Objective To explore the common reason for misdiagnosis of sarcoidosis to increase the diagnosis rate of sarcoidosis and reduce misdiagnosis rate.Methods Analyze clinical manifestation and misdiagnosis reason retrospectively of 98 patients confirmed sarcoidosis according to pathological proof,in which 39 patients are misdiagnosed.Results The major reasons for misdiagnosis were delitescent sarcoidosis progress,clinical manifestation lacking specificity and lack of research.The most common diseases misdiagnosed were pulmonary tuberculosis,lung cancer and lymphoma.Conclusion The major methods to reduce misdiagnosis are to know well about clinical characteristics,imageology manifestation and laboratory exam about sarcoidosis.

BACKGROUND: Biological function of leukocyte-associated immunoglobulin like-receptor 1 (LAIR 1) has clearly researched in China and abroad, but the in vivo biological function of LAIR is poorly understood. OBJECTIVE: To establish LAIR-2 (CD306) eukaryotic expression vectors and to purify and identify the fusion protein. DESIGN, TIME AND SETTING: A single sample observation experiment was performed at the Fourth Military Medical University of Chinese PLA between June 2007 and June 2008.MATERIALS: plg/3c vector was offered by Oxford University, pcDNA3.1 vector was provided by Meyaard doctor. Chinese hamster ovary (CHO) cell lines were preserved by the Department of Immunology, Fourth Military Medical University of Chinese PLA.METHODS: Two eukaryotic expression vectors plg/3c-LAIR-2 and pcDNA3.1-LAIR-2 were constructed and were transfected into CHO cells. The binding activities of LAIR-2 fusion protein to LAIR-2 mAbs were identified by Western blot, immunocytochemistry and flow cytometry assay.MAIN OUTCOME MEASURES: The construction of stably transfected cell lines, and the purification and identification of fusion protein. The activity of LAIR 2 protein combined to corresponding monoclonal antibody.RESULTS: Eukaryotic expression vectors were constructed and trasnsfected into CHO cells successfully. Two cells lines CHO/LAIR-2-Fc and CHO/LAIR-2 that steadily expressed LAIR-2-Fc fusion protein and LAIR-2 protein were established. Western blot assay showed that LAIR-2 protein could bind specially to LAIR-2 mAb 1A7, 3H12 and 4A9. Immunocytochemistry and flow cytometry assay demonstrated that 3H12 and 4A9 could bind to LAIR-2 expressed in the transfected CHO cells. CONCLUSION: Two ceils lines CHO/LAIR-2-Fc and CHO/LAIR-2 were successfully constructed, which can transfected to CHO cells. The eukaryotic expressed LAIR-2 protein has good binding activity to LAIR-2 mAbs.

OBJECTIVE:To establish a method for the detection of volatile constituents from the leaves and fruits of Piper ni-grum. METHODS:HS-SPME-GC-MS was used. The chromatographic conditions:column was HP-5 MS quartz elastic capillaries, carrier gas was high purity helium(99.999%),flow rate was 1.0 mL/min,the inlet temperature was 250 ℃,initial temperature of column was 50 ℃(temperature programmed),split injection with split ratio of 10:1. MS conditions:ionization mode was electron impact ion source,ionization energy was 80 eV,ion source temperature was 230 ℃,quadrupole temperature was 150 ℃,trans-mission line temperature was 280 ℃,electron multiplier voltage was 1588 V,mass scanning range was m/z 30-400. The spectra were retrieved using RTLPEST3. L and NIST08. L,and the relative contents of the volatile constituents were determined by area normalization method. RESULTS:There were 28 volatile constituents in the leaves and 15 in the fruits,respectively accounting for 67.13% and 36.85%. The major volatile constituents of leaves were β-caryophyllene (15.72%),limonene (9.39%),3-carene (9.32%),β-pinene(6.80%),α-terpine(4.98%),etc.,the main volatile constituents of fruits were 1,7,7-trimethyl-2-vinylbicyclo [2.2.1]hept-2-ene(10.45%),espatulenol(8.28%),caryophyllene oxide(4.81%),etc. 5 constituents were owned in both. CON-CLUSIONS:The study basically clears the main volatile constituents from the leaves and fruits of P. nigrum,and verifies existing obvious differences.

Objective To study the prevalence and characteristics of gastroesophageal reflux disease (GERD) in patients with idiopathic pulmonary fibrosis(IPF).Methods A total of 48 patients with diffuse parenchymal lung disease(DPLD) including 25 IPF and 23 other DPLD were enrolled from Department of Respiratory Disease in the First Affiliated Hospital of China Medical University.All patients were subjected to 24-hour esophageal pH monitoring.Pulmonary function test and HRCT of lung were performed at the same time.Results The prevalence of GERD in IPF patients was 64.0％,which was significantly higher than that in other DPLD patients.DeMeester scores were significantly higher in IPF patients than those in non-IPF group[(22.8 ± 21.5) score vs (15.7 ± 14.0) score respectively P ＜ 0.05].Numbers of reflux longer than 5 minutes [(3.8 ± 4.1) time vs (2.1 ± 2.1) time respectively) and reflux index (1.8 ± 1.7 vs 1.3 ± 1.2) in IPF group were higher than those in non-IPF group,yet without statistical significance.Patients with IPF had significantly higher values of following parameters than those in non-IPF patients including percentage of total reflux time(pH ＜ 4.0) (9.2 ± 5.1) ％,percentage of upright reflux time (8.5 ± 5.2) ％,percentage of supine reflux time (10.8 ± 10.7) ％,numbers of reflux (54.2 ± 22.7) time,numbers of regurgitation longer than 5 minutes (6.3 ± 4.2) time,thelongest reflux time (14.5 ± 15.3) min,reflux index 2.5 ± 1.7 and DeMeester scores (34.9 ± 20.3) time (P ＜ 0.05).DeMeester score was positively correlated with gastroesophageal reflux diseases questionnaire (GerdQ) score (r =0.667,P ＜ 0.01).The prevalence of typical GERD sympotoms in the IPF-GERD patients was higher (heartburn 7/16,regurgitation 6/16) than that in IPF patients without GERD (heartburn 2/9,regurgitation 1/9).Conclusion Patients with IPF have a high prevalence of GERD,but usually without typical GERD symptoms.In the hospitals 24-hour esophageal pH monitoring not available,GerdQ can be used to identify GERD in IPF patients.

This article was aimed to evaluate the α-glucosidase inhibitory activity of extracts from the root of Salvia miltiorrhiza Bunge and different processed products. The α-glucosidase inhibitory activity was screened with acarbose as positive control and by α-glucosidase inhibitory model in v itro . The results showed that the ex-tracts from the root of S. miltiorrhiza and different processed products had inhibitory activity. And the activity was higher than that of acarbose. In addition to the MeOH extract of S. miltiorrhiza carbon, the inhibitory activity of MeOH extracts from other processed products were higher than that of MeOH extract of S. miltiorrhiza. The in-hibitory activity of petroleum ether extracts of different processed products were close to S. miltiorrhiza. EtOAC extracts were lower than that of S. miltiorrhiza. The n-BuOH extracts were higher than that of S. miltiorrhiza. The inhibitory activity of extracts was positively correlated with concentrations, and it depended on the concentra-tion. It was concluded that the processed products of S. miltiorrhiza can strengthen α-glucosidase inhibitory activ-ity in different degrees.

Objective To investigate the expression of Tie-2 in rectal carcinoma and its relationship with invasion and metastasis in rectal carcinoma. Materials S-P immunohistochemical assay was used to detect the expression of Tie-2 in 40 cases of rectal carcinoma and 10 cases of normal rectal tissues. Results Tie-2 was mainly localized in the cytoplasm and nucleus of vascular endothelial cells in cancerous tissues and partly in the cytoplasm of some cancerous cells. The expression of Tie-2 in rectal carcinoma was significantly higher than that in normal rectal tissues (P<0.05); however, Tie-2 expression was not associated with differentiation, invasion depth and Dukes stage (P>0.05), but with lymphatic metastasis (P<0.05). Conclusion Tie-2 plays a key role in carcinogenesis and lymph node metastasis of rectal carcinoma.

Objective To evaluate the significance of carbohydrate antigen 50 (CA50) expression in colorectal carcinoma. Methods Immunohistochemical staining was used to detect CA50 expression in 10 cases of normal colorectal mucosa and 40 cases of cancer mucosa. Results The expression of CA50 increased in normal colorectal mucosa, cancer distant mucosa, cancer adjacent mucosa and cancer mucosa, and there were significant differences among them (P<0.05). The expression of CA50 in colorectal carcinoma was correlated with the degree of differentiation, Duke's stage and lymphatic metastases (P<0.05). Conclusion The expression of CA50 can be used as a valuable index in evaluating the biological characteristics and prognosis of colorectal carcinoma.

Background and purpose: Ursolic acid is widely present in spica prunellae, hedyotis diffusa and other heat antidotes. The growth of a variety of tumor cells can be inhibited and induced apoptosis by ursolic acid.This study was aimed to investigate the effect and possible mechanisms of UA on inducing apoptosis of human gastric carcinoma BGC823 cells. Methods: The MTT assay was used to detect the antiproliferative effect of UA on BGC823 cells. Flow cytometry was used to detect cell cycle and apoptosis of BGC823 cells. The expression level of bcl-2 and bax gene was investigated by real time-polymerase chain reaction (real time-PCR). Results: UA inhibited the proliferation of BGC823 cells in a dose and time-dependent way. After treatment by UA for 24. 48 and 72 h, the IC_(50) of BGC823 was 36.88, 34.72, and 32.18 μmol/L, respectively. UA could signifcantly induce apoptosis of BGC823 cells and block cells at G_2/M phase. UA could increase the expression of bax gene and decrease the expression of bcl-2 gene in a dose and time-dependent way. Conclusion: UA could induce apoptosis and inhibit the proliferation of BGC823 cells in a dose and time-dependent way. It could arrest cell cycle of BGC823 cells at G_2/M phase. Its mechanisms might be associated with the up-regulation of bax gene and down-regulation of bcl-2 gene.

Objectives To compare total laparoscopic gastrectomy with intracorporeal hand-sewn Gl reconstruction and laparoscopy-assisted gastrectomy for gastric cancer. Methods Between July 2009 and July 2010, 21 patients of gastric cancer underwent total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn reconstruction and 28 did laparoscopy-assisted D2 radical gastrectomy in Xijing Hospital of Digestive Diseases. All patients were operated on by an experienced surgeon. Patient demographics, TNM stage, location of tumor, the intraoperative and postoperative details of the two groups were compared. Results In the 21 patients undergoing total laparoscopic gastrectomy, there were 15 of distal gastrectomy and 6 of total gastrectomy, compared with 21 and 7 in laparoscopy-assisted group. In total laparoscopic group, intracorporeal hand-sewn technique was used for gastro-jejunal and jejuno-jejunal (J-J)anastomosis, and 25 mm circular stapler was used for esophago-jejunal anastomosis. The operation time was significant longer in total laparoscopic group than in laparoscopy-assisted group of (279 ± 65 ) min vs.(232 ±40) min (P ＜ 0.05 ). No significant difference was observed between the two groups in proximal margin [(5.7 ± 1.5 )cm vs. (5.1 ± 1.4) cm, P ＞ 0.05] and distal margin [( 3.1 ± 0.9 )cm vs. ( 2.9 ±0.9) cm,P ＞0.05]. The iv narcotic use in laparoscopy-assisted group was 1.8 d but it was not used in total laparoscopic group. The first passing flatus was on day 3 in total laparoscopic group compared with 4.8 d in laparoscopy-assisted group. Both groups had 2 postoperative early complications, one intra-abdominal infection and one lung infection in total laparoscopic group compared with one wound infection and one lung infection in laparoscopy-assisted group. There was no anastomosis-related complications after 4 months of follow-up. Conclusions The operation time and postoperative early complication was acceptable for selected patients treated by total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn GI tract reconstruction in hands of experienced laparoscopic surgeon.

Objective To prepare a peptide monoclonal antibody (McAb)against human papillomavirus 18E6 separately,and identify its specificity and pathogenicity.Metheds The advantage epitope peptide was designed and synthesized by ABCpred and Bcepred,and then used to immunize BALB/c mice after coupling with bovine serum albumin (BSA).And the McAb was prepared by hybridoma technique.HPV18E6 gene was amplified from cervical swab specimen containing HPV18 and insert-ed into expression vector pET-28a.The constructed recombinant plasmid was transformed to E.coli BL21(DE3)for expres-sion under induction of isopropyl thio-β-D-galactoside.The expressed protein was used to identified the McAb had been pre-pared.Results The hybridoma cell lines could constantly produce MAbs against HPV18E6 peptides.Sequencing proved that recombinant plasmid pET-28a-HPV18E6 was constructed correctly.Western blotting showed that the anti-HPV18E6 pep-tides antibody could specifically recognize HPV18E6.Conclusion A monoclonal antibody against the advantage epitope pep-tide of human papillomavirus 18E6 prepared could specifically recognize HPV18E6 specifically.