Hepatocellular carcinoma (HCC)is a disease with high incidence and mortality and has become a serious threat to human health. So far,none of the available markers can be used alone for early diagnosis of HCC.Recently identified serum markers with potential clinical value for early diagnosis of HCC are summarized,and their diagnostic sensitivity and specificity,as well as their applications in assessment of progression of the disease,are reviewed.It is suggested that alpha -fetoprotein should be used in combination with other serum markers to achieve accurate diagnosis of HCC at early stages.

Objective To study the influence of laparoscopic radiofrequency ablation combined with intravenous chemotherapy on hepatoma cell growth mediated by PTEN and Wnt pathway. Methods 90 cases of hepatocellular carcinoma patients from May 2013 to June 2016 were chosen as study subjects, all patients were divided into observation group (n = 45), control group (n = 45) randomly. Patients in observation group received laparoscopic radiofrequency ablation combined with intravenous chemotherapy, while those in control group received intravenous chemotherapy only. One week after treatment, two groups patients' liver lesion tissue PTEN signaling pathway, Wnt signaling pathway related gene mRNA expression were detected by RT-PCR method; serum contents of tumor markers were tested by Radioimmunoassay. Results One week after treatment, liver lesion tissue PTENmRNA expression was higher in observation group than that in control group, HIF-1, VEGF mRNA expression were lower in observation group than those in control group, the difference was statistically significant (P < 0.05); liver lesion tissue Wnt pathway related genes mRNA expression such as β-catenin, CyclinD1, c-myc, MMP-7 were lower in observation group than those in control group, the difference was statistically significant (P < 0.05); serum contents of tumor markers such as AFP, GGT-Ⅱ, IGF-2, CA19-9 were lower in observation group than those in control group, the difference was statistically significant (P < 0.05). Conclusion Laparoscopic radiofrequency ablation combined with intravenous chemotherapy can inhibit the growth of HCC cells through the PTEN and Wnt pathway, which has positive clinical significance.

Objective To explore the mechanism of the reversibility of chronic cyclosporine (CsA) nephrotoxicity in rats after long-term drug withdrawal. Methods Chronic CsA nephrotoxicity was induced in Sprague-Dawley rats by administering CsA(15 mg . kg-1. d-1) for 5 weeks,and then the effect of drug withdraw for 5 and 10 weeks was observed. Body weight,systolic blood pressure,and renal function were monitored. In addition,renal histopathology(arteriolopathy,ED-1-positive cells,and tubulointerstitial fibrosis) and expression of osteopontin(OPN) and transforming growth factor(TGF) -?1 mRNA was examined. Results Compared with the control rats,CsA-treated rats showed loss of body weight,deterioration in renal function and development of typical histopathology. All of these above parameters were significantly reversed,meanwhile,the upregulation of OPN and TGF-?1 mRNA expression decreased significantly at 5th and 10th week after CsA withdrawal. Of note,the decreased OPN and TGF-?1 mRNA expression was positively correlated with the reduction in the tubulointerstitial fibrosis score. Conclusion The established chronic CsA nephrotoxicity is reversible after long-term CsA discontinuation,and the mechanism may be associated with the down-regulation of OPN and TGF-?1 mRNA expression.

Objective: To study the protective effect of vitamin E in preventing contrast-induced nephropathy (CIN) in patient with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).
Methods: We prospectively studied 206 CAD patients with elective PCI in our hospital and divided them in 2 groups: Treatment group, the patients received oral vitamin E combining vinous hydration,n=102 and Control group, the patients received vinous hydration only,n=104. CIN was deifned by at 48h after contrast media injection, serum cretinin increased up to 25% from the baseline, or reached 44.2 μmol/L. Excluding the other kidney injury factors, the renal functions at 48 h before and after PCI were compared, the occurrence rate of CIN were also compared between 2 groups.
Results:①Overall, there were 19/206 (9.22%) patients suffered from CIN, the occurrence rate in Treatment group (4.90%) was lower than Control group (13.46%), χ2=4.506,P=0.034. For patients with hypertension, diabetes, chronic kidney disease, anemia and mehran risk score<10, the occurrence rate of CIN in Treatment group was lower than Control group,P<0.05.②Compared with pre-operative condition, at 48 h post-operation,Control group showed increased serum creatinine (Scr), blood urea nitrogen (Bun) and decreased creatinine clearance rate (Ccr), allP<0.05.③At 48 h post-operation, compared with Control group, Treatment group presented decreased Scr (86.72 ± 17.73) μmol/L vs (95.13 ± 21.67) μmol/L and increased Ccr (96.75 ± 27.23) ml/min vs (90.70 ± 17.85) ml/min, allP<0.05.④Multivariate regression analysis revealed that elder than 75 years of age (OR=7.278, 95% CI 5.158-11.480), diabetes (OR=3.919, 95% CI 1.330-8.200), chronic kidney disease (OR=6.325, 95% CI 2.137-16.816) and mehran risk score>10 (OR= 4.461, 95% CI 1.589-14.724) were the independent risk factors for CIN occurrence, allP<0.05.
Conclusion: Short-term application of vitamin E may reduce the risk of CIN occurrence at certain degree in CAD patients after PCI.

Objective To explore the effect of psychological intervention on the mental conditions and the quality of life of patients with radiation encephalopathy(REP).Methods thirty-five patients with REP from radiotherapy for nasopharyngeal carcinoma were divided into the control group(n=17)and the experiment group(n=18)according to their registration sequence. The control group was managed with conventional nursing,and the experiment group with individualized psychological intervention in addition to routine nursing for 12 weeks.The two groups were compared in terms of depression and quality of life by Hamilton Depression rating Scale(HAMD)and The short-form health survey questionnaire(SF-36).Results The two groups before treatment showed no statistical difference in scores by HAMD and SF-36(P>0.05).The experiment group was superior to the control group after intervention in depression and quality of life(P<0.01).Conclusion Psychological intervention may alleviate REP in the patients at poor psychological status and improve their quality of life.

The free radical scavenging effect of flaxseed was screened by HPLC-DPPH ( 2 , 2-diphenyl-1-picrylhydrazyl-high performance liquid chromatography assay ) and colorimetric DPPH methods. To test the effectiveness of the approach, three Lignans ( secoisolariciresinol diglucoside ( SDG ) , secoisolariciresinol ( SECO) and enterodiol( ED) ) with antioxidative properties were investigated both in monomer and mixture. HPLC conditions were optimized using following methods: Waters XBridge C18 was used as stationary phase, acetonil/H2 O was used as mobile phase and detective wavelength was set at 280 nm. Antioxidant activity of standards was investigated by reaction with or without DPPH radical for 20 min as sample and control, respectively. Both of them were analyzed by high performance liquid chromatography. According to the changes of amount of sample and control, the antioxidant activities of standards were calculated as following order:SDG>SECO>ED. Based on above DPPH-HPLC assay and UPLC-Q-TOF-MS, antioxidants extracted from flaxseed were separated, identified and screened. The radical scavenging activities were in the following order:SDG isomer (5)>SDG (4)>7α-[(β-D-glupyranosyl) oxy]-1-methoxyisolariciresinol (1)>(6R,7R, 8S)-1-methoxyisolariciresinol (2)>herbacetindiglucoside (3). It indicated that the HPLC-DPPH assay could be successfully used for the antioxidant activity screening of complex flaxseed extract.

Objective To observe the change of serum smooth muscle myosin heavy chain (smMHC) level in the patients with aortic dissection (AD),and evaluate the effect of smMHC in the early diagnosis and prognosis of AD.Methods Forty-two patients with AD were selected as AD group,30 healthy subjects were selected as control group.Blood samples were collected at four time periods (within 3 h of onset,6 h,12 h,24 h),and serum smMHC level were measured by enzyme-linked immunosorbent assay.Results Serum smMHC level of AD group,which collected (within 3 h of onset,6 h,12 h) were significantly higher than that of control group [(88.6 ±21.7),(59.4 ± 18.7),(41.3 ± 10.7) ng/L vs.(17.2 ± 8.3) ng/L,P ＜ 0.01].There was no significant difference between the serum smMHC level of AD group and control group at 24 h after onset [(18.9 ±9.5) ng/L vs.(17.2 ±8.3) ng/L,P ＞ 0.05].Serum smMHC level of Stanford A type group (25 cases) was higher than that of Stanford B type group (17 cases) within 3 h of onset [(95.4 ± 17.8) ng/L vs.(78.5 ± 18.3) ng/L,P＜0.01],and there was no significant difference bewteen the two groups which collected at 6,12 h and 24 h after onset (P ＞ 0.05).Preoperative serum smMHC level was significantly higher than that after intracavitary isolation operation [(58.6 ± 15.9) ng/L vs.(30.1 ± 12.5) ng/L,P ＜ 0.01].Serum smMHC level decreased rapidly after the operation,and there was no significant difference between the two grougs when 12 h after operation [(18.7 ± 8.9) ng/L vs.(17.2 ± 8.3) ng/L,P ＞ 0.05].The serum smMHC level of the deaths (7 cases),which collected within 3 h of onset,6 h,12 h,was significantly higher than that of the survivors (35 cases) [(101.2 ± 20.7) ng/L vs.(86.1 ± 18.9) ng/L,(65.2 ± 16.7) ng/L vs.(58.2 ± 14.2) ng/L,(50.4 ± 10.8) ng/L vs.(39.5 ± 8.3) ng/L,P ＜ 0.05],and there was no significant difference at 24 h after onset (P ＞ 0.05).Detecting serum smMHC level within 3 h of onset,the area under the receiver operating characteristic curve was 0.913,with 51.7 ng/L as a diagnostic critical value,sensitivity and specificity respectively was 88.1％ (37/42) and 96.7％ (29/30).When detecting at 6 h after onset,the area under the curve was 0.865,with 38.5 ng/L as a diagnostic critical value,sensitivity and specificity respectively was 90.4％(38/42) and 90.0％ (27/30).Conclusions The level of serum smMHC in patients with AD increase rapidly after onset,and detecting serum smMHC level within 6 h of onset have important clinical significance in early diagnosis and prognosis of AD.

OBJECTIVE To explore clinical results of fat liquefaction of incision wound following cesarean section for obese pregnant women.METHODS Totally 300 obese pregnant women with cesarean section were randomly divided into three groups: group A,iodine(PVP-Ⅰ) group(using PVP-Ⅰ(0.5%) after suturing the abdominal rectus sheath);group B(normal saline group);group C(control group without any liquid).All patients were preoperatively used antibiotics to control the infection.The rate of puerperal morbidity,white cell count and wound infection were observed.RESULTS All parameters of group A were lower than group B or C.There were significant differences among three groups(P

ObjectiveTo evaluate the value of modified early warning score (MEWS) in predicting mortality of critically ill patients admitted to emergency department.Methods A prospective cohort study was conducted. Clinical data of emergency patients admitted to resuscitation room of Peking Union Medical College Hospital from Feburary 13rd, 2014 to April 20th, 2014 were collected, and their MEWS were calculated based on medical records and their clinical outcomes was followed. Incidence of primary outcome (3-day mortality) and secondary outcome [all deaths and composite outcome of intensive care unit (ICU) transfer, cardio-pulmonary resuscitation, and death] were compared between MEWS positive (MEWS≥5) or negative (MEWS 0-4) patients, and multi-regression logistic analysis was done to look for the impact factors of primary outcome in these patients.Results 176 patients, among them 98 (55.68%) were male, were enrolled in the study. Their mean age was (56.86±21.46) years old. Mean MEWS was 4.30±2.74. There was 74 cases in MEWS positive group, and 102 in negative group. Primary endpoint occurred in 41 patients, and the 3-days mortality in MEWS positive group was significantly higher than that in MEWS negative group [37.84 (28/74) vs. 12.74% (13/102), odds ratio (OR) = 4.167, 95% confidence interval (95%CI) = 1.973-8.804,P< 0.001]. At the meantime, incidence of all death [54.05% (40/74) vs. 17.65% (18/102),OR = 5.490, 95%CI = 2.770-10.883,P< 0.001] and the incidence of ICU transfer, cardio-pulmonary resuscitation and death [64.86% (48/74) vs. 25.49% (26/102),OR = 5.396, 95%CI = 2.809-10.366,P< 0.001] were also significantly higher in MEWS positive group as compared with negative group. Multi-regression logistic showed abnormal mental status (OR = 3.606, 95%CI = 1.541-8.436,P = 0.003) but not MEWS≥5 (OR = 1.672, 95%CI = 0.622-4.494,P = 0.308)was the predictor of 3-day mortality in emergency admitted critically ill patients.Conclusions Although the incidence of severe adverse events is significantly increased in patients with MEWS≥5 compared with those with MEWS 0-4, MEWS≥5 cannot be an efficient predictor for 3-day mortality. Abnormal mental status shows some predictive value for early mortality in critically ill patients seen in emergency department.

Objective To evaluate the effect of remffentanil postconditioning on myocardial ischemiareperfusion (I/R) injury in patients undergoing open heart surgery under CPB.Methods Thirty patients (ASA grade Ⅱ or Ⅲ, NYHA class Ⅰ or Ⅱ ) of both sexes aged 18-45 yr undergoing repair: of ventricular septal defect and/or atrial septal defect under CPB were randomly divided into 2 groups ( n = 15 each): control group (group C)and remifentanil postconditioning group (group R). Anesthesia was induced with midazolam, sufcntanil, propofol and rocuronium. The patients received 5 min infusion of remifentanil at 4 μg · kg- 1 · min - 1 8 min before aortic unclamping in group R, while the patients received equal volume of normal saline in group C. Blood samples were obtained from the right internal jugular vein for determination of plasma concentrations of cardiac troponin-I (cTnI)and MDA and activities of CK-MB and SOD before induction of anesthesia (baseline) and at4, 8, 24 and48 h after aortic unclamping. Results The plasma concentrations of cTnI and MDA and activity of CK-MB were significantly lower, while the plasma SOD activity was significantly higher at 4 and 8 h after aortic unclmping, and the plasma concentration of MDA was significantly lower at 24 h after aortic unclamping in group R than in group C ( P ＜ 0.05 ). Conclusion Remifentanil postconditioning can attenuate myocardial I/R injury in patients undergoing open heart surgery under CPB through inhibiting lipid peroxidation.