Objective To evaluate the clinical value of the combined detection of serum human epididymis protein 4(HE4) ,carbo‐hydrate antigen125(CA125) ,carbohydrate antigen199(CA199) and carbohydrate antigen724(CA724) in the early diagnosis of ovar‐ian cancer .Methods 40 cases of ovarian cancer verified by pathological examination (ovarian cancer group) ,40 cases of ovarian be‐nign tumor (ovarian benign tumor group) and 40 individuals undergoing the physical examination(healthy control group) were se‐lected .The levels of CA125 ,CA199 and CA724 were measured by the electrochemiluminescence method ,the HE4 level was meas‐ured by the enzyme‐linked immunosorbent assay(ELISA) .The values of single index detection and the combined detection in diag ‐nosing ovarian cancer were analyzed .Results Serum HE4 ,CA125 ,CA199 and CA724 levels and positive rates in the ovarian cancer group were significantly higher than those in the ovarian benign tumor group and the healthy control group (P< 0 .05) .There was no statistical difference between the ovarian benign tumor group and the healthy control group (P> 0 .05) .The positive rate of the combined detection was 92 .5% ,which was significantly higher than the single index detection (P < 0 .05) .In the comparison of HE4 ,CA125 ,CA199 and CA724 single detection ,the sensitivity and specificity of HE4 detection were best .The detection rates of the stage Ⅰ and Ⅱ of ovarian cancer in the combined detection were significantly higher than that in the single index detection (P<0 .05) .Conclusion The combined detection of serum HE4 ,CA125 ,CA199 and CA724 might increase the detection rate of early di‐agnosis of ovarian cancer .

Objective:To study the antibacterial properties of pure titanium treated with benzalkonium chloride solution.Meth-ods:10 mm ×10 mm ×1 mm titanium specimens were processed by the benzalkonium chloride solution at 1%,0.5% and 0.1%respectively followed by treatment in the cultured bacterial suspension,and then the antibacterial properties of the titanium plates were examined.Additionally,the thermal cycling test was carried out for the 1% benzalkonium chloride-treated titanium plates, and subsequently put the plates into cultured bacterial suspension,the duration of antibacterial properties was observed.Results:0.5% and 1% benzalkonium chloride solution-treated titanium plates significantly inhibited the growth of candida albicans(P <0. 05),1% solution was more effective than 0.5% solution.After 1 000 and 2 500 thermal cycling,the pure titanium still retained the antibacterial ability,but the plates treated by 5 000 cycling showed no antibacterial effect.Conclusion:A certain concentration of benzalkonium chloride can make the pure titanium obtain antibacterial properties.The treated plates may maintain the antibacte-rial properties for a minimum of 3 months.

AIM: To establish the quality standard for Jixiangcao Buccal Tablets(Herba Reineckea Camea, Radix Asteris, Heaba Houttugnlae, Pericarpium Papaveris, Heaba Ephedrae etc.). METHODS: TLC was used for the identification of Herba Reineckea Camea and Pericarpium Papaveris. HPLC was used for the determination of ephedrine hydrocholoride in the Buccal tablets. RESULTS: TLC identification was highly specific and the spots were clear. The linear range for ephedrine hydrocholoride was in the range of 0.404～2.02?g and its average recovery was 97.03% and RSD 2.2%, respectively. CONCLUSION: The quality standard is able to effectively control the quality of Jixiangcao Buccal Tablets.

Objective To investigate the effect of pigment epithelium- derived factor (PEDF) on p38MAPK-CREB pathway and the expression of fibronectin (FN) in human mesangial cells (HMCs) cultured with high glucose. Methods HMCs were treated with different concentrations of glucose and the osmotic control respectively in the presence or absence of PEDF for 24 h:normal glucose (5.6 mmol/L),24.4 mmol/L mannitol,high glucose (30 mmol/L),high glucose+PEDF(30 mmol/L glucose with 10 nmol/L PEDF,40 nmol/L PEDF or 100 nmol/L PEDF).After samples were collected,the expression of phospho-p38MAPK (p-p38) and p-CREB was assessed by Western blotting,while FN mRNA and protein expression was assessed with RT-PCR and ELISA respectively. Results In contrast to normal glucose and mannitol treatments,the expression of p-p38MAPK,p-CREB and FN increased significantly in high glucose group (all P＜ 0.01).However,PEDF abolished the up-regulation of p-p38MAPK,p-CREB and FN induced by high glucose (all P＜0.05). Conclusion PEDF may inhibit fibrosis through P38MAPK-CREB pathway in diabetic nephropathy.

Objective To investigate the methods and effects of different flaps for repair of high energy injury-induced soft tissue wound of the heel.Methods From January 2002 to June 2012,the patients including 12 males and 9 females aged 18-57 years (mean,32 years) underwent heel soft tissue defect reconstruction.Causes of injury were traffic injury in 11 case and mechanical injury in 10 cases.Dimension of soft tissue defect ranged from 5 cm × 3 cm to 8 cm × 6 cm.Soft-tissue defect was repaired with sural neurovascular flaps at the posterolateral heel in 9 cases (Group A),with posterior tibial artery flaps at the posterolateral heel in 5 cases (Group B),and with medial plantar flaps at the loading area of heel in 7 cases (Group C).Sensory recovery and two point discrimination motion of the ankle joint were observed and compared among groups 12 month after operation.Heel pain was observed during weight bearing and joint activity was evaluated using the visual analogue scale (VAS).Results All the flaps survived,except for one with epidermal necrosis over the distal part,which healed after partial changing medication.Duration of follow-up was 12-24 months.There were no differences in the appearance,texture and contour between the flaps and recipient sites.Flaps showed no ulcer in the weight-bearing area and recovered their protective sense.Patients could walk normally after surgery.At postoperative 1 year,sensory recovery rate of the flaps in Groups A,B and C was 0,20％ and 100％ respectively (P ＜0.01).Appearance of the heel in all groups recovered to almost normal.Cases that could start nil weight-bearing exercise without pain accounted for 8 (89％) in Group A,4 (80％) in Group B,and 6 (86％) in Group C (P ＞ 0.05).While heel pain existed in weight-bearing exercise.Difference in VAS was significant among the three groups (P ＜ 0.05),but ankle range of motion was not (P ＞0.05).Conclusion Medial plantar flaps are suitable for tissue defect of 5-8 cm in length but sural neurovascular flaps and posterior tibial artery flaps should be considered for over 8 cm defect in order to elevate survival rate of the flaps and reconstruct limb function.

Objective To explore the effect of ilomastat combined with chemotherapeutic drug capecitabine on human laryngeal cancer hep-2 cell .Methods hep-2 cells were treated by ilomastat and capecitabine alone and their combination .The untreated group was taken as the control group .The proliferation activity of the hep-2 cells was analyzed by MTT assay ,and the Jin′s Q was adopt-ed to assess the characters of combination medication of ilomastat and capecitabine ;the expression level of MMP-9mRNA in hep-2 cell was detected by RT-PCR;the apoptosis rate of hep-2 cell was detected by the flow cytometry .Results Both ilomastat and capecitabine had the inhibiting effect on the proliferation of hep-2 cell ,and the combination of ilomastat and capecitabine increased the cell inhibitory rate(P<0 .05) ,the interaction between ilomastat and capecitabine was the synergistic effect when the combined concentration was (8+100)μg/mL ,while the interaction between ilomastat and capecitabine was the additive action when the com-bined concentration was (40+ 400)μg/mL ;RT-PCR analysis showed that compared with control group ,the expression level of MMP-9mRNA in the single ilomastat group and the combination group were both decreased (P< 0 .05) ,and the expression of MMP-9mRNA in the combination group was lower than that in the single ilomastat group (P<0 .05);the flow cytometry indicated that the apoptosis rate of hep-2 cell in the single ilomastat group and the single capecitabine group were both higher than that in the control group(P<0 .05) ,and the apoptosis rate in the combination group was higher than that in the other groups (P<0 .05) .Con-clusion Ilomastat combined with capecitabine can obviously enhance the inhibition and apoptosis-induced ability of single drug on laryngeal cancer hep-2 cell ,the action mechanism of ilomastst is down-regulation of the expression level of the MMP-9 mRNA .

Objective To investigate the result and side effect of late course accelerated three-di-mensional conformal radiotherapy (3DCRT) for esophageal carcinoma. Methods From July 2003 to March 2006, 55 patients with esophageal carcinoma receiving 3DCRT were randomly divided into late course accel-erated radiation group (group A, 27 patients) and conventional fractionation group (group B, 28 patients). The prescribed dose in group B was 64 -66 Gy, 2 Gy per fraction, 1 fraction per day, 5 fractions per week for about 6.5 weeks. Patients in group A received conventional fractionation irradiation for the first 4 weeks. Then the dose was increased to 3 Gy per fraction to a total dose of 67 -70 Gy. The treatment course in group A was about 6 weeks. The treatment response, acute site effects, 1-, 3-and 5-year local control rates and o-verall survival rates of the two groups were observed. Results In group A, 23 patients (85%) achievedcomplete response (CR) and 4(15%) achieved partial response (PR). While in group B, 16 patients (57%) achieved CR and 12(43%) achieved PR. The CR rate was significant higher in group A (χ~2 = 5.24,P=0.022). The 1-, 3-, 5-year local control rates were 85%, 54%, 54% in group A, and 70%, 56%, 33 % in group B (χ~2 = 0.68, P = 0.409), respectively. The 1 -,3-,5-year overall survival rates of the two groups were 81%, 37%, 29% and 61%, 39%, 23% (χ~2 = 0.06, P = O. 804), respectively. Both lo-cal control and overall survival were similar between the two groups. The incidences of acute radiation esoph-agitis in the two groups were similar (85% vs. 89% ;χ~2 =0. 00,P=0. 959), and the incidence of radiation pneumonitis was slightly higher in group A than in group B (67% vs 43% ;χ~2 =3.14,P =0.076). By the last follow up, 19 patients in group A and 21 in group B died. Among them, 10 in group A and 15 in group B died of local failure, while 7 in group A and 5 in group B died of metastasis. Conclusions When com-pared with conventional fractionation 3DCRT, late course accelerated 3DCRT for esophageal carcinoma can achieve better results in clinical response, though not in long-term local control or survival. The incidence of acute radiation esophagitis and pneumonitis is clinically acceptable.

Objective To discuss the way and management of extracorporeal circulation (ECC) for totally robotic assisted cardiac surgery. Methods A Total of 226 patients underwent cardiac surgery using da Vinci S robotic surgical system, including 111 patients underwent atrial septal defect repair ( ASDR) , 9 patients underwent ventricular septal defect repair ( VSDR) ,51 patients underwent mitral valvuloplasty ( MVP) , 20 patients underwent mitral valve replacement( MVR) , 27 patients underwent left atrial myxoma excise and 4 patient underwent right atrial myxoma excise. ECC for most of patients was achieved with femoral arterial cannula, femoral venous cannula and right internal jugular venous cannula, except for 1 patient underwent MVP with femoral arterial cannula and femoral two-stage venous cannula. In all the cases, vacuum-assist venous drainage ( VAVD) , continuous blood gas monitoring and ultrafiltration were used during ECC. myocardial protection was pertic cross-clamp time was 40 ～219 (105.9+38. 8)min and 21 ～166 (69.5±30.0)min respectively. During ECC, the mean urine volume was 100-2100 (771.7±477.6) ml, ultrafiltration volume was 1000-4800 (2495.4 ±811.6) ml, and the total fluid balance was subzero-balanced (172 cases) or zero-balanced(13 cases) in most of patients. Conclusion The establishment of ECC system through peripheral vessels, using VAVD and continuous blood gas monitoring are the key points of ECC for totally robotic assisted cardiac surgery, also certain learning curve of perfusion technique and close communication between the surgical team are essential during ECC.

OBJECTIVE:To understand the public cognitive status about the adverse drug reaction(ADR),and provide refer-ence for improving the ADR reporting system. METHODS:Field to fill out and recycling questionnaire on the spot were conducted to investigate the cognition of ADR about 1 379 people from the Pearl River Delta,Eastern,Western and Northern region of Guangdong Province,and analyze related influential factors. RESULTS:Totally 1 500 questionnaires were sent out and 1 379 were effective with effective rate of 91.9%. Among the respondents,931(67.5%)could correctly answer the question of ADR concept, the correct rate showed lowest in the people lived in Northern region and with no less than 40 years old and low education;only 36.1% could correctly know the cause of ADR;only 388 (28.1%) knew the individuals can report ADR;723 (52.4%) thought hospital should be held responsible for ADR;once the ADR appeared,62.2% of respondents would choose to report to the hospi-tal. The main causes of discourage individual report of ADR were due to less know about where,how and which relevant depart-ments could report,and the report way was not convenient and the procedures were cumbersome. CONCLUSIONS:The public awareness of the ADR concept is not high and the enthusiasm of report is relatively low. Therefore,the propaganda of public aware-ness of ADR should be strengthened to encourage the public to participate in the ADR report actively,and broaden the channels of ADR personal report.

Data Mining ; Diabetic Neuropathies ; drug therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Phytotherapy