ObjectiveTo investigate the changes of several typical serum tumor markers in patients with mycotic gastric ulcer and ulcerated gastric carcinoma, so as to explore their clinical value in the differential diagnosis of mycotic gastric ulcer and ulcerated gastric carcinoma. MethodsAccording to the post operation pathological results, 122 patients with gastric ulcer were divided into ulcerated gastric carcinoma group (n= 75), gastric carcinoma complicated with fungal infection group (n=4)and mycotic gastric ulcer group (n=43). Fifty-live healthy adults were set as normal control group (n= 55). Venous blood was collected and sera were separated for all subjects. Electrogenerated chemiluminescence analysis was performed to measure serum CA72-4, CA19-9, CA24-2 and carcinoembryonic antigen (CEA). Serum sialic acid (SA) level and glycylproline dipeptidyl amiuopeptidase (GPDA) activity were determined by applying Hitachi 7170 fully automatic biochemical analyzer. ResaltsThe level of CA72-4, CA19-9, CA24-2, CEA and SA was 49.85±10.36 U/L, 59.31±3.89 U/L, 38.77±12.56 U/L, 5.33±2.94μg/L and 85.12±10.86 mg/dL respectively in ulcerated gastric carcinoma group; 48.98±11.22 U/L, 80.13±4.72 U/L, 36.92±9.97 U/L, 5.38±7.22 μg/L and 85.16±9.96 mg/dL respectively in gastric carcinoma complicated with fungal infection group, significantly higher than that of normal control group and mycotic gastric ulcer group. The GPDA activity was 48.09±15.02 U/L and 48.22±13.51 U/L in ulcerated gastric carcinoma group and gastric carcinoma complicated with fungal infection group, significantly lower than that of normal control group and mycotic gastric ulcer'gr0up. The differences were statistical significant (P<0.01). (2) The positive detection rate of CA72-4, CA19-9, CA24-2, CEA, SA and GPDA was 24.00%, 29.33%, 20.00%, 41.33%, 65.33% and 72.00% respectively in ulcerated gastric carcinoma group, significantly higher than that of normal control group and mycotic gastric ulcer group. The differences were statistical sig-nificant (P<0.01). The positive rate of combined detection of SA and GPDA accounted for 78.67%.ConclusionThe detection of six tumor markers including CA72-4, CA19-9, CA24-2, CEA, SA and GPDA has an important clinical value in the differential diagnosis of mycotic gastric ulcer and ulcerated gastric carcinoma. The detection of tumor markers with high sensitivity and high sensitivity attributes to clinical therapy and prognosis evaluation when the cause of gastric ulcer is uncertain and it is difficult to choose an appropriate therapy strategy.

The reform experiences of physician fee system ( PF ) practiced at a hospital in Nanjing were analyzed to come up with key influencing factors to make the reform a success,including income level,income makeup and income equity.Most noteworthy of the authors' points was income equity,proposing such reforms as target physician salary and inter-departmental balance,especially the two key factors of implementing the price target factor and inter-departmental balance.Their efforts aim at exploring a brand new idea and successful experiences in making PF system a success in China's hospitals.

The minimally invasive approach is the direction of cardiac surgery.With the development of telemanipulation and computer technology,the minimally robotic surgery has become reality.As the one of the most minimally invasive cardiac surgery,the robotic surgical system provides cardiac surgeons with less invasive manner and dexterity manipulation.Robotic cardiac surgery is an evolutionary process and has resulted in a substantial increased attention to surgeons and patients.This review is to introduce the recent clinical application of robotic technology in cardiac surgery.

Acute ischemic stroke is characterized by high morbidity,high mortality and high disability.It seriously affects the health of middle-aged and elderly persons.Searching for the relevant factors that influence the neurological outcome in patients with acute ischemic stroke and interfering with them are one of the research hotspots in this field.Studies in recent years have shown that matrix metalloproteinase-9,neuronspecific enolase,S-100B protein,brain natriuretic peptide,copeptin,blood lipids,blood glucose and other hematological parameters may be associated with the neurological outcome in patients with acute ischemic stroke.

Objective To study the expressing status of antisense tissue inhibitor of metalloproteina se-1(TIMP-1) in hepatic stellate cells (HSC) constructed in vitro, and to eval u ate the effects on the production of type Ⅰ and Ⅲ collagens secreted by activated rat HSC. Methods HSC were extracted from normal rat liver by pronase and co llagenase digestion and purified by centrifugal elutriation, and were cultured pla stic until they were activated to a myofibroblastic phenotype after 7-10 days. RT-nest-PCR and gene recombinant techniques were used to construct the rat ant isense TIMP-1 expression plasmid which can express in eukaryotic cells, and seg uenced after being counstructed. The expressing plasmid and the pcDNA3 empty pla smid were transfected into HSC by Effectene reagent separately. The cells were sel ected after growing in DMEM containing 400 ?g/ml G418 for 3 to 4 weeks. Exp ression of TIMP-1 in HSC was d etermined by Northern blot and Western blot. We tested the interstitial collagen ase activity in culture media with FITC-labled type Ⅰ collagen as substrate. U ltimately, we quantified the typeⅠ and type Ⅲ collagen in HSC by Wester n blot. Results The exogenous antisense TIMP-1 recombinant plasmid could block the expression of TIMP-1 greatly, while there were not the same outcome i n pcDNA3 empty plasmid g roup and non-transfecting control group. The ratio of TIMP-1/GAPDH was 0.67, 2 .41 and 2.97 respectively at mRNA level( P

Objective To introduce the strategy of perioperative blood glucose control and the early outcome in diabetic and non-diabetic patients undergone coronary artery bypass grafting (CABG). Methods A total of 1019 CABG were performed and the patients were divided into diabetic and non-diabetic groups (n=211, 808, respectively). The demography was comparable between the two groups with the exception that the percentage of preoperative myocardial infarction was significantly higher in diabetic group than that in non-diabetic group. Off-pump and conventional CABG were routinely performed and the left internal mammary artery (IMA) and great saphenous vein (GSV) were used as conduit. Perioperative blood glucose was controlled according to the close supervision. The aim of preoperative 6mmol/L and postoperative 8mmol/L was achieved by means of oral medication or subcutaneous injection of insulin, which was complimented by continuous pump infusion of regular insulin to optimize the glucose level. Results 99.2% patients were discharged. The overall perioperative mortality was 0.8% and the percentage was 1.4% and 0.6% respectively in diabetic and non-diabetic group with significant difference(P0.05), respectively. Cerebral infarction occurred in 1.4% diabetic patients and in 0.5% non-diabetic patients(P

Objective To introduce the strategies of coronary artery bypass grafting (CABG) surgery for elderly patients over 65 years old. Methods Three hundred and ninety four elderly patients were retrospectively studied, 92.4% of whom were complicated with other diseases. Off-pump CABG (OPCAB) was used in 248 cases (62.4%). For the remaining patients with severely compromised cardiac function or small target vessel with diffuse lesion, conventional CABG (CCABG) was selected. Left internal mammary artery (LIMA) was harvested with extrapleural harvesting technique and grafted to left anterior descending artery (LAD) in 96.2% of patients. Saphenous vein or radial artery was utilized for the other coronary arteries. Transit-time flowmeter (TTFM) was utilized to make sure that grafts were patent with satisfactory blood flow. Perioperative blood sugar level was controlled at 6-10mmol/L by insulin. Results Grafts of per patient were 3.14?0.55 for on-pump CABG and 2.40?0.81 for OPCAB. Three patients died resulting in a mortality of 0.76%. The incidence of complication was 2.28%. The rest recovered uneventfully. Intubation time of OPCAB was significantly shorter than that of CCABG. Patients were discharged within 11.84?4.95 days after operation. Conclusion Good short-term result, namely low incidence of mortality and complication, could be obtained in elderly patients over than 65 years old undertaking CABG.

Objective To explore the effects of advanced glyeosylation end products (AGEs) on the binding of hepatic nuclear factors to the human insulin receptor (hlR) gene promoter. Methods The oligonueleotides with hlR gene promoter activity, 42 bp (spanning -1 441 to -1 400, US1) or 146 bp (spanning -638 to -493), were artificially synthesized, with point mutations at 5 key G residues in 42 bp US1 m5 oligonucleotides. US1 and rat hepatic nuclear extracts (HNE) were incubated with glucose 6-phosphate, prior to non-competition and competition gel retardation electrophoresis. Results Competition gel retardation electrophoresis showed that the binding capacity of 32p-labeled US1 probe to HNE could be signifficantly decreased with increased US1. US1-AGEs and US1m5 decreased the binding of probe to HNE as well, but only partly affected the electrophoretie bands [1,5,10 ng US1-AGEs: (41.08±2.86)%, (27.64±2.92)%, (15.35±1.81%) vs (52.05±1.79)%]; 5,10 ng US1m5: (5.20± 1.03)%, (1.81±0.21)% vs (52.05±1.79)%]. AGEs formed on HNE could increase the binding of HNE to probe, along with nonspecifie binding increasing. Conclusion The impact of AGEs on hlR gene expression seems to be related to the effects on cis-elements and trans-acting factors.

Objective To estimate the application of the wheat esterase inhibition method for the determination of organic phosphorus pesticide residues in agricultural products.Methods The wheat esterase inhibition method was used for the determination of organic phosphorus pesticide residues in chive,the quality evaluation and principal component analysis were conducted.Organic phosphorus pesticide residues in five agricultural products were detected by this method,and compared with the confirmatory test with GC.Results The detection limit,standard deviation,relative standard deviation and average recovery of this method for various organic phosphorus pesticides were 0.05-0.52 mg/kg,0.26-3.09,2.9%-4.1% and 74.5%-92.1%,respectively.The inhibitory degree of pesticide and precision was the primary factor for influencing the result of quality evaluation.Conclusion The wheat esterase inhibition method is reasonable and is applicable for the semi-quantitative analysis of organic phosphorus pesticide residues in the agricultural products

Objective: To translate Millon Clinical Multiaxial Inventory Ⅲ (MCMI-Ⅲ) into Chinese, and then test its reliability and validity. Methods: MCMI-Ⅲ was administered to patients with mental disorders and normal people. Some subjects completed SAS, SDS, HAMA and HAMD simultaneously. 7-14 days later, some subjects completed the Chinese version of MCMI-Ⅲ again. Results: Cronbach’s alpha and the split-half reliability of MCMI-Ⅲ was 0.957 and 0.919, respectively. The mean Cronbach’s alpha, split -half and test -retest reliability of the subscales were 0.72, 0.70, 0.71 respectively. Most of the items correlated significantly (P