With the rapid advancement of immunology and molecular biology,many new revelations and ideas were drew for clinical immunology in laboratory medicine.In the current circumstances of application of clinical pathway management and individual medical care,how to accurately grasp these changes to build perfect quality system for clinical immunology laboratory,clarify the immunology laboratory pathway and integrate that into clinical pathway management,make solid progress for the promotion and application of individual diagnosis and evaluate the diagnostic value of new technique and item for clinical immunology laboratory accurately might be worth pondering for every people working in clinical immunology laboratory.In this paper,the status quo and reflection of clinical immunology is reviewed.

With the development of molecular biology and molecular genetics,more attention has been taken to the advanced techniques which can be used to detect minority mutations.In recent years,many techniques such as amplification refractory mutation system,PCR clamping,pyrophosphorolysis-activated polymerization,co-amplification at lower denaturation temperature-PCR and digital PCR have been developed,which will make the hereditary disease diagnosis,cancer detection,noninvasive antenatal diagnosis step into a new stage in the near future.This review presents an overview of the principles,aoolications,advantages and disadvantages of these techniques.

Five medicines for prevention and treatment of osteoporotic fractures were introduced.They are bisphosphonates,calcitonin,selective estrogen-receptor modulator,estrogen and active vitamin D.The pharmacologic effects,safety,application and causions were explained according to principles of evidence-based medicine.

Hypertension is a common chronic disease which can lead to cardiac, cerebrovascular and renal damage; it is seriously harmful to human health. Cardiovascular disease caused by hypertension has become the first cause of death of residents in our country, the burden of disease has become more and more serious, how to manage hypertension has become an important public health issue in our country. In this review, the development and current situation of the community health management of hypertension at home and abroad are described and analyzed, the experience and practice worthy of learning are summarized to provide evidence for the prevention and control of hypertension in community.

Objective To evaluate the value of 18F-FDG PET in predicting the prognosis of pancreatic cancer. Methods Fifty-four cases of pancreatic cancer were divided into two groups. Taking standard uptake value(SUV) at 4 as the cut off point, patients (22 cases) with that not more than four were classified into group A, and those (32 cases) with SUV greater than four were into group B. The prognosis of patients by SUV was analyzed statistically. Results There was a statistically significant difference in survival between the two groups ( P =0. 01 ). The 1-,3-year survival rate was 68. 18% 、34. 91% in group A in those the SUV≤4, and 33.61% 、11.95% in group B( SUV ＞4), respectively. Cox proportional hazard model showed that tumor staging and SUV were the significantly independent prognostic factors in patients with pancreatic cancer. Conclusions 18F-FDG PET is of value in predicting the prognosis of patients with pancreatic cancer.

Objective To assess the effect of clomiphene citrate(CC)on the proliferative stage of endometrium by the addition of low-doge estrogen(progynova,PGV)and aspirin.Methods Sixty women with unexplained infertility were divided into 4 groups randomly.Untreated group,CC treated group(C group),CC+PGV treated group(CE group)and CC+PGV+aspirin treated group(CEA group),each group Was 15 cases.Endometrium thickness,pattern of endometrium and resistant index(RI)of uterine artery were detected by ultrasound,all at end proliferative stage of endometrium.Results The endometrium thickness,the rate of the endometrium thickness≥8 mm and the rate of A-endometrium in C group were significantly less than those in other 3 groups(P<0.05).The rate of A-endometrium in CE group was significantly less than that in untreated group and CEA group(P<0.05).The number of follicle diameter≥15 mm in untreated group(1.01±0.25)was signifieantly less than that in other 3 groups(1.56±0.64,1.52±0.70,1.61±0.67)(P<0.os).RI of uterine artery in C group(0.93±0.07)and CE group(0.95±0.04)were significantly higher than that in untreated group(0.81±0.05)and CEA group(0.83±0.03)(P<0.05).Conclusion Low-dese estrogen can reverse the deleterious effect of CC on.endometrial development,and low-dose estrogen and aspirin can promote uterine perfusion and improve uterine compatibility.

Objective To investigate the clinical value and effect of peripherally inserted central eatheter(PICC) in patients with tuberculous meningitis. Methods 56 patients with tuberculous meningi-tis were randomly divided into the treatment group and the control group with 28 cases in each group. The treatment group was medicated by PICC, while the patients of the control group were medicated through pe-ripheral superficial vein. The curing rate, degree of anxiety, infusion response, satisfaction with nursing and related expense were recorded. Results The curing rate and satisfaction with nursing of the treatment group were higher than those of the control group. The anxiety degree, infusion response and related ex-pense of the treatment group were lower than those of the control group.Their difference had statistical sig-nificance. Conclusions PICC has clinical value in patients with tuberculous meningitis,which is worth promoting.

Objective To evaluate the prognostic value of the Cancer of the Liver Italian Program (CLIP) score system in a study of hepatocellular carcinoma (HCC) patients who underwent radical resection. Methods Clinical pathological and follow-up data of 157 HCC patients, who underwent radical resection in our hospital from 1996 to 2004, were reveiwed retrospectively. Patients were divided into four groups according to CLIP scores. Disease-free survival rate was compared between groups, and within groups, the disease-free survival rate of patients receiving anatomic liver resection was compared with that of irregular liver resection. Results The overall 1,3,5-year disease-free survival rate was 63.6%、45.2%、35.7%,and there were significant differences among the four groups. For the zero score group, the recurrence rate of patients undergoing anatomic liver resection was lower than that of irregular liver resection (P = 0.003). Conclusions CLIP score system can be used to evaluate the recurrence rate of HCC patients receiving hepatectomy. CLIP score system can be used as a guidance for liver resection.

BACKGROUND: In order to improve the medication safety and remove export obstacles of Chinese preparations contained heavy metal and arsenide (cinnabar, realgar), it is necessary to carry on the evaluation on the efficacy and safety of cinnabar and realgar. At present, it has not been clear concerning to the pharmacodynamic mechanism of cinnabar and realgar in compound prescriptions yet.OBJECTIVE: To study the differences in cinnabar and realgar in angong niuhuang wan in the organism physiologically and pathologically so as to probe into those pharmacodynamic mechanism.DESIGN: A randomized and controlled trial.SETTING: Institute of Clinical Pharmacology of one university.MATERIALS: The experiment was performed in Institute of Clinical Pharmacology of Guangzhou University of Traditional Chinese Medicine in January 2003. Totally 51 male SD rats weighted varied from 250 g to 300 g were employed, provided by Experimental Animal Center of First Military Medical University of Chinese PLA.METHODS: SD rats were randomized into 6 groups(8-10 rats/group),named as normal group, normal & angong niuhuang san (integral recipe) group(278 mg/kg), normal & cinnabar and realgar omitted angong niuhuang san(disassembled recipe) group(222.7 mg/kg), cerebral edema model group(ligature on unilateral carotid artery by injection of pertussis bacilli (PB), 2 500 million/kg), model & integral recipe group (medication 278 mg/kg was done 1 hour before model preparation), model & disassembled recipe group(medication 222.7 mg/kg was done 1 hour before model preparation) . Five hours later after once medication(4 hours later after PB injection in model group), blood was collected and brain homogenate was prepared.MAIN OUTCOME MEASURES: Brain tissues, serum lactate dehydrogenase(LDH) activity and percentage enzyme activity of lactate dehydrogenase isoenzymes (LDH1-5).RESULTS: Compared with normal group, the general activity of LDH in normal & integral recipe group and normal & disassembled recipe group was significantly improved by 32.4% to 38.4% ( P ＜ 0.05); percentage enzyme activity of LDH1,2 was significantly increased( P ＜ 0.01 ), and that of LDH4, 5 was reduced( P ＜0.01) . Except LDH5, there were no significant differences in enzyme activity of isoenzymes in two groups. Compared with model group, the general activity of LDH in model & integral recipe group and model & disassembled recipe group was significantly improved by 23.4% to 38.5% ( P ＜ 0.01); percentage enzyme activity of LDH5 was significantly increased( P ＜ 0.01 ), there were no significant differences in two groups. In model & integral recipe group, percentage enzyme activity of LDH2,3 was significantly decreased( P ＜ 0.01), and that of LDH1,4 was no significant change. In model & disassemble recipe group, percentage enzyme activity of LDH1,4 was significantly reduced( P ＜ 0. 05, 0.01 ) and that of LDH2,3 was no significant change.CONCLUSION: In normal physiological state, angong niuhuang san produces a certain injuries on cardiac muscle and kidney. In pathological state of infectious cerebral edema, both integral and disassembled recipes inhibit LDH enzymes that have been over-activated, but the significant differences did not presented between both. Cinnabar and realgar in compound prescript provide the effects in various degrees on levels of LDH isoemzymas.

Hyponatremia is the most common electrolyte imbalance.Other than neurological complications,other complications of hyponatremia have not received due attention.Mild,chronic hyponatremia can result in subtle symptoms such as gait disturbance and falls,and increase the risks of osteoporosis and fractures.This paper reviewed the emerging relationship between hyponatremia and bone metabolism,its possible mechanisms and clinical implications.