Objective To investigate the diagnostic value of combined copeptin, cardiac troponin I (cTnI) and high sen?sitive cardiac troponin T (hs-TnT) in determination of acute myocardial infarction (AMI). Methods A total of 152 patients with AMI were selected as AMI group and 143 healthy examinees during the same period were selected as control group. (1) The levels of copeptin, cTnI and hs-TnT were detected at 0, 4, 6 and 12 h in two groups. (2) The combined detection of cop/cTnI and cop/hs-TnT were studied. The positive rates of these items were evaluated at different time points of AMI. ( 3) The diagnostic sensitivity, specificity and accuracy of different cardiac biomarkers for AMI were compared. Results (1) There were significant differences in copeptin at 0, 4, 6 and 12 h between two groups (P<0.05). There were no significant differ?ences in cTnI and hs-TnT between two groups. (2) cop/cTnI and cop/hs-TnT combined detection showed better positive rates than those of copeptin, cTnI or hs-TnT detection alone. (3) In addition, the combined detection of cop/cTnI and cop/cTnI improved significantly the diagnostic sensitivity of AMI. Compared to cop/cTnI combination, cop/hs-TnT combination detec?tion showed better diagnostic sensitivity, specificity and accuracy for AMI. Conclusion The combined detection of cop/cTnI and cop/hs-TnT are very helpful for early diagnosis of AMI, which shows a very good diagnostic value in clinical application.

Objective To investigate the effect of clemastine fumarate on lung ischemia-reperfusion (I/R) injury in rabbits.Methods Fifty New Zealand white rabbits of both sexes,weighing 2.0-3.0 kg,were divided into 3 groups using a random number table:sham operation group (Sham group,n =10),I/R group (n =20) and clemastine fumarate group (Cle group,n =20).The model of lung I/R was established by clamping the left hilum of lung and decreasing the tidal volume followed by restoration of perfusion and ventilation 1 h later in I/R and Cle groups.At 3 h of ventilation in group Sham and 2 and 4 h of reperfusion in I/R and Cle groups,blood samples were collected for determination of serum tumor necrosis factoralpha (TNF-α) and interleukin-8 (IL-8) concentrations by enzyme-linked immunosorbent assay.The left lung was lavaged,and the broncho-alveolar lavage fluid (BALF) was colleted for determination of white blood cell count.Lung specimens were obtained for microscopic examination of the ultrastructure of lung tissues and for determination of wet/dry weight ratio (W/D ratio),expression of IL-1β and IL-6 mRNA (by real-time polymerase chain reaction) and cell apoptosis (by TUNEL).The apoptosis rate was calculated.Results Compared with Sham group,the W/D ratio,white blood cell count in BALF,serum concentrations of TNF-α and IL-8 and apoptosis rate were significantly increased,and the expression of IL-1β and IL-6 mRNA was up-regulated in I/R and Cle groups (P＜0.05 or 0.01).Compared with I/R group,the W/D ratio,white blood cell count in BALF,serum concentrations of TNF-α and IL-8 and apoptosis rate were significantly decreased,and the expression of IL-1β and IL-6 mRNA was down-regulated in Cle group (P＜0.05 or 0.01).The pathological changes of lung tissues were significantly attenuated in Cle group than in I/R group.Conclusion Clemastine fumarate can attenuate lung I/R injury in rabbits.

Objective To study the diagnostic value of endoscopy assisted by laparoscopy in patients with small intestinal bleeding. Methods In case of small intestinal bleeding it is hard to define the accurate etiological factor by routine examination. From 1994 to 2002 there were 14 patients with chronic me-lena or persisted melena complicated with chronic anemia and 2 cases of acute alimentary tract hematorrhea complicated with obvious hypovolemia. Results Endoscopies assisted by laparoscopy were accomplished in all of the 16 cases. Lesions were detected in 5 cases with laparoscopy directly, and in 11 cases the pathological changes were discovered by endoscopies assisted with laparoscopy . The pathologic results were leiomyo-sarcoma 1 cases, leiomyoma 4 cases, adenoma of small intestine , hemangioma , vascular malformation and capillary telangiectasia 2 cases each, and Meckels diverticulitis with hemorrhage 3 cases. Conclusion The diagnostic value of endoscopy assisted with laparoscopy is superior to the routine examination in detecting the small intestinal bleeding. This technique has the advantage of simple, less-traumatic and high sensitivity. It is worthy to popularize in clinical practice.

Objective To discover the vital role of Rab27B in tumor cells and its potential molecular mechanism by means of quantitative proteomics analysis of Rab27B knockdown in MHCC97H.Methods The expression of Rab27B in MHCC97H cells was knocked down by the combination of Tet-on advanced inducible expression system and RNA interference technology.Then, proteins extracted from the cells were identified by LC-MS/MS system after FASP digestion and iTRAQ 4-plex labeling. Finally, the properties of differentially expressed proteins, including the subcellular localizations, biological processes and molecular functions, were analyzed by the bioinformatics method.Results There were 448 differentially expressed proteins (|Ratio|>1.21, P<0.05) identified in MHCC97H cells after Rab27B knock-down.The expression levels of 229 or 219 proteins were positively or negatively correlated with Rab27B, respectively. These differentially expressed proteins were mainly involved in vesicle transport, macromolecule localization, cellular response to stimulus.Furthermore, there were 26 differentially expressed proteins participating in 8 tumor-related signal pathways, eleven of which were in the focal adhesion signal pathway.Conclusion The analysis of quantitative proteomics in Rab27B-knockdown MHCC97H cell line by iTRAQ suggests that Rab27B not only has an impact on the exosomal secretion of tumor cells, but also regulates master proteins in signal pathways involved in cell proliferation and migration.

Despite different opinions on its definition and classification in the past,a consensus has gradually been reached regarding the na-ming,classification,and clinical diagnosis of liver failure.The classification of liver failure is described,and the definition and natural his-tory of severe exacerbation of hepatitis B are summarized.Antiviral treatment and artificial liver support in the early stage are beneficial for clinical outcomes and prognosis.

Objective To evaluate the clinical value of 99Tcm-MIBI SPECT for the differential diagnosis of parotid tumors before treatment.Methods 99Tcm-MIBI SPECT imaging of the parotid region was obtained in 32 patients with parotid tumors before surgery.Early and delayed 99Tcm-MIBI imaging were performed in all patients and the diagnosis was confirmed by pathological results after surgery.The ratio of radioactivity between the tumor and opposite side of normal parotid tissue (T/N) was measured.Fisher exact probability test and t test were used for statistical analysis.Results The sensitivity,specificity and accuracy of 99Tcm-MIBI SPECT imaging for the differential diagnosis of parotid tumor were 90.00％ (9/10),86.36％ (19/22) and 87.50％ (28/32),respectively.Among 22 patients who had benign tumors,19(86.36％) showed negative findings,and the other 3 ( 13.64％ ) patients showed false positive results.In 10 patients with malignant tumors,1 ( 10.00％ ) had false negative findings,and all the other 9 (90.00％)patients showed positive results.The difference between the benign and malignant groups was statistically significant (P =0.00018 ).In the early images,the T/N ratios of benign and malignant parotid tumors were 1.45 ±0.38 and 1.65 ±0.63 (t =20.4,P＜0.01),respectively; and in the delayed images,the ratios were 1.43 ± 0.56 and 1.77 ± 0.59 ( t =2.4,P ＜ 0.05 ),respectively.Conclusion 99Tcm-MIBI SPECT imaging might be useful for the differential diagnosis of parotid tumors before surgery.

Objective:To study the effects of poly-DL-lactic acid(PDLLA) biomembrane in the repair of cleft hard palate. Methods:Thirty-two cleft palate patients, age 2.67 to 12.83 years old, were treated. The traditional surgical method was used to close the cleft soft palate, and the PDLLA biomembrane was implanted into the surgical gap between the periosteum and bone at the hard palate and fixed with suture to close the cleft hard palate. Clinical follow-up was conducted for 6 months.Results:Operations on all 32 patients were completed successfully.The average surgical time was not prolonged, and post-operative complication was not increased. Wound healing of soft palate, uvula and hard palate was uneventful with no incidence of fistula or dehiscence. Conclusion: PDLLA absorbable biomembrane can be used to repair cleft hard palate.

Intestinal tract is one of the target organ during surgical stress. When surgical stress becomes overwhelming , the integrity of intestinal mucosal barrier is destroyed. Microorganisms and toxin in the intestinal tract then enter blood circulation through the permeable intestinal mucosa, and trigger SIRS and MODS, This processes reversely aggravate intestinal mucosal necrosis and bacterial translocation, and lead to a vicious cycle. Radical total gastrectomy is a major surgical stress. After extensive abdominal surgery, cytokines and inflammatory mediators may cause intestinal mucosal edema, increased intestinal permeability, intestinal villus height reduced, shrinkage of mesenteric blood vessel, reduced blood flow, and intestinal barrier functional deterioration. Whereas ulinastatin can protect intestinal barrier function by reducing surgical stress,alleviating SIRS and improving immunity etc. This article reviewed the investigations of ulinastatin influencing the recovesy of intestinal barrier function after surgical stress.

Objective To establish stable Graves disease (GD) mice models with immunization and electroporation (EP).Methods Fifty mice were divided into 3 groups by random number table method:experimental group (n =30),control group (n =10),blank group (n =10).Recombinant plasmid pcDNA3.1/hTSHR268 was constructed and injected to bilateral gastrocnemius in experimental group mice on the 1st,4th,7th and 10th week.The same volume of normal saline was injected in the control group and blank group at the same time.Both experimental group and control group were subjected to EP at the same time and the same location to enhance immunization.Serum T4 was tested with radioimmunoassay.TRAb N-terminal (TRAb N) and TRAb C-terminal (TRAb C) antibodies were tested with ELISA.Whole body 99TcmO4-imaging was performed and then thyroid morphology and pathology were investigated.Data were analyzed by one-way analysis of variance and the least significant difference (LSD) t test.Results GD BALB/c mice models were built successfully (80％,24/30).Serum T4 increased from (16.06±5.16) nmol/L at the basic level to(95.04±68.92) nmol/L on the 12th week(F=18.906,t=-5.598,P＜0.05).Serum TRAb N antibody increased from (0.006±0.002) U/L at the basic level to (0.251±0.110) U/L on the 12th week(F=47.491,t=-10.869,P＜0.05).Serum TRAb C antibody increased from (11.176±2.635)×103 arbitrary unit (AU)/L at the basic level to (46.395±22.001)× 103 AU/L on the 12th week(F=14.642,t =-7.787,P＜0.05).On the 18th week serum T4,TRAb N and TRAb C decreased to (36.64±23.68) nmol/L,(0.094±0.053) U/L and (24.456±6.725)× 103 AU/L respectively,which were still higher than those preimmune levels(t=-4.161,-8.085,-9.008,all P＜0.05).There were no significant change of T4,TRAb N and TRAb C in the control group and blank group.After 4 times of immunization,the 99TcmO4-uptake by thyroids in immunized mice increased.The thyroid glands of immunized mice showed enlargement.Microscope examination showed that there were lymphocytes infiltration,colloid decrease and epithelial cell proliferation in thyroids of immunized mice.Conclusion GD mice models were successfully established by injecting recombinant plasmid pcDNA3.1/hTSHR268 and EP.

TNF-?,a pleiotropic cytokine with strong proinflammatory and immunomodulatory properties is known to play an important role in inflammatory bowel disease(IBD).The biological effects of TNF-? are elicited by binding to its two cognate recepters,TNFR1 and TNFR2.For a long time,TNF-R1 was considered to be the predominant mediator of TNF-signaling,whereas TNF-R2 was ascribed only auxilliary function.However,there is increasing clinical and experimental evidence for an important independent role of TNF-?/TNFR2 signaling in chronic inflammatory conditions of IBD.The elucidation of the different effects of TNF-signaling in IBD will lead to a better understanding ot the pathogenesis of these diseases and will be the basis for the development of more specific and more efficient therapeutic approaches.