Atrial fibrillation is one of the commonest cardiac arrhythmia in the elderly, the incidence increased with increasing ages. Atrial fibrillation can induce severe cardiac insufficiency and thromboembolism, stroke is also a very important complication with high morbidity and mortality. Thus it is very necessary to pay special attention to the study of atrial fibrillation in the field of geriatric cardiovascular diseases.

Objective:To determine the effect of standardized patients in medical international students' graduation practice assessment.Methods:The students were divided into two groups ofstandardized patient assessment and traditional assessment,the theoretical and professional performance was compared and analyzed after the assessments.All the students were investigated using questionnaire.Result:The students assessed using standardized patients reported higher skill scores than those with traditional assessments,and the difference was statistically significant.However,no difference was observed in theoretical scores.Gorcltusion:The introduction of standardized patient to medical international students' graduation practice assessment alleviates the status that emphasizes theory but ignores practice due to the lack of clinical resources,eliminates the obstacles in the communication between students and patients,and is conducive to the cultivation of humanistic quality and adaptability of the students.It is worthy popularizing in international students' graduation practice assessment.

Objective: To construct a recombinant adenovirus expression vector of the SD rat Lys184del mutant cardiac troponin I gene(cTnI Lys184del).Methods: The Lys184del mutant cardiac troponin I gene of SD rat was induced by PCR-based site-directed mutagenesis,the amplified fragment containing the mutation was then inserted into the cloning vector pMD18-T.After the addition of a sequence encoding a 6?His tag at the C-terminus by PCR,the coding region of cTnI Lys184del was subcloned into Adeno-X viral DNA to form a recombinant adenoviral plasmid,which was packed into infectious recombinant adenoviral particles(Ad-cTnI Lys184del) by transfecting HEK293 cells.Results: The DNA sequence of Ad-cTnI Lys184del was proved to be correct by PCR and sequencing,and its expression was identified by Western blot analysis.Conclusion: The successfully constructed recombinant adenovirus Ad-cTnI Lys184del has provided valuable data for further researches on its functional characteristics.

Objective: To evaluate the effect and safety of continuous veno-venous hemofiltration(CVVH) in the treatment of multiple organ failure(MOF) in senile patients.Methods: Sixteen patients with multiple organ failure,aged over 80 years,were divided into a survival group,who lived more than 20 days,and a non-survival group,less than 20 days after CVVH,and observed for such clinical indexes as of renal function,K+and blood gas analysis,APACHEⅡ scores and complications.Results: After CVVH,eleven of the patients survived for over 20 days,with 1 case up to 3 years.CVVH effected a significant improvement in BUN,Scr,K+and blood gas as well as a marked reduction in complications.APACHE Ⅱ scores decreased significantly after CVVH in the survival group though not in the non-survival group,as compared with those before CVVH,which were significantly lower in the former than in the latter.Conclusion: CVVH is a safe,effective and well-tolerated method for the treatment of MOF in senile patients.Patients with higher APACHEⅡscores have a poor prognosis.

Objective To express and purify recombinant human platelet glycoprotein Ⅵ extracellular domain and prepare the polyclonal antibody against it.Methods Human platelet glycoprotein Ⅵ extracellular domain fragment (123~268 residues) was amplified by polymerase chain reaction and cloned into the prokaryotic expression vector pGEX-3x.The recombinant plasmid was constructed and expressed in E.coli after induction with isopropyl-?-D-thiogalactopyranoside (IPTG).The fusion protein was identified by Western blot analysis after purification by affinity chromatography.Rabbits were immunized with the purified fusion protein, and the collected rabbit antiserum was evaluated by sandwich ELISA, Western blot and flow cytometry.Results The coding sequence of GPVI extracellular domain was successfully inserted into pGEX-3x.Sequencing result showed that the cloned gene was identical as reported.After induction, a Mr 42kd fusion protein was expressed and confirmed by Western blot, which was identical to that expected.The titers of the antisera were up to 1∶[KG-*2]128. Sandwich ELISA result demonstrated that the prepared antibody recognized GPVI in human platelet. Western blot and flow cytometry revealed that the prepared antibody reacted with GPVI of platelet lysate and the native GPVI on human platelet surface.Conclusions Using purified prokaryotic expressed the fusion protein as antigen, the specific antibody was elicited in the immunized animals. The prepared polyclonal antibodies react specially with GPVI on human platelet surface and can be used for further studies of GPVI.

Objective To study the clinical discrepancy between patients with post infectious irritable bowel syndrome(PI-IBS) and non post infectious irritable bowel syndrome(NPI-IBS),and assess the value of serum intestinal fatty acid binding protein (I-FABP) for differential diagnosis.Methods A total of 117 patients with PI-IBS,201 patients with NPI-IBS and 31 healthy controls were prospectively recruited in General Liberation Army Hospital from 2010 to 2013.Plasma samples and clinical data were collected.Serum I-FABP level was measured by an enzyme-linked immunosorbent assay.Results The median age of patients with PI-IBS was 36 years.The median time to diagnosis in PI-IBS group was significantly longer than that in NPI-IBS group [(19.7 ± 10.3) months vs (11.4 ± 5.3) months,P ＜ 0.05].Similarly,the proportion of anxiety [58.1％ (68/117) vs 28.9％ (58/201),P ＜ 0.05] and the value of I-FABP[(42.6 ± 14.8) μg/L vs (17.3 ± 11.5) μg/L,P ＜ 0.05] in PI-IBS group were significant higher than NPI-IBS patients.The level of I-FABP of healthy controls [(10.6 ± 8.2) μg/L] was also significantly lower than that of PI-IBS patients (P ＜ 0.05),yet no difference from that of NPI-IBS group.The I-FABP value of subgroup PI-IBS patients with diarrhoea (IBS-D) was significant higher than that of NPI-IBS group [(54.8 ± 9.3) μg/L vs (12.3 ± 6.2) μg/L,P ＜ 0.05].However,other parameters including gender,age,GSRS score,and I-FABP value of subgroup constipation (IBS-C) and mix (IBS-M),were not different between PI-IBS group and NPI-IBS group (all P ＞ 0.05).Conclusion PI-IBS is an occult intestinal inflammation disease with mucosa injury.I-FABP might be a potential testing marker for the diagnosis of PI-IBS.

Objective To evaluate the feasibility in early diagnosis, predicting therapeutic effect, recurrence monitoring by examining promoter hypermethylation for cancer-associated genes E-cadherin in cancer tissue and peripheral blood of breast cancer patients. Methods The tumor tissue, paracancer- tissue and the paired plasma were examined for aberrant methylation of E-cadherin gene by methylation-specific PCR in 42 cases of breast cancer and 10 cases of breast benign diseases. Results The incidence of promoter hypermethylation of E-cadherin in tumor tissues was 52.4% and the paired plasma were 33.3%. E-cadherin hypermethylation in plasma samples and tumor samples significantly correlated with each other ( P

Objective To compare the effectiveness and the influence on life quality of endovenous laser obliteration with those of traditional surgical ligation in treating varicosis of lower extremity.Methods By using numerical random grouping method,40 patients with varicosis of lower extremity were divided into traditional surgical ligation group (high ligation plus stripping,traditional group,n=20) and endovenous laser obliteration group (laser group,n=20).The curative effect and complications were compared between the two groups.According to the brief health survey (SF-36) scale,the influences of the two treatments on the life quality were evaluated.Results During the follow-up period,the differences in the curative effect and complications between two groups were not significant (P＞0.05).The life quality assessed by SF-36 scores in the laser group was better than that in the traditional group,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the treatment of varicosis of lower extremity,endovenous laser obliteration is safe and effective,it carries less influence on the patient's life quality when compared with traditional surgical ligation therapy.

Bi-specific antibodies (BsAb) P210/MMC, P210/TNP and P40/CD3 were prepared with different approaches. Among 11 fusions, 7, 484 wells were planted, and 223 dual positive wells were obtained from 1, 111 growth wells, only five hybrid-hybridomas secreting BsAb were obtained, showing the difficulties to prepare BsAb. It was shown that bridge assay is very important for identification of the BsAb. Among 12 triomas secreting y and ? chains, only two had BsAb. Therefore, the frequency for y and ? to combine to BsAb was 16.7(2/12). BsAb(P210/TNP) with versatile adaptor could mediate cytotoxic effects on target cells of different cytotoxic agents conjugated with TNP.Moreover, BsAb(P40/CD3) could mediate cytotoxic effects of peripheral blood lymphocytes (PBLs) on target cells. With local injection, four times treatments could abolish the tumor xenografts in nude mice.

Objective To investigate the position competency of residents in the first year and to search for the standardizing training which aims at advancing position competencies. Method Twenty residents of the first year and 40 of superior doctors were taken as research targets. Question-naires including 8 aspects (basic ability, occupational spirit, communication skills, medical knowl-edge, team work, public health, information and management, and academic research) were con-ducted and were scored namelessly. The scores of items in one kind of ability were summed up to serve as the total score of this ability. The mean score of one kind of ability and the mean score of 8 kinds of abilities of residents and superior doctors was calculated. SPSS 17.0 was adopted to make statistical analysis. t-test was adopted to test the difference between the score from residents and superior doctors with P<0.05 representing statistics significance. Results The scores of 8 kinds of abilities were much lower than full scores. The scores of basic ability, occupational spirit, and team work from residents (78.5, 87.4, 41.9) were higher than those from superior doctors (72.6, 80.5, 39.5), with statistical significances (P=0.020, 0.013, 0.045). Conclusions Residents are lack of position competency and awareness, which demonstrates the gap between the training model and the demand of work. It is sug-gested that we should design the training system and evaluation methods based on doctors' compe-tences, add training for comprehensive ability and evaluate abilities of all aspects. An excellent hu-manity education should be built and quality cultivation should be taken attention to. Objective and measurable indices should be developed to increase residents' knowledge.