Traditional immunological strategy which largely based on antigen-antibody techniques such as CA153,cytokeratin CK8/18/19,is still the main diagnostic biomarkers for breast cancer.Molecular biology markers such as BRCA1/2 and HER2 are becoming popular and hot.This article summarizes recent progress of breast cancer diagnosis based on nucleic acid related strategies such as circulating DNA,miRNAs,aptamers and circulating tumor cells.

Coronary atherosclerotic heart disease is the leading cause of death in the world of non-infectious diseases.High density lipoprotein ( HDL ) plays an important role in the progression of anti-atherosclerosis.Recent studies have found that HDL can carry microRNA, and the anti-inflammation function of endothelial cell is achieved by the transport of microRNA.The specific functions of different HDL subtypes in the anti-atherosclerosis have been gradually recognized.At the same time, a series of traditional HDL anti-atherosclerotic functions also have been newly discovered, such as reverse cholesterol transport, antioxidant, anti-inflammatory and the protection of vascular endothelium.All of these advances provide a new basis for the clinical application of HDL.

Cytochrome P450 is a superfamily of metabolic enzymes and many of its members show tight correlation to the development of a variety of tumors.Cytochrome P450s are becoming novel research targets for personalized diagnosis and treatment because of its specialized enzymatic activity.This paper reviews the research progress and development of the cytochrome P 450 family in cancer field ,introduces the applications of cytochrome P 450 in clinical diagnosis and personalized medicine , looks into prospect research and application trend.

Objective To investigate the expression pattern of growth arrest-specific transcript 5 ( GAS5 ) in hepatocellular carcinoma and assess its pre-operation and post-operation levels.Methods Totally 243 patients were collected in Zhongnan Hospital in 2015, and were divided into 4 groups: pre-operation (117 cases), 1 weeks after operation (39 cases), patients with hepatitis B (55 cases) and cirrhosis ( 71 cases ) .Meanwhile, 129 controls were collected.The expression of GAS5 in plasma was detected by real-time quantitative PCR. The levels of GAS5 in subgroups were compared by Oneway ANOVA.The relationship between GAS5 and the clinical pathologic features, and its pre-operation and post-operation expression were analyzed by Student′s t test.Results GAS5 was downregulated in HCC plasma and the levels of GAS5 were associated with tumor differentiation ( R2 =0.219,P=0.011) and TNM stage (R2 =0.036,P=0.044).Compared with the levels in pre-operation group (3.958 ±0.282), GAS5 were upregulated after surgery (3.843 ±0.223),t=2.283, P=0.028.In addition, GAS5 expression in well and moderately differentiated HCC was higher than poorly differentiated ones before operation[(3.873 ±0.191) and(4.151 ±0.365),t=2.271,P=0.035], but there was no significant difference after operation[(3.880 ±0.154) and (3.879 ±0.246),t=0.032, P=0.975].The ROC curves indicated that GAS5 had a good sensitivity to differentiate HCC from the healthy ( 88%, 88/100 ) and the cirrhosis ( 90%, 90/100 ) . Conclusion GAS5 might be used to assess the treatment of HCC.

Case-based learning model was applied in teaching the course of Clinical Biochem-istry and Diagnosis for postgraduates with professional degree. Dyslipidaemia was chose as teaching content and one distinctly characterized case along with four typical cases were selected. Information of cases and core problems were submitted to students to prepare before the class. In the class, stu-dents were grouped and discussed independently. Students put forward the pathogenesis of the disease and the clinical laboratory test items for diagnosis and differential diagnosis. Teachers should adhere to the following principles: making the class student-centered and highlighting consciousness of stu-dents; creating clinical environment to stimulate enthusiasm for learning; problem-oriented and taking capacity building as the priority. After the class, teaching evaluation was designed to promote the con-tinuous improvement of teaching cases.

Objective To investigate clinical significance of Homer expression in peripheral blood leukocytes of patients with ischemic stroke (IS).Methods It was a retrospecive study.The gene expression levels of Homer were measured by RT-qPCR.266 patientscollected in Zhongnan Hospital from September 2015 to June 2016were divided into 5 groups:large-artery atherosclerosis (LAA,100 cases),cardioembolism (CE,42 cases),small vessel occlusion (SVO,68 cases),stroke of other demonstrated etiology (SOE,23 cases) and stroke of undemonstrated etiology (SUE,33 cases).Meanwhile,age and sex matched 126 healthy controls were also collected.IS diagnostic criteria for cerebral infarctionwas in accordance with the guideline for acute ischemic stroke in China in 2010.The levels of Homers in subgroups were compared by Oneway ANOVA.The area under curve (AUC) and 95％ confidence interval (CI) were calculated using ROC analyses.The odds ratio (OR) and 95％ CI were calculated using the multivariate logistic regression analyses.Results The levels of Homer1 [2.01 ± 0.15] and Homer2 [1.81 ± 0.31] in LAA patients were significantly higher than othergroups [Homer1 CE:2.40 ± 0.34;SVO:2.38 ± 0.35;SOE:2.36 + 0.33;SUE:2.40 ± 0.30;control group:2.35 ± 0.28;Homer2 CE:2.09 ± 0.38;SVO:2.08 ± 0.30;SOE:2.09 ± 0.41;SUE:2.10 ± 0.34;control group:2.12 ± 0.31] (Homer1 CE:t =9.353,P＜0.001;SVO:t =9.258,P＜0.001;SOE:t =5.396,P＜0.001;SUE:t=9.644,P＜0.001;control group:t =11.882,P＜0.001;Homer2 CE:t =4.725,P＜0.001;SVO:t =5.545,P＜0.001;SOE:t=3.640,P ＜ 0.001;SUE:t =4.669,P ＜ 0.001);There was no significant difference in the expression of Homer1 (F =0.940,P =0.441) and Homer2 (F =0.336,P =0.854) between non-LAA groupsand healthy controls.There was no significant difference in the expression of Homer3among the groups (F =0.641,P =0.669).Multinomial logistic regression analyses revealed that,higher Homerl (adjusted OR =8.62,95％ CI:4.13-18.00,P＜0.001) and Homer2 (adjusted OR=2.42,95％ CI:1.75-3.36,P ＜ 0.001) levels showed significant associations with increased odds of having LAA stroke,compared with the controls.ROC curves showed that the AUC of the combination of Homer1 and Homer2 for differentiating LAA and controls was 0.896 (95％ CI:0.862-0.929,P ＜0.001) and the AUCfor differentiating LAAand non-LAA was 0.847 (95％ CI:0.800-0.894,P ＜ 0.001).Conclusion The expression of Homer1 and Homer2 in peripheral blood leukocytes could be used as novel biomarkers for LAA stroke.

Objective To determine the expression of Human Epidermal Growth Factor Receptor 2 (HER-2) in breast cancer and its correlation with Tumor Necrosis Factor-α (TNF-α). Methods We used SABC method to detect the expression of HER-2 and TNF-α in 112 cases of primary breast cancer, and analyzed the association of HER-2 expression with clinicopathological features and TNF-α expression. Results The positive expression rate of HER-2 in breast cancer was 35.71% (40/112), of which, the expression rate was 35.05% (34/97) in 97 invasive tubic breast cancer, and 33.33% (2/6) in invasive lobular breast cancer,25.00% (1/4) in mucinous carcinoma, and 50. 00% (2/4) in intraductal carcinoma. There was no significant correlation between HER-2 and any clinicopathological features of primary breast cancer ( P ＞ 0. 05 ). The expression of HER-2 in breast cancer had no signiciant association with TNM stage, age, age of menarche,menopause, gravidity, parity and family history of cancer ( Ps ＞ 0. 05 ), The positive rate of TNF-α was 23.61% (17/72) when HER-2 was negative, whereas the positive rate of TNF-α was 52. 50% (21/40) when HER-2 was positive. The expression of HER-2 was signiciantly positively correlated with the expression of TNF-α (r = 0. 881, P ＜ 0. 05 ). Conclusion HER-2 expression had a positive correlation with TNF-α in breast cancer,but the specific mechanism is still unclear.

Objective To study the expression of tumor necrosis factor -α (TNF-a) and correlation with TNF-a in breast cancer. Methods We used SABC method to detect the expression of TNF-a in 112 cases of primary breast cancer, and analysis the relationship between TNF-α with histologic grades and ER. Results The positive expression rate of TNF-α in breast cancer was higher than those of normal tissues and lobular hyperplasia of the breast (X2 =8.573, P =0.014). There was no significant correlation between histologic grades and TNF-α (X2 =1.304, P =0.521). TNF-a had a positive correlation with ER in breast cancer (X2=11.949, P =0.001). Conclusion The positive expression rate of TNF-α in breast cancer was higher than those of normal tissues and lobular hyperplasia of the breast.TNF-α had a positive correlation with ER in breast cancer, but the exact mechanism is unclear.

Objective To study on the association of apolipoprotein E(apoE)genotype with coronary heart disease(CHD)and type 2 diabetes mellitus(T2DM).Methods PCR-RFL,multiplex amplification refractory mutation system(muli-ARMS)and PCR-SSCP methods were used to detect the genotype of apoE,and DNA sequencing technique were used for further confrm the genotype and gene variations in 2 446 Chinese individuals,including 238 cases of CHD,316 cases of T2DM and 1 892 healthy controls.Fasting blood glucose(FBG)and plasma lipids levels[TC,TG,HDL-C,LDL-C,apoA I,apoB and Lo(a)]were measured by usual methods.Results Compared with the controls,plasma HDL-C(t=2.66)and apoA I(t=2.30)levels in the CHD group were significantly lower(P<0.05),but not in T2DM group;plasma TC level(t=5.22)in the T2DM group were significantly higher(P<0.05),but not in CHD group;systolic pressure(t=8.48,5.74)diastolic pressure(t=5.66,3.35),plasma TG(t=3.38, 4.56),LDL-C(t=2.48,7.00),apoB(t=1.67,2.24),Lp(a)(t=4.16,4.15)and FBG(t=7.04, 16.93)levels were significantly higher in both CHD group and T2DM group(P<0.05).The distributions of apoE ε2/2,ε2/3,ε3/3,ε2/4,ε3/4 and ε4/4 respectively were 0.4%,13.4%,58.0%,1.3%, 26.5%,0.4% in the CHD group;0.6%,5.7%,72.8%,1.9%,14.9%,4.1% in the T2DM group; 0.5%,10.5%,69.6%,1.6%,16.8%,1.1% in the control group.Significant differences were found between the CHD group(χ2=14.90,P=0.00),T2DM group(χ2=7.08,P=0.03)and the control group for the frequencies of apoE genotype.The distribution of ε3/4 was higher(26.5% vs 16.8%)and ε3/3 Was lower(58.0% vs 69.6%)in the CHD group.In the T2DM group.the distribution of εε4/4 Was higher (4.1% vs 1.1%),and 2 cases of ε3/3 with Arg 150 His mutation in exon 4 of apoE gene were firstly reposed in China,which is none in the CHD and control groups.Conclusions The results suggested that apoE ε3/4 and ε4 genotypes might be associated with the susceptibility of CHD and T2DM.respectively. To some extent,apoE ε3/3 may not be a good genotype for T2DM because of the Arg 150 His mutation. Blood pressure and plasma lipids could be used for diagnosis of the two diseases.

Clinical laboratory undergraduate program was switched from medicine to medical technology,the changes of personnel training program compel universities to adjust the curriculum system.Six domestic known as 211 universities who have laboratory and biology undergraduate programs were scrutinized and compared.Overall,the proportion of general courses covers 30％ of the credit hours in both clinical laboratory and biology programs.Ratio of these general education curriculums to professional core courses is as high as 1.90∶1 in clinical laboratory program.Also,there were very strong medical features and very weak medical technology characteristics in the basic course in clinical laboratory program.It suggested that the curriculum system nowadays cant conform to the new personnel training objective.A novel system from abroad should be adopted to optimize clinical laboratory program accord with the principles and concepts of wide caliber training model.