目的 对血清电解质钠(Na)、钾(K)、镁(Mg)、钙(Ca)正确度验证物质应用离子色谱参考方法准确定值,并用于北京市临检中心正确度验证.方法 应用建立的离子色谱参考方法,对已研制的3个浓度水平的(批号为BCCL01、BCCL02和BCCL03)人血清基质电解质正确度验证物质进行定值,采用美国国家标准与技术研究院(National Institute of Standards and Technology,NIST)电解质标准参考物质(standard reference material,SRM)SRM 919b、SRM 918b、SRM 929a和SRM 915b进行量值传递.将NIST电解质标准物质配制5个浓度水平的钠、钾、镁、钙复合离子标准溶液,并建立标准曲线,对低、中、高3个水平正确度验证物质进行定值,计算相应不确定度.应用此物质在北京地区23家实验室开展正确度验证计划,正确度验证样本由北京市临床检验中心发放并按时统计汇报结果.依据美国临床实验室标准化协会(Clinical Laboratory Standards Institute,CLSI)EP-17A2,采用协方差的模型和Westgard模型来估算实验室总误差.结果 3个批号血清电解质正确度验证物质定值结果钠为125.6～159.1 mmol/L,钾为6.134～3.027 mmol/L,镁为1.389～0.539 mmol/L,钙为3.083～2.197 mmol/L.Westgard模型与参加实验室100％通过率结果相近,而协方差模型结果仅与60％通过率结果相近.结论 本研究应用准确可靠的离子色谱参考方法为电解质钠、钾、镁、钙正确度验证物质定值,可用于评价临床实验室4种阳离子常规检测方法的准确性.应用Westgard模型估算相比于协方差模型更能反映实验室的检测水平,所以推荐临床实验室在测定血清阳离子时使用Westgard模型估算总误差.

Monitoring copper (Cu) species in bio-samples is critical for the investigation and auxiliary diagnosis of Cu-metabolism disorders. Herein, a target-triggered DNAzyme walker, consisting of Carboxyfluorescein (FAM)-labeled substrates of the Cu-DNAzyme (Cu-Sub) coated gold nanoparticles (AuNPs) (AuNPs@FAM-Cu-Sub track) and the enzyme chain of the Cu-DNAzyme (Cu-Enzy) functionalized magnetic beads (MBs@Cu-Enzy 3D walking unit), was designed for the sensitive detection of copper species. Upon addition of copper ion (Cu2+), DNAzyme was activated and triggered the walking process, thereby releasing FAM-labeled fragments and recovering fluorescence. When compared with free-running Cu-Enzy or co-conjugated Cu-Enzy on AuNPs walking units, the MBs@Cu-Enzy walking unit exhibited a higher cleavage efficiency, shorter detection time (40 min), and a lower limit of detection (LOD = 3 nM). This improved performance was mainly attributed to multivalent interactions between the 3D track and the 3D walking unit which dramatically increased the affinity and cleavage efficiency. Importantly, good accuracy was observed for copper species analysis in clinical serum samples (n = 130), relative to other instrumentation, inductively coupled plasma atomic emission spectrometry (ICP-AES) (P > 0.01). The serum detection data indicated that total, exchangeable and relative exchangeable Cu variables could serve as potential indicators for the auxiliary diagnosis of Cu-related disorders. Thus, our target-triggered DNAzyme walker provides improved technical support for the in-depth study of clinical Cu metabolic-related diseases.

Clinimetallomics is proposed as a branch of metallomics that focuses on the study of the metallome in clinical samples of urine, blood, and tissues. As the clinical diagnosis of arsenic poisoning is mainly based on the concentration of total arsenic in urine, the toxicity of arsenic varies greatly in different speciation. Analysis of arsenic speciation with excessive total arsenic in urine can provide a basis for precise treatment. It can also be used to understand the fate of arsenic in the body of patients with arsenic poisoning after treatment with sodium dimercaptopropane sulfonate. In this study, a HPLC-ICP-MS method was established for the determination of arsenic species in urine samples from patients diagnosed with arsenism. Use the established method to detect urine samples, which can be directly assayed after simple sample dilution with 20 mmol/L EDTA-2Na. With the concentration of arsenic speciation in the range of 1.0~100.0 ng/mL, the linear correlation coefficient was higher than 0.99996. The recoveries were between 92.4% and 109.0%. The precision of the concentration and retention time (n = 3) were less than 3.0% and 0.3%, respectively, and the detection limit was between 1.42 ng/mL and 1.86 ng/mL. This method can be applied to arsenic speciation in the urine of healthy people, in patients treated for arsenic poisoning, and in patients diagnosed with arsenism.

Convenient and rapid detection of Cu2+ in serum has important clinical significance for related diseases. Herein, a ratiometric detection of Cu2+ based on specific short peptide (SPGH)-assisted enhanced chemiluminescence resonance energy transfer (CRET) has been constructed. An interesting phenomenon that tetra-peptide with the sequence of Ser-Pro-Gly-His (SPGH) was able to specifically and remarkably enhance the catalytic performance of Cu2+ has been discovered, the enhancement mechanism is mainly due to the significant increasing generation of Cu2+-induced hydroxyl radical after addition of SPGH. The chemiluminescence (CL) of the luminol-H2O2 system was efficiently catalyzed by the formed Cu(SPGH)(2) complex, which acts as an internal light source to triggers on the fluorescence of QDs via CRET, allowing the ratiometric detection of Cu-2(+) within 15 min with improved selectivity and sensitivity. The relative standard deviation was lower than 6.38 % due to the ratiometric signal improving its anti-interference ability. Importantly, it is feasible to detect total Cu in human serum, and the results were consistent with that of ICP-AES (r = 0.9321, n = 55). The reliable, rapid, yet simple ratiometric detection of Cu-2(+) in serum based on SPGH-assisted enhanced CRET provides a promising potential alternative method for Cu-2(+) detection in clinical application.

Environmental particulate matter, especially ultrafine particles (< 100 nm in diameter), can damage the endothelium and favor cardiovascular disease in the general population. With the wide application of nanomaterials, exposure to nanoscale particles (nanoparticles) in the environment is increasing. Systematic study of the interaction of nanoparticles with plasma proteins is critically important for understanding the cardiovascular toxicity of nanomaterials. We combined kinetics and thermodynamics information from surface plasmon resonance (SPR) and isothermal titration calorimetry (ITC) and conformational data from fluorescence spectroscopy and circular dichroism (CD) to explore the binding mechanism between cadmium telluride quantum dots (CdTe QDs) and plasma proteins. Special attention was paid to the interaction between CdTe QDs and coagulation-related proteins and the effects of CdTe QDs on protein conformation. The results showed that the binding affinities of CdTe QDs and plasma proteins depend on the nature of the protein and follow the order of fibrinogen (FIB)> plasminogen (PLG) > thrombin (TM) > metallothionein-II (MT-II) > human serum albumin (HSA). The interaction was primarily attributed to hydrophobic forces and the spontaneity of the occurrence of the interaction, and the protein secondary structures of FIB and PLG were changed significantly. The information gained in this study might shed light on the potential toxicity of QDs to the cardiovascular system.

Monitoring the level of exchangeable copper (CuEXC) and ceruloplasmin (Cp) in serum is of great significance for Wilson's disease (WD). In this work, a facile one-step competitive immunoassay for rapid and simultaneous detection of CuEXC and Cp has been developed based on antigens coated magnetic nanoparticles (immuno-MNPs) and antibodies functionalized quantum dots (QDs-Abs). Just by mixing immuno-MNPs, with diluted serum and QDs-Abs together, the antigens on immuno-MNPs compete with the target in serum and bind to QDs-Abs, thereby causing the changes in fluorescence intensity of QDs. Under selected conditions, this one-step method exhibited excellent precision and selectivity with the measured limit of detection of 0.2 nM and 7.0 mu g/L for CuEXC and Cp, respectively. Most importantly, this method was successfully applied to detect CuEXC and Cp without the usual time-consuming pretreatment. The results showed no significant difference (P>0.01) from those of ICP-AES and ELISA; moreover, CuEXC significantly decreased to a normal level after the treatment of preliminarily diagnosed WD patients, while the changes of Cp level is not significant (P>0.01). Therefore, the proposed one-step competitive immunoassay has great potential applications in the rapid laboratory diagnosis of WD with distinct advantages over the existing methods in terms of multi-target, accuracy, facile, fast and cost-effectiveness.

A facile and sensitive method with a tunable dynamic range has been proposed for the detection of Cu2+ based on the self-cleavage of Cu2+-specific DNAzyme and the Cu2+-based inhibition of HRP activity, and this method was applied to evaluate the copper species in healthy people and WD patients.

A fast (1 min), straightforward but efficient, click chemistry-based system that enables the rapid detection of free copper (Cu) ions in either biological fluids or living cells without tedious pretreatment is provided. Cu can quickly induce the conjugation between graphene oxide (GO) and a fluorescent dye via click reaction. On the basis of the high specificity of bioorthogonal reaction and the effective quenching ability of GO, the assay studied in this paper can respond to Cu ions in less than 1 min with excellent selectivity and sensitivity, which is the fastest sensor for Cu as far as it is known. In addition, the application of this system is verified by performing assays in living cells and untreated urine samples from patients suffering from Wilson's Disease. Such a Cu detection system shows great promises in both fundamental research and routine clinical diagnostics.

门诊上经常会遇到爸爸妈妈抱着满月的小宝宝,愁眉苦脸地对大夫说: "我家宝贝都好几天没有拉臭臭了,每天给喝好多水,妈妈也多吃蔬菜、水果了,可还是没有效果,怎么办啊?" 对于满月的宝宝,家长首先要区分他是"攒肚儿"还是便秘.母乳喂养的宝宝2～3天甚至一周不排大便,并且无痛苦表现,待到排便时,排出的是黄色软便,无硬块,这种现象称为"攒肚儿".这是正常的生理现象,因为满月宝宝消化能力提高,对母乳能充分地消化、吸收,肠道每天产生的食物残渣较少,不足以刺激直肠形成排便反射.而便秘则指大便次数和性状都发生了改变,不仅是大便次数减少,更重要的是大便硬结、干燥、排出困难.

随着辅助生育技术和促排卵药物的发展，双胎妊娠的发生率逐年升高，而双胎妊娠作为一种高危妊娠，常常因为多种原因造成胎儿发育不均衡，新生儿体重差异增大。目前狭义的双胎不均衡发育是两胎儿体重差逸20%[双胎间体重差别=(大胎体重-小胎体重)/大胎体重×100][1]。也有文献采用不同的诊断标准，如>25%或>30%[2]。本文旨在对造成双胎发育不均衡的机制和其与母婴并发症的关系做一综述。

目的:在对氯化锂-匹罗卡品（LICL-PILO）致发育期大鼠反复惊厥实验研究中,探讨GRP78（葡萄糖调节蛋白78）、Caspase-12（半胱天冬蛋白酶12）动态变化及7-NI（7-硝基吲唑）对其表达的影响。方法:Wistar大鼠144只,日龄均为21d,随机分成3组:对照组（C组）、惊厥组（SR组）、7-硝基吲唑治疗组（7-NI组）,每组48只。最后一次惊厥完成后分别与6h、12h、24h、72h后取海马,免疫组化法及半定量逆转录-聚合酶链反应（RT-PCR）法检测其GRP78、Caspase-12的表达。结果:免疫组化及RT-PCR均显示对照组GRP78表达很少,惊厥组的表达量低于7-NI治疗组（P＜0.01）,且两者均在12h达高峰;对照组caspase-12阳性细胞数极少,可以忽略不计,惊厥组的表达量高于7-NI治疗组（P＜0.01）,且两者均在24h达高峰。结论:反复惊厥发作时GRP78及Caspase-12均上调,但GRP78早于Caspase-12;7-NI可能通过抑制NO等应激源的产生来抑制GRP78及Caspase-12为标志的内质网应激途径,起到神经保护作用。

OBJECTIVE:To investigate early serum lipid profiles in preterm infants and their relationship with neonatal respiratory distress syndrome (RDS).METHODS:Appropriate-for-gestational-age (AGA) preterm infants were grouped according to gestational age (GA) or birth weight (BW). AGA full-term infants were randomly selected as the control group. Venous blood samples were collected within 12 hours after birth for measurement of biochemical indices, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG). Blood lipid levels were compared between preterm infants with and without RDS in various groups.RESULTS:Plasma TG level rose as GA and BW increased. Plasma TG levels in the 28-30 week and 31-33 week GA groups were significantly lower than in the 34-36 week GA and control groups (P<0.01). Plasma TG levels in the ≤ 1499 g and 1500-2499 g BW groups were significantly lower than in the ≥ 2500 g BW and control groups (P<0.05), and the 1500-2499 g BW group had a significantly higher plasma TG level than the ≤ 1499 g BW group (P<0.01). There were no significant differences in plasma HDL-C, LDL-C and TC levels between all groups and between preterm infants with RDS and without RDS. In the 28-30 week GA group, the preterm infants with RDS had a significantly lower TG level than those without RDS (P<0.05); also, in the ≤ 1499 g BW group, preterm infants with RDS had a significantly lower TG level than those without RDS ( P<0.05).CONCLUSIONS:Blood lipid levels are related to GA and BW. Low TG level may be one of the causes of RDS in preterm infants with a gestational age of 28-30 weeks and a BW of ≤ 1499 g.

目的 了解小于胎龄儿(small for gestational age neonates,SGA)早期血脂及脂蛋白代谢特点.方法 选择无严重并发症新生SGA 47例为研究对象,以45例足月适于胎龄儿(adequate for gestational age,AGA)作为对照组.于出生后12h内静脉采血,测定血浆总胆固醇(total cholesterol,TC)、甘油三脂(triglyceride,TG),低密度脂蛋白胆固醇(loWdensity lipoprotein cholesterols,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterols,HDL C)、载脂蛋白(apolipoproteins,apo) A1及apo-B水平,计算LDL-C/HDLC及apo-B/apo A1比值;并进一步将SGA根据是否足月、宫内发育迟缓程度(出生体重位于同胎龄平均体重P3以下为SGA1组,P3～P10之间为SGA2组)及性别进行分组,比较上述指标的水平.结果 与对照组比较,SGA患儿具有高的TC(2.41±0.61vs2.11±0.78,P<0.05)、LDL-C(0.90±0.44vs0.71±0.42,P<0.05)和apo-B(0.40±0.22 vs 0.29±0.15,P<0.01)浓度,及高的LDL-C/HDLC(1.31±1.29 vs 0.82±0.46,P <0.05)、apo-B/apo-A1 (0.60±0.35 vs 0.40±0.19,P<0.01)比值;SGA1组比SGA2组具有低的TC、HDDC及apoA1水平,而具有高的apo-B/apo-A1比值(P<0.01或<0.05);早产SGA患儿比足月SGA患儿具有低的TG水平(P<0.05);性别对SGA血脂及脂蛋白水平没有影响.结论 不良的宫内环境使SGA早期可出现脂质代谢异常,宫内发育迟缓越严重脂质代谢异常越明显,SGA远期可能更易出现心血管疾病;早产SGA血浆TG水平低于足月SGA,可能与新生儿成熟度相关.

The arrangement of molecular biology experiment and clinic course of pediactic postgraduate are discussed in this article and teaching method, teaching test , and some thoughts and experiences about the training of the research competence of students are introduced as well.

Because of the organ hypoplasia,premature infants suffer from malnutrition easily.The application of parenteral nutrition support in premature infants can significantly improve the survival rate and quality of life.The parenteral nutrition support include the infusion of glucose,amino acids,fat,electrolyte,vitamin and trace elements.The infusion pathways mainly include peripheral intravenous infusion and central intravenous infusion.Here is to make a review on the research progress of parenteral nutrition support in premature infants.

Objective To investigate the relationship between the birth weight(BW) differences and the incidence of neonatal diseases in the twins. Methods To analysis 61 pairs of twins born in Beijing Obestrtrics ang Gynecology Hospital, and compare the incidence of neonatal diseases with the twins weight differences. Results The twins birthweight discordance and neonatal diseases were: χ2 anemia=35.43, χ2 hyperbilirubinemia=31.22, χ2 neonatal serum protein=49.34, χ2 newborns sepsis=21.56, χ2 neonatal intracranial hemorrhage=28.78, χ2 poor neonatal pneumonia=33.38, χ2 neonatal apnea=54.34, χ2 neonatal apnea=16.28, χ2 poor neonatal feeding intolerance=25.34, χ2 neonatal malnutrition=36.32, all P<0.01; while χ2 neonatal polycythemia=3.89, χ2 neonatal malformations=10.21, all P>0. 05. High age, preterm children, monozygotic twins, in vitro fertilization, gestational diabetes and gestational hypertension were risk factors for birthweight differences, respectively χ2 high age=12.34, χ2 preterm children=23.56, χ2 monozygotic tires=18.80, χ2 gestational diabetes=17.38, χ2 gestational hypertension=22.21, all P<0.01. Conclusion The difference in weight of the newborn twins has a certain influence on morbidity, age, preterm children, monozygotic twins, in vitro fertilization, gestational diabetes and gestational hypertension are risk factors for body birthweight differences.

目的:掌握本地区患儿下呼吸道感染的病原体及临床特点以提高治愈率。方法:采用ELISA法做了病毒特异性IgM抗体检测,(流感病毒Flu、呼吸道合胞RSV、腺病毒Adv);肺炎支原体抗体Mp-Ab测定;血EB病毒PCR检测。结果:病毒感染已成为下呼吸道感染的主要病原微生物,年龄越小发病率越高,婴幼儿对于Flu、RSV、Adv和EB病毒普遍易感,随着年龄的增长发病率呈下降趋势;肺炎支原体感染仍以年长儿为主;对于病程较长、病情较重、临床迁延不愈者要注意EB病毒、腺病毒、肺炎支原体感染及耐药菌感染。

医学检验学作为临床医学的重要组成部分,是一门发展迅速、多技术、多学科交叉具有独特应用目的的学科.基础医学的发展及临床医学的密切结合[1] ,使医学检验到检验医学发生了巨大的转变.检验专业人才培养是检验医学院的中心任务,以教学为中心不断提高教学质量是检验医学院办学与发展的主旋律[2-3].本学院不断尝试着改进本校检验医学专业的学生培养模式,下面就具体教学工作中的几点做法,与同道分享.

目的:探讨特殊畸形儿合并肺炎的急救与护理方法。方法:对此病例的急救与护理进行临床分析。结果:患儿入院后经过医护人员积极抢救,无并发症发生,好转出院。结论:重视和加强对患儿家长的指导和宣教是关键。

Objective: To study the mechanism of Piper longum L in the treatment of RA.Methods: We take the Adjuvant Arthritis rats as investigation model,and divide them into five groups,and then observe Piper longum L,s influence on the apoptosis of synoviocyte.Results: Piper longum L could improve the ratio of apoptosis of synoviocyte in AA rats.Conclusion: Piper longum L can improve the ratio of apoptosis of synoviocyte and prevent the destruction of articulatory.