Objective To investigate the expression of vascular endothial growth faetor(VEGF) proliferating cell nudear antigen(PCNA) and their biological significance was studied in papillary thyroid carcinoma and normal thyroid tissues. Methods Immuohistochemismy S-P technique was used to examine the expression of VEGF and PCNA in specimens of 58 papillary thyroid carcinoma and 19 normal thyroid tissues. Results The positive rates of VEGF and PCNA in papillary thyroid were higher than those in normal thyroid tissues( P＜0.01 ), and a positive correlation between these two expressions existed in papillary thyroid carcinoma. Conclusion VEGF and PCNA could be regarded as parameters to evaluate the biological behavior and they might be the indices for juvant diagnosis and evaluation of papillary thyroid cancer.

Proteio degradation via ubiquitin-proteasome system(UPS) is carried out with a wide variety of signallingpathways,from cell cycle and transcription to development.The mass spectrometry-based proteomics techniques are powerful tools in the research of UPS.The recent advance in the study of UPS by proteomics techniques is briefly reviewed.

The good cooperation between the operating room nurses and anesthesiologists is benefitial to improving working efficiency and can make the patients uneventful during operating period.As an anesthesiologist,the author taught the basic anesthesia knowledge such as the commonly used anesthesia methods,the prevention and treatment of complications and gave advice to the nurses of the nursing trainning group.The cooperations before anesthesia,during anesthesia,after anesthesia were analyzed and the significance of nursing cooperation with anesthesiologist was discussed.

Objective To explore the changes in fractional anisotropy (FA) among cerebral infarction pa-tients using MR diffusion tensor imaging (DTI), and to verify the relationship between any FA changes and functional recovery. Methods Thirty-eight cerebral infarction patients were divided into two groups according to their recovery level using Brunnstrom's criteria. All the patients accepted routine MR and DTI examination, and FA values were measured during the acute, subacute and chronic stages of their recovery. Results Average FA values in the lesion area were significantly lower than in the corresponding contralateral area, and were highest daring the acute stage.There was no significant difference between the subacute and chronic stages. Conclusions The FA values of cere-bral infarction patients change during the different stages of recovery with a certain regularity. This may be valuable for clinical treatment and prognosis.

Objective To evaluate five detection methods for the laboratory diagnosis of Clostridium difficile infection in the hospitals of USA, and explore a sensitive, specific, accuracy and rapid regimen for the early diagnosis of Clostridium difficile infection. Methods A total of 174 stool specimens submitted to the clinical microbiology laboratory for Clostridium difficile testing were separately tested by five methods including toxigenic culture (TGC), Premier Toxin A&B EIA( A/B-EIA), C. Diff Quick Chek Complete( DEIA), BD G eneOhm Cdiff assay(BD-PCR) and Laboratory-developed PCR(LD-PCR). The gold standard of TGC was used as a reference criterion, and the sensitivity, specificity, positive predictive value ( PPV )and negative predictive value (NPV) of A/B-EIA, D-EIA, BD-PCR and LD-PCR assays were determined. Results Among the 174 specimens studied, 24 were defined as true positives for Clostridium difficile infection by TGC assay, giving a positive rate of 13.8% (24/174). In comparison to the standard,the sensitivity, specificity, PPV and NPV were 62.5%, 99.3%, 93.8% and 94.3% for A/B-EIA;66.7%, 98.7%, 88.9% and 94.9% for D-EIA; 83.3%, 98.7%, 90.9% and 97.4% for BD-PCR;79.2%, 93.3%, 65.5% and 96.6% for LD-PCR. Among all tested specimens, 34 were positive by atleast one of five methods, and of which 15 were concordant by all five methods. The D-EIA results were divided into three groups depending on results of GDH and (or) toxins A/B: 18 were positive for both GDH and toxins A/B, 23 were positive for only GDH, and 133 were negative for both GDH and toxins A/B. Of 18 positive specimens by D-EIA assay, all were concordant with results of BD-PCR assay and 16 were agreement with results of TGC assay. Twenty-two of 24 positive specimens by TGC assay were included in 41 specimens that were positive for GDH. Among eight false negative specimens by D-EIA assay, four were differentiated as positive results by BD-PCR. According to the present study, the sensitivity, specificity,PPV and NPV of a two-step detection algorithm in combination with D-EIA and BD-PCR assays were 83.3%, 98.7%, 90.9% and 97.4%, respectively. Conclusions From the point of technological evaluation, BD-PCR is preferable. A two-step detection algorithm combining D-EIA with BD-PCR is proposed for the laboratory diagnosis of Clostridium difficile infection. This algorithm has demonstrated an excellent sensitivity and specificity, as well as decreased test turnaround time and test cost.

Objective To assess the therapeutic effect of esomerphrazole in treating patients with gastroesophageal reflux disease (GRED) between Han and Inner Mongolia populations.Methods Those who underwent endoscopic examination and had reflux disease questionnaire (RDQ) >12 from March 2006 to March 2008 were selected. The patients were divided into Han group and Inner Mongolia group with 120 each. All patients were received esomerphrazole 20 mg daily for 6 weeks. The patients were evaluated by RDQ questionnaire at 2nd, 4th and 6th week, and were reexamined by gastroscopy at 6th week. Results After two weeks, effective rate of 50% was achieved in both groups, but it was higher in Han group than in Inner Mongolia group at 4th and 6th week. After 6 weeks, the curative rate of RE was higher in Han group than in Inner Mongolia group. Conclusion The different nations ancl habits result in the different efficacy of esomerphrazole, which may be improved by prolonging time of medication and changing habits.

Diabetes mellitus is a typical metabolic disease.Its complications cause the main damage and lead to high mortality and disability eventually.The exact mechanism of diabetes is still unknown at present,and no radical cure of it is available.Therefore,the prevention of diabetes has become a priority.Metabolomics as a new technology can identify and measure the entire metabolic changes in the organism,and therefore has been widely applied to diabetes related studies with its enormous potential.

Objective:To explore the clinical appearance,diagnosis method and curative efficacy of one patient with esophageal teratoma complicated with rupture of esophagus in order to raise the awareness of the clinicians for the disease. Methods:The patient with chest pain after eating was admitted to hospital,and upper gastrointestinal radiography,chest CT and endoscopy were taken,which showed rupture of esophagus.Then an emergency thoracic exploration was performed.A too long cleft and much necrosis were identified,so the repair of esophagus was changed into excision and anastomosis. Results: The operation was successful,and the pathological findings showed the rupture of esophageal teratoma.Follow-up showed no complication till now.Conclusion:Esophageal teratoma complicated with esophageal rupture is rare.Clinicians should improve the understanding and reduce the misdiagnosis rate.

A method was developed for purification of 20S proteasome (20S core particle, CP) by combining differential centrifugations with nondenaturing polyacrylamide gel electrophoresis (native-PAGE), irrespective of species origins of CPs. CP purified from human erythrocytes was subjected to proteomic analysis by two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS), revealing 33 spots of subunit isoforms with different molecular weights and isoelectric points, more than 14 constituent subunits. Furthermore, other four CPs were purified from yeast, mouse liver, two pancreatic cancer cell lines SW1990 and PANC-1 using this method mentioned above, and subjected to proteasome heterogeneity analysis by native/SDS-PAGE (native/sodium dodecyl sulphate polyacrylamide gel electrophoresis), together with CP from erythrocytes. The method described acts as a rapid and effective tool for CP isolations, and the results obtained may be served as a footstone for the investigations of species-dependent proteasome heterogeneity.

Objective To investigate the value of C-reactive protein (CRP),serum amyloid A (SAA) and CD64 in early diagnosis of sepsis in very low birth weight infants (VLBWI).Methods Fifty-four VLBWI suspected to sepsis and 20 VLBWI without infection in neonatal intensive care unit of the Second Hospital of Wenzhou Medical College from May 2010 to May 2012 were enrolled in this study.CRP,SAA and CD64 of sepsis group were measured at 0 and 24 hour after suspected bacterial infection; and those of control group were measured at corresponding age.CRP and SAA were detected by enzyme-linked immunosorbent assay,and CD64 was detected by flow cytometry.The difference between groups was compared by Mann-Whitney U test.Receiver operating characteristic curve was used to predict the sensitivity and specificity of the three biomarkers on sepsis.Results Fifty-four VLBWI were suspected with sepsis,and 37 patients were finally diagnosed.The levels of the three biomarkers in sepsis group were higher than those of control group not only at 0 h [CRP:13.3 mg/L(4.6-67.2 mg/L) vs 4.4 mg/L(1.6-11.2 mg/L),Z=-2.308; SAA:95.7 mg/L(4.5-265.9 mg/L) vs 7.3 mg/L(2.5-16.9 mg/L),Z=-2.425; CD64:7306 fluorescent antibody molecules/cell (2667-10 853 fluorescent antibody molecules/cell) vs 2502 fluorescent antibody molecules/cell (1839-3017 fluorescent antibody molecules/cell),Z=-3.704],but also at 24 h[CRP:35.4 mg/L (7.7 106.5 mg/L) vs 3.2 mg/L (1.1-7.8 mg/L),Z-5.501; SAA:359.3 mg/L (3.8-503.2 mg/L) vs 6.6 mg/L (3.0-12.7 mg/L),Z =-2.818; CD64:8304 fluorescent antibody molecules/cell (2819-11 758 fluorescent antibody molecules/cell) vs 2563 fluorescent antibody molecules/cell (1760-3154 fluorescent antibody molecules/cell),Z =-7.670],P＜0.05 respectively.The best cutoff value of CD64 was 2934 fluorescent antibody molecules/cell,with the sensitivity of 81.1％ at 0 h and 91.9％ at 24 h; and the specificity of 90.0％ at 0 h and 80.0％ at 24 h.Although SAA had similar sensitivity (0 h:83.8％; 24 h:86.5％) as CD64,its specificity was relatively low(0 h:65.0％; 24 h:55.0％).Both the sensitivity (0 h:62.2％; 24 h:70.3％) and specificity (0 h:70.0％; 24 h:70.0％) of CRP were low.Combination of the three infection biomarkers could increase the sensitivity (0 h:91.9％; 24 h:97.2％) and specificity (0 h:95.0 ％ ; 24 h:90.0％).Conclusions Combination of CRP,SAA and CD64 might improve the diagnostic accuracy of sepsis in VLBWI.