The differential diagnosis of malignant and benign ascites plays an important role in the treatment of diseases.There have been lots of clinical biochemical parameters for the differentiation of malignant and benign ascites,including fibronectin,lactic dehydrogenase,cholesteral,total protein,adenosine deaminase,serum ascites albumin gradient,free fatty acid,carcinoma embryo antigen,thymidine kinase,pseudouridine,telomerase,?1-antitrypsin,glucose,and pH.The diagnosis efficacy of these biochemical parameters is reviewed in this article.

Objective: To study Cu, As, Cd, Hg, and Pb in 52 batches of of hawthorn pill samples from four different production enterprises in China. Methods: The residues of five heavy metal elements were determined with microwave digestion-inductively coupled plasma mass spectrometry (ICP-MS). The valence of As and Hg in the contaminated samples was analyzed with HPLC-ICP-MS. The heavy metal pollution in hawthorn pill was evaluated with the single and comprehensive pollution index method. Results: The method had good linear correlation (r ≥ 0.999 4).The detection limit ranges of five heavy metal elements were from 0.4 to 5.6 μg/kg. The recovery values ranged from 92.54% to 102.79%. The relative standard deviations for all elements were less than 3.5%. Green Standards of Foreign Trading Medicinal Plants & Preparations was used as the standard to evaluate the pollution status of Cu, As, Cd, Hg, and Pb in hawthorn pill. The results showed that the residues of Cu, Cd, and Pb were all bellow the limit of the standard, however, the As of some samples (S30, S37) from the production enterprise in Jilin exceeded the limit, Hg in all samples exceeded the limit. The As and Hg mainly existed in the form of arsenous acid (3), arsenic acid (5) and bivalent mercury. After the evaluation, there were 32 batches of safety level samples, two batches of warning level samples (S17, S25) from the production enterprise in Tianjin, which was occupied 7.41% of their samples, one batch of mild level polluted sample (S38), one batch of moderate level polluted sample (S40), and 16 batches of high level polluted samples (S28—S37, S39, S41—S45) from the production enterprise in Jilin, all samples from that enterprise were contaminated. Conclusion: The heavy metal pollution levels of hawthorn pill sold in china shows distinct difference since the different production enterprises, which should attach great importance to it. The study provides a reference for further research on safety of Chinese medicine.

BACKGROUND:Matrix attachment region(MAR)are DNA elements that bound to the nuclear matrices after chromatin digested with restriction endonuclease.Plenty of studies have shown that MAR considered as initiaI point of DNA replication or transcription of regulatory gene.Thereby,construction of MAR expression vector can elevate the overall level of transgene expression,enhance stability of exogenous gene.as welI as increase frequency of stable transfectant cells.OBJECTIVE:To construction pLXSN-CAT recombinant retrovirus vector that containing chloramphenicol acetyltransferase(CAT)via cloning MAR sequence of human.and to explore the influence of MAR on the gene expression.METHODS:An open experiment was performed at the Department of Biochemistry and Molecular Biology.Xinxiang Medical College from September 2007 to December 2007 The PLXSN-CAT vector of CAT was constructed by the laboratory.TaqDNA polymerase,T_4 DNA ligase,DNA Marker,restriction enzyme BamH I,agarose gel DNA purification kit,as well as plasmid purification kit were purchased fromTakara Biotechn0Iogy(Dalian)Co.,Ltd.The sequence of csp-B MAR was amplified by polymerase chain reaction(PCR)method applied to human DNA.The fragment was inserted into retrovirus vector PLXSN-CAT plasmid.The recombinant plasmid was verified by double digestion and DNA sequencing.RESULTS AND CONCLUSION:The length of specific fragment applied by PCR was 931 bp,and the recombinant plasmid PLXSN-CAT-MAR presented two bands:5.9 kb and 931 bp using respective restriction enzymes BamH I The sequence of MAR was confirmed by blasting to Genbank(serial numobr:M6271 6).It suggested that MAR had been cloned into PLXSN-CATR vector correctly.The recombinant retrovirus vector PLXSN-MAR was successfully constructed.

Objective To study the clinical experience of extracorporeal circulation management in modified total arch replacement combined with stented elephant trunk.Methods Fifty-eight patients with Stanford A aortic dissection underwent modified total arch replacement combined with stented elephant trunk.With the modified surgical technique,the technology of extracorporeal circulation was also modified with bilateral antegrade cerebral perfusion,the management of the temperature and blood protection.Results All patients were operated successfully.The operative time was 248-485 (396 ± 67) min,extracorporeal circulation time was 175-260 (181 ± 33) min,cross clamp time was 64-104 (85 ± 12) min,stop circulation time was 22-48 (32 ± 5) min,and selective cerebral perfusion time was 26-54 (39 ± 7) min.The ventilator assisted breathing time was 5.0-35.5 (23.0 ± 4.5) h,and ICU monitoring time was 24-140 (88 ± 12) h.Postoperative complications included transient neurologic deficit in 3 cases (5.2％,3/58),renal dysfunction in 5 case (8.6％,5/58),and pulmonary infection in 4 cases (6.9％,4/58).Conclusion To modified total arch replacement combined with stented elephant trunk,the modified management of extracorporeal circulation with bilateral antegrade cerebral perfusion,the management of temperature and blood protection,has a low prevalence of morbidity and mortality.

Objective To evaluate the effect of the transcranial magnetic stimulation on upper-extremity function rehabilitation and changes in the excitability of cerebral cortex,and to evaluate from the viewpoint of electro-physiology the prognosis so as to guide the rehabilitation treatment of patients after stroke.Methods Forty-six patients in the early stage after a stroke were given TMS examinations of the ipsilateral brain region.Those with the motor evoked potentials (MEPs) amplitudes lower than 50 μV were classified into a motion-induced experimental negative group (the negative group),whiie those whose MEP amplitude reached 50 μV or more were classified as movement-induced positive (the positive group).Both groups were given the same treatment.Before and after 2,4 and 8 weeks of treatment the Fugl-Meyer movement function rating scale was used to assess their bilateral upper limb movement function.TMS technology was used to detect any change in the resting motor threshold (RMT) and the amplitude (Amp) of MEPs in the motor cortex.The incubation period of the cortex (CL) and the central motor conduction time (CMCT) in the contralateral motor cerebral cortex were also observed.Results After 4 weeks of treatment,the average score of the positive group on Fugl-Meyer upper movement function rating scale reached (54.99±2.76),significantly higher than before treatment and significantly higher than the negative group's average (P＜0.05).After 8 weeks of treatment,the average score in the positive group had increased further to 73.11±2.98,still significantly higher than that of the negative group (P＜0.01).After treatment,RMT decreased progressively in both groups,but that of the negative group dropped from (98.35±10.12) to (30.35±7.31) (9＜0.01),with significantly greater decline in amplitude and rate than that of the positive group (P＜0.05).After treatment,the Amp of both groups showed a gradual increasing trend.Amp increased earlier in the positive group,but there was no significant difference in the extent of the increase between the two groups (P＞0.05).After the treatment the CL and CMCT had shortened significantly in the negative group compared to before the treatment (P＜0.05),while there was no significant change in CL and CMCT after the treatment (P＞0.05).Conclusions The excitability of the contralateral motor cortex changes after a stroke.TMS can be used to characterize the MEP to monitor and predict recovery.This should help clinicians prepare more scientific rehabilitation plans.

is able to provide pathologic data and achieve the efficacy equivalent to surgery.

OBJECTIVE:To establish the HPLC fingerprint chromatogram of Danzhen headache capsules. METHODS:HPLC method was adopted. The column was Dikma Diamonsil C18 with the mobile phase of methanol-acetonitrile-water(gradient elution) at the flow rate of 1.0 ml/min;the temperature was 40 ℃,the detection wavelength was 340 nm,the sample size was 20 μl and the detection time was 65 min. RESULTS:RSDs of precision,stability and reproducibility tests were no more than 0.23%;13 com-mon peaks were identified in 10 batches of Danzhen headache capsules and the similarity of all samples were higher than 0.90. CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for the process stability evaluation and quali-ty control of Danzhen headache capsules.

Objective To use the syphilis helicoid gelatin aggregation experiment (TPPA ) method to compare the results of syphilis serological detection reagents between the ELISA method and the colloidal gold method for evaluating the clinical applica ‐bility of each detection reagent .Methods 6 291 serum samples were selected from the hospitalized patients before surgery or before blood transfusion ,and performed the preliminary screening detection by the ELISA method (reagent A and B) and the colloidal gold method ,the positive or weakly positive specimens in preliminary screening were performed the confirmation test by the TPPA method .Results In 6 291 serum specimens ,the positive cases of the reagent A ,reagent B and colloidal gold method were 66 ,64 and 56 cases respectively ,the positive detection rate of colloidal gold method had no obvious difference between the reagent A and rea ‐gent B (P> 0 .05) .The positive samples were confirmed to be 66 cases by TPPA ,including 61 cases of reagent A and reagent B positive ,and the colloidal gold method had 56 cases .5 cases of reagent A positive and 3 cases of reagent B positive were confirmed to be 3 and 2 cases by TPPA respectively ,the sensitivity of the colloidal gold method had significant difference between the reagent A and reagent B(P< 0 .05) .Conclusion ELISA method has high sensitivity and is easy to realize the automated enzyme‐linked im‐munoassay ,which is suitable for the screening of the patient sample before surgery or before blood transfusion .The colloidal gold method has low sensitivity ,but high specificity ,is simple and convenient which is suitable for large‐scale healthy physical examina‐tion and preliminary screening test before emergency surgery .In order to avoid medical disputes ,the positive samples by the ELISA method and colloidal gold method should be confirmed by the TPPA method .

Objective To provide evidence for clinical practice by analyzing the factors associated with bloodstream infection in ICU patients through retrospective case-control study. Methods Using self-made data collection form, 133 cases of blood sample record from HIS system during May 2013 to December 2015 at Peking Union Medical College Hospital ICU ward were collected. In this study, 54 patients with positive blood culture results were allocated to the case group while 79 patients with negative results were in the control group. Baseline characteristics, which included sex, age and chronic diseases, were almost the same between both groups. Binary Logistic regression analysis was used to identify factors related to blood infection. Results During May 2013 to December 2015, there were 54 blood infectious cases, among which 19 cases with positive gram bacteria accounted for 35.2%(19/54), 57.4%(31/54) of gram-negative bacilli and 7.4%(4/54) of fungal infection. Logistic regression analysis revealed that blood filtration treatment (OR=7.691), pulmonary infection (OR=7.682), ICU (OR=1.115), Acute Physiology and Chronic Health Evaluation (APACHEⅡ) scores(OR=1.096), procalcitonin (OR=1.065) were risk factors of bloodstream infection for ICU patients, while albumin (OR=0.763) was a protective factor. Conclusions Blood filtration treatment, pulmonary infection, hospital length of stay, APACHEⅡand procalcitonin are factors associated with bloodstream infection in ICU patients. Clinical procedures in ICU should mainly focus on improvement of prevention awareness, strict aseptic technology, professional quality of nursing staff. Besides, guarantee of patients′nutrition, effective treatment of primary diseases, and shortened hospital length of stay are also important to reduce the infection and improve quality of life of these patients.

Objective To explore factors related to the development of segmental instabilities in lumbar spine. Methods Fifty-seven patients with lumbar segment instabilities at L 4～5 were selected as illness group, 22 patients with facetectomy at L 4～5 as post-operation control group, and 19 healthy subjects as normal control. X-ray plain films were taken in sagittal,flexion and extension positions. Computed tomographic scans were taken to define the axial morphology of the facet joint. Magnetic resonance scans were taken to describe disc degeneration of 36 patients in illness group. Results The facet joint was oriented sagittally in the forward translation patients in flexion. The disc degeneration was slight in the rotational instability patients. The patients with total facetectomy exited forward translation in flexion. Conclusion A more sagittally oriented facet and disc degeneration are associated with forward translation in flexion and may be the cause of degenerative spondylolisthesis, whereas ligament failure is associated with rotational instability.