Objective To evaluate methodologically particle‐enhanced turbidimetric immunoassay (PETIA ) for determining quantitatively Cystatin C .Methods Cystatin C was determined quantitatively with PETIA by Cobas 8000 automatic biochemical analyzer ,and imprecision ,veracity ,sensitivity ,linearity range of the method were investigated .The correlation of fresh serum sam‐ple results between PENIA and PETIA was analyzed .The reference interval was verified .Results The within‐run CV imprecision of samples with low and high concentration of adiponectin was 3 .67% and 1 .15% respectively ,the between‐run CV imprecision of samples with low and high concectration of adiponectin was 4 .08% and 1 .53% respectively .The accuracy of the measurement devi‐ation was only -1 .25% .The sensitivity was 0 .07 mg/L .When the adiponectin concentration was between 0 .2 -8 .0 mg/L ,the method showed good linearity .A strong correlation between PETIA and PENIA was confirmed (Y = 0 .945 8X+ 0 .048 6 ,r2 =0 .991 3 ,r=0 .995 6) .Among 40 cases of healthy physical examination sample ,2 cases were with cystatin C level out of the refer‐ence range supplied by reagent kit .The values that were more than 90% in validation interval .Conclusion The PETIA assay is a convenient ,rapid ,cheap ,accurate and reliable method for quantitating the human serum concentration of adiponectin .This assay is suitable for clinical routine analysis .

Objective: To summarize surgical result of single ventricle with total anomalous pulmonary venous connection (TAPVC) in relevant patients.
Methods:A total of 25 patients of single ventricle with TAPVC treated in our hospital from 2008-09 to 2016-03 were summarized. The patients were between 5 days to 14 years of age with body weight at (3.3-49.5) kg. There were 22 patients with supracardiac type TAPVC, 1 with infracardiac type TAPVC and 2 with mixed type TAPVC;in addition,17 cases having complete atrio-ventricular canal defect, 2 having tricuspid atresia, 4 having more than moderate atrio-ventricular valve regurgitation, 5 having pulmonary atresia and 9having pulmonary venous obstruction.
Results:There were 5/25 (20%) patients died at the early stage for low cardiac output syndrome. Followed-up study was conducted in 20 survivals for (1-65) months and 7 patients had re-surgery including 5 with modified Fontan operation, 1 with atrio-ventricular valve replacement due to severe atrio-ventricular valve regurgitation, 1 with pulmonary venous stenosis repair+atrio-ventricular valve replacement due to pulmonary venousobstruction and severe atrio-ventricular valve regurgitation. 3 patients died during followed-up period because of low cardiac output syndrome, protein lost intestine disease and neurological injury respectively. The rest survivals had good general condition, no residualpulmonary venous obstruction was found.
Conclusion: The patients of single ventricle with TAPVC were frequently associated with right atrial isomerism and complex cardiac anomaly;surgical treatment still having the high mortality.

Hepatocellular carcinoma (HCC)is a disease with high incidence and mortality and has become a serious threat to human health. So far,none of the available markers can be used alone for early diagnosis of HCC.Recently identified serum markers with potential clinical value for early diagnosis of HCC are summarized,and their diagnostic sensitivity and specificity,as well as their applications in assessment of progression of the disease,are reviewed.It is suggested that alpha -fetoprotein should be used in combination with other serum markers to achieve accurate diagnosis of HCC at early stages.

BACKGROUND: Recent studies indicate that after indirect co-culture of neonate rat myocardial cells and bone marrow mesenchymal stem cells, bone marrow mesenchymal stem cells can differentiate into myocardial cells successfully. OBJECTIVE: To induce human bone marrow mesenchymal stem cells (hBMSCs) to differentiate into endothelial cells using human umbilical vein endothelial cells by indirect co-culture. DESIGN, TIME AND SETTING: In vitro study of cell engineering was done at the Medical Research Center of Guangdong Provincial People’s Hospital between January and July 2007. MATERIALS: Small quantities of bone marrow were obtained from 11 children with congenital heart disease but without hematologic diseases through manubrium of sternum puncture in the congenital heart defect corrective surgery after the permission of family member. Umbilical cord of full-term normal delivery healthy newborn was provided by the Department of Obstetrics, the First Affiliated Hospital of Sun Yat-sen University. Fresh cattle jugular vein was provided by Guangdong Dali Meat Cattle Butchery. METHODS: The hBMSCs were isolated and purified using density gradient centrifugation method and were cultured in vitro. Human umbilical vein endothelial cells were obtained from newborn umbilical cord by enzyme digestion. Cell culture insert with semipermeable membrane combined with 6-well plate was used to do indirect co-culture induction. Human umbilical vein endothelial cells were expanded in the cell culture insert, passage 3 bone marrow mesenchymal stem cells were expanded in the 6-well plate outside the culture insert at the density of 1?105 cells/well, the initial ratio of the two kinds of cells was 1:5, then low-glucose DMEM culture solution containing 10% fetal bovine serum was added, cells were cultured for 14 days. Co-culture of bone marrow mesenchymal stem cells and bone marrow mesenchymal stem cells was used as control. Introduced endothelioid cells were cultured and then seeded on the cell-free cattle jugular vein intravascular stent. MAIN OUTCOME MEASURES: Morphology changes of induced cells; introduced endothelioid cell surface antigen detected through immunocytochemical staining; the growth and adhesion condition of endothelioid cells on the intravascular stent observed under scanning electronic microsope. RESULTS: The morphologies of introduced endothelial cells were uniform, introduced endothelial cells presented a cobblestone-like appearance, they amplified fast and expressed endothelial cell-specific surface marker CD31 and vWF and the positive rate was over 99%. They also could form a continuous unicellular layer on the cell-free cattle jugular vein intravascular stent. CONCLUSION: Human umbilical vein endothelial cells can induce hBMSCs to differentiate into endothelial cells successfully and to adhere and grew on the cell-free cattle jugular vein intravascular stent through indirect co-culture method.

Objective To evaluate the results of direct anastomosis between the main pulmonary artery and right ventricle in the repair of complex congenital heart disease. Methods Between March 2001 and June 2004, seventeen patients with complex congenital heart disease underwent direct anastomosis between the main pulmonary artery and right ventricle. Among them, eleven patients were under 3 years old. Six patients had pulmonary atresia and ventricular septal defect (VSD), 4 had transposition of the great arteries and VSD, 4 persistent truncus arteriosus and 3 TOF with coronary artery straddling RVOT. Twelve patients underwent one stage complete corrective repair and 5 patients received staged procedures. Results There was 1 operative death with hospital mortality of 5.9%. Three out of 5 staged patients succeeded in the second corrective repair. At follow-up ranging from 1 to 40 months, all patients were growing well and their heart function were in NYHA class 0 or I. Conclusion Direct anastomosis between the main pulmonary artery and right ventricle can provide good results in the repair of certain complex congenital heart disease, especially in infant patients without suitable homograft.

Objective To investigate the Shenmai injection for the inhibition of hepatic and renal toxicity and leukocyte disorder during chemoradiotherapy in the women with advanced breast cancer. Methods 58 cases of female breast cancer patients with stage Ⅳ were selected and randomly divided into 2 groups, 29 cases of each group, and patients were treated with 5-hydroxytryptamine (5-HT3) receptor antagonists and white blood cell growth hormone and other conventional therapy, the control group received gemcitabine plus cisplatin chemotherapy, 28d for 1 cycles, the treatment group received more with Shenmai injection, interval was 15d, 2 groups were treated for 3 cycles. Levels of peripheral blood T lymphocyte subsets, cytokine levels and liver and kidney function, quality of life and clinical efficacy were compared. Results Compared with before treatment, levels of CD3+, CD4+ and CD4+/CD8+ in control group decreased (P<0.05), levels of CD3+, CD4+ and CD4+/CD8+ in treatment group increased (P<0.05), levels of CD8+ decreased(P<0.05), levels of IFN-γ, IL-2 and TNF-α increased(P<0.05), levels of IL-6 decreased(P<0.05), scores of KPS increased(P<0.05), scores of FACT-B decreased(P<0.05), levels of ALT, AST, BUN increased(P<0.05), and levels of CCr, WBC counts decreased(P<0.05), and compared with the control group, levels of CD3+ , CD4+ and CD4+/CD8+ in the treatment group were higher(P<0.05), levels of CD8+ were lower(P<0.05), levels of IFN-γ, IL-2 and TNF-α were higher(P<0.05), levels of IL-6 were lower(P<0.05), and the total efficiency was higher(P<0.05), levels of ALT, AST, BUN were lower (P<0.05), and levels of CCr, WBC counts were higher (P<0.05). After treatment, the efficacy of treatment group was higher than that of control group(Z=-2.142,P=0.032<0.05). Conclusion Shenmai injection can improve the efficacy of radiotherapy and chemotherapy in patients with advanced breast cancer, and it can effectively inhibit the liver and kidney damage and leukocyte disorder.

Objective To observe the clinical efficacy of acupuncture plus Chinese medicine iontophoresis in treating dry eye syndrome.Method Sixty-two patients with dry eye syndrome were randomized into a treatment group and a control group, 31 cases in each group. The treatment group was intervened by acupuncture plus Chinese medicine iontophoresis, while the control group was intervened by artificial tears. After 4-week treatment, the changes of tear secretion, tear film break-up time (BUT) and symptoms score were observed, and the clinical efficacies were compared.Result The total effective rate was 87.1% in the treatment group versus 61.3% in the control group, and the between-group difference was statistically significant (P<0.05). The total symptoms score, tear secretion and BUT were significantly changed after the treatment in both groups (P<0.05). After the treatment, the total symptoms score, tear secretion and BUT in the treatment group were significantly different from those in the control group (P<0.05).Conclusion Acupuncture plus Chinese medicine iontophoresis is an effective method in treating dry eye syndrome.

Objective To summarize clinical characteristics, diagnosis and surgery of abnormally origination of left coronary artery from the pulmonary artery. Methods Clinical data of 10 patients with left coronary artery abnormally originating from pulmonary artery were analyzed, including 5 men and 5 women, aged from 13 to 40 years. Definite diagnosis was made by ultrasonic cardiogram (UCG) and cardiac catheter examination. Three cases were simply abnormal origination, six cases combined with MI, and one case combined with both MI and ventricular aneurysm of left ventricular apex. Ligation of the abnormal coronary artery was done in four patients, three were given pulmonary artery inner tunnel plasty under extrocorporeal circulation. Open implantation of left coronary artery to ascending aorta were done in 3 patients, while plasty of mitral valve were performed in 5 and ventricular aneurysm resection in 1. Results One patient died postoperatively. The follow-up ranged from 1 month to 11 years. One patient received replacement of mitral valve 16 months after first surgery due to severe MI. All the followed-up patients presented no myocardial ischemia or infarction, no residual shunt or late death. Cardiac function was rehabilitated to grade 1. Conclusion Obvious blood dynamics and cardiovascular morphology changes existed in patients with left coronary artery abnormally originating from pulmonary artery. Early diagnosis and surgery should be done. Proper surgical approach is the key to success.

Objective To evaluate the outcomes of one-stage repair of aortic coarctation (CoA) and associated cardiac anomalies in infants through a midline sternotomy. Methods Between June 2002 and August 2005, 36 patients (27male, 9 female) underwent surgery for CoA. The age was from 18 days to 8 years[mean (14.3?9.5) months], 27 patients (75%) were younger than 1 year and 18 patients (50%) were younger than 3 months. The body weight was from 3.0 to 23 kg [mean(6.6?3.0)kg]. 27 patients were symptomatic infants and 8 patients were asymptomatic of adults. One patient had recoarctation after repair through a left thracotomy one year ago. The associated cardiac anomalies included ventricular septal defect, patent ductus arteriosus, secundum atrial septal defect, hypoplasia of the aortic arch, transposition of great arteries and subaortic stenosis. 36 cases underwent one-stage operation of extended end-to-end anastomosis through a midline sternotomy. Results One patient died postoperatively with a mortality of 2.8 %. The cause of death was heart and lung function failure. 35 cases were followed up from 4 months to 3 years .One late death occurred. 34 cases were in good condition and no recoarctation. Conclusion Outcomes of one-stage repair of CoA and associated cardiac anomalies in infants through a midline sternotomy is excellent. Technique of extended end -to-end anastomosis may potentially reduce the incidence of recoarctation.

Objective To study the mechanism of the resistance in Acinetobacter baumannii to common antibiotics.Methods Bacterial susceptibility test to ?-lactamatic antibiotics,quinolones,aminogiycosids were done by the Kirby-Bauer method and agar dilution method for 35 isolates.Penicillin-beta-lactamase,AmpCs,Metallo-beta-lactamase,ESBLs were detected by iodine-starch test,3-dimension test,microbiology sensitivity synergic test,disc agar diffusion method respectively.Outer membrane protein was analyzed by SDS-PAGE.Accumulation of ciprofloxacin was determined by direct Fluorescence method.The gene of Tem-1,aac-4 and gyrA were amplified by PCR while the gyrA was sequenced.Results 28 isolates were multi-resistant to common antibiotics in 35 isolates.16 isolates produced Penicillinase,10 isolates produced Cephalosporinase,2 isolates produced metal-beta-lactamase,3 isolates produced ESBLs.The analysis of outer membrane proteins showed that a protein of 29kD disappeared and 26kD protein enhanced in resistant isolates.The accumulation of ciprofloxacin in resistant isolates decreased.After treatment with NaN_3,the drug uptake increased to the normal level.Most of [QX(Y8]Tem-1 gene were positive except 2 drug resistant and 3 sensitive isolates.All of [QX(Y8]aac-4 were negative while gyrA were positive.DNA sequencing analysis revealed there had point mutation in the gyrA gene.Conclusion Beta-lactamase,active drug efflux,outer membrane protein permeability decreasement and gene mutation were the factors contributing to the antibiotics resistance of Abaumannii.