Objective To evaluate the value of HE4 ,CA125 in the diagnosis of epithelial ovarian cancer (EOC) .Methods A to‐tal of 54 samples with epithelial ovarian cancer ,64 suspicious benign pelvic mass ,and 60 health controls were consecutively enrolled in this study .Results Good diagnostic performance in discriminating benign from EOC patients was obtained for CA125 and HE4 . Serum level of HE4 of the patients in the three group were 189 .94 pmol/L ,56 .74 pmol/L and 46 .36 pmol/L .Levels of CA125 were 89 .39 U/L ,45 .11 U/L and 34 .24 U/L .There were stastically significant differences between the groups(P<0 .05) .The ser‐um HE4 and CA125 levels of the patients with ovarian cancer at stage Ⅲ ,Ⅳ(HE4=236 .25 pmol/L ,CA125=206 .35 U/L) were significantly higher than the cases at stage Ⅰ ,Ⅱ(HE4=96 .36 pmol/L ,CA125=67 .8 U/L P<0 .05) .Benign pelvic mass as con‐trol ,the specificity (SP) was 86 .6% ,sensitivity (SN) was 82 .6% ,positive predictive value and negative predictive value of the ser‐um HE4 were 85 .71% ,71 .67% ,73 .84% ,and 84 .31% respectively .SN of CA125 was 86 .67% ,higher than that of HE4 (71 .67% ,P<0 .01) .The area under curves (AUC) of HE4 was 0 .87 higher than that of CA125 (0 .81) ,(P<0 .01) .Combing de‐tection of ovarian cancer was higher than that of HE4 and CA125 alone .SP was 95 .15% ,negative predictive value was 92 .13%(P<0 .01) .Conclusion Overall ,the level of serum CA125 and HE4 increase significantly ,which showes well diagnostic perform‐ance to EOC from benign diseases .The combined detection of CA125 and HE4 could improve the diagnostic power in cervical cancer prominently ,so it has great reference value in the diagnosis of epithelial ovarian cancer .

Objective To explore the changes of the levels of CA-125 antigen(CA125) and vascular endothelial growth factor (VEGF) in serum and peritoneal fluid in patients with endometriosis (EMT), and the relationship with EMT. Methods One hundred and twenty patients with EMT (EMT group)and 98 patients with uterine fibroids (control group) were enrolled in this study. The levels of CA125 and VEGF in serum and peritoneal fluid were detected by enzyme linked immunosorbent assay (ELISA), and the results were compared. Results The levels of serum CA125,VEGF in EMT group were significantly higher than those in control group:(40.31±11.14) kU/L vs.(24.71±9.19) kU/L,(59.75±6.87) ng/L vs. (36.38±8.12) ng/L, there were significant differences(P<0.05). The levels of serum CA125,VEGF inⅠ-Ⅱphase andⅢ-Ⅳphase in EMT group had no significant differences ( P>0.05). The levels of peritoneal fluid CA125,VEGF in EMT group were significantly higher than those in control group:(311.46± 107.29) kU/L vs.(158.17± 55.42) kU/L,(73.28 ±10.40) ng/L vs. (40.21 ±9.84) ng/L, there were significant differences (P<0.05). The levels of peritoneal fluid CA125,VEGF in Ⅲ-Ⅳ phase were significantly higher than those in Ⅰ-Ⅱ phase in EMT group:(387.41±70.91) kU/L vs. (308.42±81.21) kU/L, (69.22±7.13) ng/L vs. (55.44±8.23) ng/L, there were significant differences (P<0.05). In EMT group, the levels of CA125 and VEGF in serum were significantly lower those in peritoneal fluid:(40.31±11.14) kU/L vs. (311.46±107.29) kU/L, (59.75±6.87) ng/L vs. (73.28 ±10.40) ng/L, there were significant differences (P<0.05). Conclusions The levels of CA125 and VEGF in serum and peritoneal fluid are closely related to EMT. Peritoneal fluid in monitoring of EMT may be more sensitive and reliable than serum.

Objective: To analyze the present situation of the management of large-scale instruments in a medical school and give some reasonable suggestions. Methods: Through the research on the use of 85 large-scale instruments in our university, we tried to find out the methods of improving the utilization ratio of large-scale instruments. Results:There are many reasons of the poor management and low utilization rate of large-scale instruments in medical schools. Conclusion: Taking some measures could effectively improve the utilization rate of large-scale instruments in medical schools, such as simplifying the working procedure, solving the operating and repair expenses, strictly controlling argumentation, drawing up scientific evaluation and incentive measures and so on.

Objective:To discuss the therapeutic effect of pharmaceutical care for old patients with chronic obstructive pulmonary disease ( COPD) . Methods:Totally 192 patients diagnosed as COPD were randomly divided into 2 groups according to a random num-ber table, 100 cases in the experimental group and 92 cases in the control group. The control group was treated with the conditional therapy, and the experimental group was treated with pharmaceutical care additionally. The studieds on COPD assessment test ( CAT) , modified British medical research council ( mMRC) and the value of pulmonary function index ( FEV1% index) were carried out and compared between the two groups. Results:There was no statistically significant difference in the CAT score, mMRC classification and FEV1% index between the two groups on admission (P>0. 05), however, after the treatment, the CAT score and mMRC classifica-tion were decreased and FEV1% index was increased in the two groups, and there was statistical significance between them ( P <0. 05). The CAT score and mMRC classification in the experimental group were lower and FEV1% index was higher than that in the control group(P<0.05). Compared with the medication errors(n=13, 14.13%) and incidence of adverse drug reactions(n=5, 5. 43%) in the control group, the medication errors(n=2, 2. 0%) and incidence of adverse drug reactions (0%) in the experimental group were significantly decreased. Conclusion:Clinical pharmacists provide effectively pharmaceutical care, which can significantly improve the clinical therapeutic efficacy in old patients with COPD.

Objective To evaluate the value of DWI parameter ADC and intravoxel incoherent motion(IVIM) derived parameters in grading extrahepatic cholangiocarcinoma(EHCC).Methods Thirty-eight consecutive patients with surgically resected and pathologically confirmed EHCC while the minimum diameter of the lesions large than 5 mm were included in this retrospective study.Patients underwent upper abdomen 3.0 T MR(including conventional MRI and DWI scansequences).Importing original images into the IVIM post-processing software,each patient were set three times of ROIs and each time interval was one week.ROI were selected in the same position of the maximum solid part of lesions area,the average value of ADC,blood flow(BF),pure molecular diffusion(D),perfusion-based molecular diffusion(D*),perfusion fraction(f) were measured.According to WHO digestive tumor specimens grading method,divided these cases into Ⅰ,Ⅱ,Ⅲ grade group.Evaluate the association by Spearman correlation analysis and compare the diagnostic potential of parameters ADC、BF、D、D*、f by using ROC analysis.Results Thirty eight cases of EHCC include:grade Ⅰ 11 cases,grade Ⅱ] 15 cases and grade Ⅲ 12 cases.ADC values of these three groups were (1.33 ± 0.22) × 10-3,(1.21 ± 0.18) × 10-3,(0.98 ± 0.10) × 10-3mm2/s,respectively.BF values were (2.40± 1.01) × 10-3,(2.37± 1.19) × 10-3,(1.64±0.46) × 10-3mm2/s.D values were (1.30±0.13) × 10-3,(1.15 ±0.13) × 10-3,(0.87±0.11) × 10-3mm2/s.D* values were (5.67±0.70) × 10-3,(6.58 ± 1.82) × 10-3,(5.43±2.82) × 10-3mm2/s.And f values were (38.03± 10.02)％,(31.36±8.34)％,(22.04±7.93)％.ADC,D,and f values were significantly correlated with histologic grade(r=0.624,0.809,0.580;P＜0.01,respectively).BF and D* were both not significantly correlated(r=0.271,0.017;P=0.099,0.920,respectively).Areas under the ROC curve for the five parameters ADC,BF,D,D*,f were 0.785,0.603,0.889,0.421,0.781,respectively.Conclusions With the reduction of histological differentiation degree,ADC,D,f values decreased.Correlation between f value and pathological differentiation degree is poor whie the correlation of D and ADC were excellent,and the correlation of D is the highest.

There is a complicated association between the liver and diabetes mellitus.Diabetes mellitus may cause various forms of liver damage,such as nonalcoholic fatty liver disease (NAFLD),hepatic cirrhosis,hepatocellular carcinoma,liver abscess,and liver transplant complications.With the growing epidemic of diabetes mellitus,this review investigates diabetes mellitus induced liver damage.

Objective To discuss the rehtionship between lipoprotein [Lp (a)],homocysteine (Hcy) and coronary artery disease (CAD) in men.Methods Two hundred and twenty-two male patients admitted for coronary angiography were classified into CAD positive group (111 cases) and CAD negative group (111 cases).The clinical data and plasma Hcy and Lp(a) levels were recorded in both groups.Logistic regression analysis was used to analyze males CAD risk factors.Results Lp (a) ≥0.3 g/L was a risk factor for CAD (OR =5.04,95％ CI 1.88-13.51,P =0.001),whereas Hcy was not related to CAD (OR =1.35,95％ CI 0.63-2.89,P =0.443).However,when both factors were considered together in an interaction model,plasma high Hcy and high Lp (a) levels were risk factors for CAD (OR =11.54,95％ CI 2.62-45.61,P=0.003).Conclusion Plasma Lp (a) and Hcy levels may increase the incidence of male CAD process.

Objective To detect the expression and effect of human tumor necrosis factor related apoptosis-inducing ligand (hTRAIL) in vivo,by using a novel double expressing adenoviral vector encoding hTRAIL and firefly luciferase ( luc ) gene ( ad -luc-hTRAIL),in which luc was used as reporter gene.Methods Lung cancer A549 cell xenografts in 16 nude mice models were established in subcutaneous inoculation way,the adenovirus vectors ( ad-luc-hTRAIL,ad-hTRAIL,ad-luc) and phosphate buffer saline (PBS) (n =4) as control were injected into tumor respectively.The size of the tumor was measured at different time points (4,7,10,14,21,28 d)after injection.The activity of luciferase in surface of the tumor was detected in vivo by using high-sensitivity cooled-charged coupled device(CCD) camera.The expression of hTRAIL was demonstrated by immunohistochemistry staining after sacrificing the animals at different time points,and immunohistochemical scores (IHS) were measured. The apoptosis rate of tumor cells was detected by using TUNEL and calculated. Analysis of variance,the paired t test and linear correlation analysis was used for the statistics. Results The growing speed of tumour xenografts was more slowly in ad-luc-hTRAIL and ad-hTRAIL groups than PBS group (t =2.71,2.72,P ＜ 0.05 ).The tumor volumes of ad-luc-hTRAIL,ad-hTRAIL,ad-luc and PBS groups 28 days after injection were (208.4 ± 42.3 ),( 181.5 ±23.9),( 403.1 ± 54.0 ) and ( 427.0 ± 59.3 ) mm3, respectively. There was no significant difference between ad-luc group and PBS group(t =2.07,P ＞ 0.05).The expression of luciferase in ad-luc-hTRAILgroup reached its peak at 7th day ( 1.37 ± 1.04),and then decreased quickly.The IHS and apoptosis rate in ad-luc-hTRAIL and ad-hTRAIL groups reached their peaks at 7th day,the peak values of IHS were 6.25 ±2.06 and 6.5 ± 2.89,the peak values of apoptosis rate were (60.75 ± 8.06 ) ％ and ( 61.50 ± 8.47 ) ％,respectively.The amount of luciferase expression ( absolute number of photons detected by CCD camera)was linear positive correlated with IHS and apoptosis rate ( rphotons/IHs =0.942,rph /rate =0.842,rIHs/rate =0.887,P ＜ 0.05 ).Conclusion The target gene hTRAIL can be transfected into lung cancer A549 cell xenografts nude mice models efficiently with a high level expression,and the therapeutic effect of hTRAIL can be monitored by detecting the expression of luc.

Objective Knowledge about the infiltration of macrophages in diabetic wounds can help to figure out the pathogene -sis of poor healing of diabetic wounds .The aim of this study was to observe the macrophage infiltration and the expression of relative in-flammatory factors during the wound healing of diabetic rats and explore the relationship between macrophages and diabetic wound heal -ing. Methods Male Sprague Dawley rats were randomly divided into STZ induced diabetic group and normal control group .Each group had 15 rats.A 1 cm2 full-thickness skin defect was created on the rat dorsum .Wound samples and was excised .On post injury day (PID) 3, 7, and 14, rats of each group were sacrificed after wound samples and tissues around the wound edge were obtained .The differences of the wound closure rate , macrophage infiltration and the relative mRNA expression of the inflammatory factors from macro-phages were observed . Results The wound closure rate was lower in diabetic group on PID 3, 7, and 14 ([29.5 ±5.4]%vs [45.9 ± 12.8]%, [71.6 ±3.1]%vs [80.1 ±6.9]%, [93.9 ±2.8]%vs [99.4 ±1.4]%, P<0.05).HE staining showed inflammatory cells infil-diabetic wound tissue on PID 3 (P<0.05) and a higher expression on PID 14 (P<0.05).The CCR7 fluorescence staining showed more positive staining cells stayed in diabetic wound on PID 14. Conclusion Macrophage infiltration decreases in the early phase of diabetic wound healing and sustains in wound tissue in advanced stage accompanied by the expression change of related inflammatory factors, which could contribute to the difficult wound healing of diabetic rats .

Objective:To evaluate the efficacy of silymarin on type 2 diabetic nephropathy in rats. Methods:Totally 60 male al-bino Wistar rats at the age of 8 weeks were involved in the study, and non-insulin-dependent diabetes mellitus was induced in 45 over-night-fasted rats by intramuscular injection of streptozotocin and nicotinamide. Among the 45 rats, three ones failed to make the model, and forty-two rats with diabetic nephropathy were randomly divided into diabetes control group (DC group), diabetes treated by low dosage silymarin group ( DT-L group) and diabetes treated by high dosage silymarin group ( DT-H group) with 14 cases in each. The dosage of silymarin in DT-L group and DT-H group was 60 mg·kg-1 ·d-1 and 120mg·kg-1 ·d-1 , respectively, and the treatment course was 60 days. The other 15 rats were divided into the normal control group ( NC group) with equal volume buffer solution. The glycosylated hemoglobin, urine volume, serum creatine, serum uric acid, and urine albumin levels were analyzed by the semi-automat-ic biochemial analyzer. Results:At the end of the study, the DC group had significantly higher levels of blood glucose, glycosylated hemoglobin, urine volume, serum uric acid and urine albumin than the NC group (P<0. 05), while the two silymarin-treated groups showed significantly lower levels of the indices than the DC group (P<0. 05). Conclusion:The results show that silymarin has pro-tective effect on kidneys of rats with type 2 diabetes mellitus, which lay foundation for the future clinical application.