Objective To determine the serum KL-6 level in patients with pancreatic carcinoma and investigate its diagnostic value. Methods The data of 53 pancreatic carcinoma (PC) patients; 68 chronic pancreatitis (CP) patients and 51 patients with high risks of pancreatic cancer (HR) with complete follow-up data were studied, and 50 healthy volunteers were used as controls. ELISA was used to measure the serum levels of KL-6, MUC4, and CA50. Radioimmunoassay methods were used to measure the serum CA19-9 levels. The sensitivity and specificity of KL-6 for the diagnosis of PC were determined, and the relationship between its levels and clinicopathologic parameters, patients' outcome were analyzed. Results The serum KL-6 levels were (753±548), (135±93), (105±55) and (99±50) U/ml in PC group, CP group, HR group and control group, and the value in PC group was significantly higher than those in other 3 groups (P <0.01). Using >232 U/ml as the cut-off point, the sensitivity and specificity of KL-6 for the diagnosis of PC was 96% and 94%. Using >244 U/ml as the cut-off point, the sensitivity and specificity of KL-6 for the diagnosis of PC was 97% and 91%. The clinical value of KL-6 was higher than those of CA19-9, CASO and MUC4. The serum level of KL-6 was not associated with clinicopathologic parameters. The median survival of patients with serum level of KL-6 =300 U/ml was (9.3 ±1.2) months, which was significantly longer than that in patients with serum level of KL-6 >300 U/ml [ (4.6 ±0.7) months, P =0.006]. Conclusions KL-6 might be a useful serological marker of pancreatic cancer, and it may play a role in the differential diagnosis between pancreatic cancer and chronic pancreatitis.

The activation of NK cell , mediated by natural killer group 2 ( NKG2 ) family receptor , plays an important role in antiviral immune response and disease progression after hepatitis B virus (HBV) infection.To explore the NKG2 receptors-mediated NK cell activation and its mechanism may be of value for anti-HBV targeting immune treatment .This article reviews the recent research progress on the role of NK cells and its NKG2 family receptors in immunity of chronic HBV infection and its mechanisms .

Objective To analyze the relationship between blood glucose level, blood pressure and weight with pancreatic cancer genesis. Then to explore the metabolism associated risk factors in pancreatic cancer genesis. Methods Form December 2002 to September 2009 in Ruijin Hospital, 548 pancreatic cancers with pathology diagnosis after pancreatectomy were collected for the study with retrospective analysis method. The association of pancreatic cancer with blood glucose level, blood pressure, weight and other metabolic factors were analyzed. Results With principal component analysis, it suggested that there were strong correlation between blood glucose level, blood pressure and weight index (BMI) increasing with pancreatic cancer. The contribution rates were 3. 614%,25. 236%, 15. 418% and 12. 918%, respectively. Single factor analysis indicated that the association between pancreatic cancers and new onset diabetes mellitus (duration≤ 2 years) was stronger than that of long-term diabetes mellitus. The occurrence rate of pancreatic cancer in patients with long-term diabetes whose blood glucose level was not well controlled recently while well controlled previously (44.6 % ) was significant hister than that in patients without diabetes (5. 6% , P＜0.05). The fasting blood glucose level of these PC patients ( 13.87± 3. 49 mmol/L) was significantly higher than new onset and other long-term diabetes patients, the comparative risk was 13.46 (95% CI 4. 560,39. 731). BMI increasing was a risk factor of pancreatic cancer, but there was no significant statistical difference between risk degree and BMI increasing level. All above metabolic diseases were risk factors of pancreatic cancer, but for pathology, location and stage of pancreatic cancer there was no statistical difference in theses factors. Conclusion This study suggested diabetes, BMI increasing and hypertension were high risk factors of pancreatic cancer genesis. New onset and long-term diabetes patients whose blood glucose not controlled well recently should be watched carefully for pancreatic cancer. Early treatment and intensive follow-up of metabolic disease might be helpful to early diagnosis and prognosis of pancreatic cancer.

Objective To investigate the association of SLC34A1 ( rs6420094 ) and RGS14 (rs4074995) polymorphisms with serum level of phosphorus in chronic hepatitis B virus (HBV) infection patients following long-term adefovir dipivoxil ( ADV ) treatment.Methods Ninety one patients with chronic HBV infections admitted in Third Hospital of Hebei Medical University during October 2012 and August 2013 were enrolled in the study.All patients received ADV treatment ( monotherapy or combination therapy) for at least two years, among whom 31 had hypophosphatemia and 60 had normal serum phosphorus levels.rs6420094 and rs4074995 were genotyped by polymerase chain reaction-restrictive fragment length polymorphism ( PCR-RFLP ) analysis.The relationship between allele frequency and serum phosphorus concentration was analyzed by Chi-Square test.Results In hypophosphatemia group, there were 13, 13, and 5 patients with genotype A/A, A/G and G/G at rs6420094, respectively;while in patients with normal serum phosphorus levels, there were 35, 24 and 1 patients with genotype A/A, A/G and G/G at rs6420094.The frequency of allele A at rs6420094 in patients with normal serum level of phosphorus was higher than that in hypophosphatemia group ( 78.3% vs.62.9%, χ2 =4.947, P <0.05 ).In hypophosphatemia group, there were 2, 11, and 18 patients with genotype A/A, A/G and G/G at rs4074995, respectively;while in patients with normal serum phosphorus level, there were 1, 21 and 38 patients with genotype A/A, A/G and G/G at rs6420094.There was no difference in the frequencies of alleles at rs4074995 between two groups (χ2 =0.625, P >0.05).Conclusion The polymorphism of rs6420094 gene may be associated with the serum level of phosphorus in patients with chronic HBV infections following long-term treatment of ADV.

Objective:To prepare poly-L-lactic acid(PLLA)electrospun nanofibers carrying icariin(ICA)(ICA /PLLA)and to evaluate the effects of the ICA /PLLA on MC3T3-E1 cells.Methods:ICA solution was dispersed into PLLA solution,and electrospun fibers were fabricated by W/O emulsion method.The morphology of ICA /PLLA was observed by SEM.The in vitro release kinetics of ICA /PLLA was examined.The attachment of MC3T3-E1 cells on ICA /PLLA was examined by propidiumiodide(PI)labling and ob-served under fluorescent microscope.The proliferation of the cells was measured by MTT assay.The differentiation of the cells was ob-served by alkaline phosphatase (ALP)assay.Results:In vitro,ICA was effectively released from ICA /PLLA for 22 days,cells were attached well on the surface in all groups,ICA did not affect the proliferation of MC3T3-E1 cells(P >0.05),but increased the ALP activity(P <0.05)of the cells.Conclusion:ICA /PLLA can effectively control the release of ICA and promote the differentiation of MC3T3-E1 cells.

Objective To investigate the mechanism of venous reverse-flow flap in the differentperiod after operation.Methods The rabbits wero randomly allocated into 3 groups.In group A,including saphenous artery and venae commutante.In group B,saphenous artery without venae commutante.In group C,surface seeping and saphenous artery and venae commutante.Flap appearance,intravenous pressure,vessel diameter,mierocircular and histological examination were mea8ured.Results The difference of introvenous pressure between group A.B and C was obvious.Reverse flow WaS found in group A and C group through microcirculation observation 2 hours post-operation.Venous valve lose efficacy while the vessel diameter wes at maximum just after the pressure peak.Conclusion Venous retrograde return in reverse-flow island flaps can be achieved more easily through"incompetent valves route"than through "communicating and collaterall by pass route".By pass route is a supplementary way.Surface seeping Can slighfly relieve the venous pressure but can cause infection.

Essential hypertension (EH), a complex polygenic disease, is considered to the result of the genetic interaction of multiple gene alterations in concert with environmental factors. Evidences showed that angiotensin-converting enzyme (ACE) gene and G protein beta3 subunit (GNB3) gene are both important susceptibility genes for EH, and that there exists putative biological connection between the two genes in developing hypertension. To investigate whether hypertension was affected by gene-gene interaction between the two genes in the northern Chinese Han population, a case-control association study including 502 hypertensive cases and 490healthy controls was conducted, selecting the ACE gene I/D polymorpinsm and the GNB3 gene C825T polymorphism. Linkage disequilibrium analysis revealed a significant nonrandom distribution only in male hypertensives, indicating that interaction between ACE gene and GNB3 gene may predispose males to the occurrence of hypertension. Multivariate stepwise logistic regression in single locus analysis, with adjustment for common risk factors for hypertension, demonstrated that the OR for DD/ID versus Ⅱ for hypertension among men was significant (OR 1.57; 95% CI, 1.09 ～2.27; P = 0.016) in dominant genetic model. In combination analysis stratified with respect to gender, slightly significant ORs were found after adjustment in males: OR for TT vs CC, 0.11; 95%CI, 0.01 ～0.99; P = 0.049 within ACE DD genotype; OR for DD/ID vs Ⅱ, 1.52; 95% CI, 1.01 ～2.29; P = 0.047 within GNB3 CC+CT genotype. The results suggest that ACE, or a nearby gene, is a male-specific susceptible gene for hypertension, and that there may exist epistatic gene-gene interaction between ACE D allele and GNB3 825C allele.

Objective To evaluate the analytical performance of lipid testing with six sigma(a) in order to promote the quality improvement.Methods Sixty-four Laboratories participated in trueness verification program and Internet-Based Interlaboratory Comparison of Internal Quality Control Data program lipid testing in 2012 were included in this study.The CVs and Bias of TC,TG,HDL-C,and LDL-C for each laboratory were evaluated from the reporting data.The sigma metrics based on the Tea from National Cholesterol Education Program according to the formula:σ =(TEa-Bias)/CV for each analyte.Quality goal index (QGI) was also calculated to investigate the reason for dissatisfied performance as follows:QGI =Bias/ (1.5CV).Results The rates for σ≥6 of TC,TG,HDL-C,and LDL-C were 21.9％,34.4％,9.38％,and 18.8％,respectively.The corresponding rates for 3 ≤ σ ＜ 6 were 31.3％,29.7％,29.7％,and 34.4％,while the rates for σ ＜ 3 were 46.9％,35.9％,60.9％,and 46.9％,severally.For analytes which σ were less than 3,91.3％-100％ of the laboratories should improve the trueness first,0.00％-8.75％ of the laboratories should improve the precision,and 0.00％-2.08％ should improve both.Conclusions Six sigma is an effective tool for quality control in clinical laboratory,which can help improve the quality level for laboratory testing.The analysis of performance of the lipid testing shows that further effort is acquired to enhance the supervision of the trueness verification.

Objective To evaluate the effectiveness of using high-fidelity simulator (HFS) in medical training of cardiopulmonary resuscitation (CPR).Methods The randomized controlled trials (RCTs),quasi-randomized controlled trials (q-RCTs) about comparing HFS with traditional teaching methods in medical training of CPR were searched from Cochrane Library,Pubmed,Web of Knowledge,CNKI,CBM and Wanfang Data.The methodological quality of the included studies was assessed and the valid data were extracted.Meta-analysis was conducted with the Cochrane Collaboration RevMan 5.0.Results Ten q-RCTs and one RCT were included.The quality of the studies were relatively low.Meta-analysis showed that compared with the traditional teaching method,high-fidelity simulation in medical training of CPR had no statistically significant differences in mastering the theoretical knowledge,but had statistically significant differences in mastering the CPR skills.Conclusions HFS in medical training of CPR skills is positive and effective,superior to the traditional teaching methods,but in terms of theoretical knowledge and satisfaction,self-confidence,more researches still need to be further confirmed.

Objective To verify the trueness and assess the traceability of results from a routine chemistry system procedure for measurement of urea and ereatinine in serun.Methods Series of fresh frozen patieot sera,whose values of urea or creatinine were assigned by isotope dilution gas chromatography mass spectrometry (ID-GC/MS) or isotope dilution liquid chromatography tandem mass spectrometry (ID-LC/MS/MS),were chosen to be analyzed by a routine chemistry system.The measurement results of urea and creatinine by the routine chemistry system were used for linear regression analysis against the assigned values bv the ID-MS method to calculate the percentage deviation and assess the expected bias.Results For urea and creatinine,the linear regression equations between the routine chemistry system and ID-MS methods were Y =0.9890X + 0.0192 (R2 =0.9990) and Y =0.9815X-6.4794 (R2 =0.9989),and the average percentage bias were-0.41％ (P ＞0.05) and-4.20％ (P ＜ 0.05),respectively.The expected percentage bias at three medical decision levels were-0.46％,-0.83％ and-0.96％ for urea and -15.90％,-5.87％ and-2.95％ for creatinine.Conclusions The results of urea analyzed by the routine chemistry system were consistent with the ID-MS method,which suggested that the results of the routine system procedure could be traced to ID-GC/MS method.For creatinine,the bias between the results of routine procedures and the assigned values met the minimum acceptance criteria' derived from biologic deviations,which would be better if its specificity improved.