Objective To evaluate the performance of six homocysteine (Hcy) analysis systems.Methods This is a methodological evaluation study.We analyzed six cycle enzymatic systems,and their correlation and deviation compared with chemiluminescence microparticle immunoassay (CMIA) from Abbott Architect plus i2000 system.Precision,accuracy,anti-interference and analytical measuring range (AMR)were evaluated,according to the CLSI EP5-A2,EP15-A2,EP7-A2,EP6-A,EP9-A2 guidelines.To assess the accuracy,we used the reference material SRM 1955 from National Institute of Standards and Technology (NIST),and EQA samples from CAP and National Center of Clinical Laboratory.Regression analysis was conducted using Passing-Bablok method.Linear regression measurement was performed using Cusum method,with a statistical significance level set at P ＜ 0.05.Correlation analysis was conducted using Pearson coefficient,with P ＜0.05 indicating significant difference.Deviation analysis was performed using Bland-Altman method.Results In the six systems (A1-D2) except A1,the within-run CVs were all ＜ 5％ and the between-run CVs were all ＜ 6.7％ at the Hey concentration range of 10-22 μmol/L.The accuracy validation of NIST SRM 1955 showed that the maximum absolute bias were-3.36,1.43,2.24 μmol/L at low,medium and high levels respectively.Measurement of EQA samples from CAP and National Center of Clinical Laboratory showed that the relative bias were all ＜ TEa (2.5 μmol/L or target value ±20％) in the six systems (A1-D2) except A1.Hb and TBIL interference were significant.The upper limit of AMR for six systems were 47.3,69.76,72.1,73.96,46.23 and 48.98 μmol/L respectively.The measurement results of six systems conelated well with that of CMIA system,with Pearson correlation coefficient (r) ＞ 0.975 (P ＜0.01,n ＞40).Compared with CMIA system,the Bland-Altman results showed that the maximum average absolute deviation was 2.9 μmol/L.Conclusions The cycle enzymatic method used to measure homocysteine has good precision,linear range,and anti-interference ability.But it is noticeable that the results of cycle enzymatic was higher than those of CMIA.Meanwhile,the six systems do not apply to measuring urine samples.

Twenty Mongolian sheep embryos at the stage of 21 days and 16 hours, 7mm in length, were studied systematically and the following characteristic features were observed. The body of the 7mm sheep embryos looks like the letter“C”. It has approximately 44 pairs of somites encircling the notochord to form a cylindrical-like rod, located at the ventral side of the spinal cord. Four pairs of branchial arches have fully developed. The heart-thorax prominence projected higher than that of the liver-abdomen prominence. The fore limb bud is paddle-like, and the hind limb bud is cumulus-form. The brain has differentiated into five regions with three flexures. And the olfactory pits, optic cups and otic vesicles have also formed. Besides the tail nerves, most of the spinal nerves have grown and the brachial and lumbo-sacral plexuses have been formed, but the latter is not so conspicuous. The two plexuses extend into the bases of the limb buds. Of the 12 crainal nervers only the 1st, 2nd and 6th pairs have not yet developed. The nerve fibers of the Froriep’s ganglions extend into the N. hypoglossus. The Rathke’s pouch extends as a long canaliculus from the dorsal wall of the ectodermal mouth cavity. The paired lateral swellings arise from the mandibular arches. The transient tuberculum impar is located between the first and second branchial arches. The opening of the thyroglossal duct on the anterior border of the 2nd arches is closed. The cumulum epiglotticum develops from the bottom of the third branchial arches. The slitlike glottis of the larynx is located in the midplane between the 4th. and 6th branchial arches. The stomach bud expands into an oblong shape and the entire stomach has so rotated that the original dorsal border has turned 45?to the left. The intestinal loop has become V-shaped, and has extended into the umbilical cord. The gall bladder, the ventral and dorsal pancreas have developed. The terminal of the trachea bifurcates into the primary branchi. The vesicles of the lung buds have formed from the branchia of both sides. The single pericardial cavity, the paired pleural cavities, and the large common peritoneal cavities communicate with each other. The mesonephros are spindle-shaped complex. The course of the mesonephric ducts can be traced into the allantoic stalk. The metanephros is formed as a tubuloalveolar dilatation. The metanephric ducts communicates with the posterior dorsal border of the mesonephric ducts. The septum primum is going to fuse with the endocardial cushions, closing the iuteratrial foramen primum. A new opening, the interatrial foramen secondum, has been formed and the septum secondum is being developed. The interventricular foramen has been formed. The arterial bulbus is separated incompletely by the two longitudinal folds. The dorsal aortae between the third and the fourth aortic arches have not yet degenerated. The buddings of the coeliac artery, the posterior menenteric artery, the external iliac artery, and the inferior vena cava are not conspicuous. The other venous rudiments have already developed. Special venous circles have been discovered in the posterior part of the posterior cardinal vein and at the base of hind limb buds, the umbilical vein have also been found and sending branches to the bases of the posterior limb buds.

The cleavages and formation of the blastula of Mongolian sheep embryos were studied. The following observations were recorded.1. The egg of Mongolian sheep undergoes two maturation divisions. During the first maturation division the egg cell has a diameter of 136 ?. The cytoplasm contains larger or smaller yolk granules. The nucleus is located by one side of the cytoplasm. The nucleolus is larger and prominent. About 25 hours 30 minutes after coitus, after the second maturation division the egg cells are located at about distal 1/3 of the oviduct, and meassuring about 180 ? in diameter. The corona radiata desintegrates. The second polar body is located between vitelline membrane and zona pellucida.2. The cleavage of the Mongolian sheep embryos is of the equal holoblastic type. The first cleavage takes place about 44 hours 35 minutes after coitus. The blastomeres are about 104 ? in diameter. About 49 hours 50 minutes after coitus, the second cleavage completes the 4 blastomeres frequently lie at rght angles to each other, the diameter is about 108 ?. The 10-cell stage is attained about 66 hours after coitus, the diameter of the blastula is about 104 ?. Mean while the blastula moves slowly half way in the oviduct.3. About 68～74 hours after coitus, the number of blastomeres reached 16～20, and the diameter is about 108 ?, and it is located in about proximal 1/3 of the oviduct. Because of the shifting of the blastomeres during cleavage they form a solid mass of cells with a cleft appearing in the cellular mass, begins to assume the outline of the morula. From 135 hours 40 minutes to 139 hours 15 minutes, the number of the blastomeres is over 36, and the morula is about 100 ? in diameter. They are now considerably different in size, the largest blastomere being almost twice as the size of the smallest. By this time the morula has reached the uterus.4. About 160 hours 20 minutes to 188 hours 30 minutes after coitus, the blastula is about 100～108 ? in diameter, and is freely moving in the uterus. On the section of the blastula, a flat cell has been discovered from the lower surface of embryonic mass. It is considered as a primary cell to form the endoderm blastocytes and is named as "endodermoblast".

The Mongolian sheep embryo develops into gastrula from 8 days 17 hours 10 minutes to 12 days 14 hours 30 minutes after coitus. The blastocyst is spherical in shape about 266—972?m in diameter. The zona pellucida has disappeared. The trophoblast consists of simple flat epithlium or simple cuboidal epithelium. About 8 days 17 hours 10 minutes to 9 days 15 hours 18 minutes after coitus the embryonic knot becomes spheroid, about 70—72?m in diameter. The embryonic knot is slightly protruding from The surface of the blastocyst and is covered by the trophoblast, the ectodermal cells of the dorsal portion of the embryonic knot form a mass. The lower surface of the embryonic knot has differentiated into the endoderm. The extraembryonic endoderm extends to the inner surface of the trophoblast from the periphery of the embryoblast. About 10 days 16 hours to 10 days 17 hours 20 minutes after coitus, in the dorsal portion of the embryonic knot forms a vesicle which is known as the primitive amniotic cavity about 40?m in diameter. The bottom of the primitive amniotic cavity has differentiated into the ectoderm, about 72—90?m in diameter. The endoderm of the lower surface of the embryonic knot continues to develop along the inner surface of the trophoblast to the equator. The developmental process of the primitve amniotic cavity of Mongolian sheep embryos is different from rabbit、guinea pig and human embryos, but it is similar to the mole embryos. About 11 days 16 hours 5 minutes to 12 days 14 hours 30 minutes after coitus, the embryonic knot becomes discal in shape and is fully developed, about 252—396?m in diameter. The primitive amniotic cavity of the dorsal portion of the embryonic disc has disappeared. The ecitoderm is exposed to the surface of the blastocyst, it consists of stratified columnar epthelium. The endoderm of the lower surface of the embryonic disc consists of the simple flat epithelium, it forms a spherical primitive gut cavity along the inner surface of the trophoblbst.

Objective To investigate the clinical significance of tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6)in the ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis(SBP).Methods TNF-? and IL-6 in the ascitic fluid of 32 cirrhotic patients with SBP were measured by ELISA.The group was compared with the value in transudatory ascites of 30 cirrhotic patients.Results The levels of TNF-? and IL-6 in the ascitic fluid of cirrhotic patients with SBP were much higher than those in transudatory ascites of cirrhotic patients(P

Objective To investigate the effective predictors of response in HBeAg-positive patients treated with adefovir dipivoxil(ADV)and to provide evidence for individualized treatment.Methods Patients administered with ADV for 48 weeks in a randomized,placebo-controlled,multicenter trial were studied.Statistical analyses,such as Backward stepwise logistic regression and 2?2 method were used for predictors analysis at week 48.Results The baseline serum ALT levels,HBV DNA levels,and undetectable serum HBV DNA by PCR at week 24 were predictors for HBV DNA negativity at week 48.The median of serum ALT levels and HBV DNA levels prior to treatment were 134.5 U/L and 6.57 lg copies/mL,respectively.Patients with baseline ALT levels higher than the median,HBV DNA levels lower than the median,and serum HBV DNA undectectable by PCR at week 24 had greater rate of HBV DNA negativity(93.3%),HBeAg loss(60%)and HBeAg seroconversion(40%)at week 48 than the others.47.8% of patients whose HBV DNA levels were positive at week 24 also achieved HBV DNA negativity at week 48,and 8.6% achieved HBeAg seroconversion.Conclusion Better response at week 48 has significantly higher serum ALT levels and lower HBV DNA levels prior to treatment and HBV DNA negativity at week 24 compared with non-response.Patients whose HBV DNA levels ware still positive at week 24 should continue therapy.

Objective To observe the specific humoral and cellular immune response in BALB/c mice injected with pS and p18S. Methods pS and p18S were constructed separately by inserting HBsAg gene fragment and the fusion gene fragment of HBsAg and mouse interleukin 18(IL 18) into the reading frame of pcDNA3.1+. Mice were injected with either plasmid intramuscularly in a total dose of 300 ?g per mouse. Every serum sample was detected for anti HBs using enzyme linked immunosorbent assay(ELISA). Furthermore, HBsAg specific cytotoxic T lymphocytes activity was measured. Results The expression of HBsAg was demonstrated by ELISA in p815 cells transfected with pS and p18S. pS can stimulate a positive antibody response. The average level was 135 mIU/ml, with the highest level of 530 mIU/ml. p18S could elicit relatively lower antibody response which was 20 mIU/ml. HBsAg specific CTL activities were 37.1% and 34% separately in pS and p18S immunized mice. It was only 13.2% when detected in pcDNA3.1+ immunization. Conclusion pS is effective to stimulate a humoral and cellular response in H 2d mice. IL 18 gene can not enhance the immune response when fused with HBsAg gene. Conversely, it seems to inhibit an immune response.

Objective To study the relationship between endoscopic and histologic mucosal changes in chronic gastritis.Methods All 403 patients with chronic gastritis were examined by endoscopy and two samples of gastric mucosa were examined by the same pathologist.Results (1)Gastroscopic results:there were 380 cases of chronic superficial gastritis(CSG),38 cases of chronic atrophic gastritis(CAG) including 15 cases of coexistence of CSG and CAG.(2)Pathologic results:365 cases of CSG;49 cases of CAG including 11 cases of coexistence of CSG and CAG.Among 403 cases,108 cases with intestinal metaplasia(IM),59 cases with mucosal erosion.39 cases had active chronic gastritis(ACG).(3)For CSG,comparing with pathology,endoscopic results had 95.3% of sensitivity and 91.6% of positive predictive value.In contrast their specific rate and negative predictive value were 15.8% and 26.6%,respectively;for CAG,endoscopy had 96.0% of specific rate and 93.2% of negative predictive value for pathologic diagnosis.Its sensitivity and positive predictive value were 46.2% and 63.2% respectively.(4)Comparing with pathologic results,endoscopic features had less sensitivity(50%),but some had a higher positive predictive value for pathologic CSG,CAG,and IM.(5)CAG was most likely associated with type Ⅱ IM(85.2%).Although most type Ⅰ IM was presented in CSG(81.0%).Conclusion Any single endoscopic finding was nonspecific for pathologic diagnosis;although some charactristical endoscopic findings had a higher positive predictive value. In other words,a single pathologic change may associated with various endoscopic findings, while a single later finding only presented one or two pathologic changes.

Patients with irritable bowel syndrome(IBS,n=41)subjected to gastroscopy,patholo- gy,esophageal manometry and 24h pH monitoring.The records were compared with that of normal in- dividuals(n=30)to clarify the relation of esophageal motor function with esophageal complaints in cas- es with IBS.Results showed that 21/41 cases with IBS presented esophageal symptoms.Rate of abnor- mal endoscopic and pathologic findings in 6 of which was statistically higher than the control's; esophageal lower sphincter pressure in IBS with symptoms declined significantly than that without and the control;esophageal peristaltic velocity and duration increased with significance;no pressure differ- ence was detected in esophageal upper sphincter;total pH score ,fraction-time pH

Objective To investigate the difference of clinical features between primary colorectal malignant T cell lymphoma and primary colorectal malignant B cell lymphoma.Methods Forty cases diagnosed as primary eolorectal malignant lymphoma (PCML) between Jan 1999 and May 2008 were studied retrospectively.Results The average age of 40 patients with PCML was (41.0±11.2) years old.Twenty-seven cases (67.5%) were diagnosed as B-cell lymphoma.Thirteen cases (32.5%) were diagnosed as T-cell lymphoma.Patients with T-cell lymphoma in PCML had more symptoms such as fever,night sweat and hematochezia,and was easier to perforate than those with B-cell lymphoma.Protrude type and single-focus and right-colon type were common in B-cell lymphoma under colonoscopy,but ulcerative type and multi-focus and fulbcolon were common in T-cell lymphoma.B-cell lymphoma had an earlier diagnosis,and more opportunities for surgery than T-cell lymphoma.Conclusions The misdiagnostic rate for PCML was high.Protrude type and single-focus and right-colon type were common in B-cell lymphoma under eolonoscopy,but ulcerative type and multi-focus and full-colon were common in T-cell lymphoma.B-cell lymphoma could be diagnosed earlier.