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1.
The laboratory of the present author is a participant of Randox International Quality Assessment Scheme (RIQAS). The author receives twenty six samples for thirty nine general chemistry analysis per year, reports of which are to be sent fortnightly. Amongst thirty nine analytes there are partial lipid profile parameters like total cholesterol and triglycerides. So, the author decided to run a pilot study of full lipid profile from these samples. At the first phase four samples from two different cycles were considered as test materials. The reports of these samples were quite satisfactory. The trial run was given for fifteen consecutive days. (Presented by the author in the Annual Conference of ACBI, 2004). The success of trial runs for fifteen days proved that EQA samples from RIQAS may be used for full lipid profile analysis. Results were compared against Randox internal quality control samples (IQA) and were found to be accurate and reproducible.  相似文献   

2.
Serum creatine kinase MB isoenzyme (CKMB) and myoglobin have been studied in 35 cases with myocardial infarction. Increased values for both serum CKMB and myoglobin have been found in all the patients in the second sample collected 4 hr. after admission while in 22 patients in the first sample collected immediately after admission. Thus, the present study shows a good correlation between serum CKMB and myoglobin and therefore, suggests the possibility of using the serum myoglobin estimation in early detection of myocardial infarction either alone or in combination with the serum CKMB.  相似文献   

3.
Currently employed markers for the detection of acute coronary syndrome are Troponin T, CK (Creatine Kinase) and CKMB activity. CKMB activity measured by immunoinhibition method can give falsely elevated results due to the presence of atypical CK and CKBB and at times lead to the mis-diagnosis of acute coronary syndrome. Hence, CKMB mass (CKMB) measured by electrochemiluminence sandwich principle was employed. In this cross-sectional study 183 samples of 61 patients were analyzed within 6 h of diagnosis of acute coronary syndrome and followed up to 72 h. The correlation coefficient between CKMB activity and CKMBM at 4–6 h was 0.744, while at 12–24 h it was 0.909 and at 48–72 h it was 0.337. Thus there was good association between the two methods at 12–24 h but, statistically for method comparison studies and for replacing one method by another, the two methods need to be in agreement with one another. In this study the two methods are not in agreement with one another and thus analytically not replaceable. Another finding was obtained that CKMBM reached cut off levels prior to CKMB enzyme activity and hence, CKMBM is clinically better than CKMB activity to detect reinfarction.  相似文献   

4.
Quality control (QC) materials are crucial for internal quality control (IQC) and external quality assessment scheme (EQAS). However, many developing countries are disadvantaged by unavailability and high cost of commercial control material. Therefore, preparing home-made lyophilized human serum will be cost effective for used as a QC material in Bhutan. We prepared lyophilized QC material using serum collected from Bhutanese volunteers. The stability of lyophilized serum was studied at 3 selected conditions by analyzing at certain intervals. The results were statistically compared with initial values. The significant p values (<0.05) were seen in glucose, BUN, ALT, total bilirubin and protein at 2–8 °C but no significant difference were observed at −20 °C at the end of 9 months. We concluded that, home-made lyophilized human serum prepared without stabilizers could be used at least up to 9 months if stored at −20 °C and 7 months at 2–8 °C. Stabilizers and additives are necessary if the materials are to be used longer than 7–9 months.  相似文献   

5.
Serum cardiac troponin T (cTnT) and CKMB (mass) were analysed in three groups of patients. The first group (n=32) were patients with acute coronary syndromes including myocardial infarction. The second group (n=35)were patients with hypertension. The third group (n=24) were patients who had succumbed to non cardiac diseases. In all 3 groups, cardiac troponin T was elevated when compared with controls (p<0.001). However, CKMB elevation was not significant in all groups. CKMB levels correlated well with troponin T levels only when CKMB was greater than 50 ng/ml (r=1.00). Small elevations of troponin T identifies minimal cardiac necrosis and patients can benefit from early invasive therapy.  相似文献   

6.
Laboratory infarction diagnostics are based on the detection of elevated serum activities of total Creatine Kinase (CK), Creatine Kinase isoensyme MB, (CKMB), Lactate dehydrogenase (LDH), isoenzyme forms of LDH and transaminases. Determination of these cardiac marker enzymes permits a highly sensitive diagnosis of transmural myocardial infarction. In such patients the diagnosis of acute myocardial infarction can be confirmed by the clinical, symptoms, and changes in the ECG in addition to the enzyme assays. The 50 AMI patients selected in the present study were those admitted to the ICCU of Shri Krishna Hospital, Karamsad. The blood samples were taken at the time of admission (ie. within four hours of the start of chest pain). The samples were analyzed for CK, CKMB, SGOT, (Serum glutamate oxaloactate transaminase) αHBDH α-hydroxybutyrate dehydrogenase and troponin T. The serum CKMB activity in AMI showed an increase only 5–6 hours after the commencement of chest pain. The elevation in SGOT and αHBDH was still delayed. At the same time we could observe that the cardiac Troponin T (cTnT) was elevated at the time of admission of the patient itself. This increase of cTnT in AMI patients was 20 times higher than the normal blood donors. The controls included 25 normal blood donors and 25 patients with polytraumatic injuries with no chest contusion. The study shows that cTnT estimation could serve in the early diagnosis of AMI. The increase of cardiac troponin T in AMI patients was 20 times higher than the normal blood donors in AMI patients at the time of admission. Cardiac troponin T in serum appears to be a more sensitive indicator of myocardial cell injury than CKMB activity and its detection in the circulation may be a useful prognostic indicator in patients with unstable angina as well. When the blood of normal blood donors or that of patients with polytraumatic injury was analysed the troponin T values were well within the normal range in both the above categories showing that cardiac troponin T is highly specific for heart tissue. Although CKMB and cardiac troponin T are released soon after the myocardial injury, the release of cardiac troponin T is much earlier than CKMB thereby invalidating the important role of cardiac troponin T in diagnosing AMI. Cardiac troponin T has been shown to be highly sensitive for cardiac injury and not elevated in any other trauma, heavy exercise or skeletal muscle injury. Cardiac troponin T is ordinarily undetectable in healthy individuals, and so its measurement can serve as a powerful tool in the diagnosis of AMI.  相似文献   

7.
Early identification of patients with acute myocardial infarction is of prime importance due to the associated very high mortality. Only 22% of the patients presenting at emergency cardiology care with chest pain have coronary disease. A number of biochemical tests like CKMB and Troponin-T/I have been introduced for early detection of the coronary syndrome (ACS). Ischemia modified albumin (IMA) has been recently introduced as a marker of myocardial ischemia. We estimated serum IMA in four sequential samples from 25 patients admitted to ICCU. Twenty five healthy volunteers formed the control group from which the normal range was derived. IMA was significantly raised in ischemia patients than in controls as well as compared to the patients who did not have cardiac ischemia. IMA demonstrated good discrimination between the ischemic and the non-ischemic patients with an Odds Ratio of 16.9 (6.29–46.87) than CKMB which showed an Odds Ratio of 2.07 (1.18–6.08). Sensitivity and specificity of IMA for the detection of ACS was 78.0% and 82.7% compared to 58.0% and 60.0%, respectively for the CK-MB assay. The area under the ROC curve of IMA for ischemic v/s non-ischemic patients was 0.834. IMA appears to be developing into a new and very potent marker, of cardiac ischemia.  相似文献   

8.
Laboratory infarction diagnostics are based on the detection of elevated serum activities of creatine kinase (CK) Creatine kinase Isoenzyme MB (CKMB) and Transaminases. Determination of these cardiac marker enzymes permits the diagnosis of transmural myocardial infarction. However in such patients the diagnosis of acute myocardial infarction can be confirmed by the clinical symptoms and changes in the ECG, in addition to the enzyme assays. The 50 AMI patients selected in the present study were those admitted to the ICCU of Shri Krishna Hospital, Karamsad. The blood samples were taken at Zero hours (i.e. at the time of admission of the patient). Within 6 hrs of the starting of chest pain, 1.5 million units of streptokinase were mixed with 100 to 150ml of normal saline and administered by infusion over a period of one hour. The blood samples were further collected at intervals of 6 hrs, 14hrs, 32hrs, 48hrs, 5th day and 7th day. The blood samples were analyzed for CK, CKMB, SGOT, α HBDH and Cardiac specific Troponin T. By 6hrs the CK and CKMB values had started rising, the rise continuing at 14hrs with peak values at 32hrs. The CK showed a slight decrease by 48 hrs. The cardiac Troponin T showed wide time window from 4 hrs to 7th day for detecting myocardial damage. The maximum cardiac Troponin T values were during the first 24hrs. Cardiac Troponin T in serum appears to be a more sensitive and early indicator of myocardial cell injury in comparison to CKMB.  相似文献   

9.
相慧  孔祥斌  陈培雄  李立强 《资源科学》2014,36(6):1203-1210
本文基于农用地分等数据库和实地挖掘土壤剖面、农户调查等数据,采用空间叠置、地统计学、统计检验等方法,对内蒙古达拉特旗耕地质量等别监测样点布控进行研究,并提出了县域耕地等别监测分区、样点布设方法和精度检验方法。研究结果表明：①县域耕地质量监测控制区的划定可以依据耕地自然质量控制区、利用等值区和经济水平等值区,通过空间叠置,确定县域耕地质量监测控制区;②监测样点的确定可以依据地统计学空间分层抽样的原理,计算监测样点的总数量,采用面积比例分配方法确定各监测控制区监测样点数量;③达拉特旗耕地质量等别监测共划分20个监测控制区,并布设了36个监测样点,经统计学检验,监测样点的代表性程度满足地统计学代表性要求。达拉特旗县域耕地等别监测样点布控方法的建立可以为其它县域耕地质量动态监测提供借鉴,为我国实现耕地数量、质量并重管理提供技术支撑。  相似文献   

10.
Context Two Biosystems analysers are used in our laboratory, a fully automated A25 and a semi-automated BTS-350. Internal quality control is done for both but external quality control only for A25. As BTS-350 is used for backup, it is important that the results of both analysers are not just comparable but also within predefined limits of systematic, random and total error (TE). Aim To evaluate the imprecision, bias and TE of the two Biosystem analysers. Materials and Methods Biosystems level-1 quality control sera lot number 70A was run in duplicate for 32 days on both the analysers. Between day imprecision (measured by the coefficient of variation), bias and TE were calculated for ten analytes and were checked to see whether they are within the acceptable minimum limits, desirable limits and optimum limits of allowable error based on specifications on Westgard’s website updated in 2014. Results On both the analysers, all the analytes except alkaline phosphatase were within the acceptable minimum limits of TE and most analytes were within the desirable limits of TE. Only TG on A25 was within the optimum limit of TE. Conclusion The two Biosystem analysers performed comparably with errors within acceptable limits for most analytes. BTS-350 was found to be a suitable and ready backup analyser for A25.  相似文献   

11.
The present study aims to evaluate specific biomarkers involved in congenital heart disease (CHD), and whether there is a significant differences between the levels of these biomarkers in the cyanotic CHD (CCHD) and acyanotic CHD (ACHD). We prospectively measured tumor necrosis factor (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), vasoendothelial growth factor (VEGF), troponin T, creatin kinase MB (CKMB), and Caspase 3 levels in 120 consecutive children with CHD (60 cyanotic and 60 a cyanotic with age 1:4 years), and 30 healthy control children. Significant elevated levels of inflammatory markers; TNF-α, IL-6 and CRP was detected in CHD, with percentage increase in cyanotic than a cyanotic subjects as compared to the normal one. Apoptotic biomarker; caspase 3 showed also significant increases in CCHD than ACHD. In addition, tissue injury mechanisms included troponin T and CKMB, exhibited significant increase in cyanotic than a cyanotic CHD. The present results demonstrate also, significant enhancement in remodeling process (VEGF), in cyanotic than a cyanotic patients. Thus, it could be concluded that, the children with CCHD were shown to have elevated levels of inflammatory cytokines, caspase 3, troponin T, and CKMB as these biomarkers may implicated in cardiac functional status.  相似文献   

12.
Total capsaicins are extracted from 2 mL aliquots of serum or plasma using methyl-isobutyl ketone, evaporation of the extract to dryness and reconstitution with 200 μL of acetonitrile. The HPLC mobile phase is 40:60 water:acetonitrile. The absorbance of the eluent is monitored at 205 nm. Standardisation uses a known mixture of pure capsaicin and dihydrocapsaicin. Accuracies are 98.9 and 100.6 % for capsaicin and dihydrocapsaicin respectively. Inter batch reproducibility for both is 15 %. The limits of detection are 2.6 and 3.8 ng/mL for capsaicin and dihydrocapsaicin respectively. Analyses of sera obtained previously from human subjects who had eaten chilli containing meals showed that in those that absorbed capsaicins (N = 30) then the median, mean and SD of their serum capsaicin were: 13.4, 18.9 and 16.3 ng/mL. The corresponding data for those sera (N = 13) that had measurable levels of dihydrocapsaicin were: 6.9, 7.5 and 3.6 ng/mL. This procedure is suitable for use in prospective studies of the metabolism of orally ingested chilli.  相似文献   

13.

Introduction:

Optimal storage of serum specimens in central laboratories for a long period for multicenter reference interval studies, or epidemiologic studies remains to be determined. We aimed to examine the analytical stability of chemistry analytes following numerous freeze-thaw and long term storage.

Materials and methods:

Serum samples were obtained from 15 patients. Following baseline measurement, sera of each subject were aliquoted and stored at −20 °C for two experiments. A group of sera were kept frozen for up to 1, 2 and 3 months and then analyzed for stability. The other experiment consisted of one to ten times of freeze and thaw cycles. Total of 17 chemistry analytes were assayed at each time point. The results were compared with those obtained from the initial analysis of fresh samples. Median or mean changes from baseline (T0) concentrations were evaluated both statistically and clinically according to the desirable bias.

Results:

Of the analytes studied, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), gamma-glutamyl transferase (GGT), direct bilirubin, glucose, creatinine, cholesterol, triglycerides, high density lipoprotein (HDL) were stable in all conditions. Blood urea nitrogen (BUN), uric acid, total protein, albumin, total bilirubin, calcium, lactate dehydrogenase (LD) were changed significantly (P < 0.005).

Conclusions:

As a result, common clinical chemistry analytes, with considering the variability of unstable analytes, showed adequote stability after 3 months of storage in sera at −20 °C, or up to ten times of freeze-thaw cycle. All the same, such analysis can only be performed for exceptional cases, and this should be taken into account while planning studies.  相似文献   

14.
目的:探讨以病例为基础的教学模式(case-based learning,CBL)在口腔修复科临床实习带教中的教学效果。方法:选取2018—2019年在徐州医科大学附属口腔医院口腔修复科实习的2018级实习生42人,随机分为两组,实验组采用CBL模式教学方法,对照组仍采用传统教学方法,比较两组学生在实习结束后对教学方法的满意度评价及考核成绩的差异。结果:实验组学生对CBL教学法有更高的满意度,且理论成绩及技能考核成绩相对更高,差异明显,有统计学意义(P<0.01)。结论:CBL教学法在口腔修复临床实习带教中取得了较好的教学效果及实习满意度,有利于提高临床带教质量,值得推广。  相似文献   

15.
刘玖芬  高阳  冯欣  薛彦萍  何海洋  赖明  代辛 《资源科学》2020,42(10):1944-1952
自然资源要素综合观测体系具有观测对象多、观测指标多、观测技术手段多等特点。为保证观测数据质量,必须构建覆盖从采集到发布数据全周期全过程的数据质量管理体系。本文针对自然资源要素综合观测对数据质量管理体系提出的新要求,基于国内外观测领域数据质量管理体系现状分析,依据ISO9000族国际标准,建立由目标层、组织层、制度层、控制层及评估层五部分组成的综合观测数据质量管理体系框架;基于模块化集成思维,构建纵横多级质量控制体系：纵向上,建立综合研究中心—一级站—二级站—三级站4级外部检查,横向上,建立观测—校对—审核3级内部检查制度;质控技术上,重点研究了不同观测过程的质控模块,建立了QC0（样品实验测试质量控制模块）、QC1（观测数据内部质量控制模块）、QC2（观测数据外部质量控制模块）、QC3（数据质量的考核和评估模块）4种质控模块,提高了质控针对性和有效性。本文旨在通过构建全面的数据质量管理体系和科学的质控方法,保证观测数据准确可靠。  相似文献   

16.
This paper presents certain simple procedures for assessing the most common types of interference, due to haemolysis, icterus or lipaemic serum in 19 routine Clinical Chemistry tests and suggests steps to overcome the problem in some tests. A change in the measured concentration, to be analytically significant, had to exceed 2.8 X % coefficient of variation (cv) of the intra-assay analytical variation of each assay. Haemolysis caused interference in 10 of the 19 assays investigated. A haemolysate haemoglobin concentration of 0.29 g/dl, visible to the eye, caused an analytically significant increase in creatinine kinase MB subunit (CKMB), lactate dehydrogenase (LDH), total protein, triglyceride, uric acid and urea, and a significant decrease in alkaline phosphatase (ALP), and total bilirubin. A higher concentration of haemoglobin (0.68 g/ dl) caused an additional significant increase in CK, and a decrease in direct bilirubin. Addition of bilirubin caused interference in all the peroxidase linked reactions as well as in the creatinine assay. At a serum concentration of 5.2 mg/dl it caused a decrease in creatinine, glucose, triglyceride and uric acid. At a higher concentration (15.9 mg/dl) it also decreased cholesterol. Lipaemia interference affected the least number of assays. An added triglyceride of 537–561 mg/dl caused an increase in glucose, uric acid, and amylase. At a level of 1122 mg/dl it also increased CKMB, and at a value of 2244 mg/dl it increased total and direct bilirubin. At the highest levels of haemolysis and lipaemia, the serum glutamate oxaloacetate transaminase (GOT) and giutamate pyruvate transaminase (GPT) gave erratic results. Overall uric acid and CKMB were the analytes most susceptible to interference, while serum caicium and phosphate did not suffer from any. The interference depends on the exact assay conditions used and the susceptibility of each individual laboratory's tests should be determined by them. The reasons for the interferences described are discussed.  相似文献   

17.
Quality in laboratory has huge impact on diagnosis and patient management as 80–90% of all diagnosis is made on the basis of laboratory tests. Monitoring of quality indicators covering the critical areas of pre-analytical, analytical and post-analytical phases like sample misidentification, sample rejection, random and systemic errors, critical value reporting and TATs have a significant impact on performance of laboratory. This study was conducted in diagnostic laboratories receiving approximately 42,562 samples for clinical chemistry, hematology and serology. The list of quality indicators was developed for the steps of total testing process for which errors are frequent and improvements are possible. The trend was observed for all the QI before and after sensitisation of the staff over the period of 12 months. Incomplete test requisition form received in the lab was the most poor quality indicator observed (7.89%), followed by sample rejection rate (4.91%). Most significant improvement was found in pre- and post-analytical phase after sensitisation of staff but did not have much impact on analytical phase. Use of quality indicators to assess and monitor the quality system of the clinical laboratory services is extremely valuable tool in keeping the total testing process under control in a systematic and transparent way.  相似文献   

18.
为掌握百色市山羊布鲁氏菌病及衣原体病感染状况。在2013年对百色市辖12个县区的养羊场进行调查并采集血清进行布病及衣原体检测。调查发现,1732个羊场中有159个发生流产、死胎的现象。431个存栏100只以上的羊场中,有87个发生过流产、死胎现象。对76个羊场采集924份血清样品使用虎红平板凝集试验及试管凝集试验进行检测,未检出布鲁氏菌阳性血清。送检520份血清,检出衣原体阳性血清52份,阳性率10%;其中检测种母羊血清139份,检出衣原体阳性血清14份,阳性率10.07%;检测种公羊血清72份,检出衣原体阳性血清9份,阳性率12.50%。经分析,百色市山羊的布病防控达到广西稳定控制标准要求;羊衣原体病在本场乃至整个百色地区有蔓延流行的风险。  相似文献   

19.
杨波  万筱雯  胡梦媛 《资源科学》2020,42(9):1788-1800
目前中国国内资源供给较难满足经济快速发展的需求,越来越多的资源类企业通过海外并购的方式获取国外资源。本文基于东道国制度质量视角,选取中国资源类企业在29个国家（地区）发生的406起海外并购事件作为研究对象,分析政治稳定、政府效率和法律制度对中国资源类企业海外并购区位选择的影响。结果表明：①中国资源类企业偏向选择在政治稳定和政府效率高的东道国进行海外并购,东道国较好的法律制度并不能吸引资源类企业海外并购,并且东道国资源密集度对海外并购区位选择具有调节作用;②油气行业区位选择主要受政治稳定性的正面影响和法律制度的负面影响,电力及其他行业主要受政治稳定性和政府效率的正面影响;③制度质量显著影响国有资源类企业海外并购区位选择,但是非国有企业海外并购区位选择仅受到政治稳定性的显著影响。因此,中国资源类企业在海外并购的过程中需要关注东道国的制度质量,尽量选择政治环境稳定、政府效率较高国家的企业进行海外并购。  相似文献   

20.
Based on the conflict and crosstalk avoidance mechanism (CCAM), we propose a sleeping–awaking method for wireless sensor networks (WSNs) in which the maximal degree node (MDN) and all its neighbors run sleep or wake simultaneously while other nodes run the CCAM. This method is said to be the same sleeping–awaking method (SSAM). The SSAM is motivated by the congestion and collision problems of cliques, MDN and its neighbor set in the communicating graph of the WSN. In this communication way, the related protocol about the SSAM is provided accordingly. Under the designed protocol, we get a Markovian switching WSN with both white noise disturbance and multiple time-varying delays. Based on the theory of exponential stability in pth moment, we show that the protocol ensures the WSNs to keep in synchronization with the target function. A numerical example shows that the WSN can keep its target-synchronization even with large time delays.  相似文献   

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