The new generation high-sensitivity cardiac troponin assays have been used in clinic for nearly 5 years in China.In 2012,several new high-sensitivity assays have been approved to be used in clinic in other countries,and they are under inspection of Chinese Food and Drug Ddministration.Because the new generation assays' sensitivity is improved,acute coronary syndrome could have been diagnosed 2-3 hours earlier,and small cardiac injuries that could not be detected by previous assays are detectable now.But its advantages also bring challenges to doctors.Many doctors can't even use previous assays well.The clinical doctors and laloiatory stuffs need to comunicate and reach a consensus just like American doctors do before American food and drug administration approve it.

Cerebral vasospasm (CVS) is a serious complication of aneurysmal subarachnoid hemorrhage (SAH).Endothelin-1 (ET-1) is an endothelium-derived vasoconstrictor substance.A large number of clinical and basic studies have shown that cerebrospinal fluid and/or ET-1 levels in peripheral blood increases in patients with SAH and play an important role in the occurrence and development of CVS.This article reviews the research status of the role of ET-1 in the occurrence and development of CVS.

BACKGROUND:To improve the survival rate of transplanted tissue, most scholars focus on cel therapy, particularly cel-assisted fat grafting.
OBJECTIVE:To analyze the effect of recombinant adenovirus-mediated hypoxia inducible factor 1alpha (HIF1α) mutant on survival rate of transplanted fat particles through transfection of adipose-derived mesenchymal stem cels.
METHODS:Recombinant adenovirus-mediatedtriple-mutantHIF1αwas inserted into an adenovirus pAdEasy-1 system, folowed by viral packaging and titer determination. Human adipose-derived mesenchymal stem cels were cultured, passaged and identified, and subsequently transfected with three kinds of viruses and blank vector (experimental group with transfection of the triple mutantof HIF1α;positive control group; negative control group; blank control group). Transfection efficiency was determined using enhanced green fluorescent protein labeling. Additionaly, MTT assay was used to detect cel proliferation.
RESULTS AND CONCLUSION:The recombinant adenovirus was successfuly constructed and packaged in line with transfection requirements. Moreover, adipose-derived mesenchymal stem cels were successfuly identified by adipogenic, osteogenic and chondrogenic induction and could be used asseed cels for subsequent experiments. RT-PCR results showed that HIF1α mRNA expression in the experimental group and positive control group was significantly higher than that in the other two groups (P< 0.05). Western blot analysis showed that the relative absorbance value in the experimental group was significantly higher than that in the other three groups (P< 0.05). A significant increase in the cel proliferation was found in the experimental group, significantly different from the other three groups (P<0.05). Therefore, our findings indicate that transfection of adenovirus-mediated triple-mutant HIF1α not only can sustain the expression of target protein in transfected adipose-derived mesenchymal stem cels under normoxic conditions, but also can promote the proliferation of transfected adipose-derived mesenchymal stem cels.

Objective To evaluate the efficacy and safety of intravenous cefmetazole in the treatment of patients with aspiratory pneumonia. Methods A multicenter, prospective and open-labeled trial was conducted. A total of 1522 patients were enrolled at the beginning, and only 1324 were evaluabled at the endpoint. The duration of treatment was 7-14 days. During the treatment and follow-up periods, we recorded any unexpected symptoms and abnormal laboratory tests. At last,we evaluated its efficacy and safety. Results The total effective rate of cefmetazole was 79. 8% (1056/1324). The total bacterial eradication rate was 75.0% ( 342/456 ) . The bacterial eradication rates of klebsiellar pneumonia, escherichia, staphyloccocus aureus and anaerobic bacteria were 78.2% (97/124), 80.8% (80/99), 89.0% (81/91), 9/11,respectively. Conclusions Cefmetazole is effective and safe in the treatment of aspiratory pneumonia.

Objective To prepare cytokine-induced killer(CIK) in vitro, and study the biological activities of CIK. Methods Lymphocytes were isolated from peripheral blood and umbilical blood, and induced by cytokine.The cell surface markers CD_3 and CD_~56 of CIK were analyzed by FACS. The proliferation of CIK was tested using 3H -TdR release method, and the cytotoxic effect of CIK on hepatic carcinoma cells was measured by MTT. Results CIK cells quickly proliferated from the second week, and expanded more than 60-fold at the 31th day after induction. The CD_3+ and CD_~56 + cells expanded more than 800 folds. The cytotoxic effect of CIK on hepatic carcinoma cells was obviously stronger than that of LAK cells, and CIK had not obvious cytotoxic effect on fetal liver cells. Conclusion CIK was a highly efficient cytotoxic cells against tumors, and had clinical application potentials.

Objective To investigate the therapeutic effect of loosening manipulation on neck tenderness points for cervicogenic tinnitus . Methods Forty cervicogenic tinnitus patients were treated with loosening manipulation on neck tenderness points. Tinnitus grading was carried out before and after treatment by following Tinnitus Severity Grading Criteria for the evaluation of therapeutic effect. Results ( 1) Tinnitus was relieved after treatment for one week and 2 weeks, and at the end of treatment course (P<0.05 compared with that before treatment). (2) After treatment for 3 continuous weeks, the cure rate was 25.0% ( 10/40) , the markedly effective rate was 37.5% ( 15/40) , the effective rate was 27.5% ( 11/40) , the ineffective rate was 10.0% ( 4/40) , and the total effective rate was 90.0%. Conclusion Loosening manipulation on neck tenderness points is effective on relieving cervicogenic tinnitus.

Objective to evaluate the clinical efficacy and safety of ADSCs infusion in patients with type 2 diabetes mellitus(t2DM). Methods Autologous ADSCs were cultured and identified. totally 48 cases of type 2 diabetes patients were divided into two groups:24 cases in A group re-ceived ADSCs and conventional treatment,while the other 24 cases in B group received conventional treatment. With 15 months′follow-up,FPG,2h-PGh,HbA1c,FC-P,AUCC,insulin medication changes and security on post-treatment 3,6,12 and 15 months were calculated. Results the AD-SCs which cultured met the clinical application of standards. FPG,2h-PGh and HbA1c in both groups were significantly decreased,and the values in A group were more impressive than B. there were significant improvement in FC-P,AUCC and insulin of A group compared with B group. there was not treatment related adverse events. Conclusion the clinical data demonstrate that the treatment with ADSCs can improve metabolic control and beta cell function in patients with t2DM. Moreover,the safety of the treatment method was considerable.

Objective-To-explore-the-feasibility-and-safety-of-endoscopic-total-thyroidectomy-via-chest-wall-approach-.-Methods-Endoscopic-total-thyroidectomy-via-chest-wall-approach-was-performed-in-20-patients-with-nodular-goiter-from-January-2008-to-December-2012.Subcutaneous-operative-space-was-created-through-an-unilateral-areola-incision-,-through-which-laparoscope-and-surgical-instruments-were-introduced-.The-neck-suture-suspension-technique-was-used-to-reveal-the-thyroid-gland-.By-using-an-ultrasonic-scalpel-,-the-thyroid-was-separated-and-removed-completely-.-Results-All-the-operations-were-successfully-completed-without-conversions-to-open-surgery-.The-operation-time-was-90-180-min-(mean,-120-min).The-blood-loss-was-15-40-ml-(mean,-20-ml).The-postoperative-hospital-stay-ranged-from-4-to-7-days-(mean,-5.8-days).There-was-1-case-of-temporary-hoarseness.No-severe-hemorrhage-,-wound-infection-,-or-subcutaneous-effusion-was-found-.-Conclusion-Endoscopic-total-thyroidectomy-via-chest-wall-approach-is-a-safe-and-feasible-procedure-.

Objective To study the components of Forsythia suspensa in stalks and leaves, and compare the content between the crude-sun-cured and the steam-sun-cured. Methods The components and content in stalks and leaves to fruits of Forsythia suspensa were compared by RP-HPLC. Results There were some same active components in stalks, leaves and fruits, and the steam-sun-cured had higher content. Conclusion The steam-sun-cured stalks and leaves of Forsythia suspensa could be used to extract components and develop the tea.

AIM: To investigate the effect of intracellular calcium free calcium ([Ca~(2+)]i) on zinic finger transcription factor (GATA_4) and fetal heart gene in cardiomyocytes. METHODS: Cardiomyocytes from fetal rat were cultured primarily. Angiotensin Ⅱ (Ang Ⅱ) and ryanodine (RY) were used to stimulate transmembrane calcium inflow and intracellular calcium release. Fura-2/AM ratio imagine analysis was applied to detect intracellular Ca~(2+) signal. Western blotting were used to measure calcineurin (CaN), nuclear activated T cell factor (NFAT_3), GATA_4 and ?-actin. RT-PCR was applied for observing ?-myosin heavy chain (?-MHC). RESULTS: AngⅡ and RY promoted intracellular free calcium concentration ([Ca~(2+)]i) in cardiomyocytes (P