Objective To explore the clinical value and the correlation of parathyroid hormone and osteocalcin in hemodialysis patients.Methods According to the dialysis duration of hemodialysis patients,they are divided into the four groups,Ⅰ (dialysis time ＜2 years),Ⅱ (dialysis time 2-5 years),Ⅲ(dialysis time ＞5-10 years),Ⅳ (dialysis time ＞ 10 years),50 cases were randomly selected from each group,50 cases of healthy people were taken as a control group,to detect the contents of PTH and N-MID in serum and analyze the results.Results The content of PTH in hemodialysis patients of Ⅰ,Ⅱ,Ⅲ,Ⅳ group were (170.9 ± 45.9) ng/L,(405.4 ± 65.3) ng/L,(717.1 ± 199.6) rng/L,(1 555.6 ± 417.8) ng/L,the content of N-MID were (79.23 ± 31.62) μg/L,(140.22 ± 50.98) μg/L,(496.11 ± 159.49)μg/L,(617.9 ± 386.18)μg/L,the content of PTH and N-MID in control group were (6.85 ± 3.74) ng/L,(16.6 ± 8.57) μg/L,PTH and N-MID levels of the four hemodialysis patients groups were significantly higher than those of normal control group,the differences had statistically significance(PTH levels of the four groups compared with the control group:group Ⅰ compared with the control group,t =25.199,P ＜0.01 ;group Ⅱ compared with the control group,t =43.091,P ＜0.01 ;group Ⅲ compared with the control group,t =25.402,P ＜0.01 ;group Ⅳ compared with the control group,t =26.211,P ＜0.01 ;N-MID levels of the four groups compared with the control group:group Ⅰ compared with the control group,t =13.518,P ＜ 0.01 ; group Ⅱ compared with the control group,t =16.909,P ＜ 0.01 ; group Ⅲ compared with the control group,t =21.229,P ＜ 0.01 ; group Ⅳ compared with the control group,t =11.007,P ＜ 0.01),the content of PTH and N-MID in Ⅰ,Ⅱ,Ⅲ,Ⅳ groups had statistically significance (four groups of PTH levels compare to each other:group Ⅰ compared with group Ⅱ,t =20.774,P ＜0.01 ;group Ⅰ compared with group Ⅲ,t =18.858,P＜0.01;group Ⅰ compared with group Ⅳ,t =23.295,P＜0.01;groupⅡ compared with group Ⅲ,t =10.495,P ＜ 0.01 ; group Ⅱ compared with group Ⅳ,t =19.233,P ＜ 0.01 ; group Ⅲ compared with group Ⅳ,t =12.805,P ＜ 0.01 ; Four groups of N-MID levels compare to each other:group Ⅰ compared with groupⅡ,t=7.189,P ＜0.01;group Ⅰ compared with group Ⅲ,t =18.130,P ＜0.01 ;group Ⅰ compared with group Ⅳ,t =9.830,P ＜ 0.01 ;group Ⅱ compared with group Ⅲ,t =15.029,P ＜ 0.01 ;group Ⅱ compared with group Ⅳ,t =8.671,P ＜ 0.01 ; group Ⅲ compared with group Ⅳ,t =2.061,P ＜ 0.05).Conclusion PTH levels were positively correlated with N-MID content in hemodialysis patients,high PTH hemodialysis patients should prevent osteoporosis early and to take appropriate treatment.

Objective To explore the clinical value of combined detection of serum human epididymal secretory protein E4 (HF4) and CA125 in the diagnosis of endometrial carcinoma.Methods From Jan 2010 to Apr 2011,the serum specimens were collected from124 cases of endometrial carcinoma,97 cases of benign disease of uterus and 109 cases of healthy women.HE4 levels in the serum were detected by ELISA,and CA125 levels in the serum were detected by the electro- ehemiluminescent immunoassay.Those results were shown with median level.Accuracy of the diagnosis was evaluated by the area under the receiver operating characteristic curve ( ROC-AUC ).ResultsThe median levels of HE4 and CA125 were 78.09 pmol/L and 33.43 kU/L in serum of endometrial carcinoma group.The median levels of HE4 and CA125 were 46.37 pmol/L and 18.26 kU/L in serum of benign disease of uterus group.The median levels of HE4 and CA125 were 31.75 pmol/L and 12.64 kU/L in serum of healthy women group.The HE4 and CA125 levels in serum of endometrial carcinoma group were significantly higher than those of benign disease of uterus group or healthy women group ( all P ＜ 0.05 ).Compared with that benign disease of uterus group,the ROC-AUC of HE4 and CA125 in endometrial carcinoma group were 0.913 and 0.801,respectively.When the specificity was 95.0％,the sensitivities of HE4,CA125,and combined detection of HF4 and CA125 in endometrial carcinoma group were 41.1％,22.6％ and 46.0％,respectively.The positive rates of HE4 and CA125 were 31％ (27/86) and 12％ (10/86) in stage Ⅰ - Ⅱ of endometrial carcinoma,while the positive rates were 63％ (24/38) and 47％ (18/38) in stage Ⅲ -Ⅳ of endometrial carcinoma,in which there were significant difference between patients in stage Ⅲ - Ⅳ and stage Ⅰ - Ⅱ (P ＜ 0.01 ).ConclusionsThe combined detection of serum HE4 and CA125 is helpful to the diagnosis of endometrial carcinoma.The sensitivity,specificity and early diagnosis of HE4 are better than that of CA125.The positive rates of HF4 and CA125 in endometrial carcinoma are related to the clinical staging.

The serum specimens were collected from ovarian cancer (n =100),benign ovarian disease (n =69) and healthy women (n =95).The serum levels of HE4 and CA125 were detected.Risk of ovarian maliqnancy algorithm (ROMA) was calculated.Accuracy of prediction was evaluated by the area under receiver operating characteristic curve (ROC-AUC).And validity of prediction was evaluated by sensitivity and specificity.The results showed that the median level of ROMA algorithm was 83.0％,8.9％ and 8.7％ in ovarian cancer,benign ovarian disease and healthy women groups respectively.The difference were statistically significant (all P ＜ 0.01).Compared with benign ovarian disease group,the ROC-AUC of ROMA algorithm was 0.900 in ovarian cancer group.The sensitivity and specificity were 81.0％ and 92.8％ in ovarian cancer group respectively.Thus ROMA algorithm is a useful parameter in risk stratification for ovarian cancer.The diagnostic accuracy of ROMA algorithm is better than that of HE4 and CA125 in ovarian cancer.

10mm, the PLG lie in the neck of gallbladder.(3)PLG complicated with clinical symptoms.(4)The PLG diameter increases or complicated with stones.But surgical treatment should be prudent for non-neoplasm PLG, especially cholesterol polys.

Objective: To discuss the value of preserving ICBN during modified radical mastectomy for breast neoplasms. Methods: Sixty-three cases of breast carcinoma who underwent modified radical mastecto-my were studied. Of them, ICBN was completely preserved in 33 cases and was dissected in 30 cases. Sen-sory function of the medial upper arm of all patients was followed up after surgery. Results: No local recur-rence or metastasis was found among the 63 patients during the first, sixth, and twelveth month of follow-up period. Among the 33 cases with ICBN reserved, 29 cases (87.88%) had normal sensation of the skin in up-per medial arm and axilla, while 4 cases (12.12%) had paresthesia. Conclsion: Preserving ICBN can en-hance the quality of life of breast cancer patients after surgery.

Objective To study the relationship between the microvessel damage and the death rate of tumor cells and determine role of microvessel damage in the tumoricidal effect of hyperthermia.Methods H22 hepatoma cells were inoculated in the right hind legs of KM mice with immunosuppression.Local hyperthermia was administered to these mice which were divided randomly into 10 groups (8 in each group),which included groups of 3,6,12,24,48,72 and 96 h after hyperthermia for 30 min and groups of hyperthermia for 15,30 and 45 min.The tumor tissues were analyzed by flow cytometry(FCM)and immunohistochemistry.The cultured H22 cells were also given hyperthermia for 15,30,45 min and analyzed by FCM.Results The apoptotic rate(0.115±0.008)was higher in the initiation phase of hyperthermia in vitro,then the necrotic rates rose gradually.The difference between in vivo and in vitro was significant in hyperthermia of the same time about death rate(P＜0.05).A strong positive linear correlation(r=0.844)was observed between the death rate of tumor cells and MVD.Conclusion Microvessel damage plays the cardinal role in tumoricidal effect of hyperthermia.

Clinical teaching mode based on the theory of empowerment is a combination of the theory of em -powerment and clinical teaching activities .It emphasizes a student -centered philosophy .By empowering students in clinical teaching , the teachers can continuously stimulate the students 'initiative and thereby give full play to the students'potential.Starting from a discussion on of cases in clinical teaching , this thesis builds an effective student -leading mode of clinical teaching based on the theory of empowerment , tries to construct a clinical teaching theoretical system based on the theory of empowerment and explores strategies for practice , in order to improve clinical teaching effectiveness and promote reform in clinical teaching education .

Objective To investigate the clinical effect of coagulation therapy in patients with gastric ulcer bleeding.Methods From January 2013 to January 2016 in Xiaoshan First People's hospital 150 cases of gastric ulcer patients with bleeding,using SPSS16.0 software to generate randomly divided into hemocoagulase group(basic treatment + hemocoagulase injection therapy)and control group(basic treatment)of the 75 cases,compared two groups of hemostatic time,hemostatic effect.Results After 72h treatment,the average hemostasis time of hemocoagulase group were significantly lower than the control group(P<0.05),the blood coagulation enzyme in patients with serum VEGF,EGF levels higher than the control group(P<0.05),gastrin and somatostatin levels lower than the control group(P<0.05),hemocoagulase group cure rate is 64％,effective in 22.67％,effective 9.33％,invalid 4％,the control group were 46.67％,25.33％,18.67％,9.33％,two groups compare difference was statistically significant(P<0.05).Conclusion Treatment of gastric ulcer bleeding patients with coagulation enzyme can shorten the hemostatic time,improve the clinical effect of hemostasis.

Objective To observe the protective effect of α-lipoic acid (LA) pretreatment on hypoxia/reoxyg-enation injury in vascular endothelial cells and preliminary explore its mechanism. Methods HUVEC were cultured intro and devided into control group,hypoxia/reoxygenation model group and LA group. Cell morphology was observed under inverted phase contrast microscope,cell viability was detected by MTT,total antioxidant capacity (TAOC),nitric oxide(NO),malondialdehyde (MDA),superoxide dismutase (SOD) activity or level were measured by various commercial kits respectively. Apoptosis of HUVEC in each group were detected by flow cytometry , cleaved caspase-3 level was measured by western blot. Results As compared to control group, the survival rate, TAOC, SOD, NO activity were significantly lower(P<0.05), and MDA level, apoptosis rate and apoptosis protein levels were significantly higher (P < 0.05) in model group. However,LA can increase the survival rate,TAOC, SOD,NO activity (P < 0.05),reduce MDA level and cell apoptosis (P < 0.05)in a dose dependent manner. Conclusion LA pretreatments provide protection against hypoxia/reoxygenation injury in HUVEC. LA exerts protective effects through inhibition of HUVEC apoptosis.