Objective To investigate the relationship between PreS1 antigen and five items of HBV serological markers(HBV M), as well as the clinical significance of combined measurement of PreS1 antigen and HBV M in patients with hepatitis B. Methods Enzyme linked immunosorbent assay (ELISA) was applied to testing serum in 268 patients with hepatitis B. Results The detection rate of PreS1 antigen was 85.88% in HBeAg'positive samples,significantly higher than that in HBeAg nega-tive samples(39.34%), P<0.01. Conclusion PreS1 antigen may effectively reflect the situation of HBV amplification. Combined measurement of PreS1 antigen and HBV serological markers in clinical examination contributes to clinical diagnosis,therapeutic effect monitoring and prognosis evaluation.

Objective To investigate the relationship between serum 25-hydroxyvitamin D level and gestational diabetes mellitus (GDM).Methods The fasting plasma glucose,fasting insulin,25-hydroxyvitamin D,and high sensitive C-reactive protein (hs-CRP) levels in the normal glucose tolerance group and gestational diabetes mellitus (GDM) group were measured.The homostasis model assessment insulin resistant (HOMA-IR) and homostasis model assessment β cell (HOMA-B) were calculated for assessing the insulin resistance and β-cell function.The relationship between 25-hydmxyvitamin D and hs-CRP,HOMA-IR,and HOMA-B were analyzed.Results The level of 25-hydroxyvitamin D in the GDM group [(2.16 ± 0.38) nmol/L] was significantly lower than that in the normal glucose tolerance group [(4.13 ±0.79) nmol/L](P =0.001).Serum 25-hydroxyvitamin D level was negatively correlated with hs-CRP (r =-0.448,P =0.002) and HOMA-IR (r =0.396,P =0.004),but was positively related with HOMA-B (r =0.495,P =0.001).Conclusions The serum 25-hydmxyvitamin D level remarkably decreases in GDM patients.Vitamin D deficiency may cause the functional damage of beta cell of islet,increase insulin resistance,and thus contribute to the development of GDM.

BACKGROUND:In recent years, prolift mesh pelvic materials have been widely used in the pelvic floor reconstruction. Scholars have been exploring the advantages and disadvantages of the prolift mesh pelvic reconstruction and the traditional hysterectomy for pelvic floor reconstruction. ＜br> OBJECTIVE:To systemical y assess prolift mesh pelvic reconstruction versus traditional hysterectomy for pelvic floor reconstruction. ＜br> METHODS:Wanfang, VIP, PubMed, Medline databases were searched for randomized control trials (RCTs) related to the clinical effectiveness of prolift mesh pelvic reconstruction versus traditional hysterectomy for pelvic floor reconstruction published from 1996 to 2014. Meta analysis of acquired data was performed through the use of RevMan5.2 software. ＜br> RESULTS AND CONCLUSION:Nine RCTs involving 780 patients were included. Of the 780 patients, 398 received prolift mesh pelvic reconstruction and 382 underwent traditional hysterectomy. Compared with, prolift mesh pelvic reconstruction was superior to the traditional hysterectomy group in terms of operative time, intraoperative bleeding, hospitalization duration, evacuation time, postoperative body temperature, and cure rate of 18 months (P＜0.05). However, there were no significant differences in the post-void residual volume, recurrence rate, the cure rate of 6 months and 12 months, quality of sexual life after 1 year postoperatively (P>0.05). These results reveal that the prolift mesh pelvic reconstruction exhibits better short-term effects on the pelvic floor dysfunction, but its long-term effects need to be further verified.

BACKGROUND: There have been some prospective, randomized, controlled studies regarding the feasibility and safety of laparoscopic gastrectomy for gastric cancer, but controversy exists.OBJECTIVE: To systemically assess the feasibility and safety of laparoscopic gastrectomy for gastric cancer.METHODS: A computer-based online research of prospective, randomized, controlled studies addressing laparoscopic gastrectomy versus open gastrectomy published between January 1994 and December 2009 was performed in PubMed, Ovid Medline, Web of Knowledge, EMbase, Chinese Journal Full-text Database and Wanfang Database. Meta analysis of acquired data was performed through the use of RevMan 5.0 software. The inverse variance method was used to test the significance of continous data, while the Mantel-Haenszel method was used for dichotomous data. The chi-square test was used for evaluation of data heterogeneity. Homogenous data was calculated using the fixed effect model, and heterogeneous data was calculated using freedom model. Statistical data was expressed as 95% confidence interval. Funnel plot was used for sensitivity analysis to show potential publication bias.RESULTS AND CONCLUSION: Five papers that corresponded to inclusion criteria were included in this study. Among 326 cases included, 164 underwent laparoscopic gastrectomy and 162 received open gastrectomy. Meta analysis revealed that laparoscopic gastrectomy took longer operating time and removed fewer lymph nodes than open gastrectomy (both P ＜ 0.01), but for early-stage gastric cancer, laparoscopic gastrectomy was superior to open gastrectomy in terms of blood loss and hospital stay (P ＜ 0.01). But there was no significant difference in terms of time to resumption of oral intake, postoperative complications,postoperative morbidity rate, and tumor recurrence. Sensitive analysis demonstrated that publication bias existed in all indices to different extents with the exception of lymph node. The five papers adopted two different modes to remove lymph nodes, so subgroup analysis was also used. Results showed that for D1 lymph node dissection, laparoscopic gastrectomy took significantly reduced blood loss than open gastrectomy. All these findings indicate that laparoscopic gastrectomy for early stage gastric cancer is feasible and safe.

Many clinical bone nonunion or delayed union often appear in the early stage of bone healing,but they have been always found too lately.Before X-ray films of visual changes indicates salt content inbones reaching 25%,the very early changes ofclinical significance can not be observed.This paper introduces the theory of fracture healing and the definition of bone nonunionand the significance of the basic multicellular unit(BMU)and the OPG-RANKL-RANK system in bone reconstruction.Many technologies such as ultrasonic testing,vibration analysis,mechanical impedance analysis,the bone marrow cavity imaging technologiy,high-resolution CT etc.have been reported in study on the bone,as well as early diagnosis of fracture nonunion.However,the molecular level of early diagnosis is deficiency.

The rate of stroke has been rising year by year and become the world's major cause of mortality and disability. The high rate of disability did not only bring economical burden to society and family, but also induce psychological damage to patients. Post-stroke depression (PSD) is a most common mental complications of stroke. In recent years, More and more attentions have been paid to PSD. This article reviewed the cause and mechanism of PSD and the treatment with Chaihu Shugan Powder on it.

Objective To explore the Troponin I(cTnI) ,myoglobin(MYO) and creatine kinase isoenzyme(CK‐MB) in early di‐agnosis of acute myocardial infarction(AMI) ,and compare their significance in the diagnosis of AMI .Methods used chemilumines‐cence method in 126 patients with AMI and 82 cases of myocardial infarction group to test cTnI ,MYO and CK‐MB ,the results were compared .Results The cTnI ,MYO ,CK‐MB quality appear time and peak time was different ,in patients with acute myocardial in‐farction(cTnI ,MYO and CK‐MB joint detection sensitivity ,specificity ,negative predictive value ,positive predictive value was higher than single test .Conclusion cTnI ,MYO and CK‐MB joint detection is helpful to early diagnosis of AMI .

Objective To establish a method for data quality control of clinical research data based on electronic data capture (EDC) system.Methods After analyzed the specific characteristics of EDC's workflow process,and also referred to international data management guideline,we established the data quality control strategy by summarizing actual data quality control experience of data management department in Peking University Clinical Research Institute.Results Application of EDC has changed traditional clinical research process,therefore EDC data quality control strategy should be built according to its own process flow,namely,selecting the appropriate EDC system,reasonable design and build electronic case report form (eCRF),standardization research center / user management processes,timely and accurate on line eCRF filling up,accurately capturing/docking ex ternal electronic data,planned data monitor and auditing,timely and efficient query management,strictly data locking and unlocking operation process,and strict electronic record life cycle monitoring.Conclusions At present time,clinical research in China is still in the earlier stage of the transition from traditional paper-based data collection (PDC) to EDC.Establishing and applying particular quality control strategy will optimize the process and results of data quality control.

Objective To detect ret mutations in two Chinese families with multiple endocrine neoplasia type 2A(MEN2A).Methods In our study,9 members from these two families including 3 patients were recruited.Polymerase chain reaction(PCR)and direct gene sequencing of PCR products by an automated DNA sequencer were applied to scan the entire 21 exons of ret proto-oncogene in the leukocyte DNA of the subjects.Results Two missense mutations were detected in exon11 of the ret proto-oncogene.One was C634R in the 2 patients from a family and the other was C634Y in 2 subjects from another family(one was the patient).Two heterozygous variants(A45A and L769L)in these 4 subjects were revealed.Conclusion Two mutations(C634R and C634Y)are detected in two families with MEN2A.Direct DNA sequencing analysis can diagnose MEN2A at gene level,which is helpful in making clinical management of the disease and in diagnosing earlier in their offspring.