Objective To explore the clinical significance of changes of plasma Endothelim-1(ET-1)and serum Transforming Growth Factor-α(TGF-α),Transforming Growth Factorβ1(TGF-β1)levels in patients with liver cirrhosis. Methods The plasma ET-1 and serum TGF-α,TGF-β1 levels were determined in 66 patients with liver cirrhosis by RIA or ELISA,among which 30 cases had abdominal fluid while the other 36 cases had not In addition,35 healthy individuals were enrolled into the study as control. Results The plasma ET-1 levels were significantly lower in the patients group than control(P ＜0.01),while the serum TGF-α and TGF-β1 levels were significantly higher in the patients than those in control(P ＜ 0.01). In cases with abdominal fluid the plasma ET-1 levels were particularly high and had significantly negative correlation with serum TGF-α and TGF-β1 levels(r = -0. 4782,-0. 5014 respectively,P ＜ 0. 01). Conclusions The plasma ET-1,serum TGF-α and TGF-β1 levels were closely related to the diseases process of liver cirrhosis and had good clinical application values in diagnosis and prognosis.

Objective To explore the coastal state of hypertension among rural population and its relationship between the prevalence of metabolic syndrome(MS).Methods Lianyungang coastal rural residents 11089 people for primary hypertension epidemic learn research,age qualified for 45～75age,measurement height,body quality,waist,blood pressure,lipid and fasting blood glucose,respectively in accordance with international diabetes Union(IDF)and CDS of MS diagnosis standard calculation illness rate,and on gender,age,and hypertension level(Ⅰ,and Ⅱ,andⅢ,level),effects factors for correlation analysis.Results 11089 people(male 3985 people,female 7104 people)in the IDF standard MS total illness rate for 44.3％(male,and female MS illness rate respectively for 25.4％,and 54.9％),CDS standard MS total illness rate for 37％,two species diagnosis standard of meet rate for 79.9％;except blood glucose outside,female residents waist,TG,and HDL-C,indicators exception occurs rate obvious than male(x2=1399.198,554.801,652.110,all P＜0.01).Conclusion Lianyungang coastal MS prevalence in rural areas is higher than the general average in the middle-aged;female patients with hypertension and obesity are very high risk population of MS;hypertension pathogenesis is longer,higher prevalence of MS.

Objective To investigate the value of combined detection of serum CA125 ,VEGF‐C andβ2‐MG levels on early diag‐nosis of retroperitoneal lymph node metastasis in the patients with ovarian cancer .Methods Fifty‐one patients with ovarian cancer undergoing retroperitoneal lymph node cleaning operation were included as the experimental group ,including 29 cases of positive retroperitoneal lymph node metastasis .Contemporaneous 32 cases of benign ovarian tumor were selected as the control group .The serum CA125 level was detected by using electricity chemiluminescence (electrocheminescence) ,serum VEGF‐C level by using en‐zyme‐linked immunosorbent assay (ELISA) and serumβ2‐MG level by using the latex enhanced immune turbidimetric method .The serum CA125 ,VEGF‐C andβ2‐MG levels were compared among various groups .Results The serum CA125 ,VEGF‐C andβ2‐MG levels in the experimental group were (1 682 .5 ± 261 .5)μg/mL ,(2 125 .6 ± 96 .7)pg/mL and (2 .52 ± 0 .61)mg/L respectively , which in the control group were (30 .5 ± 6 .3)μg/mL ,(1 738 .0 ± 79 .8)pg/mL and (1 .87 ± 0 .56)mg/L respectively ,the difference between them was statistically significant (P< 0 .01) .The serum CA125、VEGF‐C、β2‐MG levels in 29 cases of retroperitoneal lymph node metastasis were more significantly higher ,which were (1 997 .3 ± 376 .8)μg/mL ,(2 895 .2 ± 126 .8)pg/mL and (4 .95 ± 0 .69)mg/L respectively ,and the difference was statistically significant compared with the control group (P<0 .01) .The sensitivity ,specificity and accuracy rate of the combined detection of serum VEGF‐C ,β2‐MG and CA125 for diagnosing ovarian cancer retroperitoneal lymph node metastasis were 95 .8% ,97 .3% and 98 .5% respectively .Conclusion The combined detection of serum VEFG‐C ,β2‐MG and CA125 has an important clinical value in early diagnosing retroperitoneal lymph node metastasis of o‐varian cancer .

Objective To investigate the predictive value of plasma lipoprotein phospholipase A2 (Lp -PLA2 )and D -dimer in patients with hypertension complicated with stroke.Methods 70 hypertensive patients with stroke were selected as A group,72 patients with simple hypertension were selected as B group,and 71 healthy sub-jects were selected as C group.The light transmitting method was used to detect serum Lp -PLA2 ,and immunoturbi-dimetry was used to detect plasma D -dimer.The clinical value of the two joint detection and single detection in prediction of hypertension complicated with stroke was analyzed.Results The plasma Lp -PLA2 and D -dimer levels of A group were (471.88 ±181.49)ng/mL,(982.54 ±373.28)μg/mL,which were higher than those of B group[(195.17 ±34.74)ng/mL,(263.57 ±29.70)μg/mL]and C group[(122.94 ±46.25)ng/mL,(96.44 ± 8.49)μg/mL](F =189.7,171.1,all P =0.000).The plasma Lp -PLA2 level of A group was positively correlated with D -dimer(r =0.692,P <0.01).The plasma D -dimer >252g/mL forecast hypertension stroke risk sensitivity was 83.3% and specificity was 98.6%,the plasma Lp -PLA2 >176.36ng/mL forecast hypertension stroke risk sen-sitivity was 92.9% and specificity was 83.1%,and the combined prediction of hypertension stroke risk sensitivity was 87.6%,specificity was 93.5%.Conclusion The plasma levels of Lp -PLA2 and D -dimer are significantly increased in hypertensive patients with stroke,and the combined detection of the two indicators can improve the prediction of stroke risk in patients with hypertension.

Objective To evaluate the effect of propofol on mitochondrial fission in a rat hippocampal neuron model of hypoxia/reoxygenation (H/R) injury.Methods Primarily cultured hippocampal neurons of neonatal Sprague-Dawley rats were randomly divided into 4 groups (n =42 each) using a random number table:control group (group C);vehicle group (group V);H/R group;H/R+propofol group (group H/R+P).In group V,H/R was not produced,the vehicle dimethyl sulfoxide with the final concentration of 0.01％ was added,and the cells were then incubated for 6 h.In group H/R,the hippocampal neurons were subjected to oxygen-glucose deprivation for 6 h followed by 20 h reoxygenation.In group H/R+P,propofol with the final concentration of 1 μmol/L was added at 6 h of hypoxia.At 20 h of reoxygenation,the cell apoptosis (using flow cytometry),Ca2+ concentrations in cytoplasm (with the laser scanning confocal microscope),calcineurin (CaN) activities (by enzyme-linked immunosorbent assay),and expression of mitochondrial fission proteins dynamin-related protein 1 (Drp1) and fission 1 (Fis1),and apoptosis-related proteins cytochrome c (Cyt c) and apoptosis-inducing factor (AIF) (by Western blot) were measured.The apoptotic rate was calculated.Results Compared with group C,the apoptotic rate,Ca2+concentrations,CaN activities,and expression of Drp1,Fis1,Cyt c and AIF were significantly increased in H/R and H/R+P groups (P＜0.05),and no significant changes were found in the parameters mentioned a2+.bove in group V (P＞0.05).Compared with group H/R,the apoptotic rate,Ca+ concentrations,CaN activities,and expression of Drp1,Fis1,Cyt c and AIF were significantly decreased in group H/R+P (P＜0.05).Conclusion Propofol can reduce the H/R injury to rat hippocampal neurons through inhibiting mitochondrial fission.

Objective To investigate the clinical value of serum carbohydrate antigen (CA125,CA199)and vascular endothelial growth factor C (VEGF-C)in early diagnosis of ovarian carcinoma.Methods 51 cases of ovarian cancer patients with retroperitoneal lymph node dissection were performed in the observation group,including 23 cases of ovarian cancer retroperitoneal lymph node metastasis,32 cases of ovarian benign tumor were selected as the control group.The serum levels of CA199 and CA125 were detected by the method of chemiluminescence detection,and the serum VEGF-C level was detected by enzyme-linked immunosorbent assay (ELISA).Results The serum level of CA125 in patients with ovarian cancer (1 682.5 ±261.5)u/mL was significantly higher than that in the control group (30.5 ±6.3)u/mL(P <0.01),serum VEGF-C level in ovarian cancer patients (2 125.6 ±96.7)pg/mL was signif-icantly higher than that in the control group (1 738.0 ±79.8)pg/mL (P <0.01 ).The serum CA199 level of 51 patients with newly diagnosed epithelial ovarian cancer was (72.5 ±30.6)u/mL,serum CA199 level of the control group was (17.4 ±8.5)u/mL,CA199 level of retroperitoneal lymph node metastasis was (134.9 ±72.5)u/mL, ovarian cancer retroperitoneal lymph node metastasis CAl99 serum level were significantly higher than those without lymph node metastasis and the control group (t =7.39,18.34,all P <0.01).The diagnostic sensitivity,specificity and accuracy of serum VEGF-C +CA199 +CA125 in detection of ovarian cancer retroperitoneal lymph node metasta-sis were 95.5%,96.5%,99.5%.Conclusion Combined detection of CA125,VEFG-C and CA199 in serum has important clinical value in predicting lymph node metastasis of ovarian cancer.

Objective To study the influencing factors of the competing sentences test in normal-hearing adults, in order to provide references for the preparation of the competing sentences test with children and the development of the diagnostic tools of the central auditory processing disorders.Methods According to the three kinds of test tables of semantic competition, sentence constituent competition and phonetic competition for the competing sentences test, the 2×3×3 factors mixed experimental design were used to test the 48 normal-hearing adults(forty-six right-handed adults and two left-handed adults) with the competing sentences test.The correct rate was obtained and the influencing factors were analyzed.Results ①The average correct rate of the Competing Sentences Test for the forty-six right-handed normal-hearing adults was 94.98%,and for the two left-handed normal-hearing adults was 96.12%.②The right-handed subjects'' right ear accuracy rate was significantly higher than that of the left ear(P<0.01),while the accuracy rate of the left ear was obviously higher than the right ear with left-handed subjects.③The effects of genders on the results of the competing sentences test was not significant(P>0.05)with the right-handed subjects.④For the results of three types sentences,the correct rate of semantic competition was the highest, the second was the sentence constituent competition and phonetic competition was the lowest with the right-handed subjects.Conclusion No gender factors were found to affect the results of the competing sentences test among adults.The normal-hearing right-handed adults have the right ear advantage in the competing sentences test, prompting us to become concerned about the choice of the ear sides.Different competition types of sentences will have a greater impact on the difficulty of the competing sentences test, so we should pay more attention to this in the preparation of competitive sentences test tables.

Waardenburg syndrome (WS), also known as auditorypigmentary syndrome, is characterized by non-progressive sensorineural hearing loss and anomalous pigmentation. Its mode of inheritance is either autosomal dominant or autosomal recessive. So far only PAX3, MITF, SOX10 and EDNRB mutations have been identified among Chinese patients with WS. This review has provided an update for WS-related genes, mutation databases, molecular and functional data, and a discussion over the molecular diagnosis of WS.

Objective To investigate the clinical value of serum lipoprotein (a) and free fatty acid (FFA) in the diagnosis of type 2 diabetic nephropathy (DN).Methods From January to October of 2016,120 cases with type 2 diabetes in the Second People's Hospital of Lianyungang were selected.According to urinary albumin creatinine ratio (UACR),the patients were divided into three groups:normal albuminuria group (NA),microalbuminuria group (MA) and macroalbuminuria group (LA).And 40 healthy subjects were selected as control group.The levels of serum lipoprotein (a) and FFA were measured,and the correlation was analyzed by Pearson analysis.Furthermore,the receiver operating curve was used to evaluate the positive diagnostic rate of DN.Results The levels of lipoprotein (a) in the NA,MA,LA and control group were (212.8 ±69.0)mg/L,(281.7 ±70.5)mg/L,(337.2 ±71.5)mg/L and (187.4 ± 74.0)mg/L,respectively.The levels of lipoprotein (a) in the MA and LA groups were significantly higher than those in the NA and control groups (F =35.08,P ＜ 0.05).The levels of FFA in the four groups were (0.63 ±0.15)mmol/L,(0.84 ±0.13) mmol/L,(1.07 ±0.19) mmol/L and (0.47 ±0.10) mmol/L,respectively.The level of FFA in the DN group was higher than that of the control group,the difference was statistically significant (F =102.13,P ＜ 0.05),and increased with the progression of DN.Pearson correlation analysis showed that the serum lipoprotein (a) was positively correlated with FFA (r =0.64,P ＜0.05).The positive rates of serum lipoprotein (a) and FFA were 64.2％ and 73.3％ in early diagnosis of DN,the positive rate of combined detection was 84.2％ (P ＜ 0.05).Conclusion Serum lipoprotein (a) and FFA levels are significantly increased in diabetic patients with renal injury.Both of them have important clinical value in early diagnosis of type 2 DN.

Objective To investigate the significance of "merge" model versus "traditional" model in rotation training for professional clinical postgraduate students in department of gastroenterology. Methods The professional clinical postgraduate students who underwent rotation training in Qingdao Municipal Hospital from July 2012 to July 2016 were enrolled as subjects and were trained with the"merge" model and the "traditional" model, respectively. The two groups of subjects were compared in terms of clinical knowledge , skills , and core competencies . Results The postgraduates trained by the"merge" model had a significantly higher total score of clinical examinations than those trained by the"traditional" model [(92.60±2.52) vs. (83.80±3.14), t=10.93, P<0.01], while there were no significant differences in professional quality and doctor-patient communication between the two groups. Compared with those trained with the"traditional"model, the postgraduates trained by the"merge"model had significantly better understanding of clinical knowledge and clinical thinking ability, diagnosis and treatment skills, and psychological quality (χ2=27.00, 10.23, and 12.21, all P<0.01);however, there was no significant difference in clinical research ability between the two groups (χ2=1.39, P=0.24). Conclusion The model of professional clinical postgraduate training combined with standardized training of residents is superior to the traditional training model, and compared with the "traditional" model, the "merge" model is more beneficial to the training of comprehensive clinical practice abilities and thus holds promise for further application.