To explore the application value of lean management in independent clinical laboratory.
Methods
The lean management of the independent clinical laboratory was practiced by establishing lean management working group, implementing 6S management, controlling the per capita efficiency of the department, improving inefficient work processes, controlling the effective utilization rate of reagents, controlling the effective use of testing equipment, setting up the lean management improvement project, ensuring the standardization of the improvement work, and aligning improvement with cost-saving incentives.
Results
After implementing lean management in pilot departments of the laboratory, the per capita efficiency of sample testing increased by 1.94%～69.19%, the quality indicators of the departments improved by 13.88%～55.56%, and the innovation achievements of the departments increased by 6.67%～184.62%, respectively. Additionally, the variable cost of the department (including reagent cost, labor cost, equipment allocation cost, etc.) decreased by 0.68% to 14.44% respectively.
Conclusion
Lean management in clinical laboratory can be organically integrated with professional management and quality management, and play a more active role in improving efficiency, quality management, scientific and technological innovation and cost control of clinical laboratory.
The clinical laboratory aims to improve the examination quality of the external examination items by supervising the quality of the examined items sent to the third-party medical laboratory.
Methods
The clinical laboratory should supervise the quality of the sent samples before,during and after analysis.
Results
The clinical laboratory sends some special test items with small sample size, high cost and long test cycle to the third-party medical laboratory for testing, which can fully optimize the resource allocation of the clinical laboratory.
Conclusion
The clinical laboratory carries out quality supervision over the items of third-party medical laboratory for testing, so as to find problems, timely communicate and continuously improve, improve the management level of delivery service, and better serve clinical and patient services.
In this study, the exogenous neocoronin gene (RBD gene) was inserted into the PA fragment of the polymerase gene of the temperature-sensitive cold-adapted virus strain A/Ann Arbor/6/1960(H2N2), a live attenuated vaccine of influenza A virus (IAV), and rewired the PA packaging signals of the H2N2 viruses to determine the boundary of the packaging signals of the PA genes, to construct H2N2 viral vectors that can be inserted into the exogenous genes based on the boundary sequence.
Methods
Using PCR to amplify 8 gene fragments of the A/Ann Arbor/6/1960(H2N2) virus, the RBD gene was inserted into the PA fragment in a reverse genetic manipulation system and the packaging signals of the PA genes were reassembled, that is, the packaging signal sequences of the polymerase genes were added or subtracted by 3 bases at a time. At the same time, in order to fully express the full length polymerase gene and the RBD gene, nonsense mutant packaging signals sequence, Porcine teschovirus-1 2A polypeptide sequence and exogenous gene sequence encoding influenza virus codon preference were inserted before packaging signal. Ligases were used to attach 8 gene fragments of the virus to the vector, and plasmids were constructed for each gene fragment. The recombinant virus was saved by transfection, and the MDCK cell was used to amplify the virus. The integrity of the virus gene was identified at the nucleic acid level to determine whether the packaging signal of influenza virus was damaged and the packaging signal boundary of influenza virus polymerase gene.
Results
A total of 11 PA constructs were created, encoding packaging signals ranging from 108～138 bp (excluding the stop codon). And the recombinant H2N2 viruses with packaging sequences of +12bp +15bp -6bp -9bp -12bp and -15bp were successfully rescued in the eight-plasmid IAV rescue system.
Conclusions
In this study, 6 recombinant influenza viruses are successfully rescued, that is, H2N2 vectors are successfully constructed that can insert exogenous genes. The packaging signal region of the recombinant H2N2 viruses is slightly different from that of PR8, suggesting that the location of packaging signals may differ between different subtypes.
To compare the metabolic markers of polycystic ovary syndrome (PCOS)patients with different phenotypes, and establish and use new anthropometric and blood markers to evaluate the metabolic deregulations of PCOS patients.
Methods
270 PCOS patients were enrolled according to the 2003 Rotterdam criteria. 4 phenotypes of PCOS can occur based on the presence of 3 basic characteristics:oligovulation (OA), hyperandrogenism (HA), and polycystic ovarian morphology (PCOM). PCOS patients were divided into 4 groups: phenotype A (classic type): OA+HA+PCOM, with 64 patients in it; phenotype B (hyperandrogen type): OA+HA, with 64 patients in it; phenotype C (ovulatory type): HA+PCOM, with 78 patients in it; phenotype D (non-hyperandrogenic type): OA+PCOM, including 64 patients in it. Body mass index (BMI), waist-to-hip ratio, waist-to-height ratio, visceral adiposity index (VAI), and lipid accumulation product (LAP) were measured and calculated. Venous blood was drawn on the fasting stomach on the 3～5th day of menstrual period to measure blood sex hormones and blood lipids. Blood glucose and insulin (INS)were measured by oral glucose tolerance test, triglyceride glucose (TyG) index, TyG waist-to-height ratio,free androgen index (FAI) and homeostasis model assessment of insulin resistance (HOMA-IR) index were calculated, and anthropometric indexes and blood markers of PCOS phenotype patients in the 4 groups were compared. The effectiveness of new anthropometric indicators and blood markers in the diagnosis of metabolic syndrome (MetS) in PCOS patients was compared using receiver operating characteristic curve.
Results
BMI,hip circumference, follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG), FAI, anti-Müllerian hormone (AMH), total cholesterol (TC), total triglycerides (TG), low density lipoprotein cholesterol(LDL-C), TyG, TyG-waist height ratio, INS, HOMA-IR and LAP were differences among the 4 groups of PCOS phenotypes (P＜0.05). In the patients with MetS and non-MetS, there were significant differences in anthropometric indicators such as body mass, BMI, blood pressure, waist circumference, hip circumference,waist-to-hip ratio, waist-to-height ratio, reproductive hormones such as LH, LH/FSH, SHBG, FAI, AMH,the differences of blood glucose and INS such as VAI, LAP, TyG-waist height ratio, blood lipids such as TG,HDL-C, LDL-C, TyG (P＜0.05). When VAI is used to diagnose PCOS patients with MetS, the area under the curve is 0.976 (95% CI=0.960～0.992), the sensitivity and specificity were 100.000% and 89.669%,respectively.
Conclusions
There are differences in reproductive hormones, blood lipids, blood glucose, INS and anthropometrics among PCOS patients with different phenotypes in Zengcheng District of Guangzhou, and VAI has the highest efficacy in diagnosing MetS in PCOS patients, which can be applied clinically.
To understand the knowledge and behaviors of residents in Xichang city,Sichuan province, about the prevention and treatment of schistosomiasis japonica in the context of ＂Healthy China＂, in order to provide reference for the ＂14th Five-Year Plan＂ to successfully achieve the goal of eliminating schistosomiasis japonica and timely to carry out health education and popularization.
Methods
A total of 400 people were randomly selected from rural and urban areas of the city by questionnaire, and their knowledge,attitude, belief and behavior were statistically analyzed by SPSS 26.0 software.
Results
The results showed that the overall awareness rate of schistosomiasis japonica among residents in Xichang city, Sichuan province was 39.4%, the overall awareness rate of prevention knowledge was 45.6%, the correct rate of overall belief and attitude was 35.3%, and the correct rate of overall health behavior was 38.2%.
Conclusions
Xichang city, as the prefecture of Liangshan Yi autonomous prefecture, has frequent movement of ethnic minorities and is prone to epidemic prevention dead ends. Relevant departments should continuously improve the cognitive level of residents in Xichang city on schistosomiasis japonica, strengthen risk assessment and personnel behavior research in key areas, adhere to the principles of prevention first, prevention and control combined with comprehensive management,and call on all departments to cooperate together to strengthen comprehensive prevention and control measures including health education, further consolidate the results of comprehensive prevention and control measures based on the control of the source of infection, and strive to achieve the goal of comprehensive elimination of schistosomiasis.
Kingella is an emerging pathogen causing pediatric osteoarthritis, septic bacteremia, infective endocarditis, meningitis and other invasive infectious diseases. It is transmitted through close contact and mostly affects infants aged 6 months～4 years. In this paper, the biological characteristics, pathogenicity, clinical characteristics, new methods of laboratory diagnosis and drug resistance of the Kingella were briefly reviewed, in order to improve the understanding of the genus by clinicians and provide important reference for the early diagnosis, treatment and prognosis of kimellosis.
To deepen public understanding of Balamuthia amebic encephalitis(BAE) and improve early diagnosis, treatment, and care of this disease in clinical practice.
Methods
The diagnosis, treatment and care process of a patient with BAE were analyzed, including clinical data, physical examination, laboratory examination, imaging examination, diagnosis, treatment, care process and clinical regression.
Results
The 9-year-old female patient was admitted to another hospital with cough, fever and confusion, and was transferred to our hospital after ineffective symptomatic treatment. Admission physical examination and imaging findings were uncharacteristic. Two cerebrospinal fluid (CSF) metagenomic nextgeneration sequencing (mNGS) tests were performed. Both tests suggested Balamuthia mandrillaris amoeba infection, which was consistent with the results of routine, biochemical and cytological examination of the CSF. The patient died seven days after admission due to rapid progression of the disease despite symptomatic treatment and specialized care.
Conclusion
The clinical presentation of BAE lacks specificity, and CSF examination helps to diagnose the disease. Since there is no specific treatment for this disease, an exclusive treatment and care plan needs to be tailed to the individual patient.
To implement the fundamental task of cultivate virtue and cultivate people,strengthen the communication between laboratory and clinical, the paper discusses the application effect of problem-based learning (PBL) teaching method in the labor teaching of clinical medicine and clinical nursing college students.
Methods
A total of 456 college students of clinical medicine and clinical nursing of Guangdong Medical University, who were admitted to the laboratory medicine center of Affiliated Hospital of Guangdong Medical University, were taken as the research objects. The students were randomly divided into PBL group and traditional lecture-based learning (LBL) group, and the training effects of PBL group and LBL group were compared. Additionally, the students' opinions on the effectiveness of PBL and LBL teaching methods were collected through questionnaires. The t-test was performed using SPSS 25.0 statistical software and the Wilcoxon signed tank test.
Results
During the training period, the scores of students in the PBL group in class test (17.62±0.49) were significantly different from those in the LBL group (12.86±1.80) (P＜0.001).The scores in class labor practice evaluation (47.62±0.49) were significantly different from those in LBL group(43.47±1.09) (P＜0.001). The score of homework evaluation (17.36±0.70) was significantly different from that of LBL group (13.75±1.19) (P＜0.001), for “improving medical examination knowledge”“improving learning interest”“improving learning efficiency”“improving self-learning ability”“improving problem-solving ability”“improving practical operation ability”“improving the ability to combine theory and practice” and “improving labor education”, the evaluation of the PBL teaching group was significantly better than that of the LBL teaching group (P＜0.01), for “improving clinical communication ability”, the evaluation of the PBL teaching group was better than that of the LBL teaching group (P＜0.05).
Conclusion
The application of PBL teaching in the labor education of ＂quality control before examination and analysis＂ of clinical medicine and nursing college students can improve the teaching effect, enhance the awareness of clinical medical and nursing college students of the importance of quality control before analysis,and strengthen the communication and understanding between clinicians and examinations in the future.
To explore the application of peer education in the experimental teaching of academic medical doctoral students, evaluate its teaching effectiveness, and discuss ideas for reforming the academic-oriented medical doctoral experimental education.
Methods
A total of 111 doctoral students in the First Affiliated Hospital of Guangzhou Medical University were enrolled in this study and randomly divided into the traditional experimental teaching group of 55 students and the peer education group of 56 students. The satisfaction with the course, the familiarity and performance of follow-up experimental technology were investigated and evaluated by questionnaire.
Results
There was no significant difference in gender and age between the traditional experimental teaching group and peer education group (P＞0.05).The results showed that the satisfaction of the peer education group was significantly higher than that of the traditional teaching group, and the difference was statistically significant (χ2=111, P=0.008 6). Compared to the traditional teaching group, students in the peereducation group believed that they could master the follow-up experimental technology needed for later research through the peer education pattern, the difference was statistically significant (χ2=8.6, P=0.000 1). In addition, research projects were completed significantly earlier in the peer education group than those in the traditional education group (t=6.6, P=0.000 1).
Conclusion
Applying peer education was effective in the experimental study of academic medical doctoral students and has promotion and application value.
