Cardiovascular disease (CVD) is one of the most common diseases and the leading causes of death in China.It is of great importance to detect cardiac markers for early diagnosis,treatment and prognosis of CVD.Point of care testing (POCT) is emerging as a new test mode and development trend of laboratory medicine.Application of POCT technology in cardiovascular field is the fastest growing parts of all POCT.It promotes the application and development of POCT because of the contradiction between the important value of cardiac markers and the needs of quick results in severe CVD.With the technological diversification of POCT,the progressing innovation of test devise and standardized test results with reference to the Central Laboratory (CLT),the application of POCT will be more extensive and promote the development of laboratory medicine together with traditional test mode.

Objective To investigate the effects of ageing on the expression of peroxisome proliferat or-activated receptor (PPAR)? and explore the relation with insulin resistance (IR).Methods Minimal model technique of Bergman was used to estimate the insulin sensitivity of young (10-12 weeks) and aged (24 months) SD rat. The PPAR?mRNA levels of omental fat were measured by reverse transcription-polymerase chain reaction(RT -PCR) and PPAR? protein level were determined by western blotting respectively . Results The level of IR in the aged group was significantly increased compared with tha t of the young group(IR: 11 49?6 92 vs 5 28?1 94,P

Malignant tumors are the most common lethal diseases in China.Because of complexity of etiology and pathogenesis , and the lack of specific markers for early diagnosis , delayed diagnosis and treatment of cancer , the fatality rate is high.With the development of basic research , more and more early specific markers were found , but the current detection mostly depend on the professional laboratories , time-consuming , high price and have a number of inconveniences to patients on time and money.Meanwhile , it′s difficult to extend to zoon of medicine resources deficient.Recently, point-of-care testing (POCT) has been rapidly developed , because of its portability , getting results quickly , can be operated in basic medical units and economic backward areas , so it′s benefit to cancer screening in human.By the application in tumor markers, POCT can be done for the cancer early detection , early diagnosis and early treatment , so then cuts the death rate.

Objective To evaluate the effect of lobe bronchus blockade with a branchial blocker on intrapulmonary shunt during radical esophagus cancer resection. Methods Twenty four ASA Ⅰ-Ⅲ patients with normal lung function aged 18-69 yrs undergoing elective radical esophagus cancer resection were randomized into 2 groups ( n = 12 each): group A one-lung ventilation (OLV) and group B lobe bronchus blockode. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring and blood sampling. Anesthesia was induced with midazolam 50 ?g?kg-1, fentanyl 4 ?g?kg-1, propofol 2 mg?kg-1 and vecuronium 0.1 mg?kg-1. In group A double-lumen tube (DLT) was used while in group B a single lumen endotracheal tube was placed first, then a bronchial blocker was inserted fiberoptically into the bronchus of lower lobe of the operated side. The patients were mechanically ventilated (FiO2= 100%, VT = 8 ml?kg-1 , RR = 10-15 bpm, I: E = 1:2). PaCO2 was maintained at 30-35 mm Hg. Anesthesia was maintained with 1.5%-2.0% isoflurane and intermittent Ⅳ boluses of fentanyl and vecuronium. BP, HR, CVP, SpO2, PETCO2 and airway pressure were monitored during operation. Blood samples were taken simultaneously from radial artery and central vein for blood gas analysis before induction of anesthesia when the patients were lying supine and breathing spontaneously (T0), after the lungs on both sides were ventilated for 30 min in lateral position (T1) and 30 min after OLV (group A) or lower lobe bronchus was blocked off (group B) in lateral position (T2). Qs/Qt was calculated (blood from central vein was used instead of mixed venous blood from pulmonary artery) . Blood concentrations of TXB2 and 6-k-PGF1 were determined by radioimmunoassay at T0, T1 and T2. Results There was no significant difference in demographic data between the two groups. At T2 the airway pressure in group A was significantly higher than that in group B. At T2 PaO2 was significantly higher in group B than in group A. Qs/Qt was significantly increased at T1 and T2 as compared to the baselines in both groups. Qs/Qt was significantly increased at T2 compared to that at T1 in group A only, while there was no significant difference between Qs/Qt at T1 and T2 in group B. The TXB2 concentration at T2 was significantly increased as compared to that at T0 and T1 in group A and was significantly higher than that at T2 in group B. Conclusion Lower lobe bronchus blockade was superior to OLV in terms of Qs/Qt and PaO2 during esophagus cancer resection.

Objective To evaluate the clinical curative effect,survival rate and adverse reactions of three-dimensional conformal radiotherapy(3D-CRT )in combination with chemotherapy on lymph nodes metastasis of esophageal carcinoma.Methods Using supraclavicular 3D-CRT combined with chemotherapy on and simple 3D-CRT supraclavicular lymph node metastasis of esophageal cancer patients,3D-CRT com-bined synchronous chemotherapy (treatment group),51 cases,only 3D-CRT 49 cases (control group).3D-CRT combined synchronous chemotherapy 51 cases (treatment group),simple 3D-CRT 49 cases (control group).These patients 3D-CRT were given the total dose of 50 ~60Gy/25 ~30F.TN chemotherapy regi-mens were applied:paclitaxel 135 mg/m2 ,d1;Nedaplatin 25 mg/m2 ,d1,1 ~3,21 days cycle in fist week and fourth week.Results Local control and treatment group survival rates in 1,2 year were significantly higher than that of control group (P <0.05).Treatment group adverse reaction rate is higher than the con-trol group,but there was no statistically significant difference.Conclusions The recent curative effect and survival rate could be significantly improved by 3D-CRT joint TN synchronous chemotherapy regimen for pa-tients with supraclavicular lymph node metastasis of esophageal cancer,but the relatively high incidence of adverse reactions,clinical application should be considered comprehensively according to actual situation.

Objective To investigate the effects of direct peritoneal resuscitation (DPR) with sodium pyruvate from hemorrhagic shock (HS) on intestinal injury in rats.Methods Fifty SPF male Sprague-Dawley rats,weighing 200-250 g,were used in this study.The animals were anesthetized with 1％ pentobarbital sodium 40 mg/kg,tracheostomized and mechanically ventilated.Femoral artery was cannulated for mean arterial pressure (MAP) monitoring,blood-letting,blood sampling and fluid infusion.HS was induced according to the method described by Wiggers.MAP was maintained at 35-40 mm Hg for 60 min.The animals were then randomly and equally divided into 5 groups:sham operation group (group S) ; conventional resuscitation group (group CR) ; DPR with different fluid groups (DPRt-3 groups).In group CR,at 1 h after HS,the animals were resuscitated with infusion of the blood withdrawn and normal saline (the volume was 2 times volume of blood loss).In DPR1-3 groups,conventional resuscitation was performed,at the same time,1.5 ％ glucose-based peritoneal dialysis solution containing lactate,1.5％ glucose-based peritoneal dialysis solution containing lactate (40.00 mmol/L),and 1.5％ glucosebased peritoneal dialysis solution containing high lactate (80.00 mmol/L) 20 ml were infused intraperitoneally over 30 min,respectively.MAP was recorded before blood letting,at 5,30 and 60 min of HS,and at 5,30,60,90 and 120 min after the end of resuscitation.At 120 min after the end of resuscitation,the lactate level in the arterial blood was measured.The animals were then sacrificed.Small intestinal samples were obtained for determination of malondialdehyde (MDA) content,myeloperoxidase (MPO) activity and tumor necrosis factor-α (TNF-α) expression,and for microscopic examination.The damage to the small intestinal mucosa was assessed and scored.Results Compared with MAP before blood letting,MAP during HS was significantly decreased,and no significant change in MAP was found after resuscitation in CR and DPR1-3 groups (P ＜ 0.05).The lactate level in the arterial blood,MDA content,MPO activity,TNF-α expression and intestinal mucosal damage scores were significantly higher in CR and DPR1-3 groups than in S group (P ＜ 0.05 or 0.01),while lower in DPR1-3 groups than in CR group (P ＜0.01),and in DPR2,3 groups than in DPR1 group (P ＜ 0.05 or 0.01).The lactate level in the arterial blood,MDA content and TNF-α expression were significantly lower in DPR3 group than in DPR2 group (P ＜ 0.05 or 0.01).Conclusion Direct peritoneal resuscitation with sodium pyruvate can reduce the intestinal injury induced by HS and inhibition of lipid peroxidation and inflammatory responses is involved in the mechanism in rats.

Objective To conduct a systematic review with evidence collected from randomized controlled trials (RCTs) of domestic and overseas acupuncture for nervous tinnitus. Methods RCTs were searched in several databases i.e. CNKI, VIP, CBM and PubMed, using the keywords of acupuncture and tinnitus. The efficacy and methodologies were evaluated using meta-analysis by RevMan5.0. Efficacy indexes i.e. recovery rate, significant efficiency rate, total effective rate of acupuncture in treating nervous tinnitus were assessed using odds ratio (OR). Funnel plot was drawn to analyze publication bias. Begg’s rank test and Egger’s linear regression test were conducted to measure symmetry in funnel plot by using Stata 11.0. Results Fifteen RCTs involving 1082 patients met the inclusive criteria. The results of meta-analyses showed that recovery rate (OR=2.82, 95%CI 1.89 to 4.20), significant efficiency rate (OR=1.75, 95%CI 1.26 to 2.44), total effective rate (OR=3.68, 95%CI 2.62 to 5.16) were significantly higher in acupuncture group than control group. Begg’s rank test (P=0.350) and Egger’s linear regression test (P=0.887) showed partly symmetry in funnel plot with unfilled corner, which indicated that some degree of bias existed in the included studies. Conclusion According to the analysis results, acupuncture or acupuncture combining other therapies were superior to pure medication or non-acupuncture treatments. However, high-quality, large-sample, randomized, controlled trials seem to be needed to further confirm the efficacy of acupuncture, owing to the different standards and research methods, limited qualities of the included studies.

Objective To evaluate the expression of Yes-associated protein (YAP) in colorectal carcinoma and analyze its influence on tumor cell proliferation.Methods The expressions of YAP in 94paired colorectal carcinomas and pericancerous normal tissues were detected by using immunohistochemistry method.The expressions of YAP in colorectal carcinoma cell line HCT116 were inhibited with a YAP-spe-cific siRNA.Cell proliferation was then determined by methyl thiazolyl diphenyl-tetrazolium bromide (MTT) assay.Results The positive rate of YAP in colorectal carcinomas was significantly higher than that in pericancerous normal tissues [69.1％ (65/94) vs 22.3 ％ (21/94),P ＜ 0.001].The expression of YAP was associated with tumor Node Metastasis(TNM) stage and lymph node metastasis(P ＜0.05),but not associated with gender,age,tumor location and histological grade(P ＞0.05).After YAP-specific siR-NA was transfected into HCT116 using lipofectamine,the expression of YAP mRNA and protein in the experimental group were reduced by (78.2 ±2.1)％ and (81.7 ± 1.5)％,respectively,with a statistically significant difference (t =67.55,91.601,P ＜0.01).The growth of HCT116 was significantly inhibited and the reduced rate of cell proliferation was (28.1 ± 1.6) ％,(34.7 ± 2.4) ％ and (24.7 ± 1.2) ％ at the time point of 48 h,72 h and 96 h,respectively.Conclusions Expression of YAP was upregulated in colorectal carcinomas and downregulation of YAP expression could inhibit growth of colorectal carcinoma cells.YAP can be used as a new candidate target for diagnosis and treatment of a colorectal carcinoma.

There are a lot of medical colleges which carry out foreign student medical education in our country. On the basis of clinical theory situation and problems of foreign students medical education,Xuzhou Medical College implemented a number of reform measures and achieved good teaching effect.These measures included writing new syllabus of oversea students and reforming multiform teaching methods and the pattern of examination and evaluation for clinical theory.

Objective To observe the expression changes of peripheral endothelial progenitor cells (EPCs) and Ang-1/Tie2 in patients with pulmonary arterial hypertension (PAH).Methods From Jun 2011 to Dec 2012,45 patients with PAH charged in Affiliated Hospital of Hangzhou Normal University were divided into 3 groups according to mean pulmonary arterial blood pressure (15 per group):mild(Group L),moderate(Group M),and severe(Group S),with another 15 normal people as control group(Group C).The EPCs were isolated from peripheral blood of every patient,number counting using fluorescence activated cell sorter (FACS),function test using cell culture in vitro.Expression of Ang-1 and Tie2 in the peripheral EPCs were measured by RT-PCR or Western-blot.Non normal data was analyzed by non parametric statistical test.Results The statistical discrepancy existed among Group L,M,S and the control in the number of EPCs [32.0 (27.0,37.0),26.0 (19.0,31.0),24.0 (22.0,26.0) vs 40.0 (37.0,51.0),P ＜ 0.05].The ability of migration [32.1 (26.5,37.5),26.8 (22.4,35.4),21.0 (17.8,34.0) vs 39.0 (33.3,42.4),P＜0.05] and adhesion of the EPCs [57.1(50.9,61.8),51.8(45.2,58.7),46.0 (37.2,55.1) vs 64.1 (56.2,75.0),P ＜ 0.05] among study groups and control group was different in statistic,the same with the proliferation activity of EPCs in different groups [0.6 (0.5,0.7),0.5 (0.4,0.6),0.4(0.3,0.5) vs 0.7(0.6,0.8),P ＜0.05].The mRNA expression of Ang-1 and Tie2 in Group M & S were significantly reduced compared with control [4.33 (2.49,4.62) and 2.89 (2.39,3.44) vs 5.31(3.78,6.22),P＜0.05],Tie2 mRNA[1.32(1.23,1.34)and 1.23(1.08,1.42)vs 1.49(1.25,1.66),P ＜ 0.05],and the protein expression of the phosphorylated Tie 2 in Group M &S were decreased [0.16 (0.15,0.24) and 0.12 (0.08,0.18) vs 0.22 (0.19,0.28),P ＜ 0.05].No significant difference of Ang-1 and Tie2 expression was observed between Group L and control [5.42 (4.72,5.95),1.54 (1.43,1.66) and0.23(0.19,0.33),P=0.674,0.867 and 0.674].Conelusion With the severity of PAH,the number and function of circulating EPCs decreased,as consistent with Ang-1 and Tie2 expression changes,suggesting that function decrease of EPCs in patients with PAH may be associated with the decrease of Ang-1/Tie2 expression.