Objective To investigate the diagnostic value of PIgP/SC in diagnosis of primary hepatic cancer.Methods 58 patients with primary hepatic cancer,60 patients with liver cirrhosis and 60 healthy volunteers were studied.4 ml fasting venous blood was collected from all subjects.Serum level of AFP was detected with electrochemical chemiluminescence immunoassay system and plasma PIgR/SC level was detected by ELISA method.The level of PIgR/SC and AFP was detected at one week after surgical resection in patients with hepatic cancer.Results The levels of AFP and PIgR/SC in the three groups were significantly different (P＜0.01),and PIgR/SC was higher than that in patients with cirrhosis and volunteers (P＜0.01).There was no significant difference between patients with liver cirrhosis and liver cirrhosis(P＞0.05).AFP was higher in patients with HCC than patients with cirrhosis and volunteers.AFP was higher in patients with cirrhosis than volunteers,and the difference was statistically significant(P＜0.01).Sensitivity of PIgR/SC and AFP was 89.3％ and 54.8％,specificity was 84.6％ and 91％,Youden index was 0.751 and 0.458,AUC was 0.920 and 0.761,respectively.There was significant difference in AUC (Z=3.251,P＜0.05) of the two detection indexes for detection of primary hepatic cancer.Conclusion The value of PIgR/SC in diagnosis of primary liver cancer may by higher than that of AFP.

Objective To conduct a meta-analysis to explore the merits and disadvantage of total endoscopic thyroidectomy and conventional open thyriodectomy.Methods A database searching was performed on the Chinese BioMedical Literature on disc(CBM),China National Knowledge Infrastructure(CNKI),wanfang database,VIP database and PubMed database.Prospective randomized controlled studies about total endoscopic thyroidectomy and conventional open thyroidectomy were selected and analyzed.RevMan 5.2 was used for statistical analysis.Results Eleven studies matched the selection criteria,which involved 1082 patients,among whom 505 patients underwent total endoscopic thyrodiectomy (endoscopy group) and 577 patients underwent conventional open thyroidectomy (open group).Outcomes of total endoscopy group and open group in satisfaction,operation time,drainage fluid,complications and post-operative hospital stay etc were compared.Meta analysis showed endoscopy group were supeior to open group in terms of intraoperative blood loss (WMD＝-17.86,95％ CI:[-26.18,-9.54]),postoperative hospital stay (WMD＝-0.95,95％ CI:[-1.40,-0.50])and patients' satisfaction (WMD＝4.03,95％ CI:[1.20,13.58])while the operation time was longer in endoscopy group than in open group (WMD＝12.61,95％ CI:[2.85,22.38]).There was no statistical significance on postoperative drainage(WMD＝ -0.70,95％ CI:[-32.79,31.39]) or complications (RR＝0.84,95％ CI:[0.54,1.29])for the two groups.Conclusions Total endoscopic thyriodectomy has advantages in terms of satisfaction,post-operative hospital stay,and intraopetative blood loss while it takes more operation time.There is no difference among drainage fluid or complication.

Objective To explore the effect of intraoperative parathyroid hormone (IOPTH) examination on parathyroidectomy for primary hyperparathyroidism.Methods The clinical data of 41 PHPT patients who received IOPTH monitoring (IOPTH group) from Jan.2009 to Dec.2014 were retrospectively analyzed.The clinical manifestation,examination and changes of parathyroid hormone and calcium before and after operation were collected.Results There were 12 males and 29 females.36 cases had parathyroid adenoma,and 5 cases were parathyroid carcinoma.23 cases were positive in 24 cases of 99Icm-MIBI parathyroid adenoma radionuclide examination,and 2 cases were positive in 3 cases of parathyroid carcinoma radionuclide 99Tcm-MIBI inspection (P＝ 0.213).10 mins after tumor resection,PTH in all cases decreased by 50％ or more than that before tumor resection except for one case of parathyroid carcinoma.23 cases appeared hypocalcemia in 36 cases of parathyroid adenoma after surgery and 2 cases appeared hypocalcemia in 5 cases of parathyroid cancer patients (P＝0.361).No postoperative hoarseness,cough,bleeding occoured.Patients were followed up from 6 to 72 months.Hypocalcemia symptoms recovered 2 weeks to 3 months after surgery.No permanent hypoparathyroidism occured.One case of parathyroid carcinoma died of hypercalcemia 5 months after surgery.The remaining 40 cases survived without recurrence or death.Conclusions Intraoperative PTH monitoring can help doctors analyze whether all the hyperthyroidism glands have been removed,which can help to avoid miss diagnosis of multiple gland disease and unnecessary bilateral neck exploration.This method is highly accurate so it is recommended for routine use in PHPT surgery.

Objective To explore the alteration and effect of autophagy in pancreas tissue of rat injected by exenatide.Methods Diabetes model rats were induced by two-month high-sugar and high-fat diet and streptozotocin injection (35 mg/kg) in normal rats.50 SD male rats were divided into four groups according to the principle of complete random design,namely normal control group (n=10),normal exenatide-injected group (n=10),diabetes-model control group (n=l5) and diabetes-model exenatide-injected group (n=15).Rats in exenatide-injected groups were subcutaneously injected with exenatide respectively in 5 μg/kg dose each time,twice a day,at 8 a.m.and 6 p.m.Animal weights were weighted weekly and the dose of exenatide was adjusted according to current weight.Rats in the two control groups were injected with the corresponding amount of saline.Mter 10 weeks of treatment,all rats were killed and pancreatic tissues were disposed.Immunohistochemistry was used to measure the expression of GLP-1R in pancreatic tissues.Western blot was used to test the expressions of LC3-Ⅰ,LC3-Ⅱ and p62 in pancreatic tissues,and LC3-Ⅱ/Ⅰ ratio and p62 were compared between any two groups.All specimens were stained with hematoxylin-eosin (HE).The data were expressed as means ± standard deviation and were analyzed by unpaired Student t test using SPSS 18.0 statistics software.P value ＜0.05 was considered to be statistically significant for all tests.Results The pancreatic tissues from 13 rats (6 from the normal exenatide-injected group and 7 from the diabetes-model exenatide-injected group) appeared pathological changes such as gland structure damage,pancreatic cells atrophy and cells compartment broadening.The expressions of GLP-1R,LC3-Ⅱ and p62,and LC3B-Ⅱ/Ⅰ ratio in the two exenatide-injected groups were higher than those in the respective control group,and the differences had statistical significance (P＜0.05).Conclusions Long-term subcutaneous injection of exenatide can upregulate the expression of GLP-1R in rat pancreatic acinar cells and may induce the impaiment of autophagy flux in rat pancreatic cell.

Objective To investigate the expression and significance of signal pathway Wnt/β-catenin in prostate cancer stem cells.Methods Prostate cancer tissues,hyperplasia prostate tissues and normal prostate tissues were collected,then prostate cancer stem cells were selected from cell suspension in the culture system of serum-free medium by magnetic activated cell sorting system.Immunohistochemical SP test,RT-PCR and Western blot were applied to test the expression of Wnt and β-Catenin mRNA or protein in prostate cancer stem cells,hyperplasia prostate tissues and normal prostate tissues.Results The protein expression of Wnt and β-Catenin was higher in prostate cancer tissues compared with that in hyperplasia prostate tissues and normal prostate tissues;mRNA expression of Wnt and β-Catenin was higher in prostate cancer stem cells (4.57±0.83,3.93±0.78) than in hyperplasia prostate tissues (1.32±0.35,1.48±0.44) and normal prostate tissues (1.00±0.12,1.00±0.11),and the difference was statistically significant (F＝13.287,12.648,P＝0.000).Protein expression of Wnt and β-Catenin was higher in prostate cancer stem cells(0.87±0.10,1.12±0.23) than in hyperplasia prostate tissues(0.39±0.08,0.64±±0.11) and normal prostate tissues (0.33±0.09,0.45±0.10),and the difference was statistically significant (F＝16.625,14.417,P＝0.000).Conclusion Signal pathway Wnt/β-catenin is stimulated abnormally in prostate cancer stem cells,causing the occurrence of prostate cancer,providing a new research direction for treatment of prostate cancer.

Objective To explore the application of Duff in treatment for patients with early stage threat ened abortion.Method 1000 patients with early stage threatened abortion admitted from Jan.2015 to Jun.2016 were selected,and were divided into two groups.All patients were treated by conventional therapy and Duff therapy.Treatment effects of the two groups were observed and compared.Results The differences of clinical characteristics between the two groups had no statistical significance (all P＞0.05).No serious adverse reactions oc curred to either group.There was no significant difference in remission and disappearance time of clinical symptoms between the two groups (t=0.334,0.367,all P＞0.05).The total treatment efficiency was higher in the observation group than in the control group,but the differences had no statistical significance (x2=0.058,/P＞0.05).Conclusion There is a certain application value of Duff treatment for early stage threatened abortion,which is safe,efficient,and convenient,worthy of promotion.

Objective To explore the influence of epidural analgesia on stress,immune and survival in patients with ovarian cancer undergoing cytoreductive surgery.Methods 72 cases with ovarian cancer undergoing cytoreductive surgery were divided into group A and group B according to random number table method.Patients in group A were treated with epidural analgesia,while patients in group B were treated with intravenous analgesia.The stress index,the plasma cortisol and immune indexes,CD3+,CD4+,CD8+ and CD4+/CD8+ at 30 mins before surgery (T1),right after surgery (T2),12 h after surgery (T3),1 d after surgery (T4) and 3 d after surgery (T5) between the two groups were observed.The overall survival and free survival in the two groups were compared.Results The plasma cortisol levels was lower in group A than in group B (Fgroup=27.784,P=0.000).The plasma cortisol levels in the two groups increased first and then decreased (Ftime=109,268,P-=0.000),and the decrease ratein group A was higher than that in group B (Finteraction,=22.092,P=0.000).The levels of CD3+,CD4+ and CD4+/CD8+ werehigher in group A than in group B,while the level of CD8+ was lower in group A than in group B (Fgroup=5.893,6.110,7.283,5.593,P＜0.05).The levels of CD3+,CD4+ and CD4+/CD8+ in the two groups reduced first and then increased while the level of CD8+ increased first and then reduced (Ftime=12.220,14.430,15.592,11.102,P＜0.05).CD3+,CD4+ and CD4+/CD8+ in group A increased more while C D8+ reduced more than those in group B (Finteraction=8.251,9.792,8.092,7.103,P＜0.05).The overall survival rate and free survival rate of 3 years in group A and group B was 44.44％,22.22％ vs 38.89％,16.67％,respectivelyThedifferencehadnostatisticalsignificancebetweenthetwogroups (P＞0.05).Conclusion Epidural analgesia may reduce the stress response in patients with ovarian cancer undergoing cytoreductive surgery,and protect the immune function,but the influence on survival is not obvious.