Cystatin C (Cys C) is used to evaluate the glomerular filtration rate (GFR), renal function and thus reflects changes in endogenous marker. Cys C is not affected by gender, muscle mass, malignancy and its production rate is usually constant, making it one of ideal markes of GFR. This article focuses on clinical application and research of Cys C in a variety of renal diseases, especially in renal dysfunction at an early stage of clinical significance.

Objective To evaluate the efficacy of laparoscopic and open operation combined with endoscopic nasobiliary drainage(ENBD) in the management of choledocholith. Methods 44 cases treated by laparoscopic common bile duct exploration (LCBDE) and 34 ones by open common bile duct exploration(OCBDE) combined with ENBD and primary suture of common bile duct were retrospectively analyzed from January 1997 to July 2001. Results All cases were operated on successfully. The clearance rate of stones was 100%(78/78). No postoperative complications such as bile leakage, hemobilia, cholangitis, etc occurred. Postoperative hospital stay was (6 2?1 3)days in group LCBDE and (7 4?2 1)days in group OCBDE. 57 cases had been followed up for (1～4 5)years with an average of 2 6 years, and ultrasoundgraphy showed no bile duct stricture and recurrent stones. Conclusions LCBDE or OCBDE combined with ENBD and primary suture of common bile duct is safe and reliable.

Objective This study was to explore a justifiable approach for the translation of traditional Chinese medicine (TCM) terms in the light of Skopos Theory and thus to provide references to the standardization of TCM terms.Methods By exploring the source and development of a TCM term Bi,we studied its connotation,compared available English versions and decided on the choice version.Results The word arthralgia,obstruction or impediment was found to be the most frequently used word in 12 recognized publications,more frequent than the transliteration of Bi.Conclusion It is suggested that an accurate and a complete understanding of TCM terms and English expressions are required prior to translating so that the faithfulness and accuracy of the translation are maintained for the sake of optimal approximation.

Objective To investigate the risks of HBV infection among the spouses of HBV surface antigen (HBsAg)carriers and to find out effective control strategies on hepatitis B control and prevention .Methods To use case-control study(1∶2) including spouses of HBsAg carriers aged 18 -59 years-old from the nationwide sero-epidemiological survey for Hepatitis B in Chonqing province in 2005 ,and the spouses of the healthy(HBsAg negative persons)as the control groups ,adopt euzymelinked immunosor-bent assay(ELISA) to carry out the sero-epidemiological testing (HBsAg ,anti-HBc ,anti-HBs) for Hepatitis B .Results The posi-tive rate of HBsAgamong the spouses of HBsAg carriers (14 .8% ) was higher than the rate of spouse among the healthy (7 .5% ) , with difference statistically significant (P<0 .01) ,the positive rate of HBsAg in female spouse was uptrend as the marriage age grown ,multiple factor analysis found that the risks of HBV infection among the spouses were their spouse with HBsAg and without condom when the sexual behavior .Conclusion The spouses of HBsAg carriers have high risks of HBV .Premarital examinations , safety sexual behaviors with condom ,timely hepatitis B vaccination etc .are helpful for the spouses of HBsAg carriers free of hepati-tis B virus ,especially female spouses should insist on using condom when the sexual behavior because of them easier to be infected by the hepatitis B virus .

Objective To study on the method of applying laparoseopy for the treatment of choledo cholithiasis after biliary tract operation, and to evaluate its therapeutic efficacy. Methods Thirty-seven cases of common bile duct stones after operation from October 1999 to December 2003, received laparoscopic common bile duct exploration (LCBDE) were retrospectively analyzed. Results Satisfactory results were accepted in 35 cases and the rest two cases converted to laparotomy. Thirty cases had got primary healing by the help of employing endoscopic nasobiliary drainage (ENBD) , 7 cases received T-tube drainage. There was neither residual stones left nor serious after-effect including biliary fistula and hemobilia happened. Mean operative time was ( 168 ?30. 2) min. Mean postoperative stay in hospital was (11.5?1.3) d. Recurrences of calculi and bile duct stricture never happened within 6-48 m follow-up study. Conclusion The laparoscopic procedure is technically feasible and safe alternative, however, the technique in lyses of adhesions, dissection and suture of choledochus are quite difficult, therefore it is recommended to be performed in experienced hands expected to minimize the occurrence of complications, and firmly mastered the indications of conversion to laparotomy as far as possible.

BACKGROUND:Studies have found abnormalities in the biological activity and cytokine levels of bone marrow mesenchymal stem cels from psoriasis patients, while the biological activity of skin-derived mesenchymal stem cels from psoriasis lesions is rarely reported.
OBJECTIVE:To explore the influences of skin-derived mesenchymal stem cels from psoriasis lesions on T cel proliferation
METHODS:After isolation and culture, skin-derived mesenchymal stem cels from psoriasis lesions and normal controls were separately co-cultured with peripheral blood T cels. T cel proliferation was detected using MTT assay,andlevels of epidermal growth factor and transforming growth factor β1 in cel supernatant determined using ELISA method.
RESULTS AND CONCLUSION:Skin-derived mesenchymal stem cels frombothpsoriasis lesions and normal controls significantly inhibited T cel proliferation (P< 0.05). Furthermore, skin-derived mesenchymal stem cels from psoriasis lesions exhibited a weaker inhibitory effect on T cel proliferation than normal skin-derived mesenchymal stem cels (P< 0.05). Skin-derived mesenchymal stem cels from psoriasis lesions significantly increased epidermal growth factor but reduced transforming growth factor β1 compared with the normal skin-derived mesenchymal stem cels (P< 0.05). In conclusion, maybe the imbalances of growth factor levels due to skin injury elicit a decrease in the inhibitory effect of skin-derived mesenchymal stem cels from psoriasis lesions on T lymphocytes.

Objective To explore the correlation of the ER and HER-2 expression status with the short-term effect of paclitaxel and epirubicin (TE) chemotherapy advanced breast cancer. Methods Past Immunohistochemical data of 42 advanced breast cancer patients after paclitaxel combined epirubicin treatment were analyzed retrospectively. Patients were divided into four sub-groups: ER +, HER-2-group; ER +, HER-2 + group; ER-, HER-2-group; ER-, HER-2 + group. All affecting patients with complete clinical and pathological data were observed for the factors short-term effect of TE chemotherapy and for chemotherapy adverse. Results The whole 42 patients completed at least two cycles of chemotherapy, and then got efficacy evaluation. Recent response rate of the patients who got TE chemotherapy was 23 cases (54.8%).RR with different metastatic sites (P=0.038) and the number of metastasis (P=0.036) were significantly different. The mainly adverse events of chemotherapy were alopecia for 36 cases (85.7%), myelosuppression for 29 cases (69.1%), Peripheral neuritis for 10 cases (23.9%). ER,HER-2 expression in the Different sub-groups and the RR showed linear distribution (P= 0.027).RR values (83.3%) in patients of ER-, HER-2 + group was significantly higher than that of the ER +, HER-2-group (25.6%) (P=0.045). Conclusion Advanced breast cancer patients with ER-, HER-2 + were more sensitive to TE chemotherapy.ER and HER-2 expression status was a predictor of efficacy of the chemotherapy. It may be helpful to consider ER and HER-2 expression status in choosing reasonable chemotherapy.

Objective To investigate the immunization knowledge ,attitudes ,practice and requirements of the custodians of left‐behind/non‐left‐behind children in rural areas of Chongqing and to explore intervening measures .Methods Totally 1 441 com‐plete questionnaires were obtained by surveying the custodians of 1 year old left‐behind/non left‐behind children in 3 counties .Im‐munization records were checked to acquire vaccination information .Results Custodians of left‐behind children had poorer educa‐tion ,immunization knowledge and less comply with immunization behaviors than custodians of non‐left‐behind children .Village doc‐tors were essential to immunization work in rural areas .Conclusion We suggest pulling peer education in publicity and education for families with left‐behind children .It is important to mobilize the enthusiasm of village doctors ,and pay more attentions to the immunization work of left‐behind children .

Objective To detect the mutation of STK11 in a family with Peutz-Jeghers syndrome.Methods Genomic DNA was extracted from peripheral blood and harmatoma polypus of all the patients,and 9 exons and noncoding regions of STK11 were amplified by PCR.Cycle sequencing was used to analysis the DNA sequence,and western blot was used to detected the mutational STK11 protein in the harmatoma polypus.Results The 21th codon CAG in exon 5 of STK11 gene transformed to TAG in all the patients,which translated into a truncated STK11 protein.Conclusion This novel mutation is the pathogeny of PJS in this family,which could be an indicator for the diagnosis of PJS in this family.And it may lead to a higher risk of cancer in patients.

Objective To study on the effectiveness and reliability of endoscopic varicose vein ligation (EVL) combined with hand-assisted laparoscopic splenectomy (HLS) in portal hypertensive patients. Methods Retrospectively 15 cases of EVL combined with HLS were reviewed from June 2001 to October 2004. These patients with severe esophageal varicose and hypersplenism were adapted to perform endoscopic varicose vein ligation, then 1 -2 weeks after the varicose became milder or disappeared, hand-assisted laparoscopic splenectomy was conducted. Results The number of preoperative ligation was 2. 2 times in average. Esophageal varicose was completely disappeared in 11 and mild in 4. There were no postoperative complications, conversion and death in Hand-assisted laparoscopic splenectomy. The average postoperative count of platelets were (38-67) ? 106/L preoperatively raised to (89-310) ? 106/L postoperatively. In the follow up period (average 17. 6 months) , no varicose vein bleeding happened. Conclusions EVL combined with HLS is not only minimal invasive, but also a secure and effective measure for portal hypertension.