The utility of anticoagulants is a significant content of total quality management(TQA)of clinical laboratory.The accurate results of laboratory investigations are closely correlated witll appropriate application of blood anticoagulants.The paper reviews the utility field and effects on investigation result of different anticoagulants,and it also raises the current problems of using anticoagulants and Dut forward corresponding solutions.

Objective To detect serum concentrations of Dickkopf-1(DKK-1) and soluble receptor activator of nuclear factor-κB ligand (sRANKL) in patients with multiple myeloma (MM) and to investigate its clinical significance. Methods Serum DKK-1, sRANKL, osteoporotegerin(OPG) and tartrate-resistant acid phosphatase 5b (TRACP-5b) levels were quantified in 30 newly diagnosed MM patients and 20 healthy control subjects by using sandwich ELISA. Results The serum DKK-1, sRANKL,OPG and TRACP-5b levels were significantly higher than those in the healthy controls (42.96 μg/L vs 5.33 μg/L, 1.83 pmol/Lvs 0. 79 pmol/L, 1799. 30 pmol/L vs 822.40 pmol/L, 5.81 U/L vs 0. 28 U/L, respectively; all P＜0. 05). Serum levels of DKK-1 were positively correlated with sRANKL and TRACP-5b, respectively.Serum concentrations of DKK-1 and sRANKL were significantly elevated in stage Ⅲvs stages Ⅰ and Ⅱaccording to International Staging System (ISS) (46. 33 μg/L vs 37.91 μg/L, 2.26 pmol/L vs 1.19pmol/L, respectively, all P ＜0.05). Serum concentrations of DKK-1 , sRANKL and TRACP-5b were significantly higher in patients with more than 3 lytic bone lesions than those with only 1-3 lytic bone lesions (46. 30 μg/L vs 31.98 μg/L, 2. 18 pmol/L vs 0. 69 pmol/L, 6.02 U/L vs 5. 13 U/L, all P ＜ 0.05).Conclusions MM patients have increased serum DKK-1, sRANKL, OPG and TRACP-5b levels as compared with the healthy controls. Serum concentrations of DKK-1 and sRANKL have close relationship with MM stage and lytic bone disease.

Objective:To investigate the importance and appropriate application of perioperative nutritional support in patients with obstruction caused by colon cancer.Methods:19 patients received parenteral or enteral nutritional support in the period of perioperation.When nutrition was applied,the nutritional indices,liver function and renal function were observed.Results:Hb,blood K~(+) and Na~(+) were significantly increased after nutritional support.The nutritional indices did not change and were kept within normal range during nutrition.Conclusion:The nutritional support is one of the important perioperative treatments in patients with obstruction caused by colon cancer.

Objective:To explore the polarization of Th1 and Th2 immune response and the changes of transcription factor(T-bet and GATA-3) in BALB/c mice infected with toxoplasma gondii.Methods:Sixty BALB/c mice were infected with toxoplasma tachyzoite(1?104/m,0.5 ml) by intraperitoneal injection and thirty BALB/c mice only received an injection of same amount of normal saline as control.After injection,two mice of infection group and one mouse of control group were killed in odd number days.Then,the serum IFN-? and IL-4 were measured by ELISA,and the mRNA expression of T-bet and GATA-3 in mice spleens were detected by Real-Time RT-PCR.Results:In the infection group of mice,the IFN-? was remarkable increased at the fourth day and kept the peak from the 5th day to 7th day.Then,it decreased to normal level at 9th day postinjection;but IL-4 was remarkable increased at the 8th day and reached to the peak at 9th day.Then it decreased to normal level at 15th day postinjection.The mRNA of T-bet expression was increased at the third day and kept the peak from the 5th day to 7th day.Then,it decreased to normal level at 9th day postinjection.The mRNA of GATA-3 expression was increased at the 7th day and rised to the peak at 11th day.Then,it decreased to normal level at 13th day postinjection.There were not obvious changes of IFN-? and IL-4 or T-bet and GATA-3 in normal mice.Conclusion:The Th1 immune response is dominant in acute infection when mice are infected by toxoplasma.Then it biases toward Th2 response at 9th day to 13th day postinfection.The shift of Th1/Th2 polarization influences the finale of toxoplasma infection.

Objective:To study the gene expression spectrum of Th cell immune response in acute and chronic toxoplasma infection in BALB/c mice.Methods:BALB/c mice were infected with toxoplasma tachyzoite (1?104/m,0.5 ml) by intraperitoneal injection.Two mice were killed at 6th and 12th day postinjection.The immune response gene expressing levels in mice spleen cells were detected with 128 kind gene microarray chips.Partial of the results were determined with Real time-PCR.Results:There were 20 genes changed after toxoplasma infection.Eight of them (Gata-3,Ccr3,Ccr4,Bcl6,Nfatc1,CD80,Fos,CD69) were regulated upward and twelve genes (T-bet,CIITA,Irf1,Mapk9,Nfatc3,Fasl,Tyk2,Lat,Mapk10,Socs3,Socs6 and Yy1) were regulated downward.On the whole,expression of Th2 response genes presented a up trend,and Th1 response genes presented a down trend.The results of Real time-PCR were accordant with microarray in the expression of Gata-3 and T-bet gene.Conclusion:According to the Th cell immune response gene expression spectrum,Th1 immune response is dominant in the acute infention when mice are infected by toxoplasma.Then,it is biased toward Th2 immune response.

Chronic cough is one of the common symptoms of pediatric respiratory. The diagnosis of chronic cough is complicated, and the curative effect is not clear. At present, studies on chronic cough in children are still in the preliminary stage. This article summarized the etiology, pathogenesis and clinical treatment of chronic cough.

Objective:To compare and analyze clinical features between patients with early and non‐early acute coro‐nary syndrome (ACS) .Methods :A total of 120 ACS patients were selected ,including 71 patients with early ACS (early ACS group ,onset time≤12h) and 49 patients with non‐early ACS (non‐early ACS group ,onset time >12h) . Risk factors ,clinical features ,mortality ,incidence rates of myocardial infarction ,rehospitalization and major ad‐verse cardiovascular events (MACE) were compared and analyzed between two groups .Results:There were no sig‐nificant difference in percentage of each ACS risk factor between two groups , P>0.05. Compared with non‐early ACS group ,there was significant reduction in incidence rate of heart failure (73.5% vs .54.9% ) ,significant rise in incidence rates of obvious chest pain (32.7% vs .73.2% ) and shock (46.9% vs .62.0% ) in early ACS group (P<0.05 all) ,but there was no significant difference in incidence rate of arrhythmia between two groups (P>0.05) . After one‐year follow‐up , compared with non‐early ACS group , there were significant reduction in mortality (18.4% vs .4.2% ) ,incidence rates of myocardial infarction (18.4% vs .4.2% ) ,rehospitalization (30.6% vs . 14. 1% ) and MACE (38. 8% vs .16. 9% ) in early ACS group , P<0. 05 all .Conclusion:Initial symptom is more ob‐vious ,but related complications are fewer and the prognosis is better in patients with early acute coronary syndrome .

By literature research and questionnaire, the paper analyzed development mode and status of scientific researching institutions of Traditional Chinese Medicine in other countries, discussed necessity and realistic meaning of establishment of the standards, and advocated the standards must be followed the rule of standing out characteristic of traditional Chinese medicine, making use of modern scientific technology and instrument, emphasizing commonness, classifying instruction and getting hold of major point.

Objective To explore the application value of the diffusion-weighted imaging (DWI)and dynamic contrast-enhanced MRI in detection of peripheral zone of hepatic alveolar echinococcosis (HAE).Methods Twenty patients with HAE underwent abdominal plain scan,DWI and dynamic enhanced MRI.The ADC values and enhanced ratio of the central necrosis,solid component,peripheral zone and normal liver parenchyma were measured at a workstation,and further were analyzed and compared.Results 32 lesions were detected in 20 patients with HAE.Two groups were divided according to the lesion with central necrosis (group A)or not (group B).In group A, the ADC values of the solid part and normal liver parenchyma were (1.52±0.30)×10 -3 mm2/s and (1.22±0.30)×10 -3 mm2/s. Meanwhile,in group B those were (1.50±0.25)×10-3 mm2/s and (1.03±0.28)×10-3 mm2/s,exhibiting no statistical differences between the two groups.In group A and B,the ADC values of the peripheral zone of lesion were 1.34(1.10,1.61)×10 -3 mm2/s and 0.96 (0.86,1.22)×10 -3 mm2/s,exhibiting statistical differences (Z =2.867,P =0.004);meanwhile,the enhanced ratio were 1.70± 0.36 and 1.58±0.30,exhibiting no statistical difference.No correlation between ADC values and enhanced ratio was found in the peripheral zone.Conclusion DWI at 3.0T can display visually the HAE,and the ADC value may reflect the DWI features of periph-eral zone.The ADC values in combination with enhanced ratio may help for the diagnosis.

[Objective] Summing up the specific application of the three stages therapy of Professor XU Li in the treatment of cancer.[Methods]By copying the prescription and consulting the medical books of Professor XU, learning his clinical experience in treatment of cancer,summing up the core thinking of the three stages therapy and the experience of Chinese medicinal plant. [Result]By summing up the three stages therapy(assisting ,maintaining and palliative treatment),the special herb and attaching importance to develop the XIAN TIAN and HOU TIAN in the treatment of cancer ,it can improve radiation and chemotherapy therapeutic efficacy and resistance to transfer the maintenance treatment of recurrence ,improve the quality of life and prolong survival time of palliative care.By the guidance of the three stages therapy,smoothly finish the postoperative radiotherapy of nasopharyngeal carcinoma,successfully reverse the precancerous lesions of chronic atrophic gastritis with intestinal metaplasia,the two typical medical cases have significant curative effect. [Conclusion] Taking the three stages therapy in the process of the treatment of the tumor and precancerous lesions ,it can get good clinical effect,it is worth spreading in clinic.