The perioperative total serum CK and CK-MB activities were determined in 38 patients with carcinoma of the esophagus and cardia of the stomach with fluorometric and cylinder layer chromatography. The data were compared with those obtained from 18 patients undergoing pulmonary operation and 20 normal subjects. The results suggest that: (1) carcinoma of the esophagus and cardia of the stomach could not induce variation of the total serum CK and CK-MB; (2) the elevation of the total serum CK after esophagogas-trostomy might probably be due to the trauma of the skeletal muscles of the chest wall;(3)the total serum CK is non-specific for the diagnosis of AMI in the perioperation period,but CK-MB might be considered as a specific enzyme criteria.

Objective To study the change of intestinal permeability in patients with acute pancreatitis (AP) to investigate the indication of early operation in AP patients. Methods Serum concentrations of glutamine, endotoxin and urine lactulose/mannito (L/M) ratio were measured and compared at different time in 18 AP patients received non-operative treatment and 7 underwent operation . Results Serum concentrations of glutamine, endotoxin and urine lactulose mannito (L/M) ratio were significantly higher in operation treatment AP patients than those in non-operation treatment AP patients. Conclusion In the early course of AP, continued increased intestinal permeability and serum concentration of endotoxin is the indications of operation.

Objective To investigate the clinical value of a three-dimensional motion analysis system by using the body segmental method for testing the balance of hemiplegic stroke patients.Methods Twenty stroke patients with hemiplegia were measured using the lower extremity Fugl-Meyer motor assessment (FMA-L),the Brunel balance assessment (BBA),the Berg balance sale (BBS) and a 5 m timed up-and-go test (5m-TUGT).The three-dimensional motion analysis system using the body segmental method was applied in three positions-sitting,standing and walking.Spearman's rank correlation coefficient was used to determine the extent of correlation between the values measured by the three-dimensional motion analysis system and the FMA-L,BBA,BBS and 5m-TUGT results.Results Some motion analysis variables (MSAx,MSVx,MSAy,MSVy and SPxy,SP3-D) are recorded in sitting and standing,while the center of gravity (COG) swing in the horizontal plane and some other variables (MSAx,MSVx and SPxy and SP3-D) are measured while walking.Anterior-posterior COG swing had a high negative correlation with the FMA-L,BBA and BBS scores and a high positive correlations with 5m-TUGT times.But except in sitting,MSAz and MSVz were both uncorrelated with FMA-L,BBA or BBS scores or with 5m-TUGT times.COG swing in the horizontal plane in sitting and standing apparently correlates with lower extremity motor function,balance,and walking ability.However,only the X axis swing parameters of the COG while walking correlated with lower extremity motor function,balance or walking ability.Conclusions A three-dimensional motion analysis system using the body segmental method can be used clinically to monitor patients' balance in real time and dynamically in different positions and activities,and it can be used to predict motor function and balance control in hemiplegic stroke patients.

Objective To study the reliability and validity of using sacral markers in evaluating the balance function in standing and walking of stroke patients with hemiplegia.Methods Twenty-one hemiplegic stroke patients were recruited and their baseline mean sway amplitude (MSA) and mean sway velocity (MSV) were measured using sacral markers and center of gravity analysis assuming a segmented body,thegold standard for such analysis.The data were analyzed using Bland-Altman plots to obtain the 95％ limits of agreement (LOA).Results ①Test-retest reliability:The 95％ LOA of the MSA in standing was (-4.42,5.14) on the X axis,(-6.04,4.52)on the Y axis,and (-1.75,1.31) on the Z axis.The MSV in standing was (-0.08,0.09) on the X axis,(-0.10,0.08) on the Y axis and (-0.03,0.02) on the Z axis.The 95％ LOA of the MSA in walking was (-185.74,105.53) on the X axis,(-22.57,2.76) on the Y axis and (4.43,2.76) on the Z axis.The MSV in walking was (-3.10,1.76) on the X axis,(-0.38,0.54) on the Y axis and (-0.07,0.02) on the Z axis.②Validity:The 95％ LOA of the MSA in standing was (-3.62,2.55) on the X axis,(-3.95,3.94) on the Y axis and (-7.35,19.43) on the Z axis.For the MSV in standing it was (-0.06,0.04) on the X axis,(-0.07,0.07) on the Y axis and (-0.12,0.32) on the Z axis.The 95％ LOA of the MSA in walking was (-4.40,4.74) on the X axis,(-17.35,4.14) on the Y axis and (-17.35,4.14) on theZ axis.For the MSV in walking itwas (-0.07,0.08) on the X axis,(-0.29,0.07) on the Y axis and (-0.12,0.18) on the Z axis.The 95％ LOAs of the variables representing their reliability and validity are small enough to be acceptable in clinical application.Conclusions The sacral marker method can be used in assessing the balance of stroke patients.

OBJECTIVE To explore the role of gecko crude peptides (GCPs) in the proliferation, apoptosis, migration and lymphangiogenesis of human hepatocellular carcinoma cells (HepG2) and human lymphaticendothelial cells (HLECs) in vitro. METHODS The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to evaluate the anti- proliferative effect of GCPs and siRNA-VEGF-C on HepG2 cells, Hoechst 33258 staining and flow cytometry were performed to analyze cycle and apoptosis. The migration and invasion ability of cells were assayed by transwell chamber experiment and wound-healing assay. The protein and mRNA expressions of vascular endo?thelial growth factor-C (VEGF-C) and CXC chemokine receptor-4 (CXCR4) were detected by q-PCR, immunofluorescence, Western blot. The protein expressions of the extracellular signal regulated kinase (ERKI/2), c-Jun N-terminal kinase (JNK), p38-mitogen activated protein kinases (p38 MAPK), serine/threonine kinase (Akt) and phosphatidylinositol- 3- kinase (PI3K) were detected by western blot. The anti-lymphangiogenesis effect of GCPs on the HLECs was analyzed using an in vitro tube-formation assay. The protein and mRNA expressions of vascular endothelial growth factor receptor-3 (VEGFR-3) and stromal cell-derived factor-1 (SDF-1) were detected by q-PCR, Western blot. RESULTS GCPs and siRNA-VEGF-C inhibited HepG2 proliferation, invasion and migration, and the most obvious inhibitory effect was both synergistic effects. Thus, GCPs suppressed HLECs proliferation, migration and tube-like structure formationin a dose- dependent manner, and had inhibitory effect of tumor- induced lymphangiogenesis in vitro. Additionally, we found that GCPs and siRNA- VEGF- C decreased the expressions of MMP-2, MMP-9, VEGF-C, CXCR4, phospho-ERK1/2, phospho-P38, phospho-JNK and PI3K in HepG2 cells. Moreover, GCPs had a dose-dependent depressive effecton the expressions of VEGFR- 3, SDF- 1 in HLECs. CONCLUSION The low expression of VEGF- C mediated by siRNA-VEGF-C and GCPs inhibit tumor proliferation, invasion and migrationby suppressing the MAPK signaling pathway through reduced levels of VEGF-C, and GCPs inhibit tumor lymphangiogenesis by suppressing the CXCR4/SDF-1 signaling pathway through suppressed VEGF-C/VEGFR-3.

Objective To investigate the iron status in the newborns of maternal gestational diabetes mellitus(GDM) women,and explore the mechanism of iron deficiency in these newborns.Methods From June 2008 to October 2011,64 GDM women (GDM group) and 71 healthy pregnant women (control group)who delivered in the Second Affiliated Hospital of Wenzhou Medical College and their newborns were studied prospectively.Serum ferritin (SF),serum transferrin receptor (sTfR),erythropoietin (Epo),haemoglobin (Hb),serum level of insulin and plasma glucose in cord blood was measured.The neonatal birth weight (BW) and birth weight Z Score(WAZ) was recorded.The concentrations of serum fasting insulin (FINS),fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c)were tested for all the women before delivery.Results In the GDM group,the cord blood sTfR,Epo and serum level of insulin was (42 ± 10)nmol/L,(56 ±41) U/L and(18 ± 5) U/L,respectively.While in the control group,these were(35 ± 8)nmol/L,(41 ± 43) U/L and (10 ± 5) U/L,respectively.The cord blood sTfR,Epo and serum level of insulin in the GDM group were significantly higher than those in the control group (P ＜ 0.05).The cord blood SF in the GDM group[(60 ±36) μg/L] was significantly lower than that of the control group[(146 ±38) μg/L,P ＜ 0.01].The neonatal BW and WAZ in the GDM group [(3615 ± 538) g and 0.558] were significantly higher than those in the control group [(3449 ± 423) g and 0.224,P ＜ 0.05].No significant difference was found in the cord blood plasma glucose and Hb between the GDM group[(3.3 ± 1.0) mmol/L and (181 ± 18) g/L] and the control group [(3.0 ± 0.8) mmol/L and (176 ± 16) g/L,P ＞ 0.05].The FINS and HbA1c of the GDM group[(12.5 ±5.0) U/L and (6.5 ±0.7)％] were significantly higher than those in the control group [(10.9 ± 4.3) U/L and (5.3 ± 0.7) ％,P ＜ 0.05].The FPG of the GDM group and the control group were (5.3 ± 1.2) and (5.0 ± 1.0) mmol/L,respectively,with no statistically significant difference (P ＞ 0.05).Conclusion Maternal GDM may related to the iron deficiency of the newborns.

Objective To investigate the changes of the neurosensory retinal thickness in the macula in high myopia eyes by optical coherence tomography (OCT). Methods A total of 47 cases (47 eyes) of high myopia eyes and 42 cases (42 eyes) of normal eyes were divided into high myopia group and control group, respectively. The neurosensory retinal thickness in the center and at the edge of the fovea was measured by OCT. Meanwhile, the mean thickness of the neurosensory retina on OCT macular map was calculated automatically. The neurosensory retinal thickness in high myopia group was compared with that in the control group by t test. Results In high myopia group, the neurosensory retinal thickness in the center and at the edge of the fovea, parafovea, and perifovea was significantly thinner than that in the control group. However, no significant difference in the average thickness of neurosensory retina of the fovea was found between the two groups. Conclusion The thickness of the neurosensory retina in the macula in high myopia eyes is significantly thinner than that in normal eyes. When measurement of the neurosensory retinal thickness by OCT is performed, the thickness of a spot and the thickness of the area in which the spot is located should be considered.

Objective To investigate the reliability and sensitivity of a three dimensional motion analysis system by using the segmental method.Methods Ten healthy young men participated in this study.They were asked to stand with one leg and with their eyes open and closed,respectively,each lasted for 30 seconds and was re- peated twice.According to the 12-segment rigid body model of the human body,twenty-one infrared light emitting di- ode(1RED)markers were placed over the bony prominences on the proximal and distal ends of each segment,the motion track of the IRED markers was recorded by the three dimensional motion analysis system.The mean sway am- plitude( MSA )and the sway path(SP)of the center of gravity(COG)were calculated.Correlation analysis was used to determine the reliability between the two repetitions.Paired sample t-test was used to determine the sensitivity be- tween the eyes open and closed conditions.Results The correlation coefficients of the MSA of the COG in the eyes open and closed conditions were 0.623 and 0.018,respectively,and the correlation coefficients of the SP of the COG were 0.936 and 0.654,respectively.It was also shown that significant differences existed among the three directions of the MSA of the COG and the SP of the COG.Conclusion Besides the weak reliability of the MSA of COG in the eyes closed condition,the high reliability and sensitivity of the MSA and SP of the COG are found.The segmental method can be used in the scientific study of human balance control.

AIM: To evaluate the preservation of anterior capsule during vitrectomy and lensectomy.ment (RD) and grade C proliferative vitreoretinopathy (PVR)underwent pars plana vitrectomy (PPV) and pars plana lensectomy (PPL) with preservation and polishing of the anterior capsule. Of the 15 eyes, 4 eyes had giant tear, 3 had recurrent rhegmatogenous retinal detachment (RRD), 2 had diabetic retinopathy. Totally 6 eyes had gas and 9 had silicone oil tamponade. The surgeries were evaluated according to the visual acuity (VA) and the postoperative complications during the follow-up of at least 3 months.in all eyes, improved by 3± 3 lines overall. Eight eyes were implanted posterior chamber intraocular lens (PCIOL) successfully at 2-3 months after operation, including 6 having gas and 2 having silicone oil tamponade. No eyes had central anterior capsule opacity, corneal decompensation, puplillary block, retina redetachment or other complications.an intact anterior capsule in eyes with RD and PVR. Preserving the anterior capsule can help preventing intraoperative and postoperative complications of gas or silicone oil, simplify future PCIOL placement, and maintaining a normal iris appearance.

Objective To investigate the value of 3D-TEE,2D-TEE,CTA and X-ray contrast in assessing left atrial appendage (LAA) shape,size and guidance for the choice of occlusion.Methods Forty-three cases of left atrial fibrillation who were referred for LAA closure were performed TEE to measure the opening maximum diameter,and maximum depth of 2D-TEE at 0°,45°,90° and 135°.When LAA showed most clearly,the opening maximum and minimum diameter of LAA were measured by using 3D-ROOM mode,and the results were compared with those measured by CTA and X-ray contrast.Results There was no significant difference for opening maximum diameter of LAA measured by 3D-TEE,2D-TEE and X-ray contrast (all P＞0.05),but that of CTA statistically larger than 3D-TEE,2D-TEE,X-ray contrast (all P＜0.01).There were significant difference between 2D-TEE at 90°,135° and CTA,2D-TEE at 135° and X-ray contrast in assessing maximum depth of LAA (all P＜0.05).Opening maximum diameter of LAA measured by 3D-TEE was significantly correlated with each angle of 2D-TEE,CTA,and X-ray contrast (r=0.70-0.77,0.57,0.58,all P＜0.01),and the opening maximum diameter measured by 2D-TEE also correlated with CTA and X-ray contrast (r =0.57-0.71,0.45-0.51,all P＜0.01).Also the opening maximum diameter measured by 3D-TEE,2D-TEE,CTA and x-ray contrast were correlated with occluder size (r=0.93,0.70-0.77,0.57,0.47,all P＜0.01).Conclusion Compared with 2D-TEE,CTA and X-ray contrast,3D-TEE is more instructive for occluder selection.