Objective To evaluate serum level of pepsinogenⅠ( PGⅠ) ,PGⅡ, and PGⅠ/PGⅡ-ratio ( PGR ) using latex enhanced turbidimetric immunoassay in patients with different gastric mucosal lesions, and to investigate their changes and clinical significance.Methods Case-control study.Two hundred and seventy-five patients who had enteroscopy and pathological examination from the department of gastroenterology and surgery from Beijing Tongren Hospital between January 2015 and January 2016 were enrolled.Endoscopic and histopathological examination confirmed the normal control group (n=20), chronic non-atrophic gastritis group ( n=68 ) , chronic atrophic gastritis group ( n=76 ) , including antral atrophic gastritis ( n=30 ) , gastric body atrophic gastritis ( n=26 ) , and multifocal atrophic gastritis ( n=20 );intestinal metaplasia group ( n=28 ) , intraepithelial neoplasia group ( n=9 ) , benign gastric ulcer group ( n=46) and intestinal gastric cancer group ( n=28).Latex-enhanced immune turbidity method were used to detect the patients fasting serum PGⅠand PGⅡ.Then the PGR was calculated.The normally distributed data of each group were statistically analyzed by ANOVA, the data between groups were nalyzed using the Mann-Whitney U test and Kruskal-Wallis test.Results Serum PGⅠ[ ( 74.23 ±22.36 ) ] ng/ml and PGR (6.92 ±2.16) in chronic atrophic gastritis group were lower than those in normal controls[PGⅠ(98.94 ± 21.00) ng/ml, PGR 8.13 ±2.47],(FPGⅠ =18.297,PPGⅠ <0.01,FPGR =4.713,PPGR <0.01).The serum PGⅠ[(44.46 ±26.72) ng/ml] and PGR (3.09 ±0.83) in the intestinal type of gastric cancer group were lower than those in the chronic atrophic gastritis group[PGⅠ(74.23 ±22.36)ng/ml, PGR 6.92 ±2.16], (ZPGⅠ =-3.921,PPGⅠ <0.01,ZPGR =-6.662,PPGR <0.01).PGⅠ[(129.95 ±43.39) ng/ml].PGⅡ[(21.09 ±6.78) ng/ml]in the gastric benign ulcer group were higher than those in the normal controls[PGⅠ (98.94 ±21.00) ng/ml, PGⅡ(12.64 ±1.84) ng/ml], FPGⅠ =10.803,PPGⅠ <0.01;FPGⅡ =39.130,PPGⅡ <0.01. PGⅠ[(52.44 ±10.37) ng/ml and PGR (5.47 ±1.59) in the multifocal atrophic gastritis group were lower than those in the antral atrophic gastritis[PGⅠ(94.95 ±14.45)ng/ml, PGR 8.39 ±1.48],ZPGⅠ =-5.941,PPGⅠ <0.01,ZPGR =-4.911,PPGR <0.01.The AUC of PGⅠand PGR for diagnosis of chronic atrophic gastritis were 0.752 and 0.683 respectively.The sequence combined detection sensitivity was 72.37%(55/76), and the specificity was 70.85%(141/199).The AUC of PG I and PGR for diagnosis of intestinal type of gastric cancer were 0.852 and 0.895 respectively.The sequence combined detection sensitivity was 71.42% ( 20/28 ) and the specificity was 81.78% ( 202/247 ) . Conclusion The Latex-enhanced immune turbidity method of combined detection of serum PGⅠ, PGⅡlevels and PGR can be used in the clinic to monitor the status and function of gastric mucosa and are informative for gastric cancer and precancerous lesions of gastric mucosa.

Objective To study the value of SF-36 in evaluating the life quality of Chinese patients with chronic obstructive pulmonary disease(COPD). Methods The SF-36,MRC score and spirometry were collected from 50 patients with COPD,the validity was documented by performing correlation analysis and stepwise multiple regression analysis. Pearson correlation coefficients were calculated. Results The MRC score was significantly correlated with seven of the eight components(P

OBJECTIVE:To establish a method for simultaneous determination of spironolactone and erythromycin in Com-pound spironolactone gel. METHODS:HPLC was performed on the column of Thermo-Hypersil ODS2-C18 with mobile phase of 0.1 mol/L ammonium dihydrogen phosphate solution (pH was adjusted to 7.0 by triethylamine)-acetonitrile (60∶40,V/V) at flow rate of 1.0 ml/min,detection wavelength was 215 nm and 238 nm,column temperature was 30℃,and injection volume was 5 μl. RESULTS:The linear range was 0.251 6-5.032 μg/ml for spironolactone and 0.577 2-11.544 μg/ml(r=0.999 9) for erythromycin (r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 0.83%;average recoveries were 97.8%(RSD=0.74%,n=9)and 96.7%(RSD=2.60%,n=9),respectively. CONCLUSIONS:The method is simple,reproducible,ac-curate and reliable,and can be used for the quality control of Compound spironolactone gel.

Objective To study the effects of ePTFE-covered stents versus bare stents on portal hemodynamics in portal hypertensive patients receiving TIPS. Methods Sixty patients with portal hypertension underwent TIPS with 8 mm diameter bare stents and ePTFE-covered stent from April 2007 to April 2009. The clinical outcomes were observed after TIPS, and the hemodynamics of potal vein system were studied before and after TIPS and during the follow up using direct portography and color Doppler ultrasound technique. Results TIPS procedures were successful in all patients without major complications. The follow-up of patients with bare stents were (8 ± 4) months and follow-up of ePTFEcovered stents group were (6 ± 4) months. Immediately after the TIPS the portosystemic pressure gradient of the two groups decreased by 60% and 58%, respectively(t =0.79, P >0.05). During the follow-up,portosystemic pressure gradient of bare stents group increased gradually, while that in ePTFE-covered stents group maintained low portosystemic pressure gradient (13.2 ± 1.2) mm Hg vs. (9. 5 ± 2. 9) mm Hg, P =0. 015. The blood velocity and volume of venous return of potal vein system were significantly higher in ePTFE-covered stents group than in bare stents group during the follow-up using color Doppler ultrasound method. The blood velocity and volume of the shunts were significantly higher in covered stents group than in bare stents group after 1 year, (125 ±20) cm/s vs. (88 ±13) cm/s, and (1816 ±380) ml/min vs.(1074 ±239) ml/min, respectively P<0. 01. Conclusions In TIPS patients with ePTFE-covered stents high blood velocity and low portosystemic pressure gradient sustained in contrast with those using bare stents.

Objective To explore the feasibility of labeling in vitro rabbit osteoblasts with Qtracker and the features of Qtracker-labeled rabbit osteoblasts. Methods A healthy male rabbit, 3 months old, weighing 2 kg, was used in this study. After bone marrow was aspirated, bone marrow stromal cells (BMSCs) were isolated and cultured using the adherence method in vitro. The third passage of BMSCs was induced into osteablasts before incubation with Qtracker at concentrations of 1, 2, 4, 8, 16, 32 nmol/10~6 cells (Groups A, B, C, D, E, F respectively). Cells not labeled by Qtracker served as negative control (Group G). The following parameters were measured: induction, differentiation and determination of rabbit osteoblasts; the optimal mass concentration of Qtracker labeling by fluorescence microscopy and flow cytometry; the cell sur-vival rates at various concentrations of Qtraeker labeling by trypan-blue exclusion; Qtracker-labeled cell pro-liferation by MTr. Results The primary and the passage rabbit BMSCs were chiefly of fusiform shape. Rabbit BMSCs differentiated into osteoblasts following induction. The osteoblasts cytoplasm showed green fluorescence under fluorescence microscopy after being labeled by Qtracker. The mean labeling rate increased with the increased concentration of Qtracker, reaching up to (93.58±2.08) % after incubation at 8 nmol/ 10~6 cells by fluorescence microscopy, and (95.24±1.31) % by flow cytometry. There were no significant differences between Groups D, E, F(P>0.05), but significant differences were found between Groups A, B, C and Groups D, E, F (P<0.05). The labeling rate for Group G was 0. The cell survival rates were all above 96% (P>0.05) . No significant differences were found in the cell proliferation among various con-centrations (P>0.05). Conclusions Qtraeker can be used as a labeling marker for rabbit osteoblasts. When the concentration is at 8 nmol/10~6 cells, optimal labeling effect can be achieved. Rabbit osteoblasts labeled with Qtracker are of high efficiency and safety.

Objective To investigate the effect of high mobility group box‐1(HMGB1) on the migration of vascular smooth cells (VSMCs) and the role of TLR4‐dependent PI3K/Akt pathway in the process .Methods Primary VSMCs were isolated from the thoracic aorta of male SD rats and cultured in vitro .Control group ,TLR4 siRNA transfected group ,control siRNA transfected group and PI3k inhibitor (LY294002) intervention group were stimulated by HMGB1 (0 .1-1 000 .0 ng/mL) .Expression of TLR4 mRNA was detected by RT‐PCR ,protein expression of TLR4 ,Akt ,pAkt ,PI3K were detected by Western blot .Activity of the im‐munoprecipitated PI3K enzyme was assessed in a competitive ELISA .The migration and cell viability of every groups were ob‐served .Results HMGB1 (0 .1 -1 000 .0 ng/mL) stimulated VSMCs migration in a dose‐dependent manner and incubation of VSMCs with 100 ng/mL caused a rapid migration (P< 0 .05) .At the concentrations used ,HMGB1 did not cause any cytotoxic effects (P<0 .05) .Migration of VSMCs toward HMGB1 was significantly inhibited by silencing of TLR4 (P<0 .05) .Pretreated cells with TLR4 siRNA or the PI3K inhibitor LY294002 could markedly block PI3K/Akt pathway activation and VSMCs migration mediated by HMGB1 (both P<0 .05) .Conclusion HMGB1 stimulated VSMCs migration in a dose‐dependent manner and TLR4‐dependent PI3K/Akt signaling pathway played an important role in the migration of VSMCs mediated by HMGB1 .This research indicates that TLR4‐dependent TLR4/PI3K/Akt signaling pathway could be the target in the treatment of obstructive cardiovascu‐lar disease .

Objective To evaluate the performance of domestic matrix-assisted laser desorption/ionization time-of-flight mass spectrometry system Clin-TOF-Ⅱ MS with BioExplorer V2.3 database ( Clin-TOF MS system) on gram-negative bacteria identification.Methods This was a methodological comparison study.A total of 1 025 gram-negative strains of 32 genus, 56 species or species complex were included in this study from 1999 to 2000 and 2014 to 2016 in Peking Union Medical College Hospital.The Bruker Biotyper MS system ( Bruker MS system ) , Bruker Autoflex Speed with Biotyper v 3.1 database were used as control.Identification by both MALDI-TOF MS systems were parallel conducted by direct smear method.The 16S rDNA sequencing based identification was performed when either MALDI-TOF MS system gave“unbelievable result” or results from two systems were not consistent.Results Amongst the isolates studied, 98.05% (1 005/1 025) was correctly identified to species or species complex level by Clin-TOF MS system.Comparatively, 99.22%(1 017/1 025) was correctly identified by Bruker MS system.There were 17 isolates just identified to genus level and 2 isolates were “no identification” by Clin-TOF MS system, meanwhile 1 Pseudomonas monteilii misidentified as P.putida.There were only two 2 isolates identified to genus level and 3 isolates were“no identification” by Bruker MS system.But it misidentified all 3 Aeromonas hydrophila (2 isolates as A.caviae and 1 isolate as A.media).It′s noted that both MS systems identified 1 Chryseobacterium gleum and 1 C. bernardetii to genus level.Conclusion The identification capability of domestic Clin-TOF MS system was good on gram-negative bacteria.

Objective To study on virulence characteristics and multilocus sequence type of Vibrio parahaemolyticus isolated from clinic in Beijing Tongren hospital.Methods Total 152 strains of Vibrio parahaemolyticus isolates were collected from diarrheal patients of outpatients in Beijing Tongren Hospital,Capital Medical University from 2009 to 2011.PCR was used to detect hemolysin gene thermo stable direct themolysin gene (tdh),TDH-related hemolysin gene (trh),type Ⅲ secretion system 2 (T3SS2α,T3SS2β)and systematic functional gene (toxRS/new,orf8) for pandemic 03∶ K6 clone and its derivatives.The genetic features of these strains were determined by multilocus sequence typing (MLST).Results 96％ (146/152) VP harbored tdh gene,2％ (3/152) VP harbored trh gene and 100％ (152/152) VP harbored T3SS2 gene.In this study there were 107 pandemic strains (both tdh and toxRS/new positive and trh negative),38 pathogenic strains (tdh positive and/or trh positive) and 6 nonpathogenic strains (both tdh and trh negative).All nonpathogenic strains harbored systematic functional gene (toxRS/new,orf8).Only one pathogenic strains harbored orf8 gene.One clone harbored all virulence gene.In this study there were 16 sequence types,and ST3 is the pandemic sequence type,including 113 strains,and four new sequence types were found.Conclusions In this study more than 90％ Vibrio haemolyticus harbored tdh gene and ST3 was the pandemic sequence type in Beijing.One can get bacterial pathogenic charateristic and population genetics information by virulence gene testing and MLST.

Objective:To compare the clinical effects of high volume zero-balanced ultraifltration (ZBUF) with different replacement lfuid in infant patients.
Methods: A total of 40 infant patients who received aortic coarctation with deep hypothermic circulatory arrest operation in our hospital from 2012-11 to 2014-02 were summarized. The patients were randomized into 2 groups, Group A, the patients had ZBUF with plasmalyte A, n=21 and Group B, the patients had ZBUF with modiifed replacement lfuid n=19. All patients received ZBUF (15-20) ml/kg during re-warming period until the temperature reached 34°C at rectum. Blood gas analysis were conducted at 4 time points as T1 (before CPB), T2 (open ascending aorta and 5 min after calcium perfusion), T3 (ifnishing ZBUF) and T4 (end of CPB). The intra-operative CPB time and the post-operative recovery with the complication were recorded in all patients.
Results: For blood gas analysis, the calcium concentration was higher in Group B than that in Group A at T3 time point, P<0.01 and the base excess was higher in Group A than that in Group B at T3 time point, P<0.05. Those indexes were similar at T1, T2 and T4, all P>0.05. The other indexes were similar between 2 groups, P>0.05 and the post-operative recovery was similar between 2 groups, P>0.05.
Conclusion: ZBUF with modiifed replacement lfuid could avoid decreased calcium concentration and acidosis, therefore, provide a relative stable homeostasis in infant patients.

Objective:Analyze the perioperative data of children undergoing cardiopulmonary bypass(CPB) for congenital heart disease under the management of ultra-fast track anesthesia(UFTA), the factors of CPB are discussed.Methods:1 034 children who underwent CPB from May 2018 to August 2019 were analyzed retrospectively. According to the success of anesthesia, they were divided into two groups: UFTA group and UFTA failure group. Propensity score matching was used to screen the children with preoperative baseline data matching. Finally 346 cases in each group. The possible CPB factors of the two groups were analyzed by single factor analysis, and the statistically significant factors were analyzed by logistic regression analysis. Results:Univariate analysis showed that the CPB and aortic occlusion time, the lowest temperature and lowest hematocrit in CPB, the dosage of crystalloid and suspended erythrocytes, the second or more times of CPB, and the blood lactate after CPB were the factors influencing the ultra-fast track anesthesia. Logistic regression analysis showed that the time of CPB and aortic occlusion, the value of blood lactate, the dosage of suspended erythrocytes, and the second or more times of CPB were the independent influencing factors of ultra-fast track anesthesia. In the UFTA failure group, the postoperative hospitalization time, the length of stay in the ICU and the hospitalization cost were all higher than those in the ultra-fast track group. Conclusion:CPB time, aortic occlusion time, blood lactate after CPB, the dosage of suspended erythrocytes, secondary or multiple CPB were independent risk factors for UFTA.UFTA is beneficial to shorten the postoperative hospital stay, the ICU stay and the cost of hospitalization.