AIM: To explore the serum levels of visfatin (VF) and tumor necrosis factor-alpha (TNF-α) in the patients with pre-eclampsia (PE) and their correlation with insulin resistance (IR).METHODS: The severe PE pa-tients (n =30), mild PE patients (n =30) and normal pregnant women (n =40) were selected according to the classifica-tion standard of PE.The serum levels of VF and TNF-αwere measured by ELISA.Fasting plasma glucose (FPG) and fasting insulin (FIns) were detected by glucose oxidase method and radioimmunoassay, respectively.Triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol ( HDL-C) and low-density lipoprotein cholesterol ( LDL-C) were measured by an automatic biochemical analyzer.According to calculating the mean arterial pressure (MAP), body mass index (BMI) and homeostatic model assessment for insulin resistance index (HOMA-IR), the correlation between IR and the levels of serum VF as well as TNF-αwere analyzed.RESULTS: The levels of VF and TNF-αin severe PE group and mild PE group were significantly lower than those in normal pregnancy group (P <0.05).In addition, the levels of VF and TNF-αin severe PE group were lower than those in mild PE group (P <0.05).Linear correlation analysis showed that serum VF was positively correlated with TNF-αand HDL-C (P <0.05), and negatively with MAP and FIns (P <0.05). The serum TNF-αwas positively correlated with HDL-C (P <0.05), and negatively with BMI, TG, MAP and FIns (P <0.05).Multiple stepwise regression analysis showed that FBG, FIns and HOMA-IR were relative independent factors of se-
rum VF and TNF-α(P <0.05).CONCLUSION: Serum levels of VF and TNF-αare closely related to IR.

Objective To study the reasons of seroma formation and long-term existence after modified radi-cal mastectomy ( MRM) .Methods The structure of fibrous lamina for seroma postoperative breast cancer was ana-lyzed by pathological methods;the composition of drainage fluids after MRM in the different postoperative time peri-ods was determined;and the structure of fibrous lamina following an experimental mastectomy model created in rats was investigated,which the process of fibrous lamina formation was imitated.Results There were three layer struc-tures in fibrous lamina,including fibrous leakage,capillaries and fiber lay.Hematology test results supported seroma for exudate.Animal model showed that with the extension of time,fibrous lamina thickened gradually.Conclusion It is capillaries in fibrous lamina that seroma long-standing histological basis.Maybe excising or destructing the structure of subcutaneous fibrous lamina,making the procedure of wound healing to begin again as soon as possible,which is a kind of effective method to solve the problem of seroma long-term existence after MRM.

Objective To investigate the value of evaluation of pelvic floor ultrasound in the transvaginal modified patch repair and sacrospinous ligament fixation in uterine prolapse patients. Methods Thirty-two patients with uterine prolapse were included in the retrospective study from March 2016 to January 2017 in Hangzhou maternity and child health care hospital. All patients were detected by pelvic floor ultrasound before operation and cured by vaginal patch bilateral sacral spine ligament fixation treatment after. Of them, 8 cases were complicated with cystocele and 3 cases with anorectal prolapse, and all the complications were treated at the same time. The observations of the change of position, shape and activity of the implant by transvaginal at rest, on maxium Valsalva and contraction, and the transperineal pelvic ultrasound were performed to evaluate the change of pelvic floor function and compare the distance from the lowest point of the bladder, uterus and the rectal ampulla to reference line (the horizontal line at the lower margin of the pubic bone), area of levator hiatus and the thickness of the puborectalis muscle before and after operation. Results The patches were observed 2D and 3D postoperatively by pelvic ultrasound. The U-shaped hyperecho could be clearly shown around the cervix and activity of patches were clearly shown. The observation of 32 cases of patients with pelvic viscera situation by the transperineal 2D and 4D pelvic ultrasound: the distance from the lowest point of the bladder, uterus and the rectal ampulla to reference line and the thickness of the puborectalis muscle enlarged after operation (0.65±1.85 vs 0.15±1.85, 2.80±1.10 vs -1.00±1.50, 0.60±1.90 vs-0.55±1.55,0.51±0.24 vs 0.37±0.19)onmaxium valsalva,the area of levator hiatus decreased after operation (20.15±7.20 vs 29.00±9.50).The differences were both statistically significant (all P < 0.05). Uterine prolapse were not found after operation. In the 8 cases with cystocele, 5 cases were cured and 3 cases were improved. And all the 3 cases of patients with anorectal prolapse were all cured. Conclusion Combined application of transvaginal and transperineal pelvic ultrasound can clearly show the suspension of the patch after the treatment of modified patch repair and Sacrospinous ligament fixation, which provide valuable imaging information in the evaluation of preoperative pelvic functionand postoperative therapeutic effect.

Objective:To investigate the types of non-tumor diseases in patients with cancer, and to explore the effects of those dis-eases on the diagnosis and treatment of cancer patients. Methods:We collected the medical records of cancer patients from January 2013 to December 2017 in Peking University Cancer Hospital, and screened for non-tumor diseases. The clinical records of the patients in this group were analyzed retrospectively, and the effects of those diseases on the diagnosis and treatment of tumors were dis-cussed. Results:Of the 1,323 cases of inter-hospital consultation, 1,153 cases of non-tumor disease (87.2％) were selected. There were 773 men (67.0％) and 380 women (33.0％) included. The median age was 62 (14-90) years. The primary tumor types included lung can-cer, gastric cancer, lymphoma, colorectal cancer, esophageal cancer, breast cancer, malignant melanoma, liver cancer, cholangiocarci-noma/gallbladder cancer, pancreatic cancer, and other tumors. Non-neoplastic diseases included cardiovascular disease in 356 cases (30.9％), respiratory system disease (17.0％) in 196 cases, digestive system disease in 107 cases (9.3％), skin and venereal diseases in 81 cases (7.0％), nervous system lesions (6.4％) in 74 cases, urinary system disease in 72 cases (6.2％), blood disease in 70 cases (6.1％), en-docrine and metabolic diseases in 47 cases (4.1％), autoimmune disease in 23 cases (2.0％), and other diseases (11.0％) in 127 cases. Impact on tumor diagnosis and treatment was as follows:direct, 771 cases (66.9％);no influence, 313 cases (27.1％);and uncertain, 69 cases (6.0％). Conclusions:Cardiovascular disease is a major non-tumor disease associated with cancer. Non-neoplastic diseases are important factors affecting the diagnosis and treatment plans of cancer.