Objective Identifying the factors of psychological pressure from medical disputes on clinical doctors and possible solutions. Methods Self-rating Anxiety Scale (SAS) and the Occupational Stress Indicator (OSI) were called into play, to study 52 clinical doctors in a tertiary hospital in a city, who had encountered medical disputes in recent two years. In parallel, 63 clinical doctors without such disputes and 50 non-clinical workers were randomly selected as the control group for questionnaires. Results Clinical doctors with such an experience were commonly found to be anxious, and their SAS score (58. 27±11.38)averaged higher than those in the control group. Doctor-patient relationship, legal liabilities and clinical positions were found to be positively correlated to psychological pressure of clinical doctors. Conclusions Medical disputes tend to add to psychological pressure of the doctors. Clinical doctors deserve psychological counseling and training and improvement of their working conditions.

Objective　To analyse the sensitivity of fineneedle aspiration cytology (FNAC) of breast masses.Methods　A series of 1035 FNAC of breast masses was reviewed.502 cases acccepted operation for histopathologic diagnosis.Results　The sensitivity of FNAC for breast malignant tumor was 98.9% and the specificity was 85.7%.Conclusions　The FNAC of breast masses has high accuracy.

Aim To establish a simple reverse dot blot m ethod (RDB) for detecting the genotype of NAT2 in Chinese people. Methods PCR was performed to obtain a biotin labeled DNA fragment. Allele specific oligonucleotide probes were spotted onto a nylon membrane. The DNA fragment hybridized with the membrane under stringent conditions. Finally, a nonradioactive colorimetric reaction was used to detect five mutants of NAT2. NAT2 genotypes of 48 patients with pulmonary tuberculosis were detected with RDB.Results The results obtained from RDB were in consistent with those from allele specific amplification. The NAT2 allele frequencies of *5, *6, *7 were 1.04%, 22.9% and 15.6%, respectively.Homozygous wildtype,heterozygous mutant and homozygous mutant subjects were 33.3%, 54.2% and 12.5%, respectively.Conclusion RDB method was proved to be accurate and convenient, it can be u sed in rational drug therapy.

Objective To detect the expression of IL-6 in peripheral blood of patients with gastric cancer,as well as the expressions of IL-6,IL-6 receptor(IL-6R) and proliferating cell nuclear antigen(PCNA) in the neoplastic tissue in order to investigate the clinical significance of such expressions in looking for a convenient and effective way for the diagnosis and therapy of gastric cancer.Methods Enzyme-linked immunosorbent assay(ELISA) was employed for the parallel semi-determination of IL-6 levels in the peripheral blood of 30 patients with gastric cancer,as well as the levels of IL-6 and IL-6R in the neoplastic and adjacent tissues.The expression of PCNA in the neoplastic tissues was determined with immuno-histochemistry technique.Moreover,the correlation was comprehensively analyzed among IL-6,IL-6R,PCNA and the clinicopathologic findings of gastric cancers.Results The IL-6 levels in both peripheral blood and neoplastic tissues of 30 patients were significantly higher than those of the normal controls.The IL-6 levels in peripheral blood decreased significantly after operation;the IL-6 and IL-6R levels in cancer tissues were significantly higher than those in their adjacent tissues with a positive correlation between IL-6 and IL-6R levels.The expressions of IL-6,IL-6R and PCNA in both peripheral blood and neoplastic tissues of patients were positively related to the clinical manifestation of gastric cancer,including the differentiation degree of cancer cells,tumor size,infiltration extent and the metastasis of cancer cells.Conclusions IL-6,IL-6R and PCNA are the important factors which affect the degree of malignancy of the gastric cancer concerned,and they also,reflect the possibility of infiltration and metastasis of cancer cells.The IL-6 level in peripheral blood and the levels of IL-6,IL-6R and PCNA in tumor tissues of patients with gastric cancer are obviously high.The expression levels of all these factors are correlated with the clinicopathologic findings of gastric cancer.An adequate determination of IL-6 and PCNA is of benefit to the diagnosis and treatment of gastric cancer,and to the judgment of the course and prognosis of gastric cancer.

Gene chip is an important biological technology, which is developing quickly recently. In this article, we reviewed the origin, development, basic operation of gene chip. Several kinds of gene chips including tiled array, direct allele specific fluorescence targeting (DAFT) array, labeled auxiliary oligonucleotides array, ligase detection reaction array, and peptide nucleic acid array were introduced as examples for their use in mutation detection. The prospect of the use of gene chip in optimizing drug therapy was also discussed.

Objective To evaluate the predictive value of serum macrophage migration inhibitory factor (MIF) for myocardial depression in severe sepsis patients.Methods Taken prospective study method,42 cases of severe sepsis patients were enrolled from December 2011 to June 2013.The patients were monitored by PICCO system after informing consent into ICU day,and given the corresponding treatment.According to the hemodynamic parameters were divided into two groups,myocardial depression group:cardiac index ＜ 3 L/(min· m2) and global end diastolic volume index ＞ 800 ml/m2,the remaining were in non myocardial depression group,and the patients were divided into survival group and death group according to 28-d mortality.Hemodynamic parameters and serum MIF,B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnI) level at the 1st,3rd,Sth day after admission.Results Fortty-two severe sepsis patients,non myocardial depression in 22 cases (non myocardial depression group),myocardial suppression in 20 cases (myocardial depression group).At 28 d,20 patients of survival (survival group),22 patients of death (death group).The serum MIF in death group was higher than that in survival group at the 1st,3rd,5th day (P ＜ 0.01) ; BNP and cTnI at the 1st day in two groups had no statistical significance (P ＞0.05),BNP and cTnI at the 3rd,5th day in death group was higher than that in survival group(P ＜ 0.01).The serum MIF at each time point in myocardial depression group was higher than that in non myocardial depression group [survival:8.70(3.53,16.80) μ g/L vs.1.20(0.80,1.77) μ g/L,2.30(1.33,8.40) μ g/L vs.0.60 (0.60,0.99) μg/L,0.50 (0.31,2.50) μg/Lvs.0.16 (0.15,0.20) μg/L;death:11.43(8.10,17.16) μ g/L vs.2.30(1.96,3.69) μ g/L,9.70(6.55,14.65) μ g/L vs.1.90(1.88,5.27) μ g/L,7.50(5.15,14.20)μ g/L vs.2.40(0.80,8.46) μ g/L] (P ＜ 0.05).The serum MIF of death patients in two groups was higher than that of survival patients (P ＜ 0.05).MIF at the 5th day had biggest prediction value,AUC was 0.952,when the cut-off point of 0.65 μg/L,the sensitivity was 100％ (22/22) and specificity was 85％ (17/20).Multivariable Logistic regression analysis results showed that only APACHE Ⅱ scores was the independent risk factor for 28-d mortality (P ＜ 0.01),while MIF couldn' t independent forecast 28-d mortality (P ＞ 0.05).Conclusions Elevation of serum MIF prompts severe sepsis patient with poor outcome,and dynamic changes of MIF is helpful to evaluate the prognosis and severity of severe sepsis patients with myocardial depression,but MIF is not an independent risk factor for predicting 28-d mortality.

Objective:To investigate the relationship between the plasminogen activator inhibitor 1(PAI 1) gene polymorphism and cerebrovascular disease and whether it played an important role in the pathogenesis of cerebrovascular disease Methods:The 4G/5G allele polymorphism in the PAI 1 gene promotor region were genotyped by polymerase chain reaction (PCR) from peripheral blood leukocytes from 60 normal controls, 65 patients with acute cerebral infarction and 31 hypertensives complicated with cerebral hemorrhage Their plasma PAI 1 activity were assayed by ELISA Results: The plasma PAI 1 activity level in the CI group was significantly higher than those in the other two groups PAI 1 level was significantly higher in 4G allele homozygous than both those in 4G/5G heterozygous and 5G homozygous Although PAI 1 level was higher in 4G/5G heterozygous than that in 5G homozygous, the difference had not reach statistically significant There were significant differences between acute cerebral infarction PAI 1 gene polymorphism and controls (P0 05), and PAI 1 levels of the 4G/4G genotype among female patients with CI were higher than those of the male patients with CI of the same genotype Conclusion: The results suggest that PAI 1 gene polymorphism may be a susceptible factor to acute cerebral infarction in Chinese, and 4G allele homozygous genotype may be the major risk factor of acute cerebral infarction, especially it may be an independent risk factor of female CI patients

AIM: To explore the changes of myocardial energy metabolism and adenine nucleotide translocase (ANT) activity in mitochondria in rats exposed to hypoxia. METHODS: Adult male Wistar rats were exposed to simulated high altitude at 5 000 m for control (0 d), 1 d, 5 d, 15 d, 30 d in hypobaric chamber. Myocardial mitochondria were isolated by centrifugation. Mitochondria respiratory function was measured by Clark oxygen electrode. The size of adenine nucleotides pool (ATP, ADP, AMP) in mitochondria were separated and measured by HPLC. ANT activity was measured by [3H]-ADP incorporation. RESULTS: Compared to control, mitochondria state Ⅲ respiratory (ST_3) and RCR decreased and ST_4 increased sharply at 1 d, 5 d and 15 d, ST_3 still lower than that in control at 30 d, while RCR level restored. ATP contents and ANT activity decreased at 1 d and 5 d, then restored to control level at 15 d, then decreased again at 30 d. CONCLUSION: The inhibition of mitochondria respiratory function is the main reason that makes ATP contents decrease during hypoxic exposure. ANT activity and ATP content change cooperatively.

Objective To investigate the relationship between the plasminogen activator inhibitor 1(PAI 1) promotor region gene polymorphism and cerebral stroke.Methods The genotype of 4G/5G allele polymorphism in the PAI 1 promotor region were determined by polymerase chain reaction from leukocytes of 60 normal controls and 96 patients with cerebral stroke. Their plasma PAI 1 activity was assayed by ELISA.Results The plasma PAI 1 activity level in CI group was significantly higher than the CH and the control group.The plasma PAI 1 activity level (homozygote 4G/4G genotype patients) in CI and CH group was the highest,5G/5G genotype was the lowest,heterozygous 4G/5G genotype was in the middle;the difference was remarkable between 4G homozygote genotype and the other two groups,there was no remarkable significance between 4G/5G and 5G/5G genotype.There was remarkable difference between 4G/4G homozygote genotype in CI group and the controls(P 0.05 ).There was remarkable difference between the plasma PAI 1 activity in female patients with CI 4G homozygote genotype patients and the male patients of the same genotype (P

Objective To study the clinical features of primary biliary cirrhosis (PBC) in order to improve the clinical diagnosis. Methods Clinical data of fifty patients with PBC were retrospectively studied. The clinical features, results of laboratory tests, pathological findings of all the fifty patients were analyzed. Results forty-four patients were female (88%), and the mean age was 44.94?12.33 years at the time when definite diagnosis was made. The most frequent symptoms complained were fatigue (34/50, 68%), anorexia (24/50, 48%) and pruritus (13/50, 26%).The major signs included jaundice (32/50, 64%), splenomegaly (24/50, 48%) and liver palms (14/50, 28%). Serum alkaline phosphatase (ALP) and r glutamyl transpeptidase (r-GT) levels were markedly elevated in most patients, and the levels of ALP and GGT declined during the advanced stage. The levels of ALT and AST were elevated slightly. The total level of serum bilirubin was elevated in thirty-two patients (64%). Positive anti-mitochondrial antibody (AMA)/AMA-M2 were found in forty-one patients (82.0%). Pathological examination was done in 32 patients, it was shown that 28 patients (87.5%) were in early stage and 4 patients (12.5%) in advanced stage. Conclusion PBC occurs mainly in middle- and old aged women. The main clinical manifestations are fatigue, anorexia and pruritus. The elevated level of ALP, r-GT and positive AMA/AMA-M2 may be crucial to diagnosis of PBC.