Objective To investigate the clinical value of combined measure of the serum levels of CA153,CA125,CA199 and CEA in the diagnosis of breast cancer.Methods Serum levels of CA153,CA125,CA199 and CEA in 68 patients with breast cancer,50 patients with benign breast diseases and 58 healthy volunteers were measured by electrochemiluminescence immunoassay (ECLIA).Results The levels of CA153,CA125,CA199 and CEA in breast cancer group were significantly higher than those in benign breast disease and healthy volunteers.Sensitivities of CA153,CA125,CA199 and CEA were 76.4 ％ (52/68),44.1％(30/68),35.3 ％ (24/68),29.4 ％ (20/68),respectively.The positive rate of combination of tumor markers was 94.1％ (64/68).Conclusion The combined assay of CA153,CA125,CA199 and CEA can improve the early diagnostic rate of breast cancer.

Objective To analyse the necessity and feasibility of HCV RNA detection for donor screening.Methods Plasma from 50 donors was mixed into a minipool, the nucleic acid was extracted by NucliSens Extractor and amplified by NASBA, the amplification products were detected by ECL. A performance control and a positive control were coupled with the samples through storage, nucleic acid extraction, amplification and detection.Results Two specimens were found HCV RNA positive in the 10000 anti HCV negative samples.Conclusion HCV RNA screening of plasma minipools by NASBA may prevent hepatitis C virus infection.

Objective To investigate renal expression of ApoE in human lupus nephritis (LN) and its relationship with renal damages.Methods Renal expression of ApoE was examined in 40 LN patient biopsy samples by immunohistochemieal staining.The relationship between ApoE levels" and renal pathologic changes,renal injuries was analyzed.Results Only weak ApoE expression was found in normal renal tissue.The expression of ApoE was significantly higher in LN patients [ glomerular:(31.2±11.0) vs (3.0±1.6);tub-ular:(71.64±8.90) vs (0.60±0.06)].The expression of ApoE was higher in class IV than non-class IV LN [glomerular: (38.4±4.5) vs (18.0±4.6);tubular: (77.6±2.5) vs (60.0±3.2)].Spearman's relation-ship analysis showed that the expression of ApoE in glomerular and tubular was closely related to the renal histological score activity index and functional changes in LN (P＜0.01).Conclusion The expression of ApoE is high in renal tissues of LN,especially in class IV,and the high expression may be associated with LN activity and progressive renal dysfunction.

Objective To evaluate the risk factors for healthcare-associated infection(HAI)in senile dementia pa-tients,so as to adopt effective nursing measures to reduce the incidence of HAI.Methods Clinical data of 82 senile dementia patients aged≥60 years and hospitalized between January 2011 and June 2013 were analyzed retrospective-ly.Results Of 82 patients,28 (34.15%)developed HAI.The main infection site was lower respiratory tract(n=15,53.57%),followed by urinary tract(n=6,21 .43%).Univariate analysis revealed that risk factors for HAI in senile dementia patients were bedridden,long length of hospital stay ,dysphagia,indwelling urinary catheter,irra-tional use of antimicrobial agents,combined with tumor,and hypoproteinemia (all P <0.05 ).The main isolated bacteria were gram-negative bacilli(n=40,62.50%),the top three pathogens were Klebsiella pneumoniae (n=12, 18.75%),Escherichia coli (n =10,15.63%),and Pseudomonas aeruginosa (n =8,12.50%).Conclusion Reali-zing the risk factors and common pathogens of HAI in senile dementia patients is helpful for taking effective meas-ures to prevent and control the incidence of HAI .

Objective To establish the subcutaneous transplantation tumor models with Lewis lung adenocarcinoma in C57BL/6 mice, and to observe the influence of oHSV2, DDP and drug combination on tumor volume, median survival time and weight of tumor-burdened mice.Methods Subcutaneous transplantation tumor models were established with Lewis lung adenocarcinoma in tumor-burdened mice.Tumor-burdened mice were randomly divided into the control group, oHSV2 group, DDP group, oHSV2/DDP sequential group, DDP/oHSV2 sequential group and oHSV2+DDP combination group with 12 rats in each group using the random number table method.The tumor size and weight of mice were measured every 3 days.Results On the 21st day, the tumor size of tumor-burdened mice in every group was as follows: control group (1.82±0.06)cm3, oHSV2 group (0.63±0.05)cm3, DDP group (0.58±0.03)cm3, oHSV2/DDP sequential group (0.49±0.05)cm3, DDP/oHSV2 sequential group (0.42±0.04)cm3, and the difference was statistically significant (F=1 359.01, P=0.000).The data in oHSV2+DDP group were put away because of premature death in mice.The differences were statistically significant between control group and oHSV2 group (P=0.000), control group and DDP group (P=0.000), control group and oHSV2/DDP sequential group (P=0.000), control group and DDP/oHSV2 sequential group (P=0.000), oHSV2 group and DDP group (P=0.017), DDP group and DDP/oHSV2 sequential group (P=0.000), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (P=0.001).The weight of tumor-burdened mice in every group was listed as follows: control group (21.64±0.40)g, oHSV2 group (21.34±0.37)g, DDP group (15.96±0.43)g, oHSV2/DDP sequential group (19.04±0.31)g, DDP/oHSV2 sequential group (16.34±0.30)g, and the difference was statistically significant (F=588.67, P=0.000).The difference was not statistically significant between control group and oHSV2 group (P=0.076).However, the differences were statistically significant between control group and DDP group (P=0.000), control group and oHSV2/DDP sequential group (P=0.000), control group and DDP/oHSV2 sequential group (P=0.000), oHSV2 group and DDP group (P=0.000), oHSV2 group and oHSV2/DDP sequential group (P=0.000), DDP group and DDP/oHSV2 group (P=0.013), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (P=0.000).The median survival time of tumor-burdened mice in every group was displayed as follows: control group 23 d , oHSV2 group 32 d, DDP group 30 d, oHSV2/DDP sequential group 37 d, DDP/oHSV2 sequential group 39 d, oHSV2+DDP combination group 16 d, and the difference was statistically significant (χ2=120.81, P=0.000).The differences were statistically significant between control group and oHSV2 group (χ2=10.88, P=0.001), control group and DDP group (χ2=10.69, P=0.001), oHSV2 group and DDP/oHSV2 sequential group (χ2=10.09, P=0.001), DDP group and DDP/oHSV2 sequential group (χ2=9.67, P=0.002).However, the differences were not statistically significant between oHSV2 group and DDP group (χ2=0.00, P=0.996), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (χ2=2.70, P=0.100).Conclusion On the premise of that the weight of mice is no affected, oHSV2 can inhibit the tumor size and prolong the median survival time of tumor-burdened mice effectively, and the effect of DDP/oHSV2 sequential group is the most significant.This article provides an experimental basis for exploring therapeutic methods of lung adenocarcinoma.

Purpose Liver fibrosis is the common pathological process of cirrhosis developed by chronic liver disease.This study aims to explore the application of microvascular change in assessing the liver fibrosis induced by bile duct ligation based on X-ray phasecontrast computed tomography (PCCT).Materials and Methods Ten rats were equally divided into the group of bile duct ligation-induced liver fibrosis and the control group at random.Then ten excised liver tissues were imaged at beamline BL13W1 of Shanghai Synchrotron Radiation Facility in China.After the imaging studies,the liver samples were stained with Sirius red and immunostained with antibodies against cytokeratin 19 (CK19).The microvasculature in livers was reconstructed via PCCT,and the correlation analysis on microvascular density and the proportion of fibrosis area was performed.Results The microvasculature including blood vessels,dilated bile ducts and ductular proliferation were clearly revealed by PCCT technology.Moreover,the 3D microvascular density and proportion of fibrosis area in the liver fibrosis group increased significantly compared with those in the control group (P＜0.01),and the correlation between them was obvious (r=0.812,P＜0.01).Conclusion Microvascular 3D characteristics of liver fibrosis are well demonstrated by PCCT,and 3D microvascular density is significantly correlated with the proportion of fibrosis area.Those findings indicate that microvascular change is closely related to the degree of liver fibrosis induced by bile duct ligation,and thus it provides a novel means to assess the severity of liver fibrosis through microvascular change.

Objective To evaluate the diagnostic value of MRI for the mammographic sign of focal asymmetry of the breast (FAB) .Methods The morphological features of MRI and Time‐signal intensity curve (TIC) types of 46 cases of mammographic signs of FAB were analyzed retrospectively .Results In all 46 patients ,MRI detected 46 lesions in the corresponding areas of FAB on mammography ,in which 35 cases of benign lesions and 11 cases of malignant lesions were confirmed by pathology .The accuracy , positive predictive value and negative predictive value of the sub‐leaf shape and edge burr of the breast lesions were 82 .61% ,66 .67% , 86 .49% and 86 .96% ,85 .71% ,87 .18% respectively .TIC showed:in type Ⅰ ,all 17 cases were benign;In type Ⅱ ,4 cases were be‐nign and 2 cases were malignant ;In type Ⅲ ,9 cases were all malignant .The diagnostic accuracy of MRI for the benign and malignant breast lesions was 86 .96% .The positive predictive value and negative predictive values were 81 .82% and 96 .88% respectively .Con‐clusion MRI can definitely estimate the potential character of lesion in FAB ,and more accurately discriminate malignant and benign breast lesions .

Objective To explore potential related factors of left ventricular hypertrophy in maintenance hemodialy?sis (MHD) patients. Methods Sixty patients were enrolled in the study. Echocardiography was performed to exam LVH in?dexes. There are forty-three patients with LVH (LVH group), and seventeen patients without LVH (non-LVH group). Clini?cal data were collected to exam the levels of hemoglobin (HGB), creatinine (Cr), parathyrin (iPTH), albumin (ALB), triglycer?ide (TG), cholesterol(CHO), calcium(Ca), phosphorus(P), advanced oxygen protein products (AOPP) and C reactive protein (CRP). Results Compared with non-LVH group, age, BP, iPTH, AOPP were higher in LVH group patients while BMI and other biochemistry index does not show any statistical difference. Multiple linear stepwise regressions analysis shows that SBP, iPTH and AOPP are correlated factors to left ventricle mass index (LVMI). Conclusion LVH is prevalent in MHD pa?tients. BP, iPTH and AOPP are the risk factors for LVH.

Objective To analyze the clinical characteristics and risk factors of nosocomial infection (NI) in elder patients with cerebral infarction Methods A retrospective study was performed.Three hundred and two patients over 60 years old with cerebral infarction were selected as our subjects,who were in a cadre ward from Jan.2011 to Jun.2013.The incidence rate of NI and the predisposing factors of NI were investigated.Results Of 302 patients with cerebral infarction,46 cases developed NI and the incidence was 15.23％.The most common site of NI was lower respiratory tract infection,counting for 60.87％ (28/46),followed by urinary tract infection(21.74％ (10/46)).The risk factors of NI included age,prolonged hospitalization,disturbance of consciousness,invasive operation and the use of antibiotics (x2 =5.720,11.517,5.185,4.218,11.931 ; P ＜ 0.05).Conclusion The clinical staff should pay close attention to the risk factors of NI in elder patients with cerebral infarction.The methods include controlling the disease as soon as possible,shortening hospital stays,reducing invasive operation and the rational use of antibiotics can reduce the incidence of NI.

Objective To explore the predictive value of serum CEA and cytokeratin-19 fragments (CYFRA21-1)prior treatment for the epidermal growth factor receptor (EGFR) mutation and efficacy of tyrosine kinase inhibitors ( TKI ) in patients with non-small cell lung cancer.Methods The study was a clinical research.Totally 101 matched tissue and plasma samples were collected from Peking University People′s Hospital from 2012 to 2013.All clinical specimens were analyzed for EGFR mutations in exons of 18, 19, 20 and 21 by ADx-ARMS and direct sequencing, and the serum levels of CEA and CYFRA21-1 were analyzed by ECLI.The correlation between EGFR mutant status and efficacy of EGFR-TKI and clinicopathological parameters were analyzed by χ2 test, Log-rank text and Cox proportional hazards regression model.Results The mutation rate was 60.4%(61/101) by ADx-ARMS and 33.7%(34/101) by direct sequencing.Mutations were more frequently observed in the higher serum CEA level patients(≥5μg/L,78.8%).However, the rates of EGFR mutations of different CEA levels were similar.Among the patients receiving TKI therapy, the efficacy of EGFR-TKI was closely related to serum CYFRA21-1 level prior treatment and EGFR mutation (χ2 =8.903, P =0.003; χ2 =28.590, P <0.001 ).And serum CYFRA21-1 level prior treatment and EGFR mutation were independent factors for EGFR-TKI treatment affecting PFS (RR=0.298, P<0.001;RR=0.086, P<0.001).Conclusion The mutation rate of EGFR was significantly related with the expression level of CEA prior treatment, and serum CEA and CYFRA21-1 levels prior treatment could be potential predictors of EGFR-TKI efficacy.