Objective To detect the expression of IL-6 in peripheral blood of patients with gastric cancer,as well as the expressions of IL-6,IL-6 receptor(IL-6R) and proliferating cell nuclear antigen(PCNA) in the neoplastic tissue in order to investigate the clinical significance of such expressions in looking for a convenient and effective way for the diagnosis and therapy of gastric cancer.Methods Enzyme-linked immunosorbent assay(ELISA) was employed for the parallel semi-determination of IL-6 levels in the peripheral blood of 30 patients with gastric cancer,as well as the levels of IL-6 and IL-6R in the neoplastic and adjacent tissues.The expression of PCNA in the neoplastic tissues was determined with immuno-histochemistry technique.Moreover,the correlation was comprehensively analyzed among IL-6,IL-6R,PCNA and the clinicopathologic findings of gastric cancers.Results The IL-6 levels in both peripheral blood and neoplastic tissues of 30 patients were significantly higher than those of the normal controls.The IL-6 levels in peripheral blood decreased significantly after operation;the IL-6 and IL-6R levels in cancer tissues were significantly higher than those in their adjacent tissues with a positive correlation between IL-6 and IL-6R levels.The expressions of IL-6,IL-6R and PCNA in both peripheral blood and neoplastic tissues of patients were positively related to the clinical manifestation of gastric cancer,including the differentiation degree of cancer cells,tumor size,infiltration extent and the metastasis of cancer cells.Conclusions IL-6,IL-6R and PCNA are the important factors which affect the degree of malignancy of the gastric cancer concerned,and they also,reflect the possibility of infiltration and metastasis of cancer cells.The IL-6 level in peripheral blood and the levels of IL-6,IL-6R and PCNA in tumor tissues of patients with gastric cancer are obviously high.The expression levels of all these factors are correlated with the clinicopathologic findings of gastric cancer.An adequate determination of IL-6 and PCNA is of benefit to the diagnosis and treatment of gastric cancer,and to the judgment of the course and prognosis of gastric cancer.

Aim To establish a simple reverse dot blot m ethod (RDB) for detecting the genotype of NAT2 in Chinese people. Methods PCR was performed to obtain a biotin labeled DNA fragment. Allele specific oligonucleotide probes were spotted onto a nylon membrane. The DNA fragment hybridized with the membrane under stringent conditions. Finally, a nonradioactive colorimetric reaction was used to detect five mutants of NAT2. NAT2 genotypes of 48 patients with pulmonary tuberculosis were detected with RDB.Results The results obtained from RDB were in consistent with those from allele specific amplification. The NAT2 allele frequencies of *5, *6, *7 were 1.04%, 22.9% and 15.6%, respectively.Homozygous wildtype,heterozygous mutant and homozygous mutant subjects were 33.3%, 54.2% and 12.5%, respectively.Conclusion RDB method was proved to be accurate and convenient, it can be u sed in rational drug therapy.

Objective Identifying the factors of psychological pressure from medical disputes on clinical doctors and possible solutions. Methods Self-rating Anxiety Scale (SAS) and the Occupational Stress Indicator (OSI) were called into play, to study 52 clinical doctors in a tertiary hospital in a city, who had encountered medical disputes in recent two years. In parallel, 63 clinical doctors without such disputes and 50 non-clinical workers were randomly selected as the control group for questionnaires. Results Clinical doctors with such an experience were commonly found to be anxious, and their SAS score (58. 27±11.38)averaged higher than those in the control group. Doctor-patient relationship, legal liabilities and clinical positions were found to be positively correlated to psychological pressure of clinical doctors. Conclusions Medical disputes tend to add to psychological pressure of the doctors. Clinical doctors deserve psychological counseling and training and improvement of their working conditions.

Objective　To analyse the sensitivity of fineneedle aspiration cytology (FNAC) of breast masses.Methods　A series of 1035 FNAC of breast masses was reviewed.502 cases acccepted operation for histopathologic diagnosis.Results　The sensitivity of FNAC for breast malignant tumor was 98.9% and the specificity was 85.7%.Conclusions　The FNAC of breast masses has high accuracy.

Gene chip is an important biological technology, which is developing quickly recently. In this article, we reviewed the origin, development, basic operation of gene chip. Several kinds of gene chips including tiled array, direct allele specific fluorescence targeting (DAFT) array, labeled auxiliary oligonucleotides array, ligase detection reaction array, and peptide nucleic acid array were introduced as examples for their use in mutation detection. The prospect of the use of gene chip in optimizing drug therapy was also discussed.

Objective To investigate the relationship between the plasminogen activator inhibitor 1(PAI 1) promotor region gene polymorphism and cerebral stroke.Methods The genotype of 4G/5G allele polymorphism in the PAI 1 promotor region were determined by polymerase chain reaction from leukocytes of 60 normal controls and 96 patients with cerebral stroke. Their plasma PAI 1 activity was assayed by ELISA.Results The plasma PAI 1 activity level in CI group was significantly higher than the CH and the control group.The plasma PAI 1 activity level (homozygote 4G/4G genotype patients) in CI and CH group was the highest,5G/5G genotype was the lowest,heterozygous 4G/5G genotype was in the middle;the difference was remarkable between 4G homozygote genotype and the other two groups,there was no remarkable significance between 4G/5G and 5G/5G genotype.There was remarkable difference between 4G/4G homozygote genotype in CI group and the controls(P 0.05 ).There was remarkable difference between the plasma PAI 1 activity in female patients with CI 4G homozygote genotype patients and the male patients of the same genotype (P

Objective To evaluate the predictive value of serum macrophage migration inhibitory factor (MIF) for myocardial depression in severe sepsis patients.Methods Taken prospective study method,42 cases of severe sepsis patients were enrolled from December 2011 to June 2013.The patients were monitored by PICCO system after informing consent into ICU day,and given the corresponding treatment.According to the hemodynamic parameters were divided into two groups,myocardial depression group:cardiac index ＜ 3 L/(min· m2) and global end diastolic volume index ＞ 800 ml/m2,the remaining were in non myocardial depression group,and the patients were divided into survival group and death group according to 28-d mortality.Hemodynamic parameters and serum MIF,B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnI) level at the 1st,3rd,Sth day after admission.Results Fortty-two severe sepsis patients,non myocardial depression in 22 cases (non myocardial depression group),myocardial suppression in 20 cases (myocardial depression group).At 28 d,20 patients of survival (survival group),22 patients of death (death group).The serum MIF in death group was higher than that in survival group at the 1st,3rd,5th day (P ＜ 0.01) ; BNP and cTnI at the 1st day in two groups had no statistical significance (P ＞0.05),BNP and cTnI at the 3rd,5th day in death group was higher than that in survival group(P ＜ 0.01).The serum MIF at each time point in myocardial depression group was higher than that in non myocardial depression group [survival:8.70(3.53,16.80) μ g/L vs.1.20(0.80,1.77) μ g/L,2.30(1.33,8.40) μ g/L vs.0.60 (0.60,0.99) μg/L,0.50 (0.31,2.50) μg/Lvs.0.16 (0.15,0.20) μg/L;death:11.43(8.10,17.16) μ g/L vs.2.30(1.96,3.69) μ g/L,9.70(6.55,14.65) μ g/L vs.1.90(1.88,5.27) μ g/L,7.50(5.15,14.20)μ g/L vs.2.40(0.80,8.46) μ g/L] (P ＜ 0.05).The serum MIF of death patients in two groups was higher than that of survival patients (P ＜ 0.05).MIF at the 5th day had biggest prediction value,AUC was 0.952,when the cut-off point of 0.65 μg/L,the sensitivity was 100％ (22/22) and specificity was 85％ (17/20).Multivariable Logistic regression analysis results showed that only APACHE Ⅱ scores was the independent risk factor for 28-d mortality (P ＜ 0.01),while MIF couldn' t independent forecast 28-d mortality (P ＞ 0.05).Conclusions Elevation of serum MIF prompts severe sepsis patient with poor outcome,and dynamic changes of MIF is helpful to evaluate the prognosis and severity of severe sepsis patients with myocardial depression,but MIF is not an independent risk factor for predicting 28-d mortality.

Objective To evaluate the correlation between fluid balance and myocardial function and the mortality in patients with septic shock.Methods Ninety two septic shock patients enrolled between January 2013 and January 2015 were divided into survival group and non-survival group based on 28-day mortality.Fluid balance,haemodynamic parameters and B-type natriuretic peptide (BNP) were collected on days1,3,7 after admission.Results Forty four patients survived the crisis while 48 died.The 7 day average fluid balance volume in survival group was lower than those in non-survival group [(55 ± 9)ml/kg vs.(187 ± 14)ml/kg,t =54.260,P ＜0.01].The initial left ventricle ejection fraction (LVEF) in survival group was lower than that in non-survival group [(42％ ±4％) vs.(54％ ±6％),t =10.100,P ＜0.01].Serum BNP level was significantly lower than those in non-survival group [(267 ± 54) ng/L vs.(681 ± 22) nig/L,t =48.580,P ＜0.01].Multivariate logistic regression analysis showed that fluid positive balance,LVEF and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) were the independent predictors for 28 day mortality (P ＜ 0.05).Conclusions Fluid balance and myocardial function can serve as risk predictors for septic shock patients.

Objective To evaluate the predictive value of serum presepsin (sCD14-ST) for septic myocardial depression (SMD) in patients with severe sepsis or septic shock.Methods This was a prospective cohort study.A total of 84 patients with severe sepsis or septic shock were monitored by pulse indicator continuous cardiac output (PiCCO) system and divided into myocardial depression group (cardiac function index [CFI]<4.1 L/min, n=37) and non-myocardial depression group (CFI≥4.1 L/min, n=47) according to cardiac function index (CFI).Left ventricular ejection fraction (LVEF) was measured by doppler echocardiography at admission.The patients were divided into survival group (n=40) and non-survival group (n=44) based on 28-day mortality.Serum sCD14-ST,B-type natriuretic peptide(BNP), tumor necrosis factor-α(TNF-α), cardiac troponin Ⅰ (cTnⅠ) levels and hemodynamic parameters were observed dynamically at day 1,3,5 after admission.Quantitative data with normal distribution were analyzed using t-test and abnormal distribution data were analyzed using Mann-Whitney U test.Categorical data were analyzed using χ2 test.Results The serum levels of cardiac index (CI), global ejection fraction (GEF) and left ventricular contractility index (dPmax) in myocardial depression group were all significantly lower than those in non-depression group at day 1 after admission (all P<0.01).The serum levels of sCD14-ST, TNF-α and BNP in myocardial depression group were all significantly higher than those in non-depression group (all P<0.01).Serum sCD14-ST levels in 84 septic patients were positively correlated with both BNP and TNF-α (r=0.204, P<0.05 and r=0.516, P<0.01, respectively).The area under the receiver operating characteristics curve (AUC) of sCD14-ST was 0.782 for myocardial depression in patients with sepsis, with a sensitivity of 89.2% and a specificity of 78.0% at the cut-off point of 988 mg/mL.The predictive value of sCD14-ST was inferior to BNP and TNF-α (both P<0.05).The combination of sCD14-ST, TNF-α and BNP could provide better prediction value in septic myocardial depression.Logistic regression analysis showed that serum sCD14-ST was not the in dependent predictor for septic myocardial depression (P>0.05).There were 24 cases died in myocardial depression group.The mortality of myocardial depression group was significantly higher than that of non-depression group (64.9% vs 42.6%, χ2=4.132, P =0.042).The serum levels of sCD14-ST at day 1 and day 3 in myocardial depression group were significantly higher than those in non-myocardial depression group (both P<0.01).sCD14-ST levels in both groups showed downtrend.The serum level of sCD14-ST in non-survival group was significantly higher than that in survival group (P<0.01).Conclusions Myocardial depression is common in patients with severe sepsis and septic shock.High serum level of sCD14-ST is correlated with myocardial depression to some extent, but not an independent predictor.The combination of sCD4-ST, BNP and TNF-α can improve the predictive value for myocardial depression.