Objective To study the clinical significance of Carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CY-FRA21-1) ,neuron specific enolization enzyme (NSE) combined detection in the diagnosis of lung cancer .Methods Using the Chemiluminescence to detect the level of CEA ,NSE and CYFRA21-1 in 61 patient with lung cancer (lung cancer group) and 38 pa-tients with benign diseases(control group) .All datas were analyzed with t test .Optimal cut-off point and diagnostic sensitivity ,spe-cificity were obtained by receiver operating characteristic curve (ROC) .Results The level of serum CEA ,NSE and CYFRA21-1 in Lung cancer group was significantly higher than that in control group (P<0 .05) .The expression level of three tumor markers was no statistically significant difference in the different pathological types of lung cancer (P>0 .05) .The cut-off point of CEA was 3 .50 ng/mL ,sensitivity and speciality were 52 .5% ,94 .7% respectively .The cut-off point of CYFRA21-1 was 5 .21 ng/mL ,the sensitiv-ity and specificity were 67 .2% ,93 .1% .The cut-off of point NSE was 18 .09 ng/mL ,the sensitivity and specificity were 77 .0% , 52 .6% .The three combined detection sensitivity was 96 .7% ,significantly higher than separate one(P<0 .05) .Conclusion The three tumor markers(CEA ,CYFRA21-1 ,NSE) might be valuable in the diagnosis of lung cancer .The combined detection could be used as a better pattern for screening lung cancer .

The results of early resuscitation of 104 adult patients with BSA more than 50%were studied retrospectively. Although the mean amount of fluid replaced during 48h postburn was similar to the amount calculated with our formula, there existed significant individual differences. Therefore it seems not necessary to set up a rigid fluid replacement plan. To ensure adequate tissue perfusion, the fluid replacement formula might be modified as follows: 2 ml/kg/BSA%, with urinary output 30-40 ml/h, in the first 24h; and 1.5ml/kg/BSA%, with urinary output 40-50ml/h, in the second 24h. It should be emphasized that resuscitation should be started as early as possible,and adequate amount of fluid replacement is especially important during the first 2-3h postburn.There was no obvious relationship between the incidence of visceral complications and the total amount of fluid replaced during the resuscitation. Available data indicated that the amount of fluid calculated on the basis of our formula neither increased the incidence of early pulmonary edema nor influenced its development.As far as prevention of pulmonary edema was concerned, it did not seem justifiable to restrict the amount of resuscitation fluids. It was also noted that fluid therapy alone would not prevent entirely the development of postburn renal insufficiency.

The serial changes in thromboxane (TXA2) prostacyclin(PGI2),circulatory platelet aggregate ratio (CPAR),platelet count,blood viscosity,myocardial enzyme spectrum,cortisol and epinephrine were determined in 42 severely burnt patients randomly divided into two groups.The findings demonstrated that in the control group,both TXA2 and TXA2/PGI2 ratio increased significantly during the early postburn stage.Myocardial enzyme spectrum,blood viscosity,cortisol and epinephrine also increased markedly.However,levels of the above parameters in the anisodamine-treated group were significantly lower than in the control following the infusion of anisodamine.On the contrary,CPAR and platelet count in the treated group increased and were significantly higher than those in the control.Moreover,TXA2 was closely correlated with CPAR,platelet count,blood viscosity and myocardial enzyme spectrum (P

The canine model to study inhalaton injury established in our lab was employed,and neutrophil NADPH oxidase activity,blood gas analysis,lung water volume,chest radiographs,and pulmonary histopathological changes were observed in the dogs after they were exposed to smoke inhalaton.It was found that carbon monoxide poisoning,hypoxemia,metabolic aci-dosisi respiratory alkalosis and lung damage developed rapidly and early after smoke inhalation;white blood cells disappeared from the circulation 5 minutes after injury onward;the activity of neutrophil NADPH oxidase increased gradually from the 30th minute to the 6th hour after injury,then decreased and approached to its preinjury level in the 12th hour after injury.It is postulated on the basis of the above findings that neutrophils would accumulate in the lungs after smoke inhalation and experince a "respiratory burst" characterized by the activation of NADPH oxidase and the production of large amounts of oxygen and other active oxygen radicals,which would play a significant role in the pathogenesis of acute lung damage in the early stage of smoke inhalation injury.

Forty-one burn patients were divided into inhalation injury and non-inhalation injury groups.It was found that in the inhalation injury group,TXB2 level and TXB2/G-keto-PGF1? ratio in plasma and lung tissue were significantly elevated,circulatory platelet aggregate ratio markedly decreased,and blood viscosity greatly increased.Histopathologically,congestion,edema,hemorrhage and thrombosis were seen in lung tissue.The changes of TXB2 level and TXB2/6-keto-PGF1?ratio were parallel to the clinical course of the development of respiratory failure in the patients with body surface burns complicated with inhalation injury.It is believed that the imbalance of TXA2/PGI2 is one of the factors of respiratory failure in severe body surface burns complicated with inhalation injury.

Seventeen cases of postburn multiple organ failure (MOF) were studied prospectively.It was found that MOF mainly occurred in those patients with a burn area over 70% TBSA.Mortality rate of the cases of MOF was directly proportional to the number of organs involved.The incidence of pulmonary failure was the highest and the highest mortality was attributed to renal failure;MOF in the early stage after burns was mainly induced by burn shock and that in the late stage by burn wound infection.Endogenous infection seemed to be one of the important causes to precipitate the outbreak of postburn MOF.The morphological changes of the functionally failed organs were as follows:There were various degrees of cellular degeneration and necrosis.Or- ganelle changes such as swelling and vacuolization of mitochondria,enlargement of endoplasmic reticulum,gap formation of capillary endothelium etc were seen.Extravascular organ water volume of the functionally failed organs was increased.Stasis and/or hyperemia were found in the heart,the lungs,the liver and the GI,tract,but ischemia in the kidneys.The changes of the.enzyme spectrum of the myocardium,PaO2,RI,IB/DB,and DB were parallel to those of pathomorphology and extravascular organ water volume and they could reflect the severity of organ damages firly well.

Tamm-Horsfall protein(THP)was determined with radioimmunoassay in the urine and blood samples of 59 burn patients.It was found that urine and blood THP was significantly decreased postburn and the degree of decresing was correlated with the extent of the burnt body surface and the severity of renal damage.The changes of THP occurred earlier than those of the routine parameters for renal damage such as BUN or Cr.It is suggested that THP determination can be used as an index for the early damage of the Henle's loop and the distal convoluted tubules after burn injury.

Electrolyte imbslance.the changes of serum aldosterone and the ratio of an-giotensin Ⅱ/arterial natriuretic peptide were studied prospectiely in 59 cases of severe burns.Meanwhile,certain parameters of renal functions were detarmined.Hypernatremia devaloped in 6 cases.On the basis of our findings,it is believed that postburn hypernatremia might result from renal dysfunction and the greatly increased mediators,which can enhance the retention of sodium,might also play an important role in the development of postburn hypernatremia.

Objective To explore the effect of L-carnitine on panel reactive antibody (PRA) in hemodialysis patients. Methods 50 patients were classified randomly into 2 groups: L-carnitine group receiving intravenous injection of 2g L-carnitine after each hemodialysis for 6 months, and control group did not receive any L-carnitine treatment. The PRA in serum was measured by enzyme-linked immunosorbent assay (ELISA) before and after 6 months of L-carnitine treatment. Results L-carnitine significantly reduced PRA levels compared with control group(P

0.05).The CC10 levels in lung homogenate of the allergic asthma group were significantly decreased than that of control group(P0.05).Conclusion The CC10 levels in lung homogenate is decreased,and has negative correlation with AIPs,which suggests that CC10 may take part in the onset of asthma,and work as an important endogenous anti-inflammatory factor.