In the past decade, liquid chromatography-mass spectrometry has undergone rapid development in clinical laboratory medicine.Benefiting from the high sensitivity and specificity, as well as the capability of multi-component analysis in the single run, such technology is regarded as an excellent alternative to conventional immunoassays towards newborn screening for the genetic diseases, therapeutic drug monitoring and endocrine hormones detection.With the continuing progress in expertise-training, quality assurance and methodology standardization, it could be expected that liquid chromatography-mass spectrometry would become a dynamic and crucial part for routine clinical applications in the near future.

Malignant islet cell tumor, a rare type of neuroendocrine carcinoma, biologically behaves in an aggressive way and is difficulty to be treated. Sunitinib malate, a novel tyrosine kinase inhibitor, demonstrates a high efficacy in treating malignant islet cell tumor as shown by promising results in recent trials.

Apoptosis is the autonomous death of cells,which is controlled by the genes and to maintain the homeostasis of the body.Apoptosis is the important mechanism in the cell's growth and development.Recent studies have found that apoptosis can affect the neighboring cells physiological process in microenvironment through directly contact or release a series of regulatory factor,which plays an important roles in the construction of tumor microenvironment.Therefore,understanding the roles of apoptosis in the normal and tumor microenvironment has great significance for further study the pathogenesis,prevention and treatment of tumor.

Chronic diarrhea is a common complaint in gastroentology department,which is classified into a variety of types.While as eosinophilic gastroenteritis is a rare cause.A 50-year-old male patient was admitted with a 2-year history of diarrhea worsened for 10 months.Fasting could alleviate the diarrhea.Laboratory findings demonstrated anemia,low vitamins and minerals,fat malabsorption and abnormal D-xylose absorption test,delayed gastric emptying.According to the endoscopic biopsy of gastrointestinal mucosa,the diagnosis of eosinophilic gastroenteritis was made.Diabetic neuropathy may aggravate the symptom.The diarrhea resolved after the administration of steroids.

Objective To investigate the prevalence of metabolic syndrome in patients with maintenance hemodialysis, and to analyze the potential risk factors. Methods The clinical data of 472 patients with maintenance hemodialysis from 7 blood purification centers were collected. Patients were divided into the MS group and the non-MS group. The demographic data , anthropometric examinations , dialysis prescription and results of laboratory were compared between these two groups. Multivariate Logistic regression analysis was performed to analyze the risk factors of MS. Results The morbidity of MS was 34.75%. There were significant differences in weight , waist circumference , waist-hip ratio , frequency of dialysis , time of hemodialysis perweek , urea reduction ratio, urea clearance index (Kt/v), iron, intact parathyroid hormone (iPTH), leukocytes, high sensitivity C-reactive protein (hs-CRP) between these two groups (P < 0.05, resectively). Multivariate Logistic regression analysis revealed that iron (OR = 1.084, P = 0.042), iPTH (OR = 1.754, P = 0.035), waist-hip 1ratio (OR = 2.013,P = 0.021), hs-CRP (OR = 4.245,P = 0.000)were correlated with MS. Conclusion The morbidity of MS in patients with maintenance hemodialysis is higher. Iron, iPTH, waist-hip ratio, hs-CRP are potential risk fctors of MS for the patients with maintenance hemodialysis.

Thirty patients with confirmed primary sjogren syndrome and thrombocytopenia during January 2002 and December 2007 were investigated.All the participants received 0.5 mg·kg-1·d-1 Prednisone and 100 ms/d CosA for 1 year.Clinical symptoms and the levels of white blood eell.platelet count,erythrocyte sedimentation rate,liver function,immunoglobin,and rheumatoid factors were recored before and after the treatment.After one-year follow.up,platelet count was elevated(t=11.4179,P< 0.01).There was no significant change in erythrocyte sedimentation rate.The concentrations of immunoglobin and rheumatoid factors were significantly decreased at 1 year(t=5.4222,P<0.01;t= 9.2857.P<0.01).Prednisone plus CosA could effectively treat primary sjOgren syndrome combined with thrombocytopenia and result in fewer side effects.

Objective To investigate the relationship between serum visfatin level and coronary artery stenosis.Methods Based on coronary angiography,85 patients were diagnosed as coronary heart disease.According to oral glucose tolerance test,these patients were divided into 3 groups,34 patients with normal glucose tolerance(CHD group),25 with impaired glucose regulation(CIG group),and 26 with type 2 diabetes mellitus(CDM group).30 non-comary heart disease subjects with normal glucose tolerance were selected as the control group(CON group),and they underwent coronary CT angiography scan and were confirmed coronary disease-free.Blood pressure,body mass index(BMI),waist circumference(WC),waist hip ratio(WHR),fasting plasma glucose(FPG),blood lipid analysis,fasting insulin,and HbA1C were determined.Serum visfatin concentration was assayed and the status of coronary artery was assessed.Coronary artery stenosis was screened by coronary interventional angiography and assessed by Gemini scoring system in CHD,CIG,and CDM groups.Results Compared with control group,serum visfatin in CHD,CIG,and CDM groups were significantly higher(all P<0.05).Compared with CHD group,serum visfatin in CIG and CDM groups were significantly higher(all P<0.05).The correlation analysis showed that serum visfatin level was positively correlated with the involved branches of coronary arteries(r=0.807,P<0.01),serum visfatin level was positively related with Gensini coronary artery score(r=0.669,P<0.01).Visfatin was also positively correlated with WC,WHR,triglyceride(TG,r=0.200,P=0.032,r=0.185,P=0.047,r=0.321,P<0.01),while high density lipoprotein cholesterol(HDL-C)was negatively correlated with visfatin(r=-0.354,P<0.01).Multiple regression analysis showed that senlm hvel of TG and WC were the main influencing factors of visfatin.Conclusion (1)The level of serum visfatin may reflect the severity of coronary artery stenosis,detection of visfatin helps to make early diagnosis of CHD.(2)The raised serum level of visfatin in comary heart disease patients with imparied glucose tolerance is consistent with clinical evidence that diabetic patients have more severe coronary diseases.(3)WC and serum TG are main inilucencing factors,suggesting that visfatin is correlated with abdominal obesity.

One hundred and twenty one patients on maintenance hemodialysis ( MHD) from Januaury 2004 to Januaury 2009 in our hospital were enrolled in the study. Demographic characteristics, clinical data and causes of disease were documented, the survival probability was estimated with Kaplan-Meier method and the prognostic factors were analyzed with Cox regression model. The median follow-up duration was 28. 9 months. The 1,3, 5-year survival rates were 93. 0% , 66. 5% and 45. 8% respectively. By Kaplan-Meirie analysis, cardiovascular disease (x2 =6. 582, P =0. 010) , age of starting dialysis (x2= 12.439, P= 0.002), urea clearance index Kt/V ( x2 =7.633, P=0.006) and albumin levels ( x2 = 4.512, P= 0.034) were closely related to prognosis. Cox regression analysis showed Kt/V, cardiovascular disease and age of starting dialysis were independent prognostic factors ( relative risk were 3. 204, 2. 994, 2. 543 respectively).

Objective To analyze the difference between primary biliary cirrhosis (PBC) and primary Sj(o)gren's syndrome (pSS) and primary biliary cirrhosis complicating with Sj(o)gren's syndrome (SS) in clinical features,anti-60 000 SSA multiple antigenic peptides (MAPs) detection rate,and explore the potential mechanisms of PBC with SS.Methods MAPs were artificially synthesized.Enzyme-linked immunosorbent assay (ELISA) was done to detect anti-MAPs antibodies in the sera of the three groups of patients.The detection rates of anti-MAPs antibodies were compared among groups and the relations of anti-MAPs antibodies with clinical features were analyzed.Chi-square test,Fisher's exact test,t test or Wilcoxon signed rank test were conducted in this study.Results There was no significant difference in clinical features,liver function tests and antibody profiles between PBC and PBC with SS.Significant difference of anti-MAP20 antibody detection rote was detected between pSS and PBC with SS groups [25％(7/28) vs 0(0/25),x2=7.201 1,P=0.007 3],and anti-MAP3,7 and 17 antibody detection rates in PBC with SS patients [4％(1/25),4％(1/25),8％(2/25)] were similar to pSS [4％(1/28),7％(2/28),7％(2/28)].The anti-MAP7 antibody and anti-MAP12 antibody detection rates were significantly higher in patients with splenomegaly than patients without splenomegaly [38％(3/8) vs 2％(2/84),38％(3/8) vs 4％(3/84); P=0.039 4,P=0.039 4],while the antiMAP17 antibody detection rate was significantly lower in patients with salivary gland injury than patients without salivary gland injury [5％(3/64) vs 39％(5/13); x2=4.431 8,P=0.035 3].Conclusion There is significant difference in the anti-MAPs detection rates among the three patients groups,and the detection rate may be higher in patients with certain clinical manifestations.

The immune effect of two recombinant protein fragments of spike protein in severe acute respiratory syndrome coronavirus (SARS CoV) was investigated in Balb/c mice. Two partial spike gene fragments S1 (322 1464 bp) and S2 (2170 2814 bp) of SARS coronavirus were amplified by RT-PCR, and cloned into pET-23a prokaryotic expression vector, then transformed into competent Escherichia E. coli BL21 (DE3)(pLysS) respectively. Recombinant proteins were expressed and purified by Ni2+ immobilized metal ion affinity chromatography. The purified proteins mixed with complete Freund adjuvant were injected into Balb/c mice three times at a two-week interval. High titer antibody was detected in the serum of immunized Balb/c mice, and mice immunized with S1 protein produced high titer IgG1, IgG2a, IgG2b and IgG3, while those immunized with S2 protein produced high titer IgG1, IgG2a, but lower titer IgG2b and IgG3. Serum IFN-concentration was increased significantly but the concentrations of Il-2, IL-4 and IL-10 had no significant change. And a marked increase was observed in the number of spleen CD8+ T cells. The results showed that recombinant proteins of SARS coronavirus spike protein induced hormonal and cellular immune response in Balb/c mice.