Objective: To investigate the diagnostic value of combined examination of copeptin and high sensitivity cardiac troponin T (hs-cTnT) in patients at the early stage of acute myocardial infarction (AMI) . Methods: A total of 272 patients were enrolled in this study, all of them suffered from chest pain and admitted within 4 hours. The patients were divided into 4 groups according to coronary artery angiography (CAG) results. Control group, the patients with normal CAG,n=64, UAP group (unstable angina pectoris),n=50, STEMI group,n=82, NSTEMI group,n=76. All patients received in-hospital observation, plasma levels of copeptin and hs-cTnT were examined at admission and at 6 hours after the chest pain respectively. Results: Within 4 hours of chest pain, combined examination of copeptin and hs-cTnT had the higher sensitivity for diagnosing AMI than a single detection of hs-cTnT with the cut-off point of hs-cTnT ≤ 14ng/L and Copeptin < 14pmol/L. In NSTEMI group, the AUC (area under curve) for combined examination was 0.97 (95% CI 0.88-0.99), AUC for single hs-cTnT detection was 0.75 (95% CI 0.62-0.87),P<0.05. In STEMI group, the AUC for combined examination was 0.97 (95% CI 0.88-0.99), AUC for single hs-cTnT detection was 0.74 (95% CI 0.60-0.88),P< 0.05. The AUC for combined examination of copeptin and hs-cTnT in diagnosing early AMI was 0.912 (95% CI 0.812-0.961) which was higher than single detection of hs-cTnT, AUC 0.851 (95% CI 0.713-0.936), Z=2.553,P<0.05. Conclusion: Combined examination of copeptin and hs-cTnT had the higher sensitivity and accuracy for diagnosing the patients at the early stage of AMI, it may help the risk stratiifcation of chest pain which is valuable in clinical practice.

Objective To evaluate the value of coronary arteriongraphy(CAG)in diagnosing angina.Methods 219 patients with angina in clinical analysis were selected and divided into 2 groups:the stable angina(SA)group and unstable angina(UA)group.They all were accepted CAG first time.Then analysis were carried out between clinical diagnosis and results of CAG.Results The total positive rate of CAG in diagnosing angina is 58.90%.The positive rate of SA group(56.52%)shows no significant difference with that of UA group(60.00%).Single vessel lesion and multiple vessels lesion of SA group have little difference,however,the main coronary artery lesions of UA group is single vessel.Conclusions CAG is extremely important in diagnosing angina,but it has its own limit.Experience and new technique should be applied to retrieve locatization of CAG.

Mini-clinical evaluation exercise(Mini-CEX) is a new tool used to evaluate clinical skill of internal residents.Through necessity,operation and practice of Mini-CEX applied in internal residents' clinical teaching,the paper makes it known that Mini-CEX is consistent with six requisitions of resident competence raised by Accreditation Council of Graduate Medical Education (ACGME).It increases medical and directorial quality,and is combined with doctor training abroad.Mini-CEX should be spread in training and examination of internal residents.

OBJECTIVE To investigate the expression differences of seven cytochrome P450 (CYP) isoforms between L02, LX-2 and HepG2 cells and identify the most suitable cell type for different CYP researches. METHODS L02, LX-2 and HepG2 cells were treated with omeprazole (Ome), dexamethasone(Dex), phenobarbital sodium (Phe), isoniazid (Iso) and rifampicin (Rif) at 5, 10, 20 and 40 μmol • L-1. Cell viability was analyzed by CCK-8 assay. The gene expressions of CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP2E1 and CYP3A4 in LX-2 cells were assessed by real-time quantitative PCR (RT-qPCR). The protein expressions of these seven CYP isoforms in L02, LX-2 and HepG2 cells were assessed by Western blotting. Furthermore, CYP3A4 activity in the three types of cells treated with Rif 5, 10, 20 and 40 μmol • L-1 for 24 h was validated by Luciferin-PFBE. RESULTS Cell viabilities of all the three hepatocytes were over 80% when exposed to Ome, Dex, Phe, Iso and Rif (≤40 μmol • L-1) for 24 h. According to the RT-qPCR, Phe could significantly enhance the gene expressions of CYP2B6 (P<0.05) and CYP2D6 (P<0.01) in LX-2 cells. The results of Western blotting exhibited protein expression differences of seven CYP isoforms between L02, LX-2 and HepG2 cells treated with Ome, Dex, Phe, Iso and Rif (≤40 μmol-L-1) for 24 h. CYP2C9 [Integrated absorbance (IA)=1.58±0.07], CYP2C19 (IA= 0.95±0.03) and CYP3A4 (IA=1.29±0.05) had higher expression abundances in L02 cells, CYP2B6 (IA= 1.48±0.01) and CYP2D6 (IA=1.46±0.02) in LX-2 cells, and CYP1A2 (IA=1.62±0.19) and CYP2E1 (IA= 1.49±0.10) in HepG2 cells. Additionally, CYP3A4 activity in L02, LX-2 and HepG2 cells could not be up-regulated by Rif. CONCLUSION The most suitable cell type for different CYP researches is L02 for CYP2C9, CYP2C19 and CYP3A4, LX-2 for CYP2B6 and CYP2D6, HepG2 for CYP1A2 and CYP2E1, respectively.

Objective To study the relation between protein kinase C(PKC) and coronary heart disease.Methods To measure the activity of PKC and its inhibitor(PKCI) in platelets,the activity of PKC in erythrocytes from 43 patients with unstable angina pectoris(UAP),45 patients with acute myocardial infarction (AMI),and 42 healthy controls(HC),respectively.Results The PKC activity in platelet membrane from UAP and AMI patients was higher than that from HC.The PKC activity in plalelet cytosol from UAP and AMI patients was lower than that from HC.The PKC activity in platelet cytosol from UAP patients was lower than that from AMI patients.The PKC activity in erythrocyte membrane from UAP and AMI patients was higher than that from HC.The PKC activity in erythrocytes cytosol from UAP and AMI patients was lower than that from HC.Conclusion PKC is likely to be associated with the pathogenesis of coronary heart disease.

Objective To evaluate the value of plasma soluble urokinase plasminogen activator receptor (suPAR) and serum pmcalcitonin (PCT) to investigate their assessment of disease severity and prognosis in patients with sepsis.Methods The levels of plasma suPAR and serum PCT were monitored in 77 patients with sepsis.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) score were recorded.According to the disease severity and their prognosis,the value of plasma suPAR,serum PCT,APACHE Ⅱ and SOFA score on predict the disease severity and prognosis of septic patients were compared.Results The levels of plasma suPAR in septic patients [(7.9 ±6.5) ng/mL] were lower than severe sepsis patients [(8.4 ±4.5) ng/mL] and septic shock patients [(13.9 ± 8.0) ng/mL],allP ＜ 0.05.The levels of serum PCT in septic patients (6.3 ± 3.5) ng/mLwere lower than severe sepsis patients [(23.7 ± 3.9) ng/mL] and septic shock patients [(25.7 ±4.3) ng/mL],allP ＜0.05.But there was no significant difference in the levels of serum PCT between the severe sepsis group and the septic shock group.Receiver operator characteristic curve (ROC)of the level of plasma suPAR could distinguish survivors from non-survivors in septic patients,maximal area under curve (AUC) of plasma suPAR was 0.803.The best cut-off value of plasma suPAR to distinguish survivors from non-survivors was 9.905 ng/mL.And the AUC of serum PCT was 0.61 (P ＞ 0.05) ; the AUCofAPACHEⅡ score was 0.832 (P＜0.05); the AUC of SOFA score was 0.767 (P＜0.05).Conclusion Monitoring of the levels of plasma suPAR and the APACHE Ⅱ score can help to assess the severity and the prognosis of sepsis in the early stage.

Objective To analyse the clinical features of pelvic insufficiency fractures (PIF) in patients with cervical cancer after radiotherapy and explore the risk factors affecting its occurrence .Methods 55 cases of patients with cervical cancer that used radia-tion therapy as a single treatment were chosen in our hospital from February 2007 to May 2010 and the clinical features were ana-lysed;The fractures of spine ,sacrum ,sacroiliac joint ,ilium and pubis and femoral were observed and the density of fifth lumbar (L5 ) vertebrae ,left and right sacrum were detected via the CT or MRI (Hounsfield Unit)after 2-year follow-up ,the different factors on the incidence of PIF were explored .Results 12 cases (19 sites) of patients in 55 patients occured PIF after follow-up 2years ,the cumulative incidence was 21 .82% ;the distribution of PIF parts were followed :lumbar vertebrae had 5 cases ,sacral had 5 cases ,pu-bis had 4 cases ,sacroiliac joint had 2 cases ,iliac had 2 cases and femoral head had 1 case .The incidence rate of PIF that density of fifth lumbar vertebrae was ≤130 HU and >130 HU were 16 .36% and 5 .45% respectively ,the PIF′incidence rate that density of left side of sacrum was≤ -35 HU and > -35 HU were 18 .18% and 3 .64% respectively ,the incidence rate of PIF that density of right side of sacrum was ≤ -35 HU and > -35 HU were 20 .00% and 1 .82% respectively ,the density of the three parts all had statistical difference on the incidence of PIF (P<0 .05) .Univariate analysis showed that menopausal status and the average density of CT had statistical effects on PIF (P<0 .05);Multiple analysis showed that the average density of CT was the independent factors affecting PIF′incidence after radiotherapy .Conclusion The patients with cervical cancer may occur pelvic insufficiency fracture af-ter radiotherapy ,and its incidence is related to menopausal status and bone mineral density .

Objective To investigate the influence of double-effect activation of cholinergic antiinflammatory pathway on the liver injury and inflammatory response in obstructive jaundice rats by applying cholinesterase inhibitor and cholinergic M receptor blocker to activate alpha 7 nicotinic acetylcholine receptor.Methods 22 adult male Wistar rats were randomly assigned into three groups:sham operation (SO) group (n=6),bile duct ligation (BDL) induced obstructive jaundice with (BDL treatment group) or without treatment (BDL control group) (n=8 each).The medicine treatment group was given anisodamine (25 mg/kg) and neostigmine (25 μg/kg) daily via intraperitoneal injection after surgery,the control group was given equal amount of normal saline.The body weights of rats in each group were measured every other day.After 12 days,the rats were killed,and the pathological changes of liver injury,liver function and the expression levels of proinflammatory cytokines in the serum and liver tissue were observed.Results The body weight of BDL rats was significantly lower than the SO group rats,and the growth rate of BDL treatment group rats was the same as the rats in BDL control group 3 days after the starting of treatment.The AST,ALT,bilirubin and gamma-GT levels of BDL control and treatment groups were significantly higher than the SO group (P＜0.05),but there was no significant difference between BDL control and treatment groups.The serum albumin level of BDL treatment group was obviously higher than that of BDL control group,but the pathological liver injury was significantly slighter.The gene expression levels of TNF-alpha,IL-1 beta and IL-6 in the liver tissue were significantly higher in BDL groups than SO group (P＜0.05),but BDL treatment group was significantly lower than BDL control group (P＜0.05).In addition the serum TNF-alpha and IL-1 beta concentrations of BDL treatment group and control group were significantly higher than the SO group (P＜0.05),but the BDL treatment group was obviously lower than that BDL control group (P＜0.05).Conclusion The combine application of cholinesterase inhibitor and cholinergic M receptor blocker to activate the cholinergic anti-inflammatory pathway can significantly inhibit the obstructive jaundice induced proinflammatory gene expression and liver injury.

Staphylococcus aureus,an important foodborne pathogen,can contaminate foods through variety of ways and produce enterotoxin that may cause Staphylococcal food poisoning.In addition to food safety problems,Staphylococcus aureus could also cause clinical infection.The study of its pathogenicity is not only beneficial to prevent and control foodborne diseases,but also provide a new point for clinical treatment.This paper analyzes the types and characteristics of common strains of Staphylococcus aureus in food,and summaries the effect of food processing on pathogenicity and the methods for pathogenicity research in order to provide reference for the related study on pathogenicity of Staphylococcus aureus.

Objective To study the effects of H_2S on the visceral pain induced by colorectal dis- tention (CRD) and the expression of substance P (SP)in rats.Methods Forty Wistar rats were randomly divided into control group,normal saline(i,p.) group,low( 15?mol/kg),moderate (45?mol/kg) and high(75?mol/kg) dose of NaSH(i.p.) groups.All rats.except control group,were subjected to CRD for 25 seconds and their behavioral responses to CRD were assessed by measuring the abdominal with drawal reflex(AWR).The expression of SP in the ileocecal junction,colon,spinal cord of thoracic waist (T6-L5) and brain was detected by immunohistochemistry.Results The visceral pain induced by CRD produced a capacity-dependent increase of AWR score in normal saline group,and a dose-dependent reduction of AWR score in three of NaSH groups.There was no significant differences of SP expression in the ileocecal junction,colon,spinal cord of thoracic waist and thalamencepbalon between the normal saline group and the NaSH low dose group.However,the decreased SP expression in the NaSH moder- ate and high dose groups were observed in comparison to those in the normal saline group(P