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Objective:To investigate the diagnostic value of serum GP73 combined with Dickkopf-1 and AFP in hepatocellular carcinoma.Methods:117 cases of hepatocellular carcinoma in our hospital were collected as hepatocellular carcinoma group,80 patients with hepatitis B virus as the hepatitis group,and randomly selected 80 healthy subjects as the control group from September 2014 to September 2016.The serums GP73,Dickkopf-1,AFP level of every group were detected by the enzyme-linked immunosorbent assay (ELISA),and the relationship between the GP73,Dickkopf-1,AFP between clinicopathological features were analyzed,the diagnostic value of GP73,Dickkopf-1 and AFP in hepatocellular carcinoma were analyzed.Results:The serums GP73,Dickkopf-1,AFP level of hepatocellular carcinoma group were higher than those of hepatitis group,control group,and the serum AFP level of hepatitis group was higher than that of control group,the difference was statistically significant (P＜0.05).The GP73,Dickkopf-1,AFP in patients with classification B～C were higher than those in classification A among the Child Pugh classification,the difference was statistically significant (P＜0.05).No statistical significance on difference of GP73,Dickkopf-1,AFP between different differentiation,tumor size,number of tumors was found (P＞0.05).The sensitivity,specificity,positice predictive value,negative predictive value,and accuracy of GP73+Dickkopf-1+AFP in the diagnosis of hepatocellular carcinoma were higher than those of GP73,Dickkopf-1,AFP respectively,the difference was statistically significant (P＜0.05).Conclusion:Serums GP73,Dickkopf-1,AFP in patients with hepatocellular carcinoma have high expression levels,combined with the three indicators can obviously improve the diagnostic value of hepatocellular carcinoma,which has clinically important reference value.

Objective To observe the changes of red blood cell distribution width, mean platelet volume and cardiac troponin I in patients with Acute Coronary Syndromes, and to evaluate the value for early diagnosis by using ROC curve. Methods 191 patients with ACS and 206 patients with the chest pain syndromes non-ACS were selected in this study. Electrocardiogram,blood routine,creatinine, LDL-C and cardiac troponin I were determined within six hours after hospitalized,meanwhile the feature of ROC curves was observed. Results There was no significant difference between ACS group and non-ACS group about red blood cell, hemoglobin, platelet,creatinine and LDL-C［(3.82±0.57)×1012/L,(101.3±3.3)g/L,195（98.6-334.8）×109/L,69（45-120）μmol/L,(2.95±0.85)mg/dl vs (3.89±0.50）×1012/L,(103.5±3.7)g/L,201（135.2-346.9）×109/L,71（49-100）μmol/L,(2.82±0.75)mg/dL］ (P＞ 0. 05). Red blood cell distribution width, mean platelet volume and the cardiac troponin I in ACS group［13.70(12.00-15.20)%,9.4（7.42-12.31）fL,(5.63±1.39)μg/L］ were significantly higher than that of non-ACS group［12.60（11.20-13.83）%,8.2（6.24-10.97）fL,(0.04.±0.01)μg/L］ (P＜0.01) .The area under ROC curves of red blood cell distribution width,mean platelet volume and cardiac troponin I were 73.5%, 78.8%, 98.1% respectively, while the best cut-off value was 13.15%, 12.45 fL, 0.06 μg/L respectively. Conclusions The combination using of red blood cell distribution width andmean platelet volume and cardiac troponin I and other conventional cardiac markers might be served as early diagnosis marker for the ACS patients admitted to emergency departments.

Objective To evaluate the effect of infiltration anesthesia at Calot's triangle on postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.Methods One hundred and forty patients,aged 18-64 yr,with 18 kg/m2 ≤ body mass index ≤ 31 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,were randomly divided into 2 groups (n =70 each):control group (group A) and infiltration anesthesia at Calot's triangle group (group B).In group B,1％ ropivacaine 10 ml was injected into Calot's triangle before dissection of the gallbladder,while the equal volume of normal saline was injected into Calot's triangle in group A.The patients in both groups received patient-controlled intravenous analgesia (PCIA) for 48 h starting from 10 min before the end of surgery.The VAS score was maintained below 4 during PCIA.When VAS score ≥ 4,lasting for more than 30 min,tramadol 1.5 mg/kg was injected intravenously.The consumption of physic liquor for PCIA,and requirement for tramadol were recorded.The incidence of puncture-related damage to Calot's triangle and local anesthetic intoxication and adverse effects such as nausea and vomiting within 48 h after surgery were also recorded.The first postoperative flatus time was recorded.Results Compared with group A,the consumption of physic liquor for PCIA,requirement for tramadol,and consumption of tramadol were significantly reduced,and no significant change was found in the incidence of nausea and vomiting and the first postoperative flatus time in group B.No puncture-related damage to Calot's triangle occurred in A and B groups.There was no local anesthetic intoxication in group B.Conclusion Infiltration anesthesia at Calot's triangle can optimize postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.

Objective To discover the role of interleukin-18(IL-18) and CD_(54) in congestive heart failure(CHF),and evaluate the diagnostic value of IL-18 and CD_(54) in CHF.Methods Blood samples were collected from 52 children with CHF,included 18 cases in classⅡ,17 cases in class Ⅲand 17 cases in class Ⅳ.Fifteen healthy children were normal control group.The levels of IL-18 was(detec-)ted by ELISA method and the expression of CD_(54) was examined by flow cytometry.Results The levels of IL-18 and CD_(54) in CHF were significantly higher than those of control subjects(P0.05),but the levels were respectively significantly higher than that of control subjects(P

Objective To assess the application value of NCE-MRA using iMSDE prepared bSSFP sequence in lower limb in patients with diabetes. Methods This prospective study included a total of 35 patients with type II diabetes who underwent CE-MRA on the 1.5T MR scanner after the NCE-MRA. The obtained MIP images were independently rated by two radiologist with a four score table and using CE-MRA as a reference standard to evaluate the diagnostic accuracy of NCE-MRA for the narrowed arteries. The difference of the percent age of diagnostic arterial segments between NCE-MRA and CE-MRA on diabetic patients was evaluated by the χ2 test. Results Compared with CE-MRA, the diagnostic-value arterial segment ratio of pelvic arteries on NCE-MRA is decreased significantly. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of two readers in NCE-MRA were 95%/87%, 96%/95%, 57%/72%, 99%/99%, and 96%/95%(k=0.76), respectively. Conclusions The NCE-MRA using iMSDE prepared bSSFP sequence is capable of depicting vascu-lar lesions for the lower extremities in diabetic patients with the advantages of contrast agent free, short scan times and good diagnostic value in the thigh and calves.

Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS) in the diagnosis of postnatal placenta increta. Methods Twenty-six patients with postnatal placenta increta were examined by gray-scale and color Doppler ultrasound and CEUS. Then microvascular perfusion and enhanced features of lesions, myometrium and serous layer were observed. Arriving time (AT), time to peak intensity (TTP) and the lasting time of enhancement (LTE) were recorded. AT,TTP and LTE of enhanced lesions were compared with those of normal myometrium. Results Serous layer, lesions and adjcent myometrium,normal myometrium enhanced in turn. There was no obvious boundary between the lesions enhanced and adjcent myometrium. AT and TTP of the lesions enhanced were both less than those of normal myometrium ( P ＜0. 05). LTE of the part of lesions enhanced was more than that of normal myometrium ( P ＜0.05).Part of lesions never enhanced during the whole process. The serous layer of uterine was smooth and uninterrupted in 24 patients. These 24 patients all recovered after conservative treatment. The local serous layer adjcent lesions was not smooth, but no contrast agent leakage occurred in another 2 patients, and uterine lobectomy were performed in emergency because of massive hemorrhage during conservative treatment. Conclusions Microvascular perfusion and enhanced features of lesions,myometrium and serous layer could be showed clearly through CEUS.

Objective To explore the association between the sortilin-related receptor,L (DLR class) A repeats containing (SORL1) gene single nucleotide polymorphisms (SNPs) and sporadic Alzheimer's disease (SAD) in Han Chinese populations.Methods Five candicate SNPs,including rs985421,rs12364988,rs4598682,rs3781834,and rs3781836,within the SORL1 gene were genotyped by LDR-PCR methods,and the association of these SNPs with SAD risk were also analyzed in a case-control study with 179 SAD and 106 healthy controls.Results The results indicated that the A allele frequency of the SORL1 SNP rs985421 was significant difference between SAD and healthy controls (Trend test:P =0.0044,P adj =0.022; Allelic:P=0.0023,P adj =0.012).In subjects without APOE s4 allele,higher frequency of the A allele of rs985421 was observed in SAD patients compared with control subjects by the stratified analysis (OR=2.260,95％ CI =1.269-4.024,P=0.0048).In addition,logistic regression analysis further revealed that the A allele of SORL1 SNP rs985421 was significantly associated with SAD risk (OR=1.968,95％ CI =1.273-3.042,P=0.002).However,no positive signals in other four SNPs within the SORL1 gene were observed (all P＞ 0.05).Conclusions The A allele of SORL1 SNP rs985421 may be an APOE ε4-independent factor associated with SAD risk.

Objective To evaluate the feasibility of Mycobacteria growth indicator tube ( MGIT ) liquid culture combined with rifampin resistance test real-time PCR ( Xpert MTB/RIF test) in the diagnosis of tuberculosis.Methods 652 cases of suspected pulmonary tuberculosis from October 2014 to March 2015 in Quzhou People′s Hospital were enrolled. The morning sputum samples were collected for acid-fast staining, L?wenstein-Jensen ( L-J) culture, BACTEC MGIT culture and Xpert MTB/RIF test.Samples with positive results of MGIT liquid culture were subjected to strain identification and drug sensitivity test with fluid method.Methodological comparison between four methods was made and the performance of MGIT liquid culture combined with Xpert MTB/RIF test in the rapid diagnosis and drug resistance detection in Mycobacterium tuberculosis was evaluated by chi-square test. Results Among the samples from 399 confirmed tuberculosis patients, the diagnostic sensitivity of the 4 methods ( acid-fast staining, L-J culture, MGIT culture and Xpert MTB/RIF test) were 17.0%(68/399), 23.8%(95/399), 37.8% (151/399) and 37.3%(149/399) respectively.The sensitivity and specificity of MGIT culture combined with Xpert MTB/RIF test was 39.8%(159/399) and 94.8%(240/253).The sensitivity of MGIT culture combined with Xpert MTB/RIF test was significantly higher than acid-fast staining (χ2 =50.9, P<0.01 ) and L-J culture (χ2 =23.7,P<0.01).The average detection time of MGIT culture was 7.5 days ( smear positive and Xpert MTB/RIF positive), 13.4 days (smear negative and Xpert MTB/RIF positive) and 16.9 days ( smear negative and Xpert MTB/RIF negative) .The sensitivity and specificity of Xpert MTB/RIF test in rifampin resistance detection were 9/9 and 97.3% ( 129/132 ) respectively.The average detection time of fluid method for drug sensitivity test was 8.3 days.Conclusions MGIT liquid culture combined with Xpert MTB/RIF test can detect Mycobacterium tuberculosis and the drug sensitivity rapidly.The method is highly sensitive and specific.It is important for clinical diagnosis and treatment of tuberculosis.