With the development of molecular biology and molecular genetics,more attention has been taken to the advanced techniques which can be used to detect minority mutations.In recent years,many techniques such as amplification refractory mutation system,PCR clamping,pyrophosphorolysis-activated polymerization,co-amplification at lower denaturation temperature-PCR and digital PCR have been developed,which will make the hereditary disease diagnosis,cancer detection,noninvasive antenatal diagnosis step into a new stage in the near future.This review presents an overview of the principles,aoolications,advantages and disadvantages of these techniques.

With the rapid advancement of immunology and molecular biology,many new revelations and ideas were drew for clinical immunology in laboratory medicine.In the current circumstances of application of clinical pathway management and individual medical care,how to accurately grasp these changes to build perfect quality system for clinical immunology laboratory,clarify the immunology laboratory pathway and integrate that into clinical pathway management,make solid progress for the promotion and application of individual diagnosis and evaluate the diagnostic value of new technique and item for clinical immunology laboratory accurately might be worth pondering for every people working in clinical immunology laboratory.In this paper,the status quo and reflection of clinical immunology is reviewed.

Five medicines for prevention and treatment of osteoporotic fractures were introduced.They are bisphosphonates,calcitonin,selective estrogen-receptor modulator,estrogen and active vitamin D.The pharmacologic effects,safety,application and causions were explained according to principles of evidence-based medicine.

Hypertension is a common chronic disease which can lead to cardiac, cerebrovascular and renal damage; it is seriously harmful to human health. Cardiovascular disease caused by hypertension has become the first cause of death of residents in our country, the burden of disease has become more and more serious, how to manage hypertension has become an important public health issue in our country. In this review, the development and current situation of the community health management of hypertension at home and abroad are described and analyzed, the experience and practice worthy of learning are summarized to provide evidence for the prevention and control of hypertension in community.

BACKGROUND: In order to improve the medication safety and remove export obstacles of Chinese preparations contained heavy metal and arsenide (cinnabar, realgar), it is necessary to carry on the evaluation on the efficacy and safety of cinnabar and realgar. At present, it has not been clear concerning to the pharmacodynamic mechanism of cinnabar and realgar in compound prescriptions yet.OBJECTIVE: To study the differences in cinnabar and realgar in angong niuhuang wan in the organism physiologically and pathologically so as to probe into those pharmacodynamic mechanism.DESIGN: A randomized and controlled trial.SETTING: Institute of Clinical Pharmacology of one university.MATERIALS: The experiment was performed in Institute of Clinical Pharmacology of Guangzhou University of Traditional Chinese Medicine in January 2003. Totally 51 male SD rats weighted varied from 250 g to 300 g were employed, provided by Experimental Animal Center of First Military Medical University of Chinese PLA.METHODS: SD rats were randomized into 6 groups(8-10 rats/group),named as normal group, normal & angong niuhuang san (integral recipe) group(278 mg/kg), normal & cinnabar and realgar omitted angong niuhuang san(disassembled recipe) group(222.7 mg/kg), cerebral edema model group(ligature on unilateral carotid artery by injection of pertussis bacilli (PB), 2 500 million/kg), model & integral recipe group (medication 278 mg/kg was done 1 hour before model preparation), model & disassembled recipe group(medication 222.7 mg/kg was done 1 hour before model preparation) . Five hours later after once medication(4 hours later after PB injection in model group), blood was collected and brain homogenate was prepared.MAIN OUTCOME MEASURES: Brain tissues, serum lactate dehydrogenase(LDH) activity and percentage enzyme activity of lactate dehydrogenase isoenzymes (LDH1-5).RESULTS: Compared with normal group, the general activity of LDH in normal & integral recipe group and normal & disassembled recipe group was significantly improved by 32.4% to 38.4% ( P ＜ 0.05); percentage enzyme activity of LDH1,2 was significantly increased( P ＜ 0.01 ), and that of LDH4, 5 was reduced( P ＜0.01) . Except LDH5, there were no significant differences in enzyme activity of isoenzymes in two groups. Compared with model group, the general activity of LDH in model & integral recipe group and model & disassembled recipe group was significantly improved by 23.4% to 38.5% ( P ＜ 0.01); percentage enzyme activity of LDH5 was significantly increased( P ＜ 0.01 ), there were no significant differences in two groups. In model & integral recipe group, percentage enzyme activity of LDH2,3 was significantly decreased( P ＜ 0.01), and that of LDH1,4 was no significant change. In model & disassemble recipe group, percentage enzyme activity of LDH1,4 was significantly reduced( P ＜ 0. 05, 0.01 ) and that of LDH2,3 was no significant change.CONCLUSION: In normal physiological state, angong niuhuang san produces a certain injuries on cardiac muscle and kidney. In pathological state of infectious cerebral edema, both integral and disassembled recipes inhibit LDH enzymes that have been over-activated, but the significant differences did not presented between both. Cinnabar and realgar in compound prescript provide the effects in various degrees on levels of LDH isoemzymas.

Objective To investigate the clinical value and effect of peripherally inserted central eatheter(PICC) in patients with tuberculous meningitis. Methods 56 patients with tuberculous meningi-tis were randomly divided into the treatment group and the control group with 28 cases in each group. The treatment group was medicated by PICC, while the patients of the control group were medicated through pe-ripheral superficial vein. The curing rate, degree of anxiety, infusion response, satisfaction with nursing and related expense were recorded. Results The curing rate and satisfaction with nursing of the treatment group were higher than those of the control group. The anxiety degree, infusion response and related ex-pense of the treatment group were lower than those of the control group.Their difference had statistical sig-nificance. Conclusions PICC has clinical value in patients with tuberculous meningitis,which is worth promoting.

Objective To evaluate the prognostic value of the Cancer of the Liver Italian Program (CLIP) score system in a study of hepatocellular carcinoma (HCC) patients who underwent radical resection. Methods Clinical pathological and follow-up data of 157 HCC patients, who underwent radical resection in our hospital from 1996 to 2004, were reveiwed retrospectively. Patients were divided into four groups according to CLIP scores. Disease-free survival rate was compared between groups, and within groups, the disease-free survival rate of patients receiving anatomic liver resection was compared with that of irregular liver resection. Results The overall 1,3,5-year disease-free survival rate was 63.6%、45.2%、35.7%,and there were significant differences among the four groups. For the zero score group, the recurrence rate of patients undergoing anatomic liver resection was lower than that of irregular liver resection (P = 0.003). Conclusions CLIP score system can be used to evaluate the recurrence rate of HCC patients receiving hepatectomy. CLIP score system can be used as a guidance for liver resection.

Objective To observe the effect of Chinese medicine to wash, acupressure and Avene cream to moistur-ize for infantile eczema.Methods 100 babies who were diagnosed infantile eczema were chosen and separated to interven-tion group and control group randomly.The control group was treated by Chinese medicine to wash, acupressure and cream to moisturize, and the intervention group was treated by hormone medicine and Avene cream to moisturize.Observe the treat-ment effect after 7 days, 14days and 1 week after cured.Results The severity,effective rate and cure rate of two groups after 7days haven′t the statistical difference(p>0.05), and the severity of intervention group after 14days was lower than that of control group (p<0.05),the effective rate of intervention group after 14days was higher than and that of control group (p<0.05), and the recurrence rate of intervention group was lower than that of control group (p<0.05).Conclusion Combi-ning traditional Chinese and western medicine treatment can promote the treatment effect of infantile eczema , and reduce the recurrence, should be generalization.

Background and purpose:The study hasfound that tumornecrosis factor-related apoptosis inducing ligand (TRAIL) can enhance the cytotoxic effect of chemotherapeutic drugs on tumor cells. The aim of our study was to investigate the effects of the tumor TRAIL and cisplatin combined application on the growth and apoptosis of human ovarian cancer cell lines SKOV3 and OVCAR3, and the possible mechanism.Methods:Under the combined application of cisplatin and TRAIL, MTT method and flow cytometry were used to detect the proliferation and apoptosis of SKOV3 of OVCAR3 cells; the mRNA expression levels of death receptors, DR4 and DR5, were detected by real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR). At the same time, the protein expression levels of DR4 and DR5 were detected by Western blot.Results:SKOV3 and OVCAR3 cells were sensitive to TRAIL protein, and with the increasing of TRAIL protein concentration, cell growth inhibitory rate up to 64%. When the
combination application of TRAIL and cisplatin, the inhibition rate of the two cells reached more than 92%, and the two drugs showed high synergistic effect, compared with the single drug group (P<0.05). Flowcytometry analysis indicated that the synergistic killing effect of TRAIL and cisplatin was mainly due to the cell apoptosis. RTFQ-PCR and Western blot detection results showed that the DR4 and DR5 were up-regulated under the combined application of TRAIL and cisplatin.Conclusion:In vitro, TRAIL and cisplatin combined application can signiifcantly inhibit the proliferation of human ovarian cancer cells and induce tumor cell apoptosis. TRAIL can obviously enhance the sensitivity of cisplatin to tumor cells. The mechanism may be related to the increased death receptor DR4 and DR5 expression level.

ObjectiveTo investigate the diagnosis and treatment of occult thyroid carcinoma(OCT).MethodsRetrospective analysis on the clinical data of 34 cases of OCT was made. ResultsOnly 6 cases were preoperatively diagnosed as OCT. Total resection of the affected lobe and isthmus was performed on 16 cases with neck dissection in 14 cases. Subtotal thyroidectomy was performed on 18 cases. The occult cancer lesion was pathologically confirmed within ipsolateral lobe in all the 34 cases. Neck lymph node metastasis was found in 4 cases and local infiltration in 3 cases. The psammoma bodies in cancer lesion and adjacent normal gland were found in 15 cases. Thirty-one cases were followed up for an average of 9 years. One died of lung metastasis and two more of other unrelated diseases. Conclusion(1) The psammoma bodies in normal thyroid gland usually imply the existence of cancer. (2) Total thyroidectomy of a lobe or subtotal thyroidectomy was the therapy of choice. Local infiltration or neck lymph node metastasis necessitates additional neck dissection.