Objective To investigate the clinical value of combined detection of glycoprotein 125 (CA125) and human epididymis protein 4 (HE4).Methods 46 patients with ovarian malignant tumor (malignant tumor group) and 48 patients with benign ovarian tumors (benign tumor group) treated in our hospital from June 2013 to August 2015 were selected.The serum levels of CA125 and HE4 were detected in all the patients and its diagnostic value was evaluated by ROC curve.The levels of CA125 and HE4 in patients with different pathological types were compared.Results The best diagnostic value of CA125 was 47.9 U/L,The serum level of CA125 ≥47.9 U/L predicted the specificity of ovarian malignant tumor was 87.34% and that the sensitivity was 76.69%.The best diagnostic value of HE4 was 55.68 pmol/L.The serum level of HE4 ≥ 55.68 pmol/L predicted the specificity of ovarian malignant tumor was 90.34% and that the sensitivity was 83.01%.There was significant difference in CA125 and HE4 between the patients with benign and malignant ovarian tumors (P<0.05).No significant difference in the diagnosis of malignant ovarian tumor and the specificity by using combined detection of HE4 and CA125 (P>0.05)However,the sensitivity was significantly higher than that of single detection,the difference was statistically significant (P<0.05).The levels of CA125 and HE4 in patients with epithelial ovarian tumors were higher than those with non epithelial ovarian tumors,and the difference was statistically significant (P<0.05).The levels of CA125 and HE4 in patients with mucinous ovarian cancer were significantly lower than those in patients with serous ovarian cancer (P<0.05).Conclusion The combined detection of serum CA125 and HE4 can significantly improve the value of differential diagnosis of ovarian tumors,and CA125 and HE4 may play an important role in the pathological classification of malignant ovarian tumors.

Abstract: Objective To investigate the type and distribution of drug resistance of Mycobacterium tuberculosis (MTB) in Hainan tuberculosis hospital from 2019 to 2021, and to provide reference for the development of drug resistant tuberculosis prevention and control strategy. Methods From 2019 to 2021, a total of 1 687 strains of sputum were isolated and cultured and identified as MTB. Drug sensitivity testing was performed on eight anti-tuberculosis drugs: isoniazid (INH), rifampicin (RFP, R), ethambutol (EMB), streptomycin (SM), kanamycin (KM), capreomycin (CPM), ofloxacin (OFX), and propylthioisoniacamide (PTO). The drug resistance analysis was conducted. Results Among the 1 687 MTB strains, the overall drug resistance rate was 41.32% (697), with a single drug resistance rate of 11.62% (196), a multi-drug resistance rate of 4.10% (69), a extensive drug resistance rate of 23.71% (400), a pan-drug resistance rate of 1.90% (32), and a rifampicin resistance rate of 28.10% (474), and the main drug resistance types were extensive drug resistance and rifampicin resistance. The order of resistance to the eight drugs was OFX (64) > SM (62) > INH (48) > RFP (19) > CPM (2) > KM (1) > EMB (0) and PTO (0). The rate of resistance to INH and RFP of first-line drugs in newly treated patients was lower than that in retreated patients (χ2=0.110, 0.765; P>0.05); the rate of resistance to second-line drugs OFX, CPM and KM in initially treated patients was lower than that in retreated patients (χ2=1.037, 1.212, 1.653; P>0.05). The total drug resistance rate in 2019 was 51.16%, which was higher than that in 2020 (35.08%) and 2021 (38.89%). The difference between groups was significant (χ2=29.25,16.60; P=0.000), but there was no significant difference in overall drug resistance rate between 2020 and 2021 (χ2=1.823, P=0.177). Among the occupational types of tuberculosis patients, farmers were the main ones, accounting for 56.25% (949). The patients with drug-resistant tuberculosis were mainly distributed in Haikou City (165) > Wanning City (72) > Chengmai County(64) > Wenchang City (51) = Dongfang City (51) > Danzhou City (48), and patients in these six areas accounting for 64.71%(451/697). Conclusions The drug resistance rate of tuberculosis in Hainan Province is relatively high, with OFX and SM resistance being the main types of drug resistance. The extensive drug resistance rate is higher than the national average level. Therefore, surveillance and treatment should be strengthened and optimized to reduce the prevalence of drug-resistant tuberculosis.

AIM: To study the relationship among peroxisome proliferator-activated receptor-gamma2(PPAR ?2) gene Pro12Ala polymorphism,Helicobacter pylori(H.pylori) infection,and gastric cancer in China.METHODS: 104 consecutive patients with gastric cancer and 104 age-and sex-matched controls from Guangdong Province of southern China were examined.PPAR?2 Pro12Ala polymorphism was analyzed by PCR-restriction fragment length polymorphism method(PCR-RFLP).H.pylori status of subjects was determined by enzyme-linked immunosorbent assay(ELISA) for anti-H.pylori IgG.RESULTS: The prevalence of H.pylori infection was significantly higher in gastric cancer patients than that in control(81.7% vs 59.6%,2=12.27,P

Abstract: Objective To investigate the occurrence of multidrug-resistance among tuberculosis patients in Hainan Province from 2014 to 2020 and to analyze the influencing factors, aiming to provide reference for formulating drug-resistant tuberculosis control strategies in this region. Methods This study collected sputum samples from the patients with pulmonary tuberculosis admitted to the Second Affiliated Hospital of Hainan Medical University from 2014 to 2020, and performed isolation and identification of Mycobacterium tuberculosis and drug susceptibility testing. After the strains were identified as positive, drug sensitivity tests were conducted, and multi-drug resistant patients were found. Clinical data was retrospectively collected, and chi-square test and unconditioned logistic regression were used to analyze the influencing factors of multidrug resistance. Results A total of 2 672 patients underwent sputum culture, strain identification, and drug susceptibility testing in TB designated hospitals in Hainan Province from January 1, 2014 to December 31, 2020. Among them, 1 942 patients with available drug susceptibility test results and complete clinical data were enrolled, among which 398 cases with drug-resistant TB were included in the case group, and 1 544 cases without drug resistance were included in the control group. Multivariate logistic regression analysis showed that farmers, rural residence, treatment history of retreatment, irregular medication history, number of pulmonary cavities ≥3, and BMI<18.5 were independent risk factors for MDR-TB. The risk of MDR-TB in farmers was higher than that in non-farmers (OR=1.542, 95%CI: 1.150-2.020); patients living in rural areas had a higher risk of multidrug resistance than those living in urban areas (OR=1.445, 95%CI: 1.095-1.907); the risk of MDR in the retreatment patients was higher than that in the initial treatment patients (OR=5.616, 95%CI: 4.250-7.421); the risk of multi-drug resistance in patients with irregular medication was higher than that in patients with regular medication (OR=2.665, 95%CI: 2.012-3.531); the risk of multidrug resistance in patients with pulmonary cavity number ≥3 was higher than that in patients with pulmonary cavity number <3 (OR=5.040, 95%CI: 3.768-6.740); compared with patients with BMI<18.5, patients with BMI=18.5-24.0 and BMI≥24.0 had a lower risk of multidrug resistance (OR=0.735, 95%CI: 0.555-0.975 and OR=0.447，95%CI:0.225-0.888, respectively). Conclusions Retreatment, farmer occupation, rural residence, irregular medication and low BMI may be the risk factors for multidrug resistance in Hainan Province.

AIM: To study the relationship between MIF gene -173 locus polymorphism, helicobacter pylori (Hp) infection, and gastric cancer in high prevalent (Shanxi) and low prevalent (Guangdong) regions in China. METHODS: Genomic DNA was extracted from peripheral blood of 104 healthy controls, 104 gastric patients from Guangdong and 102 healthy volunteers, and 102 gastric cancer patients from Shanxi. Polymorphism of MIF-173 locus was analyzed by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). RESULTS: In high prevalence region, the number of patients who carrying with MIF -173 C/C is much higher than those of healthy controls (28.8% vs 15.4%, ?~2=5.47, P0.05). CONCLUSION: The C genotype of MIF -173 locus may be associated with the risk of gastric cancer in China.

Objective To study the effect of IL-12 on Th1/Th2 cytokine expression level and the role of IL-12 in the shi ft ing of Th1/Th2 immune response against blood-stage Plasmodium b e ighei infection in mice. Methods [WT5”BZ ]BALB/c mice were infected with 5?105 parasitized RBC and received doses of 0.03 or 0.15 ?g/d of IL-12 on the day of infection and daily for 6 days post -in fection. The levels of IFN-? and IL-4 in sera or supernatants of splenic lymp hocyte cultured in vitro were detected by the EL ISA method. Results Compared with spleen cells fro m untreated mice, spleen cells from 0.03 ?g dose of IL-12-treated mice produ ced significantly higher level of Th1-associated cytokine IFN -?, but lower level of Th2-associated cytokine IL-4 in response to PHA or sA g stimulation on day 7 post-infection, whereas spleen cells from 0.15 ?g dose I L-1 2-treated mice produced significantly lower levels of IFN-? and IL-4. The le vel of IFN-? was apparent in the sera of mice treated with 0.03 or 0.15 ?g/d I L-12 on day 3 post-infection and peaked on the day 5 post-infection, but level of I FN-? even was significantly lower in mice treated with 0.15 ?g/d IL-12 comp ara ble to that in control mice on day 7 post-infection. The level of IFN-? was n ot detected in the sera of control mice through 7 days post-infection. [WT5” H Z] Conclusion Appropriate dose of IL-12 regulates the deve lop ment of resistance to P.berghei via a CD 4+ T h1 response, which involves the cytokines IFN-?. [HT5”SS] However, higher doses of IL-12 dramatically inhibite immune pro t ective ability, which may be detrimental to resistance against P .berghei infection. [

[Objective] To explore the role of endothelin-3 (ET-3) on epithelial-to-mesenchymal transition in a malignant melanoma cell line A375.[Methods] A375 cells were cultured in vitro and classified into 3 groups to be treated with ET-3 at 100 nmol/L (ET-3 group),co-cultured with ET-3 at 100 nmol/L and endothelin receptor B (ETRB) antagonist BQ788 at 100 μmo1/L (ETRB antagonist group),or to remain untreated (blank control group).After additional 24-hour culture,Transwell chamber assay was used to detect the invasive capability of A375 cells,real time-PCR to measure the mRNA expressions of Twist and Slug,and Western blot to determine the protein expression of E-cadherin,vimentin,Twist and Slug.The changes in the morphology of A375 cells were observed.Data were assessed by analysis of variance and Scheffe's method.[Results] In the Transwell assay,the number of A431 cells permeating through the basement membrane was 4.200 ± 0.837,9.400 ± 0.548 and 3.400 ± 0.894 respectively in the blank control group,ET-3 group and ETRB antagonist group (F =88.44,P ＜ 0.01 ),suggesting that ET-3 could promote the metastasis of A375 ceils,while BQ788 could block the promotive effect of ET-3.The epithelial-to-mesenehymal transition was obvious in cells treated with ET-3 alone,but was inapparent in cells treated with ET-3 and BQ788.The ET-3 at 100 nmol/Lsignificantly decreased the protein expression of E-cadhefin from 0.33 ± 0.002 (blank control group) to 0.28 ±0.007,but increased that of vimentin from 0.83 ± 0.014 (blank control group) to 1.16 ± 0.003,while BQ788upregulated the E-cadherin expression to 0.42 ± 0.008 and downregulated the vimentin expression to 0.75 ±0.030,and significant differences were observed in the E-cadherin expression and vimentin expression among the ET-3 group,ETRB antagonist group and blank control group (F =329.98,262.94,respectively,both P ＜ 0.01 ).A significant increase was observed in the mRNA and protein expression of Slug (F=376.94,288.87,both P＜ 0.01 )and Twist (F=215.62,156.96,P＜ 0.01 and 0.05) in A375 cells after treatment with ET-3.[Conclusion] ET3/ETRB axis may promote the epithelial-to-mesenchymal transition in A375 cells likely by regulating the expression of E-cadherin,vimentin and two important transcription factors Twist and Slug.

Objective To investigate the modulation of ET-3 on the nuclear factor (NF)-κB/Bfl-1 antiapoptotic pathway in a malignant melanoma cell line A375. Methods Flow cytometry was performed to detect the apoptosis in cultured A375 cells after treatment with ET-3 of 100 nmol/L for 24 hours. ET-3 of various concentrations (0, 1, 10, 100 nmol/L) was used to treat some A375 cells with or without the pretreatment with the ETRB antagonist BQ788; after another 24-hour culture, RT-PCR and Western blot were conducted to examine the mRNA expression of Bfl-1 and protein expressions of Bfl-1 and ETRB, respectively. Results The 24-hour treatment with ET-3 of 100 nmol/L significantly reduced the apoptosis rate of A375 cells (F = 10.68, P ＜0.05). The mRNA and protein expressions of Bfl-1 were up-regulated by ET-3 in a concentration dependent manner (both P ＜ 0.01 ), while BQ788 significantly blocked the ET-3-induced up-regulation (F = 420.38,229.49, both P ＜ 0.01 ). The protein expression of pNF-κB in A375 cells was also enhanced by ET-3 of different concentrations (all P ＜ 0.05), but the enhancement was suppressed by BQ788, and there was a significant difference in the protein expression of pNF-κB between cells treated with ET-3 of 100 nmol/L and those treated with the combination of ET-3 of 100 nmol/L and BQ788 (F = 255.46, P ＜ 0.01 ). Conclusion ET-3/ETRB inhibits the apoptosis in A375 cells likely by activating the NF-κB/Bfl-1 anti-apoptotic pathway.

Objective To compare the efficacy and safety of three regiments of transient intensive insulin therapy for type 2 diabetes mellitns: thrice preprandial injection of premixed insulin aspart 30, thrice preprandial injection of insulin aspart and injection of glargine at bedtime, thrice preprandial injection of regular insulin and injection of NPH at bedtime. Methods Patients were randomly divided into 3 groups, treated with 3 kinds of intensive insulin therapy. After achieving the target goal, continuous glucose monitoring system was used to compare the blood glucose level, therapeutic time, dosage of insulin, occurrence of hypoglycemia. Results Detected by continuous glucose monitoring system, there was no statistical difference in average blood glucose [(8.3±2.1,7.5±1.9, 6.8±0.8) mmol/L, P > 0.05], blood glucose area under curve 3 hours (AUC1-3) after breakfast, therapeutic time [ (8.3±2.5, 9.1±3.8, 8.4±1.7)d, P > 0.05], dosage of insulin [(0.63± 80%, P > 0.05) among three kinds of transient intensive insulin therapy. There were no patients complaining of hypoglycemic symptom. Conclusion The short-term efficacy and safety among three intensive insulin therapeutic methods are similar. More attention should be paid to monitor the blood glucose during sleep.