Objective To explore the values of combined detection of carcino embryonic antigen (CEA),carcinoma antigen 125 (CA 125),cytokerain 19 fragment 21-1 (CYFRA2 1-1),carcinoma antigen Scc-Ag (Scc-Ag) and neuron specific enolase (NSE) for diagnosis and treatment of lung cancer.Methods The concentrations of CEA,CA125,CYFRA21-1,Scc-Ag and NSE in 198 patients with lung cancer (lung cancer group),50 with benign pulmonary disease (benign disease group) and 50 healthies (health control group) were detected by electrochemiluminescence immunoassay (ECLIA).The concentration of Pro-GRP31-98 was detected by enzyme linked immunoassay.Results Six tumor markers in lung cancer group showed significant diffcrence compared with those of benign disease group and health control group (P ＜ 0.01).The concentrations of serum tumor molecular markers were significantly higher in Ⅲ,Ⅳ stage group than those in [,Ⅱ stage group.Before the treatment,the concentrations of serum tumor molecular markers in lymph node metastasis group and lymph node recurrence group were significantly higher than those in no lymph node metastasis group and no lymph node recurrence group after the treatment (P ＜ 0.01).The positive rate of CEA,CA125 in lung adenocarcinoma group,CYFRA21-1 and Scc-Ag in lung squamous cell carcinomas group and NSE and Pro-GRP31-98 in small cell lung carcinoma group were significantly different from the other two kinds of pathological types (P ＜ 0.01).The positive rates of CEA and CA125 combinated detection in lung adenocareinoma,CYFRA21-1 and Scc-Ag combinated detection in lung squamous cell carcinomas,NSE and Pro-GRP31-98 combinated detection in small cell lung carcinoma was significantly higher than the individual detection respectively.The sensitivitv rates of CEA,CA125,CYFRA21-1,Scc-Ag,NSE and Pro-GRP31-98 were 52.52 ％,51.01％,48.99 ％,53.03 ％,49.49 ％ and 50.50 ％,respectively.And the combinated detection sensitivity rate of the six tumor markers was 96.46 ％,which significantly higher than that of a single marker (P ＜ 0.01).Conelusions The tumor molecular markers of CEA,CA125,CYFRA21-1,Scc-Ag,NSE and Pro-GRP31-98 may be the indicators in diagnosis of lung cancer.The combined detection of serum tumor molecular markers would significantly improve the sensitivity of diagnosis for lung cancers.At the same time,it should be valuablc for determination of clinical stage,histological type and follow-up studies of lung cancer.

Objective To investigate the value on clinical application of dynamic and combined detection of serum tumor markers alpha-fetoprotein (AFP),Golgi protein 73 (GP73),vascular endothelial growth factor (VEGF) and alpha-L-fucosidase (AFU) in early diagnosis and monitoring treatment of primary hepatocellular carcinoma.Methods Serum levels of AFP,GP73,VEGF,AFU in 98 patients with primary hepatocellular carcinoma (the malignant group) before and 3 months after treatment were detected by electrochemiluminescence immunoassay and enzyme-linked immunosorbent assay,which compared with the levels of 50 liver benign lesions (the benign group) and 50 healthy subjects (the normal group).Results The levels of serum AFP,GP73,VEGF,AFU in the malignant group before treatment were (219.16 ± 56.89) μg/L,(355.42 ± 109.26) μg/L,(88.21 ±24.22) μg/L,(276.51 ±83.20) U/L.These indexes in the benign group were (14.95 ± 3.26) μ g/L,(56.43 ± 15.72) μ g/L,(2.68 ± 1.27) μ g/L,(25.38 ± 11.17)U/L.These indexes in the normal group were (14.67 ± 3.07) μ g/L,(55.06 ± 14.21) μ g/L,(2.36 ± 1.14) μ g/L,(24.29 ± 10.10) U/L.There were statistical differences between the malignant group and the benign group,normal group (P ＜ 0.01).The levels of these indexes after treatment in the malignant group were (25.66 ±8.17) μg/L,(65.32 ±24.15) μg/L,(4.67 ± 1.89) μg/L,(35.23 ± 12.36) U/L,there were statistical differences between before treatment and after treatment (P ＜ 0.01).The sensitivity and accuracy of combined detection of these tumor markers in diagnosis of primary hepatocellular carcinoma were 95.92％ (94/98) and 93.24％(138/148),which were statistically higher than single detection(P＜ 0.05).Conclusion The dynamic and combined detection of serum tumor markers could be applied as supplementary means in early diagnosis and monitoring treatment of primary hepatocellular carcinoma.

Objective To discuss the correlation between nature of carotid plaque by dual-source CT examination and serum levels of hypersensitive C-reactive protein (hs-CRP),lipoprotein a (LPa) and homocysteine (Hcy),and provide a better theoretical basis for the prevention and treatment of ischemic cerebrovascular disease.Methods Fifty carotid plaque patients with ischemic cerebrovascular disease symptoms (group A),50 carotid plaque patients without ischemic cerebrovascular disease symptoms (group B)and 50 healthy people (group C) were selected.All objects were detected the carotid plaque by dual-source CT,and the serum levels of hs-CRP,LPa and Hcy were detected by the automatic biochemical analyzer.The correlation between the nature of carotid plaque by dual-source CT examination and the serum levels of hs-CRP,LPa and Hcy was analyzed.Results The total number of carotid plaque,number of unstable plaque and number of stable plaque in group A were 357,220 and 137 pieces,respectively.Those in group B were 200,13 and 187 pieces,respectively.There were statistical differences between group A and group B (P ＜ 0.01).Patients in group A and group B were mainly with unstable plaque and stable plaque,respectively.Healthy people in group C were without carotid plaque.The serum levels of hs-CRP,LPa and Hcy in group A were (36.74 ± 13.22) mg/L,(563.15 ± 178.69) mg/L and (40.15 ± 12.31) μ mol/L,respectively.These in group B were (12.36 ± 4.35) mg/L,(393.56 ± 86.45) mg/L and (29.45 ± 7.63) μ mol/L,respectively.These in group C were (3.26 ± 1.26) mg/L,(220.17 ± 35.24) mg/L and (14.32 ± 2.44) μ mol/L,respectively.The serum levels of hs-CRP,LPa and Hcy in group A were significantly higher than those in group B and group C,and those in group B were significantly higher than those in group C,there were statistical differences (P ＜ 0.05).The serum levels of hs-CRP,LPa and Hcy were positive correlation with the number of carotid unstable plaque,the correlation coefficients between the serum levels of hs-CRP,LPa and Hcy and the number of carotid unstable plaque in group A were 0.469,0.398 and 0.363 (P ＜ 0.05),respectively,in group B were 0.276,0.145 and 0.127(P ＜ 0.05),respectively.The correlation coefficients between group A and group B were significantly different (P ＜ 0.05).Conclusions The combination of dual-source CT examination and the serum levels of hs-CRP,LPa and Hcy is more beneficial to judge the stability of plaque,and it can help predict the nature of the carotid plaque.This view is important clinically for the prevention and treatment of the occurrence and the development of the ischemic cerebrovascular disease.

Objective To investigate the value of combined detection of serum tumor biomarkers including alpha-fetoprotein (AFP),tumor specific growth factor (TSGF),golgi protein 73 (GP73) and osteopontin (OPN) in diagnosis of primmy hepatic carcinoma.Methods AFP,TSGF and GP73 levels were measured by electro-chemiluminescence immunoassay,and OPN levels by enzyme-linked immunosorbent assay (ELISA) in 122 cases of primary hepatic carcinoma,50 cases of liver benign lesions and 50 cases of healthy control.The biological parameters and the levels of AFP,TSGF,GP73 and OPN were studied.Results The serum levels of AFP,TSGF,GP73 and OPN in primary hepatic carcinoma were higher than those in the liver benign disease group and the normal control group (all P ＜ 0.01).Sex and age of the patients at diagnosis showed no significant association with the levels of the four serum tumor biomarkers in the primary hepatic carcinoma groups (all P ＞ 0.05).But the tumor size,amount,tumor stage,metastasis and recurrence showed significant association with the levels of those in the primary hepatic carcinoma groups (all P ＜ 0.05).The sensitivity,specificity and veracity of serum AFP,TSGF,GP73 and OPN as individual diagnostic marker was only 57.38 ％,68.85 ％,70.49 ％ and 69.67 ％,respectively.The sensitivity of combined detection of AFP and TSGF was 80.33 ％,and that of combined detection of AFP,TSGF and GP73 was 85.25 ％.While,the sensitivity of the four serum tumor markers in combination was 98.36 ％,the accuracy was 95.65 ％.The sensitivity and accuracy of combined detection with the four serum tumor markers were significantly higher than those of the individual markers and other combination detection methods (all P ＜ 0.05).Conclusions Serum markers of AFP,TSGF,GP73 and OPN can serve as a means for diagnosis of primary hepatic carcinoma.Combined detection of the four serum tumor biomarkers can improve the sensitivity,accuracy and the negative predictive value,which is benefit to early diagnosis and interference.

Objective To investigate the clinical value of serum tumor makers CA15-3,19 fragments of cellular keratin antigen(CYFRA21-1)combined with the color Doppler ultrasound and mammography X-ray in diagnosis of early breast cancer.Methods According to the postoperative pathologic diagnosis,collected 106 cases of patients with breast cancer (breast cancer group) and 50 cases of patients with benign breast lesions (control group),the serum tumor makers CA15-3,CYFRA21-1,the color Doppler ultrasound and mammography X-ray were compared with postoperative pathology and statistical analyzed retrospectively.Results The sensitivity of CA15-3 was 63.2%(67/106),specificity was 94.O% (47/50);the sensitivity of CYFRA21-1 was 73.6%(78/106),specificity was 88.0%(44/50);the sensitivity of color Doppler ultrasound was 77.4%(82/106),specificity was 90.0%(45/50);the sensitivity of mammography X-ray was 75.5%(80/106),specificity was 92.0%(46/50);the sensitivity of the four combined detections was 96.2%(102/106),specificity was 80.0%(40/50).The sensitivity of combined detection was higher than any of them individually,there was statistical significance (P<0.05).Conclusions Combined diagnosis is an effective way of early breast cancer detection.It has high positive rate of diagnosis and reliable guidance significance for diagnosis and treatment.

ObjectiveStromal cell-derived factor -1 (SDF-1 ) is closely related to the biological characteristics of breast cancer. We aimed to explore whether estrogen affected breast cancer by SDF-1. MethodsThe breast cancer cell line MCF-7 and MRC5 were chosen, and divided into three groups: the control group, the estrogen group and the estrogen + estrogen receptor blocker group. Each group was cultured with different physiological concentrations of 17-β estrogen at certain time, and the same alcohol concentration of 17-β estradiol at different time points, and then the enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of SDF-1 in culture medium, and the semi-quantitative reverse transcriptionpolymerase chain reaction (RT -PCR) was used to detect the expression of SDF-1 mRNA in each group.ResultsSDF-1 can be detected in the culture medium of both MCF-7 and MRC5 cell lines. All different concentrations of 17-β estradiol may increase the secretion of SDF-1 in MCF-7 cells. When adding 17-β estradiol to the concentration of 107mol/L, the secretion of SDF-1 reached the peak in 2 hours, which was 6 times and 2.7 times that of control group ( P ＜ 0.01 ). The effect could be ehminated by pure estrogen receptor ICI182,780. In addition, the mRNA expression of SDF-1 was consistent with the SDF-1 protein levels-l07 mol/L group. The expression of SDF-1 mRNA was higher than both that of the control group and the blocking group in 2 hours (P ＜ 0.05 ). ConclusionsIn some breast cancer cell lines, physiological concentrations of estrogen can increase the secretion of SDF- 1, and this effect is mainly achieved through the estrogen receptor. Estrogen can influence the biological characteristics of breast cancer by SDF-1.

Objective To explore the clinical value of combined detection of CA15-3, TSGF, OPN and CA125 in the diagnosis and treatment of breast cancer. Methods The serum specimens from 187 patients with breast cancer (cancer group) were collected, tumor markers CA15-3 and CA125 were detected with electrochemiluminescence method, TSGF was detected with chemocolorimetry, and OPN was detected with enzyme-linked immunosorbent assay. Compared with 50 cases of patients with benign breast disease (control group), The relationship between these marker and clinical stage, recurrence and metastasis of breast cancer were analyzed. Results The serum levels of CA15-3, CA125, TSGF and OPN in cancer group were significantly higher than those in control group (P ＜0.05). Four markers in high clinical stage(Ⅲ and Ⅳ stage)[(83.21±28.67), (89.13±32.34), (278.66±137.23) U/ml and (97.4±11.7) ng/ml, respectively] were higher than those in low stage( Ⅰ and Ⅱ stage) [(60.03±19.35), (58.21±17.56), (155.79±113.11) U/ml and (77.5±10.81) ng/ml,respectively] (P ＜0.05), and those in lymphnode metastasis patients and in recurrence patients were significantly higher than those in corresponding groups (P ＜0.05). The sensitivity and specificity of the combined detection of four tumor markers were 96.3 % (180/187) and 80.0 % (40/50), respectively. The average time of combined detection of serum tumor markers was 2 months ahead of the mammographic features in the recurrence patients with breast cancer. Conclusion The dynamic combined detection of CA15-3, TSGF, OPN and CA125 are better markers for monitoring recurrence and metastasis of breast cancer,which are benefit to early diagnosis and interference.

Objective To study the clinical value of nipple discharge detection in the early diagnosis of breast cancer,CA153 ,CEA levels were measured both in nipple discharge and serum. Methods 153 consecutive patients with nipple discharge in Rizhao hospital were studied,among them there were 91 cases with breast cancer and 62 cases with benign disease. The nipple discharged and serum from the 153 cases with nipple discharged were collected and CA153, CEA levels were measured with electrochemiluminescence method. Results The CA153, CEA levels of nipple discharge in breast cancer were significantly higher than the control group(CA153:t =28.949,33.844;CEA:t = 19.773,16.623, all P ＜ 0.01). The positive rate of CA153, CEA in nipple discharge were significantly higher than in the serum (P ＜ 0.05). Conclusion The positive rate of CA153, CEA in nipple discharge were significantly higher than in the serum. The detection of CA153 ,CEA had important value in the early diagnosis of breast cancer.

Objective To apply the percutaneous endoscopic gastrostomy (PEG) for deglutition disorders of the elderly. Methods 32 elderlypatients with deglutition disorders accepted PEG were reviewed. They accepted post-operative enteral nutrition and were followed upmonthly with their weight, body mass index and mini-nutritional assessment (MNA). Results 2 cases presented skin infection of stoma, nomore complications happened. Their weight, body mass index and MNA improved significantly 3 months after treatment (P<0.05). ConclusionPEG is an effective treatment for the elderly deglutition disorders.

Upper limb dysfunction can severely threaten the quality of life of the patients with breast cancer after mastectomy. This paper reviewed the researches on its pathogenesis, diagnosis, treatment, prevention and so on in the last 10 years. Early rehabilitation is very important for upper limb dysfunction after mastectomy.