An improved microfluorimetric method for determination of serum vitamin A was presented. In this method, the excitation wavelength 345nm and emission maximum 480nm were selected, and cyclohexane as solvent for extraction of saponified vitamin A in the serum samples to be tested was used. The sensitivity was sufficient for measurement of vitamin A content in 20*l serum taken from normal fasting blood without elimination of interference. The recovery averaged 99.0% (93.0-105.5).When this method was applied to laboratory study or field work, practically, the results showed that the values of vitamin A obtained seemed to correlate with its nutritional status of experimental animals or subjects investigated. The procedure was simple, reproducible and easily acceptable, espicially in the field work.

35 rats were divided into 5 groups. Group 1-3 were fed rations containing 20, 12 and 6% caseien respectively, group 4 containing 12% mixed protein of soybean and gluten. The food of group 5 was the same as that of group 1 but the amount was only half of that of group 1. Every animal was given 8?g vitamin A by stomach tube daily for 3 weeks and then 25?g for 2 weeks. Afterward serum vitamin A values were determined in all animals, then 132?g vitamin A was administrated by stomach tube. After 3.5 hours, the vitamin A values in serum and liver were determind. The results showed that in group 3 and 5 serum vitamin A contents decreased and the liver values rose. It was suggested that the release of vitamin A from liver had been interfered by semistarvation or low protein intake. There is no difference between group 2 and 4.

Ninety rats were divided into 8 groups. Group 1-5 were fed vitamin A free ration and each group was divided into 2 subgroups at the beginning and 12, 23, 36, 43, days after the experiment respectively. Group 6-8 were fed the ration containing 66, 132, and 198?g vitamin A per 100g diet respectively fer 30 days, and each group was also divided into 2 subgroups. The results showed that RBPR% was better than the serum vitamin A content in evaluating vitamin A nutritional status. It was suggested that the vitamin A nutritional status could be graded as follows: deficient(abore 70%)) mar-ginal(60-70%),normal (20-60%), and sufficient (under 20%)by RBPR%.

Objective To discuss the clinical value of Protein induced by Vitamin K Antagonist-Ⅱ (PIVKA-Ⅱ) and alpha-Fetoproteins (AFP) in diagnosing hepatocellular carcinoma (HCC) and monitoring the treatment effects.Methods Patients were recruited by the Affiliated Hospital of Qingdao University,from August 2013 to March 2014.Serum levels of PIVKA-Ⅱ and AFP were measured by both chemiluminescence assay (CLIA) and electrochemiluminescence assay (ECLA) in patients with HCC (n =148),intrahepatic cholangiocellular carcinoma (n =37),gastric cancer and colorectal cancer (n =44),cirrhosis (n =63),chronic hepatitis B (n =38) and healthy subjects (n =57).To analyze the areas under the receiver operating characteristic curves (ROC-AUC) and to compare the sensitivity and specificity of single PIVKA-Ⅱ or AFP assay,and the combined detection.To analyze the correlation of PIVKA-Ⅱ and both tumor size and TNM staging,so do AFP,respectively.To compare the serum level changes of the two indicators in HCC patients before and after treatment.Results The serum levels of both PIVKA-Ⅱ and AFP in HCC group were higher than that in intrahepatic cholangiocellular carcinoma,gastric cancer and colorectal cancer,cirrhosis,chronic hepatitis B and healthy subjects groups (PIVKA-Ⅱ:U =866.50,424.00,958.00,292.00 and 448.00 ; AFP:U=713.00,440.50,1 182.00,614.00 and 399.00,P ＜0.001).The ROC-AUCs of the single PIVKA-Ⅱ or AFP assay and the combined detection in HCC group were not statistically different (P ＞ 0.05).The sensitivity of PIVKA-Ⅱ (87.16％) was higher than that of AFP (68.92％,x2 =4.73,P ＜ 0.05) in diagnosing HCC ; the sensitivity of the combined detection of PIVKA-Ⅱ and AFP(93.24％) was higher than that of PIVKA-Ⅱ itself (87.16％,adjusted x2 =64.70,P ＜ 0.01) ;while the specificities among them did not show statistical significance (P ＞ 0.05).Tested by Spearman rank correlation,the serum levels of PIVKA-Ⅱ and AFP were both positively related to tumor size (r =0.716,0.475 respectively,P ＜ 0.001).The serum levels of PIVKA-Ⅱ and AFP in HCC patients increased gradually correlated with tumor size (H =72.70,37.02 respectively,P ＜ 0.001) and the positive rates of PIVKA-Ⅱ and AFP were gradually improved (x2 =26.74,21.62 respectively,P ＜ 0.01),too.Based on the International TNM Staging System,the serum levels of PIVKA-Ⅱ and AFP (H =46.63,21.38 respectively,P ＜0.001) and the positive rates of PIVKA-Ⅱ and AFP (PIVKA-Ⅱ:x2 =20.40,P ＜0.01 ;AFP:x2 =8.33,P ＜0.05) in HCC patients from Ⅰ-Ⅳ stages were increased as TNM stages elevated.The serum levels of PIVKA-Ⅱ and AFP in HCC patients were both dropped sharply compared with preoperative levels (Z =-4.59,-4.22 respectively,P ＜ 0.001) and also both dropped in each of the Ⅰ-Ⅳ TNM stages (PIVKA-Ⅱ:Z =-2.85、-2.98、-2.70 respectively,P ＜ 0.05 ; AFP:Z =-2.48、-3.82、-2.50 respectively,P ＜ 0.05) compared with serum levels before treatment.Conclusion PIVKA-Ⅱ and AFP both have high clinical application values in diagnosing HCC and monitoring treatment effects.The sensitivity of PIVKA-Ⅱ in diagnosing HCC is significantly higher than AFP,and the sensitivity can be elevated by the combined detection in diagnosing HCC without reducing the specificity.

Objective    To discuss the diagnosis and treatment of culture-negative aortic infective endocarditis. Methods    The clinical data of 73 patients with infective endocarditis of the aortic valve whose results of bacteria culture were negative from January 2013 to January 2018 were retrospectively analyzed, including 59 males and 14 females aged 14-71 (39.2±14.8) years. Results    Sixty seven (91.8%) patients received aortic valve replacement, 2 (2.7%) patients received the second operation in hospital, and 12 (16.4%) patients had concomitant mitral valvuloplasty. In-hospital death occurred in 8 (11.0%) patients. Postoperatively, 11 (20.7%) patients had a low cardiac output and 4 (11.0%) patients had heart block, and 1 patient required implantation of a permanent pacemaker. The 1- and 5- year survival rates were 92.3%±2.3% and 84.5%±4.5%, respectively. Conclusion    There are difficulties in the diagnosis and treatment of culture-negative infective endocarditis. Most of the affected patients are in a healed status, which could be a cause of negative culture results. In-hospital mortality in the patients is associated with a history of previous cardiac surgery, whereas the long-term survival rate is good for the patients after surgery.