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 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.

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.

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 glucose metabolism in patients with liver cirrhosis and to explore the relationship between glucose and liver function.Methods 164 liver cirrhosis patients with abnormal glucose metabolism were divided into A,B and C groups according to Child-Turcotte-Pugh(CTP)classification system.Glucose metabolic disorder and relation between blood sugar level and liver function were observed and analyzed.Results We divided the patients into three subgroups according to their blood sugar levels:hypoglycemia group,impaired fasting glucose group and diabetes mellitus group.Patients of Grade C were with the highest incidence of hypoglycemia,with a P value P

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 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 investigate the therapeutic efficacy of surgical treatment of myocardial bridge. Methods Fifteen patients with myocardial bridge had been treated in our hospital from January 1999 to October 2006. Thirteen patients who had typical angina had been treated regularly by medication, but their symptom remission was not satisfactory. One patient suffered from acute myocardial infarction, and another 1 patient complained of palpitation and syncope. All the patients were given surgical treatment. Surgical strategies included minimally invasive off-pump surgery in 9 patients (supraarterial myotomy in 3 patients, coronary artery bypass grafting in 2, and coronary artery bypass grafting with supraarterial myotomy in 4) and on-pump surgery in 6 patients (coronary artery bypass grafting with supraarterial myotomy in 5 patients and supraarterial myotomy in 1). Results All the operations were successfully completed. The operative duration of off-pump and on-pump surgery was 2.8?1.9 h and 3.5?1.7 h, respectively. The extracorporeal circulation time was 59?37 min. No surgery related death or complications occurred. At 3 months after operation, all the patients were free from symptoms, and electrocardiogram returned to normal in 11 patients. During a follow-up for 0.5~7 years (1.9?1.2 years), recurrent palpitation was seen in 1 patient and others reported no angina. Conclusions Surgical treatment of myocardial bridge has good immediate and long-term results.

The advent of human infections with avian influenza A(H7N9)and the emerging communicable disease has brought us profound thoughts on lemology teaching recently. We analyzed the exiting challenges of lemology teaching, including great changes in communicable diseases com-posing but limited class hours, decreasing of communicable diseases cases, medical students' psycho-logical apprehension, lack of teachers, more and more requirements in the prevention and treatment for communicable diseases from the public, etc. Several suggestions on how to further improve the lemology teaching quality were proposed including adjusting the curriculum arrangement, paing atten-tion to accumulate teaching cases, applying multi-media materials, taking full advantage of the teach-ing cases from specialized hospital, teaching students knowledge about themselves protection, improv-ing the quality of young teachers, emphasizing discipline characteristics and the importance of public health, reforming the teaching method and promoting the effect of teaching in communicable diseases.

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.