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This paper aims to explore whether cultural inclusivity has a significant impact on corporate social responsibility (CSR). The research shows that firms located in regions with higher cultural inclusivity tend to take on more social responsibilities, suggesting that corporate humanistic care and environmental awareness are linked to cultural inclusivity. Furthermore, the effect of cultural inclusivity is more evident in large firms, state-owned enterprises, and firms with high board independence. The use of natural disasters as an instrumental variable in the analysis helped to address endogeneity concerns. Additionally, the outcomes indicate that regions with greater exposure to cultural inclusivity tend to exhibit more characteristics of "gender equality" and fewer characteristics of "power gap", which have a strong correlation with CSR. These findings shed light on the impact of cultural inclusivity on corporate governance and help explore the informal institutional factors influencing CSR at the geographical level. [ABSTRACT FROM AUTHOR]

Background: As the characteristic functional component in ginger, gingerols possess several health-promoting properties. Long non-coding RNAs (lncRNAs) act as crucial regulators of diverse biological processes. However, lncRNAs in ginger are not yet identified so far, and their potential roles in gingerol biosynthesis are still unknown. In this study, metabolomic and transcriptomic analyses were performed in three main ginger cultivars (leshanhuangjiang, tonglingbaijiang, and yujiang 1 hao) in China to understand the potential roles of the specific lncRNAs in gingerol accumulation. Results: A total of 744 metabolites were monitored by metabolomics analysis, which were divided into eleven categories. Among them, the largest group phenolic acid category contained 143 metabolites, including 21 gingerol derivatives. Of which, three gingerol analogs, [8]-shogaol, [10]-gingerol, and [12]-shogaol, accumulated significantly. Moreover, 16,346 lncRNAs, including 2,513, 1,225, and 2,884 differentially expressed (DE) lncRNA genes (DELs), were identified in all three comparisons by transcriptomic analysis. Gene ontology enrichment (GO) analysis showed that the DELs mainly enriched in the secondary metabolite biosynthetic process, response to plant hormones, and phenol-containing compound metabolic process. Correlation analysis revealed that the expression levels of 11 DE gingerol biosynthesis enzyme genes (GBEGs) and 190 transcription factor genes (TF genes), such as MYB1, ERF100, WRKY40, etc. were strongly correlation coefficient with the contents of the three gingerol analogs. Furthermore, 7 and 111 upstream cis-acting lncRNAs, 1,200 and 2,225 upstream trans-acting lncRNAs corresponding to the GBEGs and TF genes were identified, respectively. Interestingly, 1,184 DELs might function as common upstream regulators to these GBEGs and TFs genes, such as LNC_008452, LNC_006109, LNC_004340, etc. Furthermore, protein–protein interaction networks (PPI) analysis indicated that three TF proteins, MYB4, MYB43, and WRKY70 might interact with four GBEG proteins (PAL1, PAL2, PAL3, and 4CL-4). Conclusion: Based on these findings, we for the first time worldwide proposed a putative regulatory cascade of lncRNAs, TFs genes, and GBEGs involved in controlling of gingerol biosynthesis. These results not only provide novel insights into the lncRNAs involved in gingerol metabolism, but also lay a foundation for future in-depth studies of the related molecular mechanism. [ABSTRACT FROM AUTHOR]

Populus wilsonii is an important species of section Leucoides, and the natural populations mainly grow in southwest China. In this study, a single genotype of wild P. wilsonii was sequenced and assembled at genome size of 477.35 Mb in 19 chromosomes with contig N50 of 16.3 Mb. A total of 38,054 genes were annotated, and 49.95% of the genome was annotated as repetitive elements. Phylogenetic analysis identified that the divergence between P. wilsonii and the ancestor of P. deltoides and P. trichocarpa was 12 (3–23) Mya. 4DTv and Ks distributions supported the occurrence of the salicoid WGD event (~65 Mya). The highly conserved collinearity supports the close evolutionary relationship among these species. Some key enzyme-encoding gene families related to the biosynthesis of lignin and flavonoids were expanded and highly expressed in the stems or leaves, which probably resist the damage of the natural environment. In addition, some key gene families related to cellulose biosynthesis were highly expressed in stems, accounting for the high cellulose content of P. wilsonii variety. Our findings provided deep insights into the genetic evolution of P. wilsonii and will contribute to further biological research and breeding as well as for other poplars in Salicaceae. A genome assembly for the Chinese poplar tree, Populus wilsonii, provides a unique resource to guide research into poplar development and breeding efforts. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to answer the question of how business models (BMs) maintain stability while coping with environmental uncertainties. This study proposes a dynamic co-evolution of knowledge management and business model transformation based on a comparative analysis of the focal firms' BMs and their main partners in two e-commerce ecosystems in China. Design/methodology/approach: The open data of listed companies regarding the introduction of emerging topics on the transformation tendency of BMs in the post-COVID-19 business world is qualitatively analysed. The theoretical foundation is based on a critical review of the literature. Findings: Three aspects of the co-evolution between knowledge management and business model transformation are introduced. These three aspects are as follows: knowledge integration helps with multi-system business integration and decision-making collaborations; knowledge sharing helps to enhance cognitive ability and network value based on businesses; and the creation of new knowledge helps enrich the knowledge base and promote the transformation of BMs. Research limitations/implications: Solely attributing a firm's ability to cope with environmental uncertainties to its business model weakens the importance of its knowledge management. This study argues that the co-evolution between knowledge management and business model transformation also plays a key role in a firm's response to issues post-COVID-19. Originality/value: This study calls for the development of a normative theory of co-evolution between knowledge management and business model transformation, implying uncharted territories of knowledge management based on interaction with business model designs in e-business ecosystems. [ABSTRACT FROM AUTHOR]

Background: Serum lipid concentrations are affected by long-term high-fat diets; thus, we hypothesize that lipid levels increase after the Spring Festival in China.Method: In total, 20,192 individuals (male: n=10,108, female: n=10,084) were enrolled in this retrospective cross-sectional study based on clinical data from the Laboratory Information System (LIS) and Hospital Information System (HIS) in Peking Union Medical College Hospital from 2014 to 2018. Total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were analyzed.Results: The serum TC [male vs. female: (4.71 ± 0.90 vs. 4.56 ± 0.85) mmol/L], TG [male vs. female: (1.71 ± 1.56 vs. 1.02 ± 0.68) mmol/L], and LDL-C [male vs. female: (3.01 ± 0.77 vs. 2.73 ± 0.74) mmol/L] levels were significantly higher in males than in females (P < 0.001); serum HDL-C [male vs. female: (1.18 ± 0.28 vs. 1.50 ± 0.34) mmol/L] was significantly lower in males (P < 0.001). In February, the TC, TG, and LDL-C levels were 8.4%, 16.3%, and 9.3% higher than the lowest levels recorded, respectively. The prevalence of dyslipidemia of the two weeks before the Spring festival was significantly lower than that of the first week after the Spring festival (43.6% (168/385) vs. 54.1% (126/233), P=0.007). Additionally, the prevalence of dyslipidemia was statistically higher in the first week after the Spring Festival than in May-January.Conclusion: Higher TC, TG, and LDL-C in winter could be associated with high-fat diets during the Spring Festival. The Spring Festival was immediately followed by a higher lipid concentrations. Thus, we don't recommend lipid assessment or physical examination immediately after the holiday especially Spring festival. [ABSTRACT FROM AUTHOR]

aim of the current study was to explore the spatial and temporal distribution characteristics of registered cases of cataract surgery in China from 2013 to 2017. Methods: A database for spatial analysis of cataract surgery in China in 2013– 2017 was established using ArcGIS10.0 software as a platform for data management and presentation. Spatial autocorrelation analysis of cataract surgery was undertaken, and temporal and spatial scan analysis was done using SaTScan 9.5 software. Results: From 2013 to 2017, annual cataract surgery rates (CSRs) in China were 1200, 1400, 1782, 2070, and 2205 per 1 million population, indicating a gradually increasing trend. Local Moran's I autocorrelation analysis showed that there was spatial clustering of CSR in China, with Anhui being a low-high clustering region. Findings of global hotspot analysis Getis-Ord General G showed that General G index of national CSR was < 0.01, Z = 1.12, P = 0.26. Findings of staged spatial-temporal scan analysis indicated that 18 areas of aggregation were found in 2 stages. Observed differences in each clustering area were statistically significant (P < 0.05). Conclusion: CSRs in China showed increasing trend year by year and were randomly distributed, with spatial clustering, and Anhui was reported as a low-high clustering region. However, high-risk areas still persist, requiring focused attention and targeted prevention and control measures. [ABSTRACT FROM AUTHOR]

As one of the largest markets of electronic and electric equipment, China has not completely established the formal recycling system of WEEE compared with the developed countries. As a result, China is facing the huge challenge of resource waste and water/soil environmental pollution. In this paper, according to the current regulations on WEEE recycling and disposal issued by Chinese government, the business model of the Chinese WEEE recycling system was designed, and a bilevel programming-based model was proposed to help the disposal factories to establish the regional efficient and economical WEEE recycling network. This model addressed the optimization of bilateral benefits of disposal factories and the third-party recycling agencies/stations. An experiment based on a regional WEEE recycling business data was solved by the NSGA algorithm to validate the proposed model. With the result, the proposed model was compared with the related studies on Chinese WEEE recycling network planning. With the comparison and the analysis on the experiment result, it was found that the proposed model had considerably stable convergence and optimization performance, which proved that this model can be regarded as a useful tool to the planning of the Chinese regional WEEE recycling network. In the last part, the future improvement of the proposed model was also discussed. [ABSTRACT FROM AUTHOR]

This study was to investigate the attitude of physicians and nurses to physician-nurse collaboration and the job satisfaction of the ICU staff in China. About the physician-nurse collaboration (Table1) On the physician-nurse collaboration issue, both physicians and nurses have demonstrated a positive attitude with nurses more positive. B Conclusions: b In China, more than one third of the ICU staff is not satisfied with their salary and not few nurses resigned from their job, however, both physicians and nurses have shown a positive attitude towards their collaboration. [Extracted from the article]

Very-long-chain fatty acids (VLCFAs), including hexacosanoic, tetracosanoic, and docosanoic acids, are peroxisomal disease markers, whose abnormal accumulation warrants prompt detection for timely, effective treatment. This study aimed to establish and validate a robust liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based method to simultaneously quantify VLCFAs and provide reference intervals among Chinese individuals, quantify VLCFAs in pregnancy, and explore potential associations between plasma and amniotic fluid. Analytes were extracted via water-bath incubation with HCl and liquid-liquid extraction. Method linearity, limit of detection/quantitation, precision, carryover, and recovery were evaluated according to Clinical and Laboratory Standard Institute (CLSI) guidelines. VLCFAs showed good reproducibility based on low within-run coefficient variations (CVs) and total CVs, and correlation coefficients of linearity were > 0.99. The reference interval of C22:0, C24:0, and C26:0 were 32.0–73.4 μmol/L, 30.3–72.0 μmol/L, and 0.20–0.71 μmol/L, respectively; C24:0/C22:0 and C26:0/C22:0 ratios were 0.75–1.28 and 0.005–0.0139, respectively. Plasma and amniotic fluid of the same pregnant women displayed no significant correlation in the second trimester. This study presents the simple, efficient, accurate, and robust LC-MS/MS method to simultaneously detect C22:0, C24:0, and C26:0 without derivatization; it can be used to establish reference intervals among Chinese individuals and has diagnostic and other clinical applications. • LC-MS/MS to detect very-long-chain fatty acids (VLCFAs) was successful in China. • Reference intervals of VLCFAs were established for the Chinese population. • VLCFAs were compared between plasma and amniotic fluid in late pregnancy. • Simultaneous VLCFAs detection can improve the diagnosis of peroxisomal disorders. [ABSTRACT FROM AUTHOR]

Objectives: Diagnosis of thyroid disease among individuals dwelling at high altitude remains a challenge. Reference intervals (RIs) for thyroid-associated hormones among Tibetans living at various high altitudes were established to improve diagnosis., Methods: One thousand two hundred eighty-one subjects were randomly recruited from Nyingchi, Shigatse/Lhasa, and Ali of Tibet. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were measured by the Cobas e601 electrochemiluminescence analyzer. We used multiple linear regression and variance component analysis to assess the effect of sex, age, and altitude on hormones. RIs were established by refineR algorithm and compared with those provided by the manufacturer., Results: Serum TSH was significantly lower in males than in females, while FT3 and FT4 were higher in males. Both FT3 and FT4 decreased with increasing age. FT3 increased with altitude, while TSH and FT4 were less influenced by altitude. The RI for TSH was 0.764-5.784 μIU/ml, while for FT4, the RIs were 12.36-19.38 pmol/L in females and 14.84-20.18 pmol/L in males. The RIs for FT3 at Nyingchi, Shigatse/Lhasa, and Ali in females were 4.09-4.98, 4.31-5.45, and 4.82-5.58 pmol/L, while in males, the values were 4.82-5.41, 4.88-5.95, and 5.26-6.06 pmol/L, respectively. The obtained RIs for TSH and FT4 were generally higher, while that for FT3 was narrower than the RIs provided by Cobas., Conclusions: Specific RIs were established for thyroid-associated hormones among Tibetans, which were significantly different from those provided by the manufacturer., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ma, Zhong, Zou, Liu, Li, Pang, Liu, Zejipuchi, Tian, Hou, Wang, Cheng and Qiu.)

Aim: To measure and evaluate the distribution and possible contributing factors of seven bone metabolism-associated biomarkers in Tibet, a plateau province of China., Methods: A total of 1615 individuals were recruited from Tibet at three different altitudes. The levels and possible contributing factors of serum calcium, serum phosphorus, ALP, 25OHD, PINP, CTX, and PTH were evaluated., Results: In total, 1246 Tibetan adults (males: n = 543) were eventually enrolled in this study. Multiple linear regression recognized age, sex, altitude, and BMI as the major effect factors. The levels of ALP, PINP, and CTX in males continuously decreased with age; however, those in females increased after approximately 39 years of age. Males had higher 25OHD levels (23.9 vs. 15.4 ng/ml) but lower levels of serum phosphorus (1.12 vs. 1.19 mmol/L) and PTH (41.3 vs. 47.4 pg/ml) than females. Before the age of 50, males had higher levels of calcium, ALP, PINP, and CTX than females, and the opposite trend was observed after the age of 50. The highest levels of serum calcium and phosphorus and the lowest levels of PINP and CTX were found in the Shigatse/Lhasa region, suggesting a better bone metabolism status. Compared with reports from plain areas of China, significantly higher levels of PINP (65.3 vs. 49.36 ng/ml) and CTX (0.46 vs. 0.37 ng/ml) were recorded in Tibetan adults., Conclusion: A more active bone turnover status was found in Tibetan adults than in individuals from the plain areas of China., (© 2021 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

Objectives: Iodine is a critical trace element for the synthesis of thyroid-related hormones, and either low or high iodine status can lead to thyroid dysfunction. This study aimed to evaluate the iodine status of the Tibetan population., Methods: From September 2016 to August 2018, we enrolled 1499 healthy adults from three areas of varying altitudes in Tibet. Urine iodine concentrations (UICs), adjusted UICs, and serum iodine concentrations (SICs) were measured using inductively coupled plasma mass spectrometry., Results: The median UIC, adjusted UIC, and SIC was 137.9 μg/L, 118.4 µg/gCr, and 58.3 μg/L, respectively. Of the participants, 30.4% had UICs <100 µg/L, 63.0% had UICs ranging from 100 to 300 µg/L, and 9.6% had UICs >300 µg/L. The correlation between UIC, adjusted UIC, and SIC was good (r > 0.65, P < 0.01). The SICs were more stable than the UICs, and were not associated with age or sex. The prevalence of clinical hyperthyroidism, clinical hypothyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, positive thyroid peroxide antibody, positive thyroglobulin antibody, either positive and both positive was 0.5%, 1.3%, 1.7% and 17.9%, 9.3%, 6.5%, 12.5%, and 2.5%, respectively. The prevalence of almost all thyroid disorders was higher in women than in men., Conclusion: This multicenter cross-sectional study found that the human iodine status of adults in Tibet was considered adequate, based on the World Health Organization's criteria., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Thyroid diseases are highly prevalent worldwide, but their diagnosis remains a challenge. We established reference intervals (RIs) for thyroid-associated hormones and evaluated the prevalence of thyroid diseases in China., Methods: After excluding outliers based on the results of ultrasound screening, thyroid antibody tests, and the Tukey method, the medical records of 20,303 euthyroid adults, who visited the Department of Health Care at Peking Union Medical College Hospital from January 2014 to December 2018, were analyzed. Thyroid-associated hormones were measured by the Siemens Advia Centaur XP analyzer. The RIs for thyroid-associated hormones were calculated according to the CLSI C28-A3 guidelines, and were compared with the RIs provided by Siemens. The prevalence of thyroid diseases over the five years was evaluated and compared using the chi-square test., Results: The RIs for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were 0.71-4.92 mIU/L, 12.2-20.1 pmol/L, 3.9-6.0 pmol/L, 65.6-135.1 nmol/L, and 1.2-2.2 nmol/L, respectively. The RIs of all hormones except TT4 differed significantly between males and females. The RIs of TSH increased with increasing age. The prevalence of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was 0.5% and 0.8%, 0.2% and 0.6%, 3.8% and 6.1%, and 3.3% and 4.7% in males and females, respectively, which differed from those provided by Siemens., Conclusions: Sex-specific RIs were established for thyroid-associated hormones, and the prevalence of thyroid diseases was determined in the Chinese population.

Background: The ALDH2 rs671 genetic polymorphism has been linked with cardiovascular diseases (CVDs), but comprehensive epidemiological studies are lacking. An observational, retrospective big data study was carried out to evaluate the associations between this polymorphism and clustering cardiovascular risk factors (CRFs) in a Chinese population., Methods: A total of 13,101 individuals (8431 males and 4670 females) were enrolled. Genetic polymorphism was assessed using gene mutation detection kits, coupled with an automatic fluorescent analyzer. Other data were obtained from the records of the Department of Health Care at Peking Union Medical College Hospital., Results: Comparing the concentrations of common biochemical analytes, including BMI, SBP, DBP, ALT, AST, γ-GT, TBil, Cr, Glu, TC, TG, and HDL-C among individuals with the GG, GA, and AA genotypes of ALDH2 rs671, we found significant differences in males (all p < 0.001), but not in females. For males, the frequencies of hypertension, diabetes, and obesity were significantly higher for GG than for GA or AA (all p < 0.05). However, there was no significant difference for dyslipidemia, and no significant associations were observed for all frequencies in females. The prevalence of individuals with 1-4 CRFs was significantly higher among GG males than those carrying GA or AA, and fewer GG males had non-CRFs (all p < 0.05)., Conclusion: Polymorphisms of ALDH2 rs671 are associated with clustering CRFs, especially hypertension and diabetes in males, but not in females. These associations are likely mediated by alcohol intake, which is also associated with this gene.

Objectives: Drug-laboratory test interactions (DLTIs) are one of the major sources of laboratory errors. Calcium dobesilate (CaD) interference on serum creatinine testing is a widespread problem that has long been ignored in China. A national EQA-based survey was launched to investigate the current status of CaD interference on creatinine routine methods used in China and enhance the education of CaD interference in clinical laboratories., Methods: A descriptive survey was developed to characterize the status quo of Chinese laboratory professionals' cognition to CaD interference. Four of survey samples which were spiked with/without interference additive were shipped to 175 participant laboratories. The target reference values from a reference measurement procedure were compared against the results from participating laboratories to evaluate the CaD interference on serum creatinine measurements using enzymatic method or Jaffé method., Results: The lack of knowledge of DLTIs and the barriers to collect information from pharmacological and laboratory data systems had become the main problems on implementing DLTIs education in China. A significant negative influence of CaD on enzymatic method was observed regardless of measurement platforms. Jaffé method was generally free from interaction with CaD but showed poor precision and accuracy at low creatinine concentrations., Conclusions: More efforts should be made to enhance the education of DLTIs in clinical laboratories in China.

Context: Urinary iodine (UI) is commonly used for evaluating iodine status, whereas serum iodine (SI) is more closely correlated with bioavailable iodine. However, no reliable reference intervals (RIs) for clinical use are available. We aimed to establish RIs for SI, UI, and a ratio of UI to urinary creatinine (U-Cre) applicable to the Chinese population., Methods: This multicenter cross-sectional study enrolled 930 apparently healthy adults from six representative cities in China (Beijing, Dongying, Guiyang, Urumqi, Shenzhen, and Qiqihar) in 2017. Thyroid ultrasonography and thyroid function tests, including antithyroid antibody tests, were performed to exclude individuals with latent thyroid diseases. An iodine intake-related questionnaire survey was performed. SI and UI were measured using inductively coupled plasma-mass spectrometry. Possible influencing factors of iodine levels were evaluated using multiple regression analysis., Results: Post-exclusion, the final analysis included 894 individuals. Seafood intake frequency was positively correlated with SI (standardized partial regression coefficient = 0.23) but not with UI and UI/U-Cre. SI was positively correlated with serum TT4 (Spearman correlation coefficient: 0.40), TT3 (0.23), and FT4 (0.18). SI and UI showed no age- or sex-specific variations. Significantly higher UI/U-Cre values were observed in Qiqihar than in Beijing, Guizhou, and Shenzhen. Shenzhen showed the lowest UI levels among all evaluated cities. With application of latent abnormal values exclusion procedurere, the RIs for SI, UI, and UI/U-Cre in the population were 36.0-79.3 μg/L, 19-385 μg/L, 22-450 μg/g, respectively., Conclusions: We established RIs for UI and SI among healthy Chinese individuals with no thyroid nodule or dysfunction., Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest in relation to this study., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: This nationwide study aimed to establish Chinese specific reference intervals (RIs) for thyroid related tests: thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), total triiodothyronine (TT3), anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin antibodies (TG-Ab)., Method: Apparently healthy individuals (n = 2380) were recruited from Beijing, Guizhou, Urumqi, Dongying, Shenzhen, and Qiqihar in China. All the tests were measured by immunoassay testing. Ultrasonography was performed to exclude thyroid nodules. Multiple regression analysis was performed to identify sources of variation (SVs). Standard deviation ratio (SDR) was calculated by ANOVA for judging the need to partition RI by any given SV. RIs were computed by the parametric method., Results: TPO-Ab and TG-Ab cutoffs were determined as 5 mIU/L and 2 IU/L, respectively using probability plot analysis and extrapolation of the central linear segment. Individuals with thyroid nodule and/or autoantibodies showed altered levels of thyroid hormones, and were thus excluded (n reduced to 1828). Gender difference was observed for FT3 and TT3 with females having lower levels than males. A significant relationship between age and FT3 was observed in males by Spearman correlation analysis (r = -0.231, p < .05). Although the SDR for gender difference in TSH levels was low, the difference in the upper limits of the RI was beyond allowable bias, and thus RIs (mIU/L) were partitioned by sex: females 0.72-5.50, males 0.70-4.59., Conclusion: By this nationwide study, RIs for thyroid hormones and cutoff values for anti-thyroid autoantibodies were established as matched to the Chinese population., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background Thyroid hormone levels are essential for diagnosing and monitoring thyroid diseases. However, their reference intervals (RIs) in elderly Chinese individuals remain unclear. We aimed to identify factors affecting thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels using clinical "big data" to establish hormone level RIs for elderly Chinese individuals. Methods We examined 6781, 6772, and 6524 subjects aged ≥65 years who underwent FT3, FT4, and TSH tests, respectively, at the Peking Union Medical College Hospital between September 1, 2013, and August 31, 2016. Hormones were measured using an automated immunoassay analyzer (ADVIA Centaur XP). RIs were established using the Clinical Laboratory Standards Institute document C28-A3 guidelines. Results The median TSH was significantly higher in women than in men; the opposite was true for median FT3 and FT4 levels. No differences were observed in TSH or FT4 by age in either sex or overall; FT3 levels significantly decreased with age. Seasonal differences were observed in TSH and FT3 levels but not FT4 levels; the median TSH was the highest in winter and lowest in summer, whereas the median FT3 was the lowest in summer (albeit not significantly). RIs for TSH were 0.53-5.24 and 0.335-5.73 mIU/L for men and women, respectively; those for FT3 were 3.76-5.71, 3.60-5.42, and 3.36-5.27 pmol/L in 64- to 74-, 75- to 84-, and 85- to 96-year-old subjects, respectively. The RI for FT4 was 11.70-20.28 pmol/L. Conclusions RIs for TSH in elderly individuals were sex specific, whereas those for FT3 were age specific.

Background: Lp-PLA2 is a novel inflammation marker in cardiovascular disease. While several manufactures have registered Lp-PLA2 activity reagents, few studies have investigated the consistency among these assays. In this study, we compared and recalibrated Lp-PLA2 activity assays., Methods: Serum samples from 110 patients and 140 healthy individuals were collected for method comparison and reference interval validation, respectively. Fresh human serum pools (847 and 442 U/L) were used for recalibration. Lp-PLA2 activity was analyzed using all five assays with a Beckman AU 5800 analyzer. Passing-Bablok regression equations and Bland-Altman plots were used to estimate the relationship and bias among the results. A 2.5% confidence interval (CI) and 97.5% CI were used to establish a laboratory reference interval., Results: Assay imprecision varied from 0.8%-2.9%, while the overall coincidence rates ranged from 75.5%-98.2%. Passing-Bablok regression shows excellent linear correlation between Evermed and Diasys (R 2  = 0.999), while that between Diazyme and Evermed was poor (R 2  = 0.846). The R 2 and correlation coefficient r among assays were 0.846-0.999 and 0.8947-0.9993, respectively. The mean bias percentages ranged from -71.5%-1.6% and -2.0%-11.6% before and after recalibration. As Diazyme and Diasys were not comparable, the Diazyme assay was not recalibrated. The reference intervals determined for Diasys, Evermed, Hengxiao, and Zybio were 184-605, 208-704, 81-328, and 273-696 U/L, respectively., Conclusions: Our results indicate that recalibration increased assay agreement and also highlight the need for each laboratory to establish its own reference interval for Lp-PLA2 activity., (© 2018 Wiley Periodicals, Inc.)