Objective To investigate the test analysis of tumor marker CA19‐9 ,CEA ,CA242 ,CA125 and AFP for jointly assess‐ing the chemotherapeutic effect of gastric cancer .Methods Totally 160 patients with gastric cancer in our hospital from January 2010 to December 2013 were selected as the research subjects .The expressions of related tumor markers were detected before treat‐ment and at 3 months after treatment .The relationship between the TNM staging and the tumor markers ,changes of tumor markers before and after treatment ,and changes of tumor markers in the patients with recurrence and metastasis ,and patients without recur‐rence and metastasis were analyzed .Results Different TNM staging had significant correlation with tumor markers associated posi‐tive expression rate .The positive expression rate of related tumor markers in the patients with stage Ⅲ and stage Ⅳ were signifi‐cantly higher than that in the patients with stage Ⅰ - Ⅱ .The positive expression rates of CA19‐9 ,CA242 ,CA125 and AFP after chemotherapy were significantly decreased compared with before treatment (P<0 .05) ,while the CEA level had no statistically sig‐nificant difference before and after treatment (P>0 .05) .After treatment ,the CEA ,CA19‐9 ,CA242 ,CA125 and AFP positive ex‐pression rates were declined ,moreover showing statistical differences compared with pre‐treatment (P<0 .05) .The CEA ,CA19‐9 , CA242 ,CA124 and AFP levels in the patients with recurrence and metastasis were significantly higher than those in the patients without recurrence and metastasis (P<0 .05) .Conclusion CA19‐9 ,CEA ,CA242 ,CA125 and AFP have a significant correlation with tumor TNM staging ,their expression level and positive expression rates have certain correlation with the prognosis in the pa‐tients with gastric cancer ,which is worthy of focus in clinic .

Objective: To investigate the inlfuence of different blood pressure (BP) circadian rhythm on cardiac function in hypertensive patients.
Methods: A total of 180 hypertensive patients with well controlled day-time blood pressure were divided into 3 groups. Dipper group, n=30, Non-dipper group, n=99 and Reverse dipper group, n=51. The relationship between cardiac function, relevant clinical index and blood pressure circadian rhythm were analyzed.
Results: The mean systolic and diastolic BP, BP classiifcation and the antihypertensive medication were similar among 3 groups.①The ratio of peak mitral E wave to peak mitral annulus E' wave (E/E') increased accordingly from Dipper group, Non-dipper group and Reverse-dipper group as (8.1 ± 2.4), (8.6 ± 2.5) and (9.6 ± 3.2), P<0.05. ②Left atrial volume index (LAVi) in Reverse-dipper and Non-dipper groups were higher than that in Dipper group as (43.8 ± 11.8) ml/m2, (40.7 ± 9.8) ml/m2 and (36.6 ± 8.5) ml/m2, P<0.05 or P<0.01. ③E/E' was positively related to nocturnal systolic BP and age, negatively related to nocturnal BP decline rate (nocturnal BPR); E/E' was independently related to age and BPR. LAVi was positively related to nocturnal systolic BP, pulse pressure, age and hypertension course, negatively related to the mean diastolic BP, day-time diastolic BP and BPR; LAVi was independently related to BPR, pulse pressure and hypertension course. Left ventricular ejection fraction had no statistic differences among 3 groups.
Conclusion: Abnormal blood pressure circadian rhythm was associated with the cardiac injury in hypertensive patients. The cardiac injury increased accordingly from Non-dipper group to Reverse-dipper group and the main damage was in diastolic function.

Objective To study the diagnostic value of single detection and combined detection of serum NSE ,CYFRA21‐1 , CA50 ,SCC and CEA in the patients with esophageal squamous cell carcinoma .Methods The single detection and combined detec‐tion of serum NSE ,CYFRA21‐1 ,CA50 ,SCC and CEA levels were measured in 110 cases of esophageal squamous cell carcinoma and 101 health controls in our hospital from October 2013 to October 2015 .The detection results were statistically analyzed . Results The positive rate and expression levels of serum NSE ,CYFRA21‐1 ,CA50 ,SCC and CEA in the esophageal squamous cell carcinoma group were higher than those in the health control group with statistical significance(P<0 .05) .The sensitivity and diag‐nostic efficiency of combined detection of NSE ,CYFRA21‐1 ,CA50 ,SCC and CEA for diagnosing esophageal squamous cell carcino‐ma were 93 .64% and 86 .73% respectively .Conclusion The 5 tumor markers combined detection of serum NSE ,CYFRA21‐1 , CA50 ,SCC and CEA can improve the sensitivity and diagnostic efficiency for diagnosing esophageal squamous cell carcinoma .

Objective: To investigate the effects of Chinese herbal drug-containing serum, prepared by administration of Chinese herbal medicine for activating blood (Xiongshao Capsule, XS) or for activating blood and detoxifying (Xiongshao Capsule plus Huanglian Capsule, XSHL) in rats, on cell viability, oxidative damage and apoptosis of human umbilical vein endothelial cells (HUVECs) induced by oxidized low-density lipoprotein (ox-LDL). Methods: Thirty-two rats were randomly divided into 4 groups: control group, positive control group (simvastatin 1.8 mg/kg), activating blood (XS, 0.135 g/kg) group, and activating blood and detoxifying (XS Capsule 0.135 g/kg and Huanglian Capsule 0.135 g/kg, XSHL) group. Corresponding drugs were continuously administered to the rats for 7 days and then drug-containing serum was harvested 1 hour after the last administration. HUVECs isolated from newborn children by collagenase digestion were stimulated by ox-LDL (100 μg/L) and incubated with corresponding drug-containing serum for 24 hours. Untreated HUVECs were also used as a normal control. The morphology and structure of HUVECs were observed by an inverted microscope. Cell viability was measured by methyl thiazolyl tetrazolium method, and cell membrane damage was determined by lactate dehydrogenase (LDH) leakage. Activity of superoxide dismutase (SOD) was examined by spectrophotometry, and content of malondialdehyde (MDA) in the cell lysate was examined by thiobarbituric acid assay. HUVECs were stained with Annexin V-fluorescein isothiocyanate and propidium iodide and analyzed on a flow cytometry to determine apoptosis. Results: Compared with the normal HUVECs, the cell viability and the activity of SOD were significantly decreased while the content of MDA and apoptosis rate were significantly increased after 24-hour ox-LDL stimulation (P<0.01, P<0.05). Simvastatin-, XS-, and XSHL-containing serum significantly promoted the ox-LDL-stimulated HUVEC viability and inhibited early apoptosis (P<0.01, P<0.05), while had no significant effect on LDH leakage. Simvastatin-containing serum and XS-containing serum also showed significant decrease in MDA content and increase in SOD activity, while XSHL-containing serum showed no significant effects. There was no significant difference between the XS-containing serum group and the XSHL-containing serum group. Conclusion: Both sera containing XSHL and XS show protective action against the oxidative damage and apoptosis of HUVECs induced by ox-LDL.

BACKGROUND:As a member of bone morphogenetic proteins,growth differentiation factor-5 shows promising potential in the application of cartilage and bone repair.The affinity of growth differentiation factor-5 onto bone tissue determines protein use efficiency,so it is of great significance to prepare growth differentiation factor-5 with bone targeting capability. OBJECTIVE:To modify growth differentiation factor-5 using bisphosphonates and investigate the effects of modified protein on the growth of preosteoblasts in mice. METHODS:Pamidronate disodium/growth differentiation factor-5 complex was prepared using chemical crosslinking to couple growth differentiation factor-5 with pamidronate disodium.The functional groups and structures of the complex were characterized using Fourier transform infrared spectroscopy and circular dichromatography.To determine the bone targeting in vitro,the binding of the modified growth differentiation factor-5 with calcium phosphate and in vitro release amount of growth differentiation factor-5 were measured with an ELISA kit.Growth differentiation factor-5(control group)and the pamidronate disodium/growth differentiation factor-5 complex(experimental group)were co-cultured with preosteoblasts MC3T3-E1.Individually cultured cells were blank controls.The effect of the complex on cell proliferation and differentiation was evaluated. RESULTS AND CONCLUSION:(1)The infrared spectroscopy and circular dichromatography results indicated that the bisphosphonate/growth differentiation factor-5 complex was successfully prepared without significant changes in the protein secondary structure.In vitro protein adsorption results showed that growth differentiation factor-5 adsorption on calcium phosphate was increased by about one time after coupling with a bisphosphonate.In the presence of cysteine,growth differentiation factor-5 could be released from the bisphosphonate/growth differentiation factor-5 complex.(2)CCK-8 assay results showed that the absorbance value of the experimental group cultured for 4 and 7 days was higher than that of the control group and blank control group(P<0.000 1).After 7 days of culture,the expression of alkaline phosphatase in the experimental group was significantly higher than that in the control group and blank control group(P<0.000 1).After 13 days of culture,the content of calcium nodules in the experimental group was significantly higher than that in the control group and the blank control group(P<0.000 1).The results of qRT-PCR showed that the mRNA expression of alkaline phosphatase,osteocalcin and Runx2 in the experimental group was higher than that in the control group and the blank control group after 7 days of culture(P<0.01,P<0.001,P<0.000 1).(3)These findings exhibit that bisphosphonate modification can enhance the binding capacity of growth differentiation factor-5 to calcium phosphate as well as improve its biological activity.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.