Objective To explore the best cut-off value of serum human epididymis protein 4(HE4)in the diagnosis of ovarian cancer,and analyze the clinical significance of combined detection of HE4,carbohydrate antigen 125 (CA125)and D-dimer for early screening and diagnosis of ovarian cancer.Methods A total of 49 patients with ovarian cancer,63 patients with benign tumor and 47 healthy women were collected.The content of CA125,HE4 and D-dimer were detected by chemical luminescence immunoassay and turbidimetric inhibition immunoassay,respectively.Results The new cut-off value of HE4 was 54.31 pmol/L.The serum levels of HE4,CA125 and D-dimer in the ovarian cancer group were all significant higher than those in the ovarian benign tumor group and the healthy group(P＜0.05).No significant difference between the healthy group and benign disease group was found in CA125 and D-dimer content(P=0.293,0.359),while a significant difference in HE4 level(P＜0.01).The sensitivity and specificity of combined detection of the HE4+CA125 increased to 91.8％,85.4％,which was higher than that of the diagnosis detection of the three indicators respectively.The sensitivity and specificity of combined detection of the HE4 +CA125 +D-dimer were 95.0％,76.5％,which was higher than the combined detection of the HE4+CA125.Conclusion The combined detection of CA125+HE4+D-dimer could improve the sensitivity for early diagnosis and screening of ovarian cancer.

Objective To evaluate the effectiveness and prospect of innovative interactive follow-up mode for rehabilitation ofpostopera-tive breast cancer patietns in new medical environment. Methods The novel patient-centered medical care was promoted,and Pink Ribbon Clubs was established in different regions. Meanwhile,the patients’ self-support groups were formed, and a specialist for out-patients follow-up of outpatients by telephone or on the internet was arranged to provide psychological assessment,with timely and effective response. All data concerning to the follow-up were recorded and the patients were required to complete the relevant questionnaires. Results Compared with the same period in 2013,the follow-up rate was significantly increased to 80. 25%,and the patients showed higher satisfaction. The incidence of lymphedema in the patients was significantly reduced from 13% in 2013 to 7%. The quality of life was significantly improved and self-rat-ing score on depression was decreased from (51. 90 ± 8. 55) to (35. 81 ± 6. 21). Conclusion The kind of“Trinity” interactive mode is an effective follow-up mode with the clinical benefit in patients’ rehabilitation of physical and mental health,which is worthy of further applica-tion.

ObjectiveTo study the correlation between the etiology and clinical features of erythroderma.MethodsThe clinical data on 182 patients with erythroderma were retrospectively collected and analyzed.ResultsThe male-to-female ratio was 2.8 ∶ 1 and the average age at onset was 58.6 ± 14.6 years.Of the 182 cases,135 (74.2％) were due to pre-existing dermatoses,14 (7.7％) to drug reaction,8 (4.4％) to malignancies,while 25(13.7％) had no obvious precipitating factors.The most frequent triggering factor was systemic consumption of drugs(52 patients,28.6％ ),and glucocorticosteroid was the most prevalent causative drug.Seventy-six patients were followed up,recurrence was observed in 14 patients but not in 58 patients,and 5 patients died,2 patients with idiopathic erythroderma were finally diagnosed with mycosis fungoides (MF)after multiple skin biopsies.ConclusionsPre-existing dermatoses are the most frequent cause of erythroderma.Idiopathic erythroderma is liable to relapse,possibly associated with malignancies,and should be closely followed up.

Reducing the level of emotional expression conflict of patients is of great significance to promote the functional recovery of breast cancer patients,improve their prognosis and improve their quality of life.We introduce the research progress of ambivalence over emotional expression in breast cancer patients in terms of the connotation,measurement tools,influencing factors,and intervention methods.There is still a lack of research on measuring the emotional expression conflict of breast cancer patients in China,and it is still necessary to develop a measurement tool with cultural characteristics to obtain the true level of emotional expression conflict of patients.In clinical practice,complementary and alternative medicine,cognitive behavioral intervention,mindfulness training,expressive writing intervention,and other intervention strategies have achieved certain results in improving patients'negative emotions,but personalized intervention strategies still need further exploration.

Objective To observe the effect of Qixian Tongluo Formula on contralateral corticospinal tract(CST)remodeling and motor functional recovery in rats with cerebral infarction,and to explore its potential molecular mechanism from the perspective of regulating factors related to never remodeling.Methods The rat middle cerebral artery occlusion(MCAO)model was established by silk thread ligation.Fifty model rats were randomly divided into model group,citicoline group(0.054 g·kg-1),Qixian Tongluo Formula low-,medium-and high-dose(7.83,15.66,31.32 g·kg-1)groups,and sham operation group,with 10 rats in each group.The intervention administration was started on the 3rd day after operation once a day for 26 consecutive days.On the 3rd,14th and 28th day after operation,the gross motor function was evaluated by Longa score,and the fine motor function was evaluated by beam-walking test(BWT)score.The contralateral motor cortex was injected with the nerve tracer biotin dextran amine(BDA)on the 14 th day after operation to anterogradely trace the CST.On the 28th day after operation,the expression of axonal growth associated protein-43(GAP-43)and BDA positive fibers in the contralateral motor cortex and cervical spinal cord were detected by immunohistochemistry.The co-localization areas of BDA positive fibers and presynaptic marker protein vesicular glutamate transporter 1(VGLUT1)in the cervical spinal cord gray matter were detected by immunofluorescence.The expressions of brain-derived neurotrophic factor(BDNF),glial cell-derived neurotrophic factor(GDNF),nerve growth factor(NGF)and nerve remodeling-associated inhibitory factor[Nogo-A,oligodendrocyte myelin glycoprotein(OMgp)and myelin-associated glycoprotein(MAG)]in the contralateral motor cortex were detected by Western Blot.Pearson correlation analysis was used to analyze the correlation between Longa score or BWT score and BDA/VGLUT1 co-localization area,respectively.Results Compared with the sham operation group,rats in the model group had obvious symptoms of motor function deficits,and the Longa scores were significantly increased(P＜0.01)and the BWT scores were significantly decreased(P＜0.05,P＜0.01)at each time point.The expression of GAP-43 in the contralateral motor cortex and cervical spinal cord was up-regulated(P＜0.05),the number of edge-crossing fibers from the posterior funiculus in cervical cord was increased(P＜0.05),the co-localization area of BDA/VGLUT1 in the gray matter of the cervical spinal cord was increased(P＜0.05),the expressions of BDNF,GDNF and NGF in the contralateral motor cortex were up-regulated(P＜0.05),while the expressions of Nogo-A,OMgp and MAG were down-regulated(P＜0.05).Compared with the model group,the Longa scores in each administration group on the 14th and 28th day after MCAO operation were significantly decreased(P＜0.01),the BWT scores were significantly increased(P＜0.01),the expression of GAP-43 in the contralateral motor cortex and cervical spinal cord was significantly up-regulated(P＜0.01).The number of edge-crossing fibers from the posterior funiculus in cervical cord was significantly increased(P＜0.01),the co-localization area of BDA/VGLUT1 in the gray matter of the cervical spinal cord was significantly increased(P＜0.01).The expressions of BDNF,GDNF and NGF in the contralateral motor cortex were significantly up-regulated(P＜0.01,P＜0.05),while the expressions of Nogo-A,OMgp and MAG were significantly down-regulated(P＜0.05),and the most significant effect was observed in the high dose group.The Longa score was negatively correlated with the co-localization area of BDA/VGLUT1(r=-0.89,P＜0.01),and the BWT score was positively correlated with the co-localization area of BDA/VGLUT1(r=0.84,P＜0.01).Conclusion Qixian Tongluo Formula can improve motor function through promoting contralateral CST remodeling in MCAO rats after cerebral infarction,and the molecular mechanism may be related to the regulation of the expression of nerve remodeling-associated factor in the contralateral motor cortex.