Objective:To discuss the diagnosis of medullary carcinoma of thyroid(MCT)before operation and dur-ing operation.Methods:The levels of serum calcitonin(CT)and carcinoma embryonicantigen(CEA)of the patients who had thyroid nodule were measured before operation,by ELISA and chemiluminescence.To the patients who CT and CEA level rose,we observed frozen sections,and they were tested by immunohistochemistry for CT,CEA,CK19, TTF -1,CD56,Syn and Cga.Results:All 32 patients were diagnosed as medullary thyroid carcinoma during January 2007 to August 2013.Twenty -two patients(22 /40,55.00%)were detected as medullary thyroid carcinoma by frozen section and immumohistochemical staining in the patients that CT and CEA level rose before operation.The level was obviously higher than nomal group(10 /655,1.53%)(P <0.05).The levels of serum calcitonin(CT)and carcinoma embryonicantigen(CEA)was positively correlated with medullary thyroid carcinoma(P <0.05).The levels of serum calcitonin(CT)and carcinoma embryonicantigen(CEA)were in keeping with the expression of CT,CEA in the tissue of medullary thyroid carcinoma (P <0.05).The comparison had no false negative between the result of <br> pathological immunohistochemical in the operation and after operation.Conclusion:Some patients with thyroid nodule were measured before operation.If the levels of serum calcitonin(CT)and carcinoma embryonicantigen(CEA)were high,we could test by immunohistochemistry for CT,CEA,CK19,TTF -1,CD56,Syn and Cga in the operation.It could improve the accuracy rate of diagnosis of MCT.This method has high accuracy,rapid,easy and inexpensive.It could make diagnose easily,and reduce misdiagnose and missed diagnosis.

OBJECTIVE To research the protective influence of the flavonoids of Ardisa japonica( FAJ) on acute liver injury in mice caused by carbon tetrachloride. METHODS Chemical methds was used to extract the flavonoids. Intraperitoneal injection of CCl4 peanut oil was administrated to establish model of acute liver injury. Biochemical makers,ALT,AST,TNF- α,IL- 1β and IL- 6 in serum of mice with acute liver injury were determed,and liver tissue was taken for histopathologic. RESULTS The FAJ could inhibit the activity of ALT,AST,TNF- α,IL- 1β and IL- 6 in the serum of acute liver injury mice( P < 0. 01,P < 0. 05). The pathological examination also showed that the liver injury had significant improvement. CONCLUSION The FAJ have protective effect on CCl4-induced acute liver injury in mice,which may be related to its anti- inflammatory effects.

目的探讨血浆B型钠尿肽（BNP）对肺心病的预后评估意义，为临床诊治工作提供参考依据。方法选择2009年3月2012年3月收治的82例肺心病作为研究对象，并以同期健康者30例作为对照，分别采用快速免疫荧光法测定血浆BNP水平并进行比较分析，对肺心病患者进行治疗并进行跟踪随访，按照预后分为两组，比较不同预后患者的血浆BNP水平。结果肺心病患者的血浆BNP水平明显高于健康者（P〈0.05），且患者的血浆BNP水平随着心功能不全I、II、III、IV级依次递增；预后良好的患者血浆BNP水平明显低于预后不良者（P〈0.05）。结论肺心病患者的血浆BNP水平明显增高，且与疾病的严重程度关系密切，对该疾病的诊断及治疗预后有重要的临床价值。

随着社会的发展及进步，人们对烟草危害的认识以及国家对烟草问题的重视，使人们的戒烟意识逐渐增强。但传统的戒烟方法（如健康教育、监督机制、药物戒烟等）有时收效甚微，且可能造成身心损害。近年来采用中医药方法戒烟逐渐受到广大吸烟者的青睐。2012-01-2013-01，我们采用耳穴贴压联合针刺体穴对106名符合条件的吸烟者进行干预治疗，结果如下。

目的 探讨血清癌胚抗原(CEA)、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)和基质金属蛋白酶2(MMP-2)联合检测在结直肠肿瘤中的意义,为结直肠肿瘤的诊断提供一种简单、快捷、准确、创伤小的实验方法.方法 选取经病理证实未进行手术或放化疗的结直肠癌患者165名,同时选取非肿瘤血清CEA升高病人125名,正常对照组100名,用酶联免疫吸附试验法检测患者血清CEA,TGF-β1,VEGF和MMP -2含量,对比分析三者数值是否有统计学意义.结果 结直肠癌患者血清CEA,TGF-β1,VEGF和MMP -2水平明显高于正常对照组和非肿瘤血清CEA升高组,差异有统计学意义(t值分别为53.78,35.92,40.93,30.09,32.89,27.34,19.55及9.88,均P<0.01).血清TGF-β1,VEGF和MMP-2水平与血清CEA含量呈正相关(0.48,0.36和0.45,均P<0.01).血清CEA,TGF-β1,VEGF和MMP-2联合检测可降低非肿瘤血清CEA升高组异常率,提高特异度.结论 血清CEA,TGF-β1,VEGF和MMP-2联和检测可以提高结直肠肿瘤的诊断率,为临床治疗提供依据,有望成为新的鉴别方法.

Objective To explore the Clinical Significance of BNP for Risk Stratification,Treatment and Prognosis in Submassive PTE. Methods A total of 56 patients with confirmed submassive PTE was divided into two groups according to plasma BNP levels,according the treatment: blood gas analysis,echocardiography and the prognosis were analyzed and compared in ENPpatients. Results Comparing the two groups,the observation group PO2,A-aDO2,oxygenation index,myocardial enzyme in plasma increased incidence of( or),right ventricular and right atrial enlargement,PASP,middle( or weight) of three tricuspid regurgitation rate,recurrence within 1 years,combined with pulmonary artery high pressure,with pulmonary heart disease and death rate compared with the control group,the difference has statistical significance( P<0. 05). Conclusion The detection of plasma BNP contributes to the high-risk screening and prognostic assessment of submassive P1E. and has clinical significance for selectingthe treatment scheme as well.

目的 观察铜绿假单胞菌抗菌物质对白色念珠菌的体外抑菌活性.方法 用交叉条带实验方法测定铜绿假单胞菌对18株白色念珠菌等的体外抑制活性.结果 铜绿假单胞菌抗菌物质对白色念珠菌体外抑菌活性良好,第6和8株铜绿假单胞菌对白色念珠菌的抑制率均达到了100%,铜绿假单胞菌产生色素的菌株抗真菌活性显著优于不产色素的菌株.铜绿假单胞菌抑制白色念珠菌的生长,主要是铜绿假单胞菌产生的绿脓素.结论 铜绿假单胞菌产生的抗菌物质对白色念珠菌具有较强的抗真菌活性.

高尿酸血症(HUA)是一种嘌呤代谢障碍性疾病.HUA患者易合并空腹血糖受损和(或)糖耐量受损.研究认为血尿酸增高与胰岛素抵抗关系密切,我们对HUA并糖尿病前期(PDM)与胰岛素抵抗(IR)的关系进行探讨. 对象与方法 1.一般资料:2008年2月～2010年10月本院体检及住院的男性HUA患者168例,年龄35～65(47.5±6.5)岁.分为HAU组(A组)56例、HUA并PDM组(B组)112例;无症状HUA诊断标准:空腹血尿酸＞420μmol/L,无痛风发作史;PDM诊断符合:6.1mmol/L≤空腹血糖＜7.0mmol/L和(或)7.8mmol/L≤餐后2小时血糖＜11.1mmol/L.尿常规检测尿蛋白均阴性,排除高血压、肥胖、肝肾功能异常者.选择同期年龄及性别相匹配的健康体检者40例为对照组(C组).

Objective To evaluate the point moxibustion combined with Chinese herbs enema treatment on chronic kidney disease phase three to four.Methods 78 patients were divided into treatment group and control group by a randomized,parallel-group clinical trial.On the basis of the control diet and symptomatic treatment,42 cases in treatment group received the point moxibustion combined with Chinese herbs enema treatment,once a day.36 cases in the control group received Jishengjupizhuru decoction,once a day.The course of treatment was 12 weeks in two groups.The changes of creatinine,serum creatinine clearance(Ccr),blood urea nitrogen(BUN),hemoglobin(Hb),albumin(Alb),total protein and traditional Chinese medicine(TCM) syndrome integral before and after treatment were observed.Results After treatment,there was not statistically significant on the clinical effects(P>0.05);There was significant difference between before and after treatment on traditional Chinese medicine syndrome total score in two groups(P<0.05).There was obvious difference between two groups on traditional Chinese medicine syndrome total score after treatment(P<0.05).The levels of Cr increased significantly in the treatment group and control group(P<0.05),and Ccr decreased significantly(P<0.05).There was difference between two groups and before and after treatment(P<0.05);in the treatment group and control group Hb rose significantly(P<0.05),but there was no difference between two groups(P>0.05);there was no significant difference between two groups on other laboratory indicators before and after treatment(P>0.05).Conclusion Point moxibustion combined with Chinese herbs enema treatment has certainly clinical efficacy and should be widely applied.

目的探讨尿酸干预治疗对无症状高尿酸血症并糖尿病前期患者血糖的影响。方法无症状高尿酸血症并糖尿病前期患者112例分为3组,A组50例给予低嘌呤饮食联合降尿酸药物干预治疗,B组30例给予低嘌呤饮食干预,C组42例不予任何干预措施,A、B组疗程均为1a,比较3组治疗前、后血尿酸及空腹血糖水平。结果与治疗前及C组比较,A,B组血尿酸、空腹血糖水平降低(P<0.05),A组较B组降低明显(P<0.05)。结论血尿酸干预治疗可降低无症状高尿酸血症并糖尿病前期患者血糖水平。

[目的]探讨中药扛板归对二甲基亚硝胺诱导的肝纤维化大鼠血清转氨酶的影响.[方法]用二甲基亚硝胺诱导建立大鼠肝纤维化模型,不同浓度扛板归及秋水仙碱干预后,测大鼠血清丙氨酸氨基转移酶(ALT)、天门冬氨酸转移酶(AST)活性.[结果]扛板归高、中剂量组及秋水仙碱能显著降低AST、ALT.[结论]扛板归可能通过保护肝细胞而降低转氨酶,对二甲基亚硝胺诱导的大鼠肝纤维化具有较好的护肝作用.

Objective:To explore the diagnostic value of urinary protein excretion of Alb,IgG,α2-macroglobulin andα1-microglobulin for Early glomerular disease by a model of logistic regression and ROC curve.Methods:Methods Collected 22 cases of patients with glomerular diseases,tubular interstitial disease patients,12 cases of non-renal parenchymal disease group 20 patients,35 cases of healthy controls,while urinary albumin,α2-macroglobulin,IgG,Four protein α1-microglobulin excretion.Applied Logistic Regression Model,drawing ROC curves and calculate the area under the curve (AUC) to evaluate the diagnostic value of each index.Results:Urinary albumin and IgG in the detection and diagnosis of glomerular disease was positively correlated (P0.01;P0.05),while the α2-macroglobulin,α1-microglobulin is not associated (P0.05) ;four proteins combined detection and diagnosis of glomerular disease,the area under the ROC curve (AUC) was 0.94,higher than the detection of urinary albumin and IgG in the AUC were 0.861,0.856.Conclusion:Detection of urinary albumin and IgG as a diagnostic marker of glomerular disease,joint detection of four proteins has a good complement,which can significantly improve the diagnostic specificity of glomerular disease.

目的探讨尿蛋白组分分析在肾损伤中的筛查、诊断价值。方法用乳粒增强免疫散射比浊法检测178例肾损伤患者非浓缩晨尿高、中、低分子尿蛋白水平,并与肾活检病理学结果比较。结果根据尿蛋白水平及变化特点归纳为肾小管性蛋白尿、白蛋白尿、选择性蛋白尿、混合性性蛋白尿4类型,每种升高的尿蛋白与健康对照组比较差异均有显著性(P<0.001),诊断肾损伤程度、性质、部位与病理诊断结果相符。结论非浓缩晨尿蛋白组分分析是评价肾脏功能、筛查或诊断肾脏疾病的敏感、可靠手段。

目的 观察心力衰竭患者血清基质金属蛋白酶-2(MMP-2)、组织金属蛋白酶抑制因子-2(TIMP-2)水平变化与心力衰竭的关系.方法 采用酶联免疫吸附法分别检测50例心力衰竭患者血浆MMP-2、TIMP-2水平,并与临床病理资料进行对比分析.结果 MMP-2在NYHA1、2级组表达水平明显高于NYHA3、4级;在左心室射血分数(LVEF)≤50%组表达水平明显低于LVEF＞50%组;E/A≤1组明显低于E/A＞1组;冠脉病变Ⅲ、Ⅳ型组明显低于冠脉病变Ⅰ、Ⅱ型组;在血脂异常组和血脂正常组患者间无显著差异.TIMP-2在NYHA1、2级组表达水平明显低于NYHA3、4级;在左心室射血分数(LVEF)≤50%组表达水平明显高于LVEF＞50%组;E/A≤1组明显高于E/A＞1组;冠脉病变Ⅲ、Ⅳ型组明显高于冠脉病变Ⅰ、Ⅱ型组;在血脂异常组和血脂正常组患者间无明显差别.MMP-2水平与患者冠脉病变支数(r=0.76845 P＜0.05)、冠脉病变程度(r=0.5640,P＜0.01)、左室舒张末期内径(r=0.6088,P＜0.01)、射血分数(r=0.7004,P＜0.01)之间存在相关;TIMP-2水平与冠脉病变程度(r=0.5609,P＜0.01)、左室射血分数(r=0.4652,P＜0.01)之间存在相关;MMP-2、TIMP-2之间不存在明显相关(r=-0.2674,P＞0.05).结论 MMP-2、TIMP-2在心力衰竭患者不同阶段表现不同,检测两者的变化可动态观察患者的预后.

目的探讨非浓缩晨尿轻链蛋白检测诊断早期糖尿病患者肾损伤的临床价值。方法选择124例2型糖尿病(T2DM)患者(T2DM组)及40例健康体检者(对照组),均留取晨尿,用乳粒增强免疫散射比浊法检测轻链蛋白kapUl、amU及α1-微球蛋白(α1-MG)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)。结果 T2DM组尿kapUl、amU、α1-MG及NAG水平均显著高于对照组,尤以大量白蛋白(Alb)尿及微量Alb尿患者为著(P<0.01或0.001);T2DM组各蛋白阳性率均显著高于对照组,且正常Alb者kapUl、amU阳性率明显高于α1-MG、NAG阳性率(P<0.01或0.001)。结论非浓缩晨尿轻链蛋白kapUl、amU可反映早期肾小管重吸收功能损伤情况,可作为诊断早期DN的指标。