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.

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.

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.

Objective To observe the effects of recombinant plasmid of rat's interstitial collagenase on experimental liver fibrosis. Methods We constructed the recombinant plasmid of rat's interstitial collagenase fused Flag peptide which can be expressed in eucaryotic cells. After bound to galactose terminal glyco poly L lysine(G PLL), we transferred the recombinant plasmid to the rat's fibrotic liver in vivo by intravenous injection, then observed the effects of the plasmid on the fibrotic liver by RT PCR, immunohistochemistry and the observation of pathology. Results The recombinant plasmid of interstitial collagenase could be expressed in rat liver, the expression of the plasmid could increase the degradation of type Ⅰ and type Ⅲ collagen in the rat's fibrotic liver compared with fibrotic modal group ( P 0.05). Conclusion The recombinant plasmid of interstitial collagenase have some effects on liver fibrosis, but this effects is limited.

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 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 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