Objective To study the clinical value of heart‐type fatty acid binding protein(H‐FABP) ,high‐sensitive cTnI(hs‐cT‐nI),homocysteine(Hcy)andcystatinc(Cys‐C)intheearlydiagnosisofacutemyocardialinfarction(AMI).Methods 150casesof AMI patients with coronary arteriography (AMI group) were selected from the cardiovascular department admitted within the first 6hours of chest pain attack .An additional 30 case for control group .The level of four novel cardiac marker were measured in each group of serum .Results The level of serum H‐FABP ,hs‐cTnI ,Hcy and Cys‐C in AMI group were markedly higher than control group(P<0 .05) ,and rose with the increase of coronary artery lesions with statistical difference (P<0 .05) .Each cardiac markers showed high specificity in the diagnosis of AMI ,amongst which H‐FABP and hs‐cTnI ,stood out with sensitivity of 97 .34% and 89 .98% respectively .With Youden index ,positive likelihood ration ,negative likelihood ration ,positive predictive value and negative predictive value ,H‐FABP and hs‐cTnI appeared to have higher diagnostic value than Hcy and Cys‐C in AMI .Conclusion H‐FABP and hs‐cTnI displayed significant clinical value as a most sensitive indicator in the early diagnosis of AMI (within 6 hours of attack) . The level of H‐FABP ,hs‐cTnI ,Hcy and Cys‐C elevated as coronary artery lesions increase .

Objective To analyze the correlation between LC-MS/MS method and enzymatic cycling assay for determination of homocysteine concentration in human serum,and the application of two methods in the determination of homocysteine concentration.Methods Homocysteine concentrations of 63 serum samples were collected and determined by LC-MS/MS method and enzymatic cycling assay,respectively.The correlation between the concentrations by different methods was analyzed and evaluated.Results The concentrations were(19.11 ± 15.69) μmol/L by LC-MS/MS method and(16.95 ± 14.41) μmol/L by enzymatic cycling assay,the P value evaluated by paired-samples T test showed that there was statistical difference among the concentrations determined by two different methods (t =6.25,P ＜ 0.05).The conversion formula was YLC-MS/MS method =1.074Xenzymatic cycling assay + 0.892,R =0.987.Conclusion There is good correlation between LC-MS/MS method and enzymatic cycling assay for the determination of homocysteine concentration in serum,providing a theoretical basis for estimating the concentrations in the same serum sample by the two methods.

AIM: In order to explore the mechanism of the GC - like effect of Tsiao Shaihutang (TSS), the down - regulation of glucocorticoid receptor and mRNA by TSS were studied. METHODS: GR sites were determined by receptor radio ligand binding assay method. At the same time, GR mRNA level was determined by quantitative reverse- transcriptive polymerase chain reaction (RT- PCR) method. RESULTS: (1) GR sites and GR mRNA level were down - regulated significantly after GC, TSS (P < 0.01 ) treatment . (2) GR sites and GR mRNA level in GC plus TSS group were obviously higher than those in GC group (P < 0.01 ). CONCLUSIONS: These data suggested that TSS can significantly down- regulate GR and GR mRNA level.

With the development and changes of the modern medical system,the public is paying more and more attention to health,and the professionalism of the physicians becomes more and more important.In recent years,studies have found that doctors are often troubled by professionalism dilemmas in clinical practice.This article reviews the literature on the professionalism dilemmas.Firstly,it defines the concept of professionalism dilemmas and points out the hazards of professionalism dilemmas for individuals,teams and the entire medical industry.We can explore the factors that affect the professionalism dilemmas from the intemal and external aspects,and finally put forward some suggestions for effective prevention and improvement of the professionalism dilemmas.First,physicians themselves have to enhance self-reflection ability.Second,medical schools,through training,shouldenhance the ability of physicians to face occupations professionalism dilemmas,Third,medical institutions should give policy support to to protect physicians.Through the study of the professionalism dilemmas of physicians,we should strengthen the professionalism of physicians and enhance the sense of professional responsibility and mission of medical and health personnel so that they can better fulfill their obligations,serve the people's health better and promote the healthy development of the entire medical and health undertaking.

Tumor-infiltrating lymphocytes (TILs) are a heterogeneous subset of lymphocytes, mainly T cells, present in tumor parenchyma and stroma. After being digested and isolated from tumor tissue and then cultured in vitro for activation and multiplication, it can be infused back into the patient's body to kill tumor cells. TILs have the advantages of high diversity of TCR, excellent ability to infiltrate into tumor sites, and low toxicity and are considered promising for the treatment of malignant solid tumors. At present, TIL therapy has been tested as a second-line treatment in a variety of solid tumors and has achieved preliminary results. Although there is still no clinical cohort report on the application of TILs in biliary tract cancer (BTC), recent clinical reports on multiple cancers have provided information on the efficacy of TIL therapy in a small number of BTC patients, which preliminarily confirmed the safety and efficacy of TIL therapy. However, since BTC is generally considered an immunologically repulsive tumor in which most effector T cells are sequestered at the tumor edge, the antitumor effect of TILs in BTC remains difficult to predict. Combination therapy with different anti-tumor methods and the development of new techniques to modify cells to enhance the anti-tumor ability of TILs are possible directions for breakthrough in the future.