Objective To investigate the identification role of plasma high sensitive Creactive protein (hs-CRP) and lipoprotein (a) (Lp [a]) levels in the diagnosis of patients with acute ischemic stroke according to the TOAST classification. Methods The levels of plasma hsCRP and Lp (a) in 82 acute stroke patients ( ＜24 hours) and 60 healthy controls were detected using immune scatter turbidimetry and immune transmission turbidity, and try to make use of Holter, ultrasonography, magnetic resonance imaging, magnetic resonance angiography/CT angiography/dagital subtraction angiography and other tests. Finally, they were classified according to the diagnostic criteria of the TOAST classification of ischemic stroke. Results There were significant differences in plasma hs-CRP and Lp (a) levels between all the subtypes of the acute ischemic sroke group and the control group (all P ＜0. 001). The the level of plasma hsCRP in patients with cardioembolism (CE) was highest. Hs-CRP could be used as a biological marker of CE subtype (odds ratio[OR] = 1. 84,95% confidence interval [CI] 1. 18-2. 85, P ＜ 0. 05). When its concentration was ＞ 3. 48 mg/L, the sensitivity and specificity of predicting CE were 89% and 83% respectively. The plasma level of the AT patients was highest, it could be used as a biological marker of AT subtype (OR = 1. 02, 95% CI 1. 01-1. 03, P＜0. 05); when its concentration was ＞ 183. 5 mg/L, the sensitivity and specificity of predicting AT were 87% and 85% respectively. Conclusions The plasma hs-CRP and Lp (a) levels of patients with acute ischemic stroke may provide some help for timely and accurate etiological typing.

P-selectin is also known as CD62. It promotes the occurrence of ischemic cerebrovascular disease by mediating the activation of endothelial cells and platelets as well as the processes of the formation and development of atherogenesis. A number of studies have confirmed that P-selectin plays important roles in the occurrence and development of the risk factors (such as hypertension, diabetes, hypercholesterolemia, heart disease, smoking, alcohol abuse and hyperfibrinogenemia) for ischemic cerebrovascular disease. It remains to be confirmed by further studies whether P-selectin can be used as an independent risk factor for predicting the occurrence of ischemic cerebrovascular disease.

The aim of our study was to observe changes of biliary trace elements and hepatolienal ultrasonography in patients with HL D treated synthetically by metal-binding a- gents DMSA and DMPS.Using Aloka SSD2 5 6 ultrasonography and WFX-1 E2 atomic ab- sorption spectrophotometer,we analysed and asseyed the sonograms and biliary trace ele- ments of30 patients with differentultrasonographic typesbefore and six weeksafter DMSA and DMPS treatment.Biliary B juice were obtained by duodenal drainage.The results showed that the biliary copper content of patients with glinting echogenic dots type,rock stratum type and tree-like type increaed markedly after therapy(P

Objective To study the correlation between GSTM1 genetic polymorphism and bladder cancer susceptibility. Methods In a case control study, the GSTM1 genotype was assessed by a PCR based method. 69 patients with transitional cell carcinoma of the bladder and 88 controls matched for age and sex were studied. Results The frequency of GSTM1 null genotype among the bladder cancer patients was 58% compared with 41% among controls(OR=2.0, 95%CI=1.05～ 3.79 ,? 2=4.51, P

Objective To study effect of nasal tolerance with rat-derived 97-116 peptide of AChR α-subunit(Rα97-116(V108A))on the manifestation of muscle weakness and the immunity function of experimental autoimmune myasthenia gravis(EAMG).Methods Twenty-two EAMG model Lewis rats immunized thrice with Rα97-116(V108A)were divided randomly into tolerance group and control group.They were respectively immunized with Rα97-116(V108A)and PBS buffer solution for 10 days via nasal mucous.Then the body weight and Lennon score of two group Lewis rats were measured.Their serum anti-AChR antibodies were tested by ELISA,the expression levels of CD28,CTLA4,B7-1 and B7-2 were determined by flow cytometry.Results Compared with control group at different time points.the body weight of tolerance group rats(tolerance group(228.1±5.8)g,control group(215.0±16.2)g,t=2.395,P＜0.05)increased,the mean clinical score of rats(tolerance group 1.55±0.44.control group 2.10±0.66,t=-2.20,P＜0.05)decreased and the amount of serum anti-AChR antibody(tolerance group 0.97±0.20,control group 1.27±0.26,t=-2.857,P＜0.05)decreased obviously.the amount of CD28,B7-1,B7-2,CTLA4(%)expressed on the surface of peripheral blood cells(tolerance group:27.35±7.05,4.73±0.58,2.71±0.35,1.72±0.44,control group:40.02±8.81,9.52±1.25,5.88±1.09,2.64±0.47)down-regulated markedly(t=3.479,10.861,8.755,4.403,all P＜0.01).Conclusion Nasal mucous tolerance with Rα97-116(V108A)could ameliorate muscular weakness of EAMG rats while activates T cell and inhibits B cellular immunity.

Objective To explore the effects of second biopsy and resection on tumor recurrence and progression in patients with high risk non-muscle invasive bladder cancer. Methods The second biopsy and resections were performed 4-6 weeks after the first transurethral resection in 52 patients. Routine follow-up was done in another 71 patients. The tumor recurrence and progression rates were compared. Results Residual tumors were found in 54%(28/52) of patients underwent second biop-sy and resection, including muscle-invasive tumors in 5 patients. Two patients underwent radical cys-tectomy due to resection findings. During same period, 71 patients were routinely followed. After a median observation of 27 months, patients underwent second biopsy and resection showed lower recur-rence rate (P<0.05). The progression rate was no difference between the 2 groups(P0.05). Conclusion Second biopsy and resection may reduce recurrence rate in high risk non-muscle invasive bladder cancers, but may not change the tumor progression rate.

Objective To identify gene mutations and explore the molecular mechanism of a pedigree with inherited coagulation F Ⅶ deficiency. Methods The levels of F Ⅶ: Ag in the proband and other family members were measured by ELISA assay. The values of PT, F Ⅶ: C and other coagulant parameters were determined by one-stage clotting for laboratory phenotype diagnosis. All the exons,exon-intron boundaries and 5',3' untranslated sequences of F7 gene were amplified by direct sequencing. The detected mutations were further confirmed by sequencing the other stand. The CLC Protein Workbench software was used to analyze the species conservation of the mutated site and the protein secondary structure. 100 healthy individuals were selected to exclude gene polymorphism. Results PT, FⅦ∶C and FⅦ: Ag in the proband and his sister were abnormal, which were 36. 3 s, 5.0%, 40. 7% and 33.4 s,5. 0%, 37.4%, respectively. Both PT and FⅦ∶C in the proband's father, mother, daughter and niece were slightly abnormal, which were 14.9 s, 14. 6 s, 15.5 s, 14. 6 s and 70%, 85%, 59%, 79%, respectively.The heterozygous mutations c. 784T ＞ C and c. 964T ＞ G in exon 8 of F7 gene were found in the proband,resulting in the substitutions of Ser269Pro and Cys329Gly respectively. Compound heterozygous mutations c. 784T ＞ C and c. 964T ＞ G were found in the proband's sister. The proband's mother was heterozygous for c. 784T ＞ C. His father, daughter and niece were heterozygous for c. 964T ＞ G. The protein biological characteristics analysis revealed that the Cys329Gly caused the change of spatial configuration, and Ser269Pro led to the change of amino acid polarity and hydrophobicity. Conclusion Compound heterozygous mutations of Cys329Gly and Ser269 Pro in F7 gene may be the underlying molecule mechanism of FⅦ deficiency in this pedigree.

Objective To compare the stress distributions on the anterior horn,body part and posterior horn of menisci between the normal and the injured knees with anterior cruciate ligament (ACL) deficiency using the three-dimensional finite element analysis.Methods A three-dimensional finite element model of tibiofemoral joint was created to simulate the motion states of the normal and ACL-deficiency knees at extension,as well as 15° and 30° flexions.Meanwhile,700N axial load and 134N posterior load were applied to the femur.Then,the stress on the anterior horn,body part and posterior horn of medial and lateral menisci were compared between the normal and ACL-deficient knees.Results With ACL deficiency,when stretching the knees straightly,the stress on the anterior horn of medial meniscus increased to 100.7％ of the normal knees,bigger than that of the affected lateral meniscus (30.7％).At 15° and 30° flexions,the stress on the posterior horn of the medial meniscus in ACL-deficiency knees increased by 36.4％ and 59.7％ respectively when compared to normal knees,while the stress on that of the lateral meniscus did not increase significantly.Apart from the stress on the body part of the lateral meniscus increasing by 39.5％ at extension in ACL-deficiency knees,no obvious changes were observed in the stress on the body part of the medial and lateral menisci.Conclusion ACL deficiency has different effect on the stress of different parts of the meniscus.It mainly increases the stress on the anterior horn of the medial meniscus at extension and that of the posterior horn of the medial meniscus at flexion.

Objective To detectthe phenotype and gene mutations underlying aninherited dysplasminogenemia pedigree and search the virulence gene.Methods The peripheral venous blood samples of the proband and his family members (fourteen subjects of three generations in total) were collected,and their prothrombin time(PT),activated partial thromboplastin time(APTF),thrombin time(TT),fibrinogen (FIB),fibrinogen degradation products (FDP),D-dimmer (D-D)weretested on a STAGO analyzer,the plasminogen activity (PLG:A) and plasminogen antigen (PLG:Ag) were analyzedby thechromogenic substrate assay and rocket immunoelectrophoresis,respectively.All 19 exons,5' and 3' untranslated regions of PLGwere amplified with PCR.Direct DNA sequencing was used to analyze the amplified products,which wereconfirmed by backward sequencing.Three bioinformatics online softwares (SIFT,PolyPhen-2 andMutationTaster) were used to forecast the possible impact of the mutations on the protein function.At last,themodel analysis of mutate site was taken on a Swiss-Pdb Viewer software.Results The PLG:Avalue of theproband and other 6 family members were decreased to the half,while the PLG:Ag was normal.The D-Dand FDP value of the proband,his grandma and father were slightly higher.DNA sequencing has revealedthat the proband and the other 6 members of this family had the same mutation of g.38829G ＞ A in exon 15,leading to the missense mutationp.Ala601Thr.The results of bioinformatics softwares showed that themutation could affect the thePLGfunction.Protein model analysis indicated that the hydrophobic interaction force and hydrogen bond between the amino acids were changed,which might affect the stability of the PLG.In addition,all the members of this family take the heterozygous SNP of g.2501C ＞ A in the 5 ＇UTR.Conclusions The p.Ala601Thr found in the inherited dysplasminogenemia pedigree in the exon 15 was responsible for the reduced PLG:A of the family,the dysplasminogenemia and this mutation were both reported for the first time in China.

Objective To investigate the variety and clinical value of the neutrophil volume and cytoplasm-nucleus complex in patients with bacterial infection, cardiovascular or cerebrovascular accident and major surgery operation. Methods 125 patients with bacterial infection, 64 patients with acute cardiovascular or cerebrovascular accident, 66 patients after major surgery operation and 69 normal subjects were selected in the study. Total WBC counts (WBC), percentage of neutrophils (NE), and the VCS parameters of neutrephils including the mean channels of cell volume ( NEV), conductivity ( NEC), light scatter(NES) and the SD of these parameters( NEVSD, NECSD, NESSD)were measured by automatic blood cell analyzing instrument. The sensitivity and specificity of the WBC, NE and the VCS parameters of neutrophils were analyzed with receive operating characteristic (ROC) curve. Results The levels of NEV, NES and NEVSD in acute bacterial infection group were 154.3 ± 15.2, 135.7 ± 9.9, 26.8 ± 4.2 respectively. The levels of NEV, NES and NEVSD in post major surgery operation group were 147.2±8.9, 141.5 ± 7.7, 23.0 ± 2. 8 respectively. The levels of NEV, NES and NEVSD in acute cardiovascular or cerebruvascular accident group were 144.9 ± 5. 2, 146.0 ±5.0, 19. 6±1.6 respectively. The levels of NEV, NES and NEVSD in healthy control group were 139.7±4.6, 145.0±3.8, 18.2±1.3 respectively. The differences of these parameters among these groups had statistical significance ( F = 17. 650, 38. 122, 54. 604,P<0. 05). And the changes of NEV, NES and NEVSD in bacterial infection group were most obvious among those three groups. The levels of NEV, NES and NEVSD were 146.5±9.5, 144.3 ± 9.4, 21.3 ± 3.3 respectively in stress diseases groups which included acute cardiovascular or cerebrovascular accident group and post major surgery operation group. The differences of these parameters between stress diseases group and acute bacterial infection group had statistical significance ( t = - 2.840, 7.533, - 8.999,P<0.01). The areas under the ROC curve of NEVSD, NEC, NES and NECSD were 0.893, 0. 845, 0. 833 and 0. 849 respectively. The sensitivity of 83. 3% and specificity of 82. 0% could be achieved by selecting the cut-off equal to or greater than 24. 0. Conclusions The variety of neutrophil volume, nuclear size and cytoplasmic granularity changed obviously in patients with acute bacterial infection and common stress diseases, and the variety in acute bacterial infection is more obvious than that in common stress diseases. The sensitivity and specificity of VCS parameters of neutrophils are higher than those of WBC or NE for predicting infection, and the NEVSD is the most predictable indicator of acute bacterial infection.