Table of Content

30 August 2019, Volume 34 Issue 8

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Role of follicular regulatory T cells in the pathogenesis of Hashimoto thyroiditis

ZOU Guanghui, SUN Fenyong, DAI Jiaqi, YAN Jie, ZHANG Yun, YIN Zhiqiang

2019, 34(8):  682-686.  DOI: 10.3969/j.issn.1673-8640.2019.08.002

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Objective To investigate the roles of peripheral blood follicular regulatory T cells（Tfr）and regulatory T cells（Treg） in Hashimoto thyroiditis（HT）. Methods A total of 30 patients with HT and 30 healthy subjects were enrolled. Free triiodothyronine（FT₃）,free thyroxine（FT₄）,thyroid stimulating hormone（TSH）,anti-thyroid globulin antibody（TgAb）,anti-thyroid peroxidase antibody（TPOAb） and the ratio of peripheral blood Treg（CD4⁺CD25⁺CD127^low/-） and Tfr（CD4⁺CXCR5⁺CD25⁺CD127^low/-） were determined. According to the results of serum thyroid function indicators,HT patients were classified into normal thyroid function group and hypothyroid function group. The correlations were evaluated by Pearson correlation analysis. Results Serum TSH,TgAb and TPOAb levels in HT group were higher than those in healthy control group（P<0.05,P<0.000 1）,and serum FT₄ level and peripheral blood Treg and Tfr ratios were lower than those in healthy control group（P<0.05,P<0.001）. There was no statistical significance for serum FT₃ level and Tfr/Treg ratio between the 2 groups（P>0.05）. The ratios of Treg and Tfr in normal thyroid function group and hypothyroid function group were lower than those in healthy control group（P<0.05,P<0.01,P<0.001）. Serum TSH and TPOAb levels in hypothyroid function group were higher than those in normal thyroid function group（P<0.05,P<0.01）,and serum FT₄ level was lower than that in normal thyroid function group（P<0.05）. There was no statistical significance for serum FT₃,TgAb level,Treg ratio,Tfr ratio and Tfr/Treg ratio between the 2 groups（P>0.05）. TPOAb levels were negatively correlated with Treg ratio,Tfr ratio and Tfr/Treg ratio （r=-0.428,-0.562 and -0.402,P<0.05）. There was no correlation of TgAb level with Treg ratio,Tfr ratio and Tfr/Treg ratio（r=-0.353,-0.178 and -0.310,P>0.05）. Conclusions The decreasing of Treg and Tfr ratios may be involved in the pathogenesis of HT.

Changes of CA125 in pregnancy and relationship with other biochemical indicators

WANG Zhiheng, YING Chunmei

2019, 34(8):  687-690.  DOI: 10.3969/j.issn.1673-8640.2019.08.003

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Objective To evaluate the changes of carbohydrate antigen 125（CA125） in pregnancy,and to investigate the relationship of CA125 with other biochemical indicators. Methods A total of 167 pregnant and 46 non-pregnant women were enrolled. Of the 167 pregnant women,57 cases were in the first trimester of pregnancy（8-12 weeks）,55 cases were in the second trimester of pregnancy（15-19 weeks）,and 55 cases were in the third trimester of pregnancy（33-36 weeks）. Serum levels of CA125,creatinine（Cr）,alkaline phosphatase（ALP）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,blood urea nitrogen（BUN）,blood glucose（Glu）,triglyceride（TG） and total cholesterol（TC） were determined. The correlations of biochemical indicators and CA125 were evaluated by Pearson correlation analysis. Results The levels of serum CA125,ALP,TG and TC in pregnant women were higher than those in non-pregnant women（P<0.05）,and Cr,BUN and Glu were lower（P<0.001）. Serum ALT and AST had no statistical significance between pregnant and non-pregnant women（P>0.05）. The CA125 level was higher in the first trimester than those in the third and second trimesters of pregnancy（P<0.05）,and that in the third trimester was higher than that in the second trimester of pregnancy（P<0.05）. The levels of serum ALP,TG and TC in the third trimester were higher,and ALT and Glu were lower than those in the first and second trimesters of pregnancy（P<0.05）. There was no statistical significance between the first and second trimesters of pregnancy（P>0.05）. There was no statistical significance for Cr,BUN and AST among all pregnant groups（P>0.05）. BUN（r=0.221,P<0.05） and Glu（r=0.165,P<0.05）were positively correlated with CA125 in pregnancy,while Cr,ALP,ALT,AST,TC and TG were not correlated with CA125 （r=-0.005,-0.059,0.028,0.028,-0.140 and -0.071,respectively,P>0.05）. Conclusions Serum CA125 levels are increased during pregnancy,especially in early pregnancy,and the levels of CA125 during pregnancy are associated with BUN and Glu.

Roles of serum microRNA-122 and microRNA-155 in patients with chronic hepatitis B

WANG Yingzhi, LIU Hua, WANG Wenjuan, GAO Feng, YANG Cuixia

2019, 34(8):  691-695.  DOI: 10.3969/j.issn.1673-8640.2019.08.004

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Objective To analyze the relationship between serum levels of microRNA-122（miRNA-122）,microRNA-155（miRNA-155） and viral replication,antiviral therapy and drug resistance gene mutation in patients with chronic hepatitis B（CHB）. Methods A total of 24 healthy subjects and 35 patients with CHB were enrolled. Serum levels of miRNA-122,miRNA-155,hepatitis B virus（HBV） DNA load,hepatitis B surface antigen（HBsAg）,hepatitis B surface antibody（HBsAb）,hepatitis B e antigen（HBeAg）,hepatitis B e antibody（HBeAb）,hepatitis B core antibody（HBcAb）,alanine aminotransferase（ALT）,the drug resistance gene mutation of HBV and the genotyping of HBV were determined,and the correlations were analyzed. Results In CHB group,serum level of miRNA-122 was higher,and serum level of miRNA-155 was lower than those in healthy control group（P<0.05）. Spearman correlation analysis showed that the relative expression of serum miRNA-122 in CHB patients without antiviral treatment with nucleoside drugs（non-treatment group,18 cases） was positively correlated with the pattern of hepatitis B serological markers（r=0.73,P=0.00）,it was positively correlated with HBV DNA load,HBsAg,HBeAg and ALT in non-treatment group（r=0.69,0.74,0.53 and 0.48,respectively,P<0.05）,and it was negatively with age（r=-0.58,P=0.01）. In treatment group（17 cases）,the relative expression of serum miRNA-122 was positively correlated with the level of HBsAg（r=0.54,P<0.05）,while the relative expression of serum miRNA-155 was correlated with HBV DNA load（r=-0.54,P<0.05）. CHB group was subclassified into HBV DNA negative group and HBV DNA positive group according to whether HBV DNA was detemined or not. The relative expression of serum miRNA-155 in HBV DNA positive group was lower than that in HBV DNA negative group（P<0.05）. Conclusions Serum miRNA-122 is correlated with HBV DNA load,HBsAg,HBeAg and ALT,and it may predict viral replication and severity of CHB. Serum miRNA-155 may be valuable in predicting and evaluating the therapeutic effect of CHB.

Clinical application of plasma GAS5 in the diagnosis and treatment of systemic lupus erythematosus

CHEN Yanhong, SUN Li, FU Yu, LIU Yan, NIU Guoping

2019, 34(8):  696-700.  DOI: 10.3969/j.issn.1673-8640.2019.08.005

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Objective To investigate the role of plasma growth arrest-specific 5（GAS5） in the diagnosis and treatment of systemic lupus erythematosus（SLE）. Methods A total of 169 patients with SLE,50 patients with rheumatoid arthritis（RA） and 50 patients with primary Sjögren's syndrome（pSS） were enrolled,and 102 healthy subjects were enrolled as healthy control group. Plasma GAS5 level was determined by real-time quantitation reverse transcription polymerase chain reaction（qRT-PCR）. The correlations between GAS5 and anti-double-stranded DNA（dsDNA） and anti-Smith（Sm） antibodies were analyzed. Receiver operating characteristic（ROC） curves were used to identify the diagnostic efficiency of plasma GAS5 for SLE. In the 169 patients with SLE,39 cases were selected,and their plasma GAS5 levels were compared before and after treatment. Results Compared to RA,pSS and healthy control groups,the GAS5 level was higher in SLE group（P<0.001）. GAS5 had positive correlations with anti-dsDNA antibody（r=0.53,P<0.001） and anti-Sm antibody（r=0.45,P<0.001）. The area under curve（AUC） of plasma GAS5 was 0.84. At the optimal cut-off value of 0.56,the diagnostic sensitivity and specificity were 89% and 75%. The AUC of GAS5 for the diagnosis of RA and pSS were 0.61 and 0.53,respectively. The GAS5 level after treatment was decreased compared with that before treatment. Conclusions Plasma GAS5 can provide a reference for the diagnosis and treatment of SLE. It can be used as a new biomarker for the diagnosis of SLE.

Morphological characteristics of bone marrow metastasis in children with common tumors

WANG Huan, GAO Yuan, JIANG Linlin, ZHANG Hong

2019, 34(8):  701-703.  DOI: 10.3969/j.issn.1673-8640.2019.08.006

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Objective To analyze the clinical features of bone marrow metastasis and the morphological characteristics of bone marrow metastasis tumor cells in children with common tumors,in order to improve the diagnosis of diseases. Methods A total of 38 children diagnosed with bone marrow metastasis were enrolled. The clinical features and the results of laboratory examinations were analyzed retrospectively. Results Bone marrow cytology revealed common morphological changes in bone marrow metastasis,and in the smear there were various amounts of scattered or clustered into tumor cells "just the distribution of body mass". However,they had different morphological characteristics,especially for chrysanthemum-like distribution of neuroblastoma cells and the piles of strips around the cells. Conclusions Bone marrow cytology is of guiding significance in the metastasis diagnosis of bone marrow tumors. Atypical morphology can be combined with other laboratory examinations for diagnosis.

Role of RDW combined determination with NLR in ankylosing spondylitis

WANG Jing, ZHENG Qun, JIN Xiaxia, LU Guoguang, SHEN Bo

2019, 34(8):  704-709.  DOI: 10.3969/j.issn.1673-8640.2019.08.007

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Objective To study the combined diagnostic role of red blood cell distribution width（RDW） and neutrophil to lymphocyte ratio（NLR） for ankylosing spondylitis（AS）,and to investigate the relations with disease activity and severity. Methods A total of 78 AS patients and 78 healthy subjects were enrolled. The results of blood routine test,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,immunoglobin（Ig）A,IgG and IgM and other laboratory indicators were recorded. AS patients were classified into stage Ⅰ,Ⅱ,Ⅲ and Ⅳ according to the results of magnetic resonance imaging（MRI）. The relationship between RDW,NLR and the activity of AS was evaluated by Spearman analysis. Receiver operating characteristic（ROC） curve was used to obtain the areas under curves（AUC） and the cut-off values of RDW,NLR and RDW combined with NLR for the diagnosis of AS. AS patients were classified according to the cut-off values of RDW and NLR,and the difference of laboratory indicators was compared between the groups. Results NLR,ESR,CRP,RDW,IgG,IgA and IgM had statistical significance between AS group and healthy control group（P<0.05）. Both RDW and NLR were correlated with CRP and ESR （r=0.231,0.306,0.352 and 0.343,P<0.05）. The AUC of RDW,NLR and RDW combined with NLR for the diagnosis of AS were 0.784,0.725 and 0.812,respectively. The cut-off value of RDW was 13.2,the sensitivity was 59.0%,and the specificity was 96.2%. NLR had a cut-off value of 2.14,a sensitivity of 60.3% and a specificity of 79.5%. The sensitivity of the combined determination of NLR and RDW was 61.5%,and the specificity was 94.9%. The ESR of AS patients with RDW≤13.2 was lower than that with RDW>13.2（P=0.014）,and AS patients with NLR≤2.14 had lower CRP than that with NLR>2.14（P=0.018）. There was no statistical significance in RDW and NLR among the different stages of AS patients（P>0.05）. Conclusions RDW combined with NLR can be used as a new auxiliary diagnostic indicator for AS patients,which can reflect disease activity but not disease severity.

Analysis on the laboratory examination results of 5 cases of diclonal multiple myeloma

ZHENG Wei, LU Jie, HAO Aijun, ZHANG Yinhui

2019, 34(8):  710-716.  DOI: 10.3969/j.issn.1673-8640.2019.08.008

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Objective To analyze the clinical and laboratory examination characteristics of diclonal multiple myeloma ,and to improve the detection rate of diclonal multiple myeloma. Methods The clinical data were collected from 5 cases of diclonal multiple myeloma in Huazhong University of Science and Technology Tongji Medical College Tongji Hospital from 2014 to 2017. Results In the 5 cases of diclonal multiple myeloma,there were 2 cases of IgG-IgA and 3 cases of IgG-IgG. Two cases were treated and changed into monoclonal multiple myeloma. Conclusions The clinical characteristics of diclonal multiple myeloma are lacking in specificity. Patients with diclonal multiple myeloma must be fully determined in laboratories to improve the detection rate of diclonal multiple myeloma.

Correlation of bioavailable 1,25（OD）₂D level with bone mineral density and bone metabolic markers in patients with nephrotic syndrome

SUN Liangbo, JING Haining

2019, 34(8):  717-721.  DOI: 10.3969/j.issn.1673-8640.2019.08.009

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Objective To investigate the correlation between bioavailable 1,25-hydroxyvitamin D [1,25（OH）₂D] level and bone mineral density（BMD） and bone metabolic markers in patients with nephrotic syndrome（NS）. Methods A total of 80 NS patients（NS group） and 60 healthy subjects（healthy control group） with similar sex,age and body mass index（BMI） were enrolled. The data on sex,age,height,weight,blood pressure,smoking history and drinking history of all the subjects were recorded,and BMI was calculated. The BMD,serum creatinine（SCr）,total cholesterol（TC）,triglyceride（TG）,albumin（Alb）,calcium,phosphorus,intact parathyroid hormone（iPTH）,total 1,25（OH）₂D and vitamin D binding protein（DBP） were determined,and bioavailable 1,25（OH）₂D was calculated. Multivariate Logistic regression analysis was used to evaluate the correlations between the indicators and 1,25（OH）₂D levels. Results The systolic blood pressure,serum Alb,Ca,total 1,25（OH）₂D and bioavailable 1,25（OH）₂D levels in NS group were lower than those in healthy control group（P<0.05）,and the diastolic blood pressure and serum TC,TG,phosphorus and iPTH were higher than those in healthy control group（P<0.05）. There was no statistical significance between the 2 groups in smoking history ratio,drinking history ratio,SCr,estimated glomerular filtration rate（eGFR）,serum DBP and BMD （P>0.05）. Total 1,25（OH）₂D and bioavailable 1,25（OH）₂D levels in NS group were positively correlated with BMD,Alb and DBP（P<0.01） and were negatively correlated with iPTH and TC（P<0.01）,and there was no correlation with the other indicators（P>0.05）. Conclusions Low levels of total 1,25（OH）₂D and bioavailable 1,25（OH）₂D in NS group are related to BMD and bone metabolic markers.

Plasma aldosterone and renin levels in patients with aldosterone adenoma

CHANG Fujiang, ZHANG Xuepei, WANG Shengzheng, TAO Jin, FU Tianlong

2019, 34(8):  722-725.  DOI: 10.3969/j.issn.1673-8640.2019.08.010

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Objective To investigate the role of chemiluminescence immunoassay（CLIAS） for determining plasma aldosterone and renin for screening aldosterone-producing adenoma（APA）. Methods A total of 79 patients with APA and 96 patients with essential hypertension（EH） were enrolled,and plasma aldosterone and renin levels were determined by CLIAS. Plasma levels of aldosterone and renin and aldosterone to renin ratios（ARR） before and after operation were compared. Receiver operating characteristic（ROC） curve was used to evaluate the performance of ARR for the diagnosis of APA. Results The plasma levels of aldosterone and ARR in APA group were higher than those in EH group（P<0.05）,and plasma renin levels were lower than those in EH group（P<0.05）. ROC curve analysis showed that the area under the curve of orthostatic ARR was 0.938,the optimal cut-off value was 42.8,the sensitivity was 98.0%,the specificity was 91.6%,and the Youden index was 0.896. Postoperative aldosterone levels were lower（P<0.05）,renin levels were higher（P<0.05）,and ARR was lower（P<0.001） compared with those before operation. Conclusions CLIAS can be used in determining plasma aldosterone and renin.

Roles of urinary type Ⅳ collagen and serum phospholipase A2 receptor antibody in membranous nephropathy

WANG Lei, HUANG He, XU Minyi, ZHOU Fangfang, LU Pei, HUANG Qiufang, XIONG Zhongbo, WEI Xiaoqing, DAI Yue

2019, 34(8):  726-729.  DOI: 10.3969/j.issn.1673-8640.2019.08.011

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Objective To investigate the roles of urinary type Ⅳ collagen（ⅣC）and serum phospholipase A2 receptor（PLA2R） antibody in membranous nephropathy（MN）. Methods A total of 73 patients with MN,42 patients with mesangial proliferative glomerulonephritis（MsPGN） and 50 healthy subjects were enrolled,and urinary ⅣC level was determined by magnetic particle chemiluminescence. Serum PLA2R antibody level of 57 cases of MN and 14 cases of MsPGN were determined by enzyme-linked immunosorbent assay（ELISA）. The correlation between serum PLA2R antibody level and urinary microalbumin（mAlb） level was analyzed. Results Urinary ⅣC levels in MN and MsPGN groups were higher than that in healthy control group（P<0.01）,while the difference between MN and MsPGN groups was not statistically significant（P>0.05）. In the 57 cases of MN,30 cases were positive for PLA2R antibody,and the positive rate was 52.6%,while 14 cases of MsPGN were all negative. The level of urinary ⅣC in the PLA2R antibody positive group of MN patients was higher than that in the PLA2R antibody negative group（P<0.01）. There was no statistical significance for urinary mAlb level between the 2 groups（P>0.05）. PLA2R antibody level was positively correlated with urinary ⅣC level（r=0.370,P<0.01）,while there was no correlation with urinary mAlb level（r=0.027,P>0.05）. Conclusions Urinary ⅣC and serum PLA2R antibody can be used in the diagnosis,treatment and prognosis monitoring of MN,and serum PLA2R antibody has clinical value in the differential diagnosis of idiopathic and secondary MN.

Correlations of virulence factor expression and drug resistance for Candida albicans isolated from oral cavity

SUN Kangde, ZHANG Jiasheng, CHEN Xu, YU Zhongmin, CHEN Fuxiang

2019, 34(8):  730-735.  DOI: 10.3969/j.issn.1673-8640.2019.08.012

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Objective To study the in vitro expression of virulence factors and the drug resistance of oral Candida albicans,including the secretion of hydrolytic enzymes,biofilm formation and mycelium phase production,and to investigate the correlations. Methods The activities of secreted aspartyl proteinase（SAP）,phospholipase（PL） and lipase（Lip） of Candida albicans were determined by bovine serum albumin agar,egg yolk agar and tributyrate agar,respectively. The formation of biofilm was determined by crystal violet staining assay,and the expression of hyphal wall protein 1（HWP1） gene was determined by real-time fluorescence polymerase chain reaction（PCR）. Antibiotic susceptibility test was performed. Results The 80% isolates produced a high level of SAP,98% isolates displayed a high level of PL,78% isolates produced a medium level of Lip,and none displayed a high level of Lip. All isolates were able to form biofilm,and the ability of biofilm formation of 30 isolates（60%） was strong. There was a positive correlation between the in vitro expressions of SAP and PL（P<0.05）. No relationship was found in the other virulence factors,while there was no statistical significance in the level of virulence factors in vitro and HWP1 expression between drug-resistant and drug-sensitive isolates. Conclusions Most of isolates display high levels of SAP and PL and medium levels of Lip,which produce biofilm strongly. There is a positive correlation between the in vitro expressions of SAP and PL. The virulence of oral Candida albicans has no correlation with drug resistance.

Role of Xpert MTB/RIF Ultra in the detection of Mycobacterium tuberculosis and rifampicin resistance

WANG Wei, LI Jing, LI Zheng, YANG Jing, YUAN Xing, ZHANG Guolong, CHEN Huihui

2019, 34(8):  742-745.  DOI: 10.3969/j.issn.1673-8640.2019.08.0015

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Objective To evaluate the role of Xpert MTB/RIF Ultra in the detection of Mycobacterium tuberculosis and rifampicin resistance by comparing with Xpert MTB/RIF. Methods Patients with pulmonary tuberculosis symptoms were enrolled and classified into case detection group（CDG） and multidrug-resistance risk group（DRG）. The sputum samples of the 2 groups were detected by Xpert MTB/RIF and Xpert MTB/RIF Ultra,respectively. The MGIT960 liquid culturing was used as a reference method to compare the sensitivities and specificities in the detection of Mycobacterium tuberculosis and rifampicin resistance. Results The sensitivity of Xpert MTB/RIF Ultra in the detection of Mycobacterium tuberculosis was 96.1%,which was higher than that of Xpert MTB/RIF（85.2%）. The specificities were the same. Xpert MTB/RIF Ultra was sensitive in the detection of tuberculosis with negative acid-fast staining smear,and the sensitivity（75.5%） was higher than that of Xpert MTB/RIF（22.6%）. Conclusions Xpert MTB/RIF Ultra is superior to Xpert MTB/RIF in the detection of tuberculosis,especially in patients with negative acid-fast staining smear tuberculosis.

Effectiveness analysis of MALDI-TOF MS based on direct on-plate extraction of formic acid in identifying Corynebacterium and coryneform-like bacteria

ZHANG Ningmei, MI Sirong, QU Ning

2019, 34(8):  746-751.  DOI: 10.3969/j.issn.1673-8640.2019.08.016

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Objective To evaluate the effectiveness of matrix-assisted laser desorption ionization-time of flight mass spectrometry（MALDI-TOF MS） in identifying Corynebacterium and coryneform-like bacteria by comparing with API Coryne. Methods A total of 129 isolates of coryneform bacteria were collected from the clinical samples of 50 patients. The identification of Corynebacterium and coryneform-like bacteria was performed using MALDI-TOF MS based on direct on-plate extraction of formic acid and API Coryne,respectively. The isolates were identified with the cut-off scores（specie level ≥1.7,genus level ≥1.5 and no identification <1.5） for MALDI-TOF MS. The first 500 bp of the 16S rRNA gene of the above isolates was sequenced to determine the types of them. Results A total of 129 isolates of coryneform bacteria were isolated from the clinical samples of patients,and the first 500 bp of the 16S rRNA gene was sequenced. The results showed that 95 of them were Corynebacterium,covering 13 species,and 34 of them were coryneform-like bacteria,covering 15 genera. For MALDI-TOF MS bacterial identification,100% of Corynebacterium were identified as genus level,and 98.9% of them were identified as specie level. The 94.1% of coryneform-like bacteria were identified as genus level,and 88.2% of them were identified as specie level. However,API Coryne was able to identify 84.2% of Corynebacterium to the specie level and 61.8% of coryneform-like bacteria to the genus level. Conclusions MALDI-TOF MS based on formic acid direct on-plate extraction is more effective in identifying Corynebacterium and coryneform-like bacteria than API Coryne.

Development of BCR-ABL1 candidate reference material and evaluation of measurement uncertainty

YU Shuping, YUAN Dandan, CUI Ming, JING Rongrong, WANG Huimin

2019, 34(8):  752-757.  DOI: 10.3969/j.issn.1673-8640.2019.08.017

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Objective To develop the breakpoint cluster region-abelson murine leukemia viral oncogene homolg 1 （BCR-ABL1） fusion gene candidate reference material for chronic myeloid leukemia（CML）. Methods A plasmid containing the BCR-ABL1 fusion gene was constructed by molecular cloning technology,and its concentration was quantified by ultraviolet spectrophotometry and digital polymerase chain reaction（PCR） following sequence validation. The homogeneity and stability were evaluated by real-time quantitative PCR（RQ-PCR）. The uncertainty was evaluated according to the Guide to the Expression of Uncertainty in Measurement. Results The copy concentration of plasmid candidate reference material was（2.50±0.35）×10⁶ copies/μL. The homogeneity and stability of plasmid were good. Conclusions The method for constructing BCR-ABL1 candidate reference material and a homogeneous and stable BCR-ABL1 candidate reference material have been established.

Establishment and analysis of comparison methods among POCT blood gas analyzers

HE Yong, WANG Hui, LI Xiaoling, NIE Xin, JIANG Hong

2019, 34(8):  758-762.  DOI: 10.3969/j.issn.1673-8640.2019.08.018

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Objective According to the requirement of comparison of the Clinical and Laboratory Standards Institute and the characteristics of point-of-care testing（POCT） blood gas analysis,to establish a comparison method based on quality control data,and to compare the consistency of 23 blood gas analyzers in the clinical departments and central laboratory of West China Hospital of Sichuan University. Methods With the reference to the requirement of the Clinical and Laboratory Standards Institute,all quality control results of 23 blood gas analyzers in 30 d were collected. The mean,standard deviation（s） and coefficient of variation（CV） were calculated,and CV must be less than 1/3 allowable total error（TEa）. The mean of means and its s and CV were calculated. Based on the same mean should be got from the same system and quality control of the same lot,when the CV of means less than 1/2 TEa,the results should be consistent. Results CV of 3 levels of pH,partial pressure of carbon dioxide [P（CO₂）] and partial pressure of oxygen [P（O₂）] were less than 1/3 TEa [pH TEa 0.54%,P（CO₂） TEa 8.00% and P（O₂） TEa 12.00%],and CV of 3 levels of pH mean for 23 analyzers were 0.07,0.08 and 0.02,respectively,which were all less than 1/2 TEa. CV of 3 levels of P（CO₂） mean for 23 analyzers were 0.63,1.78 and 1.48,which were all less than 1/2 TEa. CV of 3 levels of P（O₂） mean for 23 analyzers were 2.88,1.90 and 0.95,which were all less than 1/2 TEa. Conclusions The results of 23 blood gas analyzers in west China Hospital are consistent,which meet the requirement of larboratory accreditation and the third class A hospital accreditation.