The provincial key laboratory, which is characterized by cell engineering and therapeutics research, has formed three research directions with characteristics and advantages in scientific research, personnel training and social service. The laboratory has a management and professional technical team with strong scientific research ability, and has established a relatively perfect advanced scientific research platform and platform open management mechanism. In the long-term process of adhering to opening and sharing, the laboratory has continuously strengthened the management and technical team construction. Strengthen the system construction and the implementation of regulations while implementing the national policies and regulations on cell preparation research and development. Through the fusion and development of basic and clinical subjects, we actively promote the combination of the efforts of industry, academia, research and application. Through the basic skills training and academic exchange, we improve the scientific research efficiency and scientific and technological output quality. On the basis of adhering to the "three-level management", "the academic leaders responsibility system" of scientific research and "the technical head responsibility system" of platform technology were promoted. And clinical needs as a link to promote the development of disciplines and win-win cooperation. To promote the coordinated development of frontier scientific research, clinical technology research incubation industrial resource storage, stem cell drug research and development, and high-level personnel training through the construction of new interdisciplinary disciplines and overlapping research directions. Therefore, in the face of the new situation and new requirements for the construction of an innovative country and high-quality development, this paper aims to share the main management and operation experience of the provincial key laboratory cell engineering technology platform for 20 years, and combined with the cases of "industry, academia, research and application", to provide practical exploration and reflection on interdisciplinary and collaborative innovation to serve medical needs.
To analyze the sources, classification, treatment measures and improvement effects of the complaints accepted by Shenzhen Luohu Hospital Group Inspection Center from May 2018 to August 2022, in order to explore effective measures to improve patients' medical experience and satisfaction. The intelligent laboratory management platform was used to analyze the complaints of the regional inspection center from May 2018 to August 2022, and the whole process from acceptance to effect evaluation was analyzed in terms of the causes of complaints, treatment measures and patient satisfaction. Results show that there were 67 complaints from May 2018 to August 2022, of which 47 were valid complaints. The effective complaints include clinical complaints and patient complaints, of which clinical complaints are the main (39 cases), followed by patient complaints (8 cases). Among the effective complaints, the most complaints were caused by the reporting time, followed by reporting errors, while the complaints caused by inspection errors and unskilled operation were less, with 1 and 2 cases respectively. The main reasons for the complaints leading to the reporting time are: instrument failure, inadequate communication, network transmission errors, improper operation of personnel. The main reasons for complaints caused by reporting errors include: detection system errors, reagent errors, improper personnel operation, etc. With the help of intelligent management platform, the testing center records the electronic process of complaints, summarizes and analyzes the causes and handling measures of complaints, which can effectively improve the service level and patient satisfaction.
Hazardous chemical management is an important aspect of laboratory safety management in colleges and universities. In view of the longstanding issues with hazardous chemicals in Guangzhou Medical University, the university has implemented an intelligent information management system for hazardous chemicals, and has established and practiced the concept of “four effectiveness” in managing hazardous chemicals. The safety management department monitors the entire process of hazardous chemicals procurement, usage, storage and tracking. This method has great convenience and effectiveness and provides reference for the management of hazardous chemicals in colleges and universities.
To explore the application of the recommended standards of different analytical performance specifications in the external quality assessment (EQA) of complete blood cell count.
Methods
A total of 8 times of EQA data in Shanxi province from 2019 to 2022 were collected. The pass rates of WBC, RBC, Hb, hematocrit (HCT), PLT, meancorpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobinconcentration (MCHC) were analyzed using national standards, health industry standards, and limits based on biological variation (BV) (minimum, desirable and optimal). The differences between the pass rates of different evaluation limits were compared.
Results
The overall pass rate of complete blood count EQA in Shanxi province was 88.82% to 97.32%. There were significant differences in the pass rates of different rounds for 6 projects (WBC, RBC, HCT, MCV, MCH, and MCHC) (P<0.05). Using different evaluation limits, the difference of the pass rates were statistically significant (P<0.05).
Conclusions
Appropriate evaluation limits should be selected to assess the quality of testing based on current testing levels and different modes of analytical performance specifications. The evaluation limits based on BV (desirable) should be selected to evaluate WBC, RBC, and Hb. The evaluation limits recommended by health industry standards should be selected to evaluate HCT, PLT, MCV, MCH, and MCHC.
To investigate the impact of different proportions of sodium citrate anticoagulation and corrected blood collection volume on the results of thromboelastography (TEG) test in normal people and anemia patients respectively, so as to provide guidance for clinical blood collection.
Methods
29 patients with anemia admitted to The Third Affiliated Hospital of Guangzhou Medical University from July 2022 to March 2023 were selected as the observation group, and 20 normal individuals were selected for TEG test as normal group. The anemia patients were divided into two groups according to the correction formula, which were the pre-correction group and the post-correction group. The difference of TEG results before and after adjustment of blood collection volume was analyzed. The normal subjects were divided into four groups according to the ratio of anticoagulant to whole blood: group A (1:4), group B (1:9), group C (1:12) and group D (1:14). The TEG test was performed and the results of each group were statistically analyzed.
Results
Reaction time (R) and coagulation time (K) in group A were significantly higher than those in group B (P<0.05). The angle and maximal amplitude (MA) in group A were lower than those in group B, and the differences were statistically significant (P<0.05). There was no significant difference between group C, D and group B (P<0.05); In patients with anemia (HCT>0.2), angle in the corrected group was higher than that in the pre-corrected group. In patients with anemia (HCT≤0.2), R and MA in the corrected group were higher than that in the pre-corrected group.
Conclusions
When the blood collection volume was insufficient, the results of TEG test were significantly different from the normal ratio (1:9), suggesting that the blood collection volume must be proper in clinical blood collection to ensure the accuracy of experimental results. There was a significant difference in TEG test before and after correction in anemia patients. In order to improve the accuracy of the test, the blood collection test should be conducted after correcting the amount of anticoagulant or blood collection.
To establish the clinical reportable range (CRR) of Sysmex CS-5100 automatic coagulation analyzer for the detection of D-dimer.
Methods
According to the EP6-A document issued by the Clinical and Laboratory Standard Institute (CLSI), the polynomial regression analysis method was used to carry out the D-dimer analysis measurement range (AMR) experiment on the Sysmex CS-5100 automatic coagulation analyzer. The statistical analysis of the nonlinear coefficient was used to determine whether there was non-linearity, and the optimal polynomial method was determined by calculating the regression standard error. This study determine the upper limit of the AMR by calculating whether the linear deviation of each concentration point meets the industrial standard, and establish its CRR in combination with the functional sensitivity (FS) and the maximum dilution ratio.
Results
According to FS test, the concentration of D-dimer is 0.065 7 mg/L when CV is close to 20%, so FS is 0.065 7 mg/L. No outliers were found in the experimental data of AMR. The relative error of repeated measurement of experimental samples was 1.89%, which was lower than the in batch imprecision target (2.5%). After the highest two groups of data were discarded in polynomial regression analysis, the best fitting curve was determined to be cubic polynomial after reanalysis of the first to ninth experimental data, and the linear deviation was not beyond the allowable deviation range (7.5%). The determined AMR of D-dimer is 0.065 7~5.26 mg/L; The maximum allowable dilution is 1∶32, and the CRR of D-dimer is 0.065 7~168.32 mg/L.
Conclusions
The CRR was established, which was significant for clinical diagnosis with the high test value.
To explore the epidemiological characteristics of mycoplasma pneumoniae (MP) infection in children's respiratory from 2020 to 2021 in Guangzhou, and to observe the changes in the levels of peripheral blood lymphocyte subsets in infected children.
Methods
Serum mycoplasma pneumoniae antibody (MP-IgM) were collected from 17 453 children using indirect immunofluorescence assay (IFA) with respiratory tract infection who visited Guangdong Women and Children Hospital from January 2020 to December 2021. Among them, 443 children who were positive for MP-IgM and had undergone lymphocyte subset testing were selected as the observation group and control group. The levels of peripheral blood lymphocyte subsets (CD3+, CD19+, CD16+CD56+, CD4+, CD8+, CD4+/CD8+) were analyzed statistically.
Results
Among the 17 453 children with respiratory tract infections, 4388 cases were positive for MP-IgM, with a total positive rate of 25.14%. The positivity rate of MP-IgM is highest in autumn (30.15%) and lowest in winter (19.54%); the positive rate of MP-IgM antibody remained at a high level from June to November, peaking in May. The positive rates of male and female children were 21.94% and 30.39%, respectively. The MP-IgM was lowest in the infant group (0~<1 years old), and highest in the preschool children (3~<7 years old). Among the eight respiratory tract infections, the highest positive rate for influenza virus B (IV-B) was 44% in the mixed infection with MP-IgM, while the lowest positive rate for chlamydia pneumoniae (CPn) was 1%. There were significant differences in the levels of CD4+, CD8+, CD4+/CD8+ between the observation group and the control group (P<0.01).
Conclusions
MP infection are most prevalent in autumn, with a higher positive rate in female children than in male children and a higher positive rate in preschool age children. Among the eight other respiratory tract infections associated with MP-IgM, the highest mixed infection rate was found for IV-B. The level of lymphocyte subsets can indicate the infection status. In clinical practice, strengthening the observation and treatment of the immune status of children can provide guidance for clinical medication and treatment.
To analyze the situation of Brucella infection in Shanxi province from 2020 to 2021, and provide a reference basis for the prevention and control of brucellosis in Shanxi province.
Methods
A retrospective analysis was conducted on the results of Brucella testing using the Rose-Bengal Plate Test (RBPT) and Standard-tube Agglutination Test (SAT) for 4265 suspected cases awaiting diagnosis.
Results
The annual average positive rate of Brucella in Shanxi province increased from 18.39% in 2020 to 19.41% in 2021. According to regional statistical analysis, the positive rate in Xinzhou and Lyuliang is over 28.17%, while the positive rate in Linfen and Yuncheng areas increased from 15.49% to 24.15%. In the age group analysis, it is mainly concentrated between the ages of 41 to 60, with a positive rate of over 23.81%. The positive rate for the 31~40 age group increased from 13.61% to 20.71%.
Conclusions
Brucella infection is on the rise in Shanxi province, with a trend of increasing positive rates in young and middle-aged population. Brucellosis has the tendency of spreading from the northern regions to the southern regions. As well as the southern areas of Linfen and Yuncheng, active propaganda, education, and control measures needed in the northern areas of Lyuliang and Xinzhou.
To report a case of Streptococcus suis infection with anemia and fatigue as the initial symptom in Tianmen City, analyze the source of infection and transmission route, and provide scientific basis for local epidemic prevention and control.
Methods
Streptococcus suis infection was confirmed by blood culture and epidemiological investigation was carried out.
Results
Blood culture of the patient was positive for Streptococcus suis type 2, and epidemiological investigation showed that Streptococcus suis was present in the slaughtering pig farm.
Conclusions
Slaughterhouse workers are susceptible to Streptococcus suis disease. It is necessary to strengthen the sanitary management of slaughterhouses, monitor the epidemic situation of pigs and standardize the personal protection to prevent the transmission and spread of human infection with Streptococcus suis disease.
To help inspectors to detect the crystals of the drug early in daily testing and provide a reference for clinical safety medication by exploring the characteristics of amoxicillin-clavulanate crystals in urine.
Methods
The morphological characteristics of amoxicillin-clavulanate crystals were observed and the physicochemical tests were carried out. Combined with relevant domestic and foreign literatures, other crystals with similar morphology in urine were identified and distinguished.
Results
Amoxicillin-clavulanate potassium crystals were confirmed in the urine of 3 patients.
Conclusions
The crystal of amoxicillin-clavulanate potassium is more likely to precipitate from the urine of patients with overdose of amoxicillin-clavulanate potassium. When similar needle-shaped crystals are found, the inspector should consider the adverse reactions of amoxicillin-clavulanate potassium, communicate with the clinician in time, ask about the medication, and prompt clinicians to pay attention to the dose of medication to prevent patients from renal injuries due to excessive medication.
To summarize the management and teaching experience of standardized training bases for laboratory medicine residents in recent 7 years, and to provide reference for the training of laboratory doctors in the future.
Methods
The basic situation, faculty management, process management and quality control of resident physicians in laboratory medicine base from 2015 to 2021 were analyzed, and experience was summarized and thoughts were put forward.
Results
The medical specialty enrollment faced the shortage of student sources, and the employment feedback of resident training physicians was better after graduation.The teaching echelon is not sound, and it is suggested to remove teachers who hold administrative positions. The 360-degree evaluation scheme is a common template for all residential training bases in the hospital, and a more suitable mutual evaluation scheme should be set up for inspection bases. The rotation model and assessment scheme in process management need to be closely integrated with the actual situation of the professional group.
Conclusions
Residential training management and teaching of laboratory medicine should be combined with the characteristics of each sub-specialty, mobilize the enthusiasm of teachers to develop detailed training plans, implement the quality of training, and cultivate excellent laboratory doctors for clinical application talents.
Basic clinical laboratory course is one of the specialized courses of medical laboratory, values establishment and people cultivation are the most important tasks of ideological and political education in this course. The exploration of its implementation path mainly focuses on five aspects: formulating ideological and political instructional objectives, comprehensively improving teachers' ideas about ideological and political education, establishing ideological and political elements library and applying it to actual teaching procedures, evaluating the effect of ideological and political education in this course, finally summarizing the achievements and deficiencies of ideological and political education throughout the process, and timely adjusting ideological and political cases to keep pace with the times.
