Objective To explore the early diagnostic value of Golgi membrane protein 73 (GP73),alpha-fetoprotein (AFP) and alpha-fetoprotein-L3 (AFP-L3) in patients with high risk of primary hepatic carcinoma (PHC).Methods Sixty-four cases of PHC were selected as the PHC group,60 cases of liver cirrhosis(LC) as the LC group,53 cases of hepatitis as the hepatitis group and 51 healthy checked-up people as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum level of GP73 in all the cases.AFP-L3 was isolated by using affinity micro centrifugal column,AFP and AFP-L3 were detected with chemiluminescent immunoassay and then the proportion of AFP-L3 was calculated.Results The positive rate of serum GP73,AFP and AFP-L3 in PHC group was significantly higher than that in LC group and hepatitis group [78.1％ (50/64)vs.25.0％ (15/60),17.0％ (9/53);48.4％ (31/64) vs.31.7％ (19/60),22.6％(12/53) ;53.1％(34/64) vs.30.0％(18/60),20.8％(11/53)] (P ＜ 0.05),In control group,GP73,AFP,AFP-L3 was no positive.The levels of GP73,AFP and AFP-L3 in PHC group were significantly higher than those in LC group,hepatitis group and control group [(245.69 ± 89.18)μ g/L vs.(116.37 ±38.52),(97.29 ± 24.58),(23.48 ±9.12) μ g/L; (403.27 ± 128.46) μg/L vs.(75.62 ± 19.35),(66.49 ± 15.14),(3.46 ± 1.02) μg/L; (15.64 ±3.19)％ vs.(5.24 ± 1.15),(4.21 ± 0.96),(2.95 ±0.73)％] (P ＜0.05).The levels of GP73,AFP in LC group and hepatitis group were significantly higher than those in control group (P ＜ 0.05).The levels of GP73,AFP and AFP-L3 had no statistically significant difference between LC group and hepatitis group (P ＞ 0.05).Sensitivity and accuracy of three combined detection for PHC was 96.9％(62/64),91.7％(209/228),significantly higher than that of AFP,AFP-L3 single detection (P ＜ 0.05).GP73 single detection and any two combined detection was no significant difference in sensitivity and accuracy,compared with three combined detection (P ＞ 0.05).The levels of GP73 in PHC patients with different age,gender,serum level of AFP,TNM stage and tumor diameter had no statistically significant difference (P ＞ 0.05).The levels of GP73 in PHC patients with positive HBsAg,extrahepatic metastases and LC had significant difference (P ＜ 0.05).Conclusions The diagnosis value of GP73 is evidently higher than AFP and AFP-L3 for PHC,and combined determination is superior to single marker.Combined determination enhances the degree of precision in populations with high risk of PHC diagnosis.

Early venous filling is a special imaging manifestation of cerebral angiography in patients with acute ischemic stroke. Endovascular therapy for acute ischemic stroke has been carried outwidely. However, reports involving disappearance of early venous filling and then confirming its reversibility during follow-up angiographic review are somewhat scarce. Here a case in which the early venous filling after emergency thrombectomy disappeared during follow-up examination is reported. A 71-year-old male was admitted with sudden onset of left-sided weakness for 42 minutes. Intravenous thrombolysis and bridging middle cerebral artery mechanical thrombectomy were performed. Early filling of the thalamostriate vein was visible in the digital subtraction angiography series immediately after recanalization and follow-up imaging revealed infarction of the basal ganglia. Follow up angiography showed that the phenomenon of early venous filling disappeared two weeks later.

Purpose To synthetically evaluate MR diffusion kurtosis imaging (DKI) using Meta-analysis to differentiate diagnostic value of benign and malignant breast lesions and quantitatively analyze mean kurtosis (MK) values of benign and malignant breast lesions in an attempt to provide evidence-based facts for clinical decision making. Materials and Methods Computer-based retrieval of Chinese and English literatures concerning differential diagnosis of benign and malignant breast lesions with application of DKI publicly published at home and abroad in PubMed, Ebsco, Embase, CNKI, Cochrane Library, CBM, VIP Data database from January. 1, 2006 to September. 30, 2017. Two valuators independently screened and extracted data according to inclusion and exclusion criteria, and drew on QUADAS for quality assessment, Stata 12.0 and Meta-Disc 1.4 software for Meta analysis and extraction of relevant parameters. Results Totally 8 up-to-standard literatures were included, including 3 in English and 5 in Chinese. The total number of focus was 689. Corresponding effect model analysis revealed that MK value in malignant breast lesion group was higher than that in benign lesion group, the difference of which was statistically significant. The optimal diagnostic threshold was determined by the maximum Youden index, which was approximately 0.71 in size,with combined sensitivity of 0.907(95% CI 0.860-0.939),specificity of 0.910(95% CI 0.856-0.945),positive likelihood ratio of 10.053(95% CI 6.293-16.059),negative likelihood ratio of 0.102(95% CI 0.068-0.154),and diagnostic test odds ratio of 98.203(95% CI 55.014-175.296).The area under receiver operating characteristic curve was 0.96.MK value suggested 94% posterior malignant rate of malignant breast lesions, and 13% malignant rate of benign breast lesions. Conclusion MK value has high diagnostic value for benign and malignant breast lesions with good sensitivity and specificity.