Objective To evaluate the clinical application value of flow fluorescence assay in determination of serum pepsinogenⅠ and Ⅱ.Methods The precision of flow fluorescence assay in the detection of serum pepsinogen Ⅰ and Ⅱ were evaluated. Methodology comparison were conducted between flow fluorescence assay and enzyme-linked immunosorbent assay(ELISA)kit through detecting clinical samples.The reference ranges for PGⅠ and PGⅡ/PGⅠ ratio of healthy population were established. The levels of PGⅠand PGⅡ/PGⅠ ratio were detected in serum samples of patients suffering superficial gastritis,atrophic gastritis and gastric cancer.Results The within-run and between-run coefficient of variation of PGⅠ were 4.26%-5.35% and 6.73%-7.75%,respectively.And those of PGⅡ were 5.48% - 6.42% and 8.46% -8.85%,respectively.Methodology comparison be-tween flow fluorescence assay and ELISA demonstrated good linear correlations.The linear equation wasY =0.91 1X -22.635(r=0.966,P <0.05)and Y =0.892X -0.548(r=0.980,P <0.05)for PGⅠ and PGⅡ,respectively.The lower limit of the reference range of PGⅠ and PGⅡ/PGⅠ ratio were 32.77 ng/mL and 4.1 6,respectively.The PGⅠ and PGⅠ /PGⅡ ratio of patients suf-fering atrophic gastritis and gastric cancer were statistically significantly lower than those in patients suffering superficial gastritis (P <0.05).Conclusion The flow fluorescence assay could conduct simultaneous detection of PGⅠ and PGⅡwith good methodo-logical performance and high efficiency.The determination of PGⅠ and PGⅡlevels through flow fluorescence assay could provide laboratory basis for the screening and diagnosis of atrophic gastritis and early gastric cancer.

AIM: To observe the role of endothelin antagonist bosentan that inhibits cultured neonatal mice cardiomyocyte from endothelin-1 (ET-1) induced cell hypertrophy. METHODS: Digested by trypsin, neonatal mice cardiomyocytes were isolated and cultured in 4 groups. With a group of regular culture cells as control, other three groups were respectively treated by bosentan 10 -8 mol?L -1, ET-1 10 -10 mol?L -1 andET-1 10 -10 mol?L -1+bosentan 10 -8 mol?L -1 which were initially administered to the culture medium. The cell growing was observed carefully through micrography. 72 hours later, the level of atrial natriuretic peptide (ANP) and ET-1 in the media of the 4 groups were determined by method of radioimmunoassay. RESULTS: The values of ANP in different groups were: 6.46? 0.38 ?g?L -1 in control, 4.87? 0.56 ?g?L -1 in bosentan group, 13.60? 1.12 ?g?L -1 in ET-1 group and 9.42? 0.58 ?g?L -1 in ET-1+bosentan group. Also by micrographic observation, endothelin induced cell hypertrophy was proved, and the hypertrophy could be reversed by bosentan. CONCLUSION: Endothelin induces hypertrophy of cultured neonatal mice cardiomyocytes, but it can be inhibited by endothelin antagonist of bosentan.

The concept of “disease prevention theory” contains a wealth of preventive medicine thought. Pre-ventive health care service in Traditional Chinese Medicine( TCM) is an important measure for enhancing health qual-ity and improving the quality of living. This contributes to the building of a harmonious society and suits the changing medical model. Despite a series of achievements, there are also some problems in preventative health care service. Based on an analysis of influencing factors on policy implementation, the problems are discussed in the paper. The study provides some suggestions on preventive health care services, including the perfection of operations and man-agement mechanisms, the improvement of awareness on preventive health care service, the strengthening of the talent team, an increase in funding, and an evaluation of policy implementation.

Objective To evaluate the cross-screws fixation for displaced radial neck fractures.Methods A total of 29 patients with displaced radial neck fracture (Mason type Ⅱb) were treated by open reduction and cross-screws fixation at our department from October 2009 to August 2012.They were 18 males and 11 females,aged from 18 to 56 years (average,37.2 years).The fractures affected 16 left and 13 right sides.The time from injury to operation was from 3 to 72 hours,with an average of 33.9 hours.All fractures were displaced by more than 2 mm or angulated by more than 30°,and caused by simple falling.The elbow function was evaluated by the Broberg & Morrey scoring system at one year postoperation.Results All the 29 patients were followed up for an average of 16 months (range,from 12 to 29 months).All fractures healed within 3 months,ranging from 4 to 12 weeks (mean,10.6 weeks).By the Broberg & Morrey scores at one year postoperation,15 patients were rated as excellent,10 as good,3 as fair and one as poor,giving an excellent to good rate of 86.2％.No wound infection,neural injury,fracture displacement or fixation failure occurred.No implants were removed due to local uneasiness.Conclusion Cross-screws fixation can achieve satisfactory outcomes for radial neck fractures.

Objective: To determine whether 3-dimentional CT scans is able to effectively improve the detection rate of AO B3 distal radius fractures in clinics.Methods: From Jan 2013 to Jan 2014, 30 patients with distal radius fractures were retrospectively enrolled in this study, all the patients directly visited the skeletal trauma emergency department in Beijing Jishuitan Hospital post injury and all of them accepted open reduction and internal fixation of distal radius fractures at last.All the radiographic data including X ray films and 3-dimentional CT scans of these patients were collected.Two independent observers were required to make primary AO classifications for each fracture by X rays at first, then to make final AO classifications by 3-dimentional CT scans.Finally, the detection rates of CT scans and plain films for AO B3 distal radius fractures and B3.3 distal radius fractures were compared, the agreements of the two methods for diagnosing AO B3 and B3.3 fractures were calculated by Cohen''s Kappa calculations.Results: All the 30 fractures were confirmed to be AO B3 distal radius fractures intraoperatively, and 10 of them were B3.3 fractures.The results were completely consistent with the results of 3-dimensional CT scans.However, only 80%(24/30) AO B3 distal radius fractures and 60%(6/10) B3.3 distal radius fractures could be diagnosed only by X rays.The detection rate of CT scans was proved to be significantly higher than X rays for diagnosing B3 distal radius fractures(100% vs.80%,P<0.05), the detection rate of CT scans was also proved to be significantly higher than that of plain films for detecting B3.3 distal radius fractures(100% vs.60%,P<0.05).The agreement of 3-dimentional CT scans and X ray was poor for detecting both the AO B3 distal radius fracture and B3.3 distal radius fracture (kappa=0).Most importantly, in the study process, two special kinds of B3 distal radius fracture were initially found and described by us.One was named as radial B3 fracture, and the other was named as ulna B3 fracture.Conclusion: 3-dimentional CT scans can effectively improve the detection rate of B3 and B 3.3 distal radius fractures, and also help find two special kinds of B3 fractures.

Objective To explore the efficacy of breast-conserving therapy of ductal carcinoma in situ (DCIS),and to evaluate its safety.Methods 54 patients with DCIS receiving breast-conserving therapy(the experimental group) and 49 patients with DCIS treated with mastectomy(the control group) in the First Affiliated Hospital of Wenzhou Medical College from Mar.2010 to Mar.2013 were retrospectively analyzed.The follow-up results of the 2 groups were analyzed in terms of the local recurrence,distant metastasis and the 3-year diseasefree survival(DFS).The efficacy and safety of breast-conserving treatment were evaluated.Results All patients were followed up for 5 months to 39 months,with the average of(22.3 ± 8.5) months.No local recurrence happened in the experimental group.There was 1 case of chest wall recurrence in the control group.One case in the experimental group and 2 cases in the control group had distant metastasis.DFS rate in the 2 groups was 100％ and 95.9％ relatively.No statistically significant difference was found between the 2 group in terms of the above items (P ＞ 0.05).Conclusion For DCIS patients,the difference between breast-conserving therapy and mastectomy surgery in the rate of local recurrence and distant metastasis was not significant.Breast-conserving therapy is safe for DCIS patients and should be further promoted.

Objective To explore the surgical treatment of urethral recurrence after neobladder reconstruction in patients with bladder cancer. Methods In 89 consecutive patients with radical cystectomy, 5 patients (5.6%) presented with a noninvasive urethral recurrence at a median of 18 months (range 9 to 32 months). All 5 patients were treated by transurethral resection and intraurethral instillation with hydroxycamptothecin used as initial therapy. Mean follow-up was 37 months (24 - 52 months). Results All the 5 patients survived after the treatment. There was no one showed recurrence or distant metastasis. All the 5 cases achieved continence. Conclusion Urethral preservation at initial therapy for incipient noninvasive urethral recurrence would be a good choice and could maintain the quality of life.

Objective To explore the curative effect and security of transurethral holmium laser resection for adult ureterocele.Methods 22 cases with adult ureterocele were retrospectively studied.Eight adult ureterocele cases were male and 14 cases were female.The mean age was 36.5 years (ranged from 20 to 67years).All of the patients were unilateral onset,15 cases on the left side and 7 cases on the right side.The mean course of the disease was 31 months (ranged from 15d to 12 years).The clinical presentations were varied.All 22 cases were treated by tran-surethral holmium laser resection.About one -third of cyst wall were left in order to avoid vesicoureteral reflux and hydronephrosis.Results All 22 cases succeeded uneventfully.The pathologic study confirmed that 22 cases were ure-terocele.The mean hospital stay was 8days (ranged from 6 to 12days).Mean follow -up time was 17 months (12 -26 months),while 2 cases were lost.All 20 cases urine alalysis was normal.Five patients showed no hydronephrosis, while 10 cases showed less hydronephrosis.Cystoscopy showed all 20 cases ureteral healing was smooth,and none showed recurrence of ureterocele.Voiding cystourethrography showed none of vesicoureteral reflux.Conclusion Transurethral holmium laser resection would be a good choice for adult ureterocele,because the treatment has the advantages of simple operation,low requirement of equipment,safety and reliability.Especially for the primary level hospital,transurethral holmium laser resection is worth further clinical promotion.

Objective To study the changes of coagulation and fibrinolysis in rabbit model of non-overt disseminated intravascular coagulation induced by low-dose endotoxin and therapeutic effects of anticoagulation by heparin.Methods Twelve male rabbits were randomly divided into 2 groups,one receiving endotoxin intravenously(10 ?g/kg,n=6),one receiving endotoxin intravenously and 100 U/kg Heparin simultaneously(n=6).The blood sample obtained before experiment was used as control.Coagulation parameters including prothrombin time(PT),activated partial thromboplastin time(aPTT),thrombin time(TT),fibrinogen concentration,D-dimers,thrombelastography(TEG)were measured during 6 h after endotoxin induction.Tissue specimens of lungs and kidneys were examined.Results Parameters of coagulation deteriorated significantly in the endotoxin-induced rabbits,but was not altered in heparin-treated rabbits.TEG monitoring in the endotoxin-induced rabbits reflected consumption of clot factors and platelet dysfunction,and hypocoagulation status in heparin-treated rabbits.In endotoxin-induced group,fibrin deposition was found in lungs and kidneys.Conclusion Non-overt disseminated intravascular coagulation induced by low-dose endotoxin in rabbits is improved by heparin.

Objective To improve the detail of the surgery for cicatricial ectropion,and the the effect was investigated. Methods Based on 46 patients withⅡ,Ⅲdegree cicatricial ectropion admitted to our department,choose the junction of normal skin and scar tissue as the incision line according to the degree of ectropion and local situation,and to reserve and recover the orbicularis oculi muscle as possible. The released areas exceeded separately the external canthus and reached the level of eye fissure,take advantage of full-thickness skin graft to correct the parallel lines and make fixation to the eyelid ectropion fusion skin graft on external canthal ligament. Results After followed up for 6 months to 2 years,46 cases of eyelid skin grafts survived completely and eyelids were in good reduction,with none case of incomplete eyelid closure. Conclusion Choose the surgical incision and the released areas in a proper way to reserve the structural integrity of orbicu-laris muscle and make skin graft fixation to inner and external canthal skin can prevent effectively the recurrence of ectropion and improve surgical progress.