,血清SCC的线性范围为0.1~70.0 ng/mL,决定系数R^2大于0.995。120例表观健康体检人员的血清SCC检测结果均在厂家提供的参考区间范围之内。结论上海透景化学发光法血清SCC定量测定试剂盒在非配套免疫检测系统(雅培全自动免疫分析仪i2000SR)中具有良好的精密度,与雅培化学发光法SCC试剂盒的检测结果和线性范围一致,可初步满足临床需要。     

湖北地区健康人群缺血修饰白蛋白血清水平参考区间的建立及临床应用

目的:应用美国临床实验室标准化委员会颁布的CLSIC28-A3文件建立湖北地区健康人群缺血修饰白蛋白(IMA)的参考区间,并采用急性冠状动脉综合征(ACS)心肌缺血患者和健康人群验证此参考区间的可靠性。方法:按要求选择健康人群血清标本,采用白蛋白钴结合试验测定血清IMA,经统计分析后确定IMA参考区间。选择ACS心肌缺血患者和一批健康人群,同法测定其血清IMA,并与肌钙蛋白I(cTnI)平行检测比较,验证新建立参考区间的可靠性。结果:IMA的参考值为>65.20U/ml。ACS心肌缺血患者的IMA水平为46.00U/ml(95%CI:45.10～47.10),阳性率为98.90%;cTnI的血清水平为3.31ng/ml(95%CI:2.53～4.51),阳性率为93.40%。健康人群的IMA水平为70.20U/ml(95%CI:67.20～73.10);cTnI的血清水平为0.23ng/ml(95%CI:0.21～0.54)。结论:利用CLSIC28-A3文件建立IMA参考区间简便可行,能较客观反映临床症状,有助于缺血性心肌损伤的诊断。     

基蛋生物肌酸激酶同工酶项目性能验证

目的评价基蛋生物Getein1600荧光免疫定量分析仪分析CK-MB的正确度、精密度、线性范围,为POCT的应用提供质量保证。方法参考美国临床与实验室标准化协会(CLSI)EP9-A2文件对基蛋生物Getein1600荧光免疫定量分析仪与雅培I2000全自动免疫分析仪进行方法学比对,验证正确度;采用EP15-A进行精密度验证;采用EP6-A对线性范围进行验证。结果CK-MB在两台仪器的比对结果相关性良好(R=0.9936,P>0.05);CK-MB均值为4.58、10.47、14.99时总CV分别为8.75%、9.29%、6.45%。CK-MB项目线性范围参考品理论值与测试平均值回归系数R2=0.990,在3.06~72.51ng/mL浓度区间呈线性,该分析测量范围通过验证。结论基蛋生物Getein1600荧光免疫定量分析仪性能验证良好,与厂家说明书声明相符。     

血管紧张素转移酶紫外分光光度法的方法学评价

目的初步评价血管紧张素转移酶检测试剂盒性能。方法依据临床和实验室标准协会颁布的《定量临床检验方法的初步评价,批准指南第2版（EP10-A2）》提供的方法,按特定的顺序连续测定低、中、高浓度的质控品5d,对该试剂盒检测方法的性能进行初步评价。结果血管紧张素转移酶低、中、高浓度的质控血清的靶值分别为49、89.5、130U/L时,按特定的顺序连续测定5d,没有离群值。线性回归方程为y=0.879x＋8.45,相关系数为0.9964;绝对偏差分别是0.64、1.26、-9.6U/L;总不精密度（CV%）分别为4.39%、2.26%、1.39%。结论血管紧张素转移酶检测试剂盒检测方法的线性、总变异和抗交叉污染能力均达到EP10-A2文件的标准,符合临床应用要求。高值的偏差提示超出可接受范围,需要进一步进行评估。     

免疫透射比浊法血清白蛋白检测试剂盒的性能验证和临床应用评价

目的对免疫透射比浊法血清白蛋白检测试剂盒进行性能验证和临床应用评价。方法根据美国临床实验室标准化委员会(CLSI)的标准要求,使用全自动日立生化分析仪7600-020,对该试剂盒的精密度、正确度、检出限、线性范围、干扰实验、参考区间、方法学比对进行验证,并将检测结果和厂家提供的的性能指标进行比较。结果该试剂检测血清白蛋白的批内精密度为1.1%、批间精密度为1.2%,均小于厂家提供的指标;正确度在允许偏倚范围内;检出限为0.152g/L;线性斜率为0.9755,相关系数的平方R2为0.9945,大于0.99符合要求;生物参考区间符合率100%;在厂家说明书标示的干扰物浓度范围内,对检测结果没有明显影响;与溴甲酚绿法做比对实验,相关性回归方程为Y=0.9894X-1.1033,R2为0.9794,在低值结果中两种方法学差异呈非线性分布,无法用校正系数调整。结论免疫透射比浊法血清白蛋白检测试剂盒在7600-020生化分析仪上主要分析性能符合厂家的声明,结果准确可靠,抗干扰能力强,可以开展用于临床检验分析。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.