Objective To explore changes of serum levels of liver function indicators and their reference intervals in pregnant women in the last trimester of pregnancy ,and to analyse its clinical significance .Methods From July 2013 to June 2014 ,a total of 4 659 cases of pregnant women in the last trimester of pregnancy and 3 089 healthy non‐pregnant women were enrolled in this stud‐y .Serum levels of alanine aminotransferase(ALT) ,aspartatre transaminase(AST) ,total protein(TP) ,albumin(Alb) ,pre‐albumin (PA) ,total bilrubin(TBIL) ,direct bilrubin(DBIL) ,indirect bilrubin(IBIL) ,γ‐glutamyl transpeptidase(GGT)and mitochondrial as‐partate aminotransferase(m‐AST) were determined by fully automatic biochemical analyzer .Results Compared with healthy non‐pregnant women ,serum levels of ALT ,AST ,TP ,Alb ,PA ,TBIL ,DBIL ,IBIL and GGT were significantly decreased ,while serum le‐vers of ALP ,m‐AST and TBA were significantly increased in pregnant women in the last trimester of pregnancy ,there were statis‐tically significant differences(P<0 .05) .Conclusion This study suggested that the liver functions of pregnant women were signifi‐cantly different from healthy non‐pregnant women .Each clinical laboratory should establish reference intervals of liver function indi‐cators for pregnant women at each stage of pregnancy ,so as to timely ,correctly and reasonably evaluate their liver functions and material nutrition status ,and provide better antenatal care services .

Objective:To develop a luminescent oxygen channeling immunoassay for pregnancy associated plasm a protein A.Methods:The monoclonal antibody of PAPP-A was labeled with biotin ,the polyclonal antibody of PAPP-A was coated on receptor particles.The LOCI reagents also contained sensitizer particles coated with streptavidin.The optimal test conditions and analytical per-formance of the method were studied.Results:The within-run and the between-run coefficients of variation were 5.91%-7.94% and 6.14%-9.69%,respectively;the analytical sensitivity was 2.8 mU/L and the function sensitivity was 4.6 mU/L,good linear in 2.8 mU/L-8 000 mU/L range;the recovery rate was 96.7%-100.3%.The interference rate of hemolysis , icterus and triglycerides were less than 10%; there is no Hook effect of PAPP-A concentrations up to 8 000 mU/L;the correlation coefficient between clinical samples detection results and Time resolved fluoroimmunoassay analysis results was 0.974.Conclusion:This LOCI can be used for the quantitative of serum PAPP-A,and detection performance in line with the requirements of clinical diagnostic reagents .

BACKGROUND:Silver nanoparticles (AgNPs) show strong antibacterial effect and are not easy to have drug resistance. But the antibacterial mechanisms of AgNPs have not been wel developed.
OBJECTIVE:To explain the antibacterial mechanisms of AgNPs.
METHODS:We investigated the influence of Ti, TiO2 and TiO2 containing AgNPs onEscherichia coliand Staphylococcus aureus by bacterial inhibition ring test. Escherichia coli was cultured in LB liquid medium with 0, 5, 10 mg/L AgNPs. We measured the absorbance value of bacterial culture. DNA gel electrophoresis was used to study the effect of AgNPs onEscherichia coliDNA. Then we researched the character of apoptosis on Escherichia coli by Annexin V and PI staining, using flow cytometry.
RESULTS AND CONCLUSION:The inhibiting effect of Ti and TiO2 onEscherichia coliandStaphylococcus aureus was not obvious. But the inhibition rings of TiO2 containing AgNPs to bacteria appeared. The absorbance value of Escherichia coliculture was reduced whenEscherichia coliwas co-cultured with AgNPs. And this decrease tendency was in direct proportion with AgNPs concentration. AgNPs reduced the amount of DNA of Escherichia coli and this tendency was directly proportional with AgNPs concentration. TheEscherichia coli apoptosis rate induced by AgNPs was increased and this tendency was positively correlated to the AgNPs concentration. These results indicate that AgNPs can induce bacterial apoptosis to influence the growth of bacteria.

Objective:Our aim was to study the levels of atrial natriuretic peptide (ANP) and pulmonary perfusion imaging in determining of pulmonary artery hypertension (PAH). Methods: We measured ANP levels by using radioimmunoassay after making various types of PAH in rabbits. Catheterization and pulmonary perfusion tomographic imaging were used in the control group. Results: When the pulmonary artery pressure increased slightly, the ANP levels were lower in PAH group than that of control group, but the difference was not significant (t=1, P>0.05). At the same time, pressure measured by catheterization did not change as the control group, but the ratio of back/abdomen radiopharmaceuticals distribution which was measured with pulmonary perfusion tomographic imaging was significantly higher in PAH group than that of the control (t=2.5, P<0.05). The difference between the ANP levels when the pulmonary artery pressure increased medially and seriously was significant (t＝4.0 and 6.5, P＜0.05). The other two methods got the same result (P＜0.05). Results of three examining methods were positively related. Conclusion:The ANP levels can determine the degree of PAH, and it was simple. But it was not as sensitive as that of pulmonary perfusion tomographic imaging.

Objective In order know the clinical effects of vitamin B1 point injection combined with Chinese manipulation and Qi Gong therapy on the postoperative urinary retention after hemorrhoid operation. Methods Totally 150 patents with postoperative urinary retention after hemorrhoid operation were divided into the experimental group and the control group with 75 cases in each group randomly.The experimental group were treated with vitamin B1 injection at San Yin Jiao point by disposable ascepfic syringe,at the same time Chinese manipulation and Qi Gong therapy were used to masage the bladder in the lower abdomen.The tradi- tional nuusing cares,such as changes of body position,induction by bicker and foment by hot water bag,were used in the conutrol group.The improving conditions of postoperative urinary retention was compared between them.Results The total effective rate was 93%(44 cases with marked effect,26 cases with drect)in the cxperimental group and 53%(17 cases with marked effect,23 cases with effect)in the control group respectively,with a very significant difference between the two groups,X2=31.7,P＜0.01.The experimental group was significantly better than that of control group in the time of uresis after surgery,P＜0.01.Conclusions Vitamin B1 point injection combined with Chinese manipulation and Qi Gong therapy is an effective mursing measure to alleviate urinary retention after henmrrhoid operation.

Objective To explore the genetic pathogen of patients with non-syndromic hearing impairment and to provide prenatal diagnosis for the families of hereditary deafness. Methods Mutation screening of GJB2, SLC26A4, GJB3 and mitochondrial 12 S rRNA genes was performed in 208 patients with non-syndromic hearing impairment by gene chip. Then direct sequencing was used in 41 patients who were found one mutation of GJB2 or SLC26A4 gene. And prenatal diagnosis was carried out in two families by direct sequencing. Results Eighty-six patients (41.35％) were found at least one mutation by gene chip. Among them, 40 patients were found to carry two mutations and 46 patients were found to carry one mutation. The most frequent mutation was 235delC, which was found in 46 patients. And 12 cases were found the second mutation through direct sequencing. A total of 52 (25.00％) patients were detected two mutations. Prenatal diagnosis showed that one fetus carried compound mutations of 299-300delAT and 235delC, and another one carried heterozygous mutation of IVS7-2A>G. Conclusion Patients with non-syndromic hearing impairment can be accurately diagnosed by gene chip and Sanger sequencing. The prenatal diagnosis is primary means for high-risk fetuses.

Objective To discuss the influence of special nursing intervention for the quality of life of outpatients with chronic pelvic inflammatory disease. Methods Divided 80 patients into the observation group and the control group randomly, there were 40 cases in each group. Routine nursing, treatment and disease-related lecture were used in both the groups, while the combined therapy of Chinese and Western medicine was used in the observation group in addition. Evaluated the quality of life and the effects of treatment by the World Health Organization′s quality of surviving chart between the two groups after 3-month intertention and 6-month follow-up. Results The scores of quality of environment field, physiology field ,psychological field, sociological field, independence field and mental field in the observation group was (70.33+16.85 ) (70.38+18.80), (71.43+18.28),(70.13+19.08), (73.10+17.70) and (75.38+7.30) respectively, while in the control group was (61.38+16.17), (56.70+17.69), (43.13+19.77), (55.00+19.08), (53.75+16.45) and (49.80+17.26) respectively, the difference between the two groups was significant, the t values were 2.424-8.631, P < 0.05. The effective rate of treatment in the observation group was 95.00%(38/40), while in the control group was 82.5%(33/40), the difference was significant, U=2.507, P < 0.05. Conclusions Special nursing intervention can promote the quality of life ,effects of treatment and the satisfaction of treatment in outpatients with chronic pelvic inflammatory disease, improve their psychological state and the compliance.

Dyspnea is an important issue for the patients with chronic heart failure. Breathing training, especially the inspiratory muscle training can help to improve the patients′ cardiopulmonary function, endurance and quality of life. In this paper, the foreign research about the method, effect evaluation and appropriate case of inspiratory muscle training in patients with chronic heart failure were reviewed so as to explore a specific strategy of inspiratory muscle training for China′s patients with chronic heart failure.

Objective To evaluate the risk factors for recurrence of node-negative advanced gastric cancer(N0-AGC) after radical resection.Methods Data of 270 N0-AGC cases after curative intent resection were collected from 2001 to 2008 in Tianjin Cancer Hospital.There were 45 cases with postoperative recurrence.Univariate and multivariate analysis were applied to investigate risk factors for postoperative recurrence.Results The recurrence time was 2-68 months,the survival time was 5-87 months.Univariate analysis showed that tumor size,depth of tumor invasion,number of negative lymph nodes were associated with recurrence of N0-AGC.Multivariate analysis identified tumor size,depth of tumor invasion,number of negative lymph nodes as independent recurrence factors for entire cohort,depth of tumor invasion,number of negative lymph nodes were risk factors for locoregional recurrence.Tumor size,adjuvant chemotherapy for hematogenous metastasis.Conclusions For T4 stage,tumor diameter ＞4 cm advanced node-negative gastric cancer patients,extended lymphadenectomy was recommended to decrease locoregional recurrence,and adjuvant chemotherapy to reduce hematogenous spread.

Objective To investigate the risk factors for group 14v lymph node metastasis in advanced gastric cancer.Methods The clinical data of 170 patients with advanced gastric cancer who were admitted to the Tianjin Cancer Hospital from January 2007 to December 2011 were retrospectively analyzed.All the patients received D2 gastrectomy + group 14v lymph node dissection.All the patients were with gastric adenocarcinoma.The general information of the patients,and the number of lymph node dissected and lymph node with positive expression were recorded.Univariate and multivariate analysis of clinicopathological factors influencing the group 14v lymph node metastasis were done using bivariate Logistic regression model.The correlation between the group 14v lymph node metastasis and regional lymph node metastasis was analyzed using the bivariate Logistic regression analysis.Results Of the 170 patients,459 group 14v lymph nodes were dissected,and 2.7 lymph nodes for each patient (range,1-17 lymph nodes) ; 55 positive lymph nodes were detected in patients with group 14v lymph node metastasis,and 1.7 lymph nodes for each patient (range,1-3 lymph nodes).The results of univariate analysis showed that group 14v lymph node metastasis was correlated with the degree of radical dissection of tumor,diameter of the tumor,lymph node metastasis (N stage) and distal metastasis (M stage).Compared with patients with advanced gastric cancer and with R0 resection of tumor,tumor diameter≤4 cm,N0 stages,and M0 stages,patients with R1 or R2 resection,tumor diameter ＞4 cm,N2 stages,N3 stages,and M1 stages had higher risk of group 14v lymph node metastasis (OR =3.899,2.646,19.231,33.929,5.000,95％ confidence interval:1.11113.677,1.075-6.516,2.333-158.548,4.310-267.112,1.617-15.464,P ＜ 0.05).The resnlts of multivariate analysis showed that N stage was the independent risk factor influencing the group 14v lymph node metastasis.Compared with patients in N0 stage,patients in N2 or N3 stage had higher risk of group 14v lymph node metastasis (OR =15.248,26.287,95％ confidence interval:1.811-128.386,3.244-213.034,P ＜ 0.05).Group 4sb,4d,5,6,7,8a,9,11p,12a and 16 lymph node mnetastasis were coxelated with group 14v lymph node metastasis (OR =3.923,3.335,2.693,5.641,3.100,4.203,3.655,3.660,3.838,17.400,95％ confidence interval:1.264-12.177,1.425-7.807,1.149-6.312,2.126-14.965,1.311-7.330,1.735-10.185,1.395-9.582,1.331-10.666,1.086-13.571,2.707-111.837,P ＜0.05).Conclusion N stage is an independent risk factor of group 14v lymph node metastasis,and the status of group 6 lymph node is the best indicator for group 14v lymph node metastasis.