Objective To explore the tumor markers for the diagnosis of primary liver carcinomas (PLC) by detecting the serum protein spectrum differently expressed between PLC patients and healthy controls. Methods We detected the serum protein spectrum in 50 PLC patients and 50 healthy controls using surface enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) technique and find the significant protein peaks. The serum Alpha-fetoprotein (AFP) levels in all 100 serum samples were also measured by ELISA. Results The protein peaks, which could discriminate healthy individuals from PLC patients, were detected. Four protein molecules (3354.71, 8825.80, 4345.08, 13 715.01) had a significant difference between PLC patients and the normal controls (P <10-5), indicating that these protein molecules might be a potential marker for PLC. The specificity and sensitivity of SELDI-TOF-MS were 94% and 90% respectively. Sixteen PLC patients were AFP positive and the sensitivity was 54%(27/50). Conclusion With a high specificity and sensitivity, the detection of serum protein spectrum can be performed easily and quickly by SELDI-TOF-MS technique, which provides a serological way in identifying PLC and most likely to benefit from AFP strategies.

Objective To evaluate the safety of a surgical appwach for transabdominal cardial carci- noma.Methods We retrospectively analyzed 326 patients undergoing transabdominal esophagastrostomy or esophagojejunostomy from 1998 to 2006 via the EEA(end-to-end anastomosis)stapler.Results By the surgi- cal approach for transabdominal cardial carcinoma,the average length of reseete esophagus above the carci- noma was about 6～8 cm realized the low average of remnant carcinoma at the margin and operation mortality and anastomotic leakage,which was lower than those in the thoraeotomy appmaeh significantly.Conclusion The transabdominal approach makes a clear operative field in posterio-inferior mediastinum,it is beneficial for radical resection of eardial carcinoma and intramediastinal esophagogastric or esophagojejunal mechanical anastomosis,and it fits to the old,the weakening and with the disease of heart and lung.

In accordance with students' learning needs and future professional development, individualized practices of formative assessment are analyzed in terms of diverse evaluators, accumula-tive learning contents, after-class tutoring, thus to maximize student's learning potentials, to be capa-bility-oriented, to make students highly qualified and competent for their future clinical position and academically developed. Additionally, the assessing competence of teachers is vital to the successful implementation of formative assessment. Importantly, each medical university can explore further into the practice of formative evaluation, based on the orientation of itself.

Based on the educational structure theory, the difference between mass education and elite education is probed at the macroscopic level to make it clear that the essence of Physician education and training program of excellence is elite education for occupational purposes; at the mi-croscopic level the orientation of English teaching for the class ofexcellent physicians is determined as English for occupational purposes. Moreover, the curriculum system of medical English is designed, and teaching materials associated with clinical medicine are selected, the language laboratory simulat-ing hospital scenes is constructed, and the transboundary team of teachers is built comprising university teachers and doctors in hospitals. At the level of individual, the competency model of English forexcellent physicianshas been developed, English competence requirements in medical industry being clearly established . In a word , the study of macrostructure points out the direction and target of English teaching for excellent physicians; the study of microstructure perfects the mode of English teaching forexcellent physicians;and the study of individual structure indicates the ultimate foothold of English education forexcellent physicians. Three aspects are integrated into an organic whole.

Objective To study the clinical characteristics and curative effects of pancreatic cystade- nocarcinoma in order to improve its diagnostic and therapeutic accuracy.Methods A retrospective analysis was done on the clinical materials of 13 cases of pancreatic cystadenocarcinoma hospitalized in Shanxi Cancer Hospital from 1990 to 2006.Results The preoperative diagnosis were as follows:pancreatic cystadenocarci- noma 6 cases,pancreatic cystadenoma 2 cases,pancreatic cancer 1 case,pancreatic pseudocyst 4 cases.The misdiagnosis rate was 53.8 %.Surgical operation was done on the 13 cases,and 10 of them were treated by radical operation.A 5-year follow-up was done on 6 still alive cases,and 1 of them lived over 11 years.3 cases were treated by palliative operation,and all of them died within 3 years.Conclusion Since there is no specific clinical manifestations of pancreatic cystadenocarcinoma,it is very difficult to get an accurate preop- erative diagnosis.Radical operation is the most effective therapeutic methods.

Objective To observe the ZEEK thrombus aspiration catheter use on the level of vascular and myocardial perfusion in acute ST-segment elevation myocardial infarction (STEMI) patients,as well as the impact of early prognosis in order to clear the relative best use of ZEEK thrombus aspiration catheter.Methods Eighty-eight acute STEMI patients who underwent percutaneous coronary intervention (PCI),according to the direct use of ZEEK thrombus aspiration catheter or after pre-expansion with small balloon,divided into direct aspiration group 45 cases,and inflation pre-aspiration group 43 cases.All patients underwent stenting,observed the perfusion of the vascular and myocardial levels after stenting,after 1 month,determined N end of B type natriuretic peptide (NT-proBNP) level,observed segmental wall motion score index (WMSI) and left ventricular ejection fractions (LVEF).Results Direct aspiration group was significantly better than inflation pre-aspiration group in the TIMI frames count,rate of TIMI coronary myocardial perfusion grade 2-3 grade and after 2 h ST segment resolution ＞ 50％ rate [(31.3 ± 7.9) frames vs.(42.5 ± 8.5) frames,84.4％(38/45) vs.72.1％(31/43),86.7％(39/45) vs.74.4％(32/43),P＜0.01 or ＜ 0.05].After 1 month,direct aspiration group was significantly lower than inflation pre-aspiration group in the peak of creatine kinase isozyme MB,NT-proBNP and WMSI [(2141.3 ± 306.5)U/L vs.(2734.5 ± 366.1)U/L,(443.2 ± 226.4) ng/L vs.(512.9 ± 281.7) nig/L,1.32 ± 0.16 vs.1.59 ± 0.23,P ＜ 0.05],but there was no significant difference in LVEF between two groups (P ＞ 0.05).Conclusions Repeated aspiration to infarction responsibility lesion segments using ZEEK thrombus aspiration catheter,and direct stenting,which is superior to the thrombus aspiration and stenting placement after single or multiple pre-expansion.

Objective:To determine the effects of Jinlong capsule combined with interventional therapy on the immune functions of primary hepatocellular carcinoma patients. Methods:Sixty randomly selected cases of clinically diagnosed primary hepatocellular carcinoma were divided into the observation group and the control group. Three days after operation, the observation group was given four Jinlong capsules three times a day for 30 days (one treatment). Meanwhile, the control group received interventional therapy after the operation. One to four days following one treatment, peripheral blood specimens were collected from the two groups to determine the cellular immune function indices. Results:The cell numbers (mean) of the peripheral blood components CD3, CD4, NK, SIL-2R, TSGF, and SIL-2R and the CD4/CD8 ratio in the observation group showed no significant difference before and after treatment. In the control group, these indices were significantly different before and after treatment. Conclusion:The Jinlong capsule facilitates the cellu-lar immunity recovery of patients with primary hepatocellular carcinoma after interventional therapy.

Objective To investigate the expression of lymphotoxin-β and its receptor in the skin of a mouse model of allergic contact dermatitis (ACD).Methods BALB/c female mice at 6 to 8 weeks of age were randomly divided into the experiment group (n =15) and normal control group (n =10).Topical 2,4-dinitrofluorobenzene (DNFB,0.5％) was used to establish a model of ACD in the experiment group followed by challenge with DNFB (0.2％) at the right external ear on the 6th day.The normal control mice remained untreated.The right external ear was resected from all of the mice 24 hours after the challenge and divided into 2 parts for the measurement of mRNA and protein expressions of lymphotoxin-β and lymphotoxin-βreceptor by fluorescence-based real-time quantitative PCR and immunohistochemistry,respectively.Results The median mRNA expression levels of lymphotoxin-β and lymphotoxin-β receptor were 3.630 and 1.148respectively in the experimental mice,with the interquartile range being 1.187 and 0.617 respectively,and were both 1.000 in the control mice with the interquartile range being both 0.000.There was a significant difference between the experimental and control group in the mRNA expression levels of lymphotoxin-β and lymphotoxin-β receptor (P ＜ 0.01 ).Immunohistochemistry showed a significant increase in the expression of lymphotoxin-β and lymphotoxin-β receptor proteins in the experimental group compared with the control group (P ＜ 0.01 ).Conclusion There is an increment in the mRNA and protein expressions of lymphotoxin-β and lymphotoxin-β receptor in the lesions of ACD in mice.

Objective To construct the prokaryotic recombinant expression vector of PTD4-Cu,Zn-SOD.Methods By using the techniques of gene recombination,the primers of Cu,Zn-SOD and the oligonucleotide sequences of PTD4 were designed,PCR amplification was performed for Cu,Zn-SOD genes,the PCR products were identified,reclaimed and purified,and pET16b served as carrier.The prokaryotic recombinant expression vector of pET16b-Cu,Zn-SOD was constructed using double digestion with Xho Ⅰ and BamH Ⅰ,ligated reaction and plasmid transformation.Then PTD4 gene and pET16b-Cu,Zn-SOD carrier were double digested with Nde Ⅰ and Xho Ⅰ and ligated,and the plasmid was transformed,and the prokaryotic recombinant expression vector of pET16b-PTD4-Cu,Zn-SOD was constructed.The reconstructed vector was analyzed by restriction mapping and was verified by gene sequencing.Results The prokaryotic recombinant expression vector of pET16b-PTD4-Cu,Zn-SOD with a length of 6 207 bp was constructed successfully.The carrier fragment about 5.7 kp and PTD4-Cu,Zn-SOD gene fragment about 510 bp were obtained by double digestion with Nde Ⅰ and BamH Ⅰ,which was consistent with the expected results.The results of gene sequencing showed that the base sequences of pET16b-PTD4-Cu,Zn-SOD were correct when compared with the expected gene sequences.Conclusion The prokaryotic recombinant expression vector of pET16b-PTD4-Cu,Zn-SOD is constructed successfully.

ObjectiveTo analyze the obvious and hidden preoperative and intraoperative blood loss during treatment of the intertrochanter fracture with proximal femoral nail anti-rotation (PFNA) so as to provide necessary data support for clinical perioperative treatment.MethodsThe clinical data of 216 patients with intertrochanteric fractured treated with PFNA between December 2005 and September 2010 were analyzed retrospectively.An analysis was done on preoperative and postoperative blood routine, perioperative and postoperative blood loss and transfusion, perioperative obvious and hidden blood loss and perioperative and postoperative blood transfusion.ResultsThe average blood loss was 48.9ml during operation, with no blood transfusion.Obvious hemochrome decrease (＜9 g/L) was found in 42 patients at 2-4 days after operation and the patients received blood transfusion for mean 300 ml.The mean obvious blood loss was 62.3 ml, while the mean hidden blood loss was 385 ml in all the patients.There was no obvious difference between males and females.ConclusionThe intertrochanter fracture is mostly seen in the elder patients.Compared with the minimal invasive operation, PFNA has more hidden blood loss, as indicates that much attention should be paid to the vital signs of the patients after surgery for prevention of the complications.