Objective To evaluate the application value of serum tumor markers in small cell lung Cancer, and analyse the relationship between serum tumor markers and immunohistochemistry indicators.Methods The electrochemical luminescence technology was used to detect the concentration of carcino-embryonic anti-gen(CEA),neuronspecific enolase(NSE),cyto-keratin fragment 19(CYFRA21-1),the immunological lumines-cence technology was used to detect the concentration of ProGRP,the expression of Ki-67,TTF-1 were detec-ted by MaxVision immunohistochemistry methods,the date was analyzed by two independent sample rank sum test,rank correlation methods,chi-square test and ROC curve.Results The concentration of CEA,NSE,pro-gastrin-releasing peptide(ProGRP),CYFRA21-1 in SCLC were higher than that in benign disease,the concen-tration of CEA,NSE,ProGRP,CYFRA21-1 in extensive stage were higher than that in limited stage(P<0. 05),the difference was statistically significant.The ROC area of NSE,ProGRP were large,they were 0.972 and 0.965,the Kappa value of the NSE+ProGRP was 0.860,optimstic data consistency with "the gold stand-ard".There was a negative relationship between Ki-67 and CEA,NSE,ProGRP,the positive rate of TTF-1 was higher than CYFRA21-1,while lower than ProGRP,But NSE,CEA and TTF-1 have same results(P>0.05). Conclusion Combined detection NSE and ProGRP is of great value in the diagnosis and periods of SCLC,the sensibility and specificity of NSE+ProGRP was high in SCLC,he high expression of Ki-67 was not responsed the concentration of serum tumor markers,TTF-1 had the same results with NSE,while inferior to ProGRP in detect of SCLC.

Objective To learn the current status of family doctor service at pilot communities in Guangzhou, and discover existing problems and influencing factors by investigating the residents who have contracted such service , those have not and the family doctors . Methods This study chose typical community health centers of six communities in Guangzhou in January 2016 .In random sampling , residents who visited doctors during the survey and all the family doctors were surveyed .EpiData was used to doubly inputdata,withSPSS20.0forstatisticalanalysis.Results 66.0％ofthoseresidentswhohavenot contracted the service are willing to contract a family doctor .According to the binary logistic regression analysis after eliminating the interference factors , there are two factors affecting their willingness:gender and whether needing a family doctor for themselves and their family for health management .According to the binary logistic regression analysis after eliminating the interference factors , the influencing factors of renewing contract are overall satisfaction and necessity for signing family doctors .Conclusions The smooth development of the family doctor service is faced with many bottlenecks , while improving willingness to contract and renew contract to family doctors are the cornerstone for sustainability of the family doctor system.

Objective To investigate the safety and efficacy of endoscopic varices ligation(EVL) plus endoscopic varices sclerotherapy(EVS)for esophageal varices hemorrhage in patients with liver cirrhosis. Methods Fifty?two liver cirrhosis patients with esophageal varices bleeding were randomly divided into EVL group(n=24)and EVLS group(n=28)according to random numbers generated by computer after first EVL. The EVL group continued undergoing EVL, and the EVLS group was treated by EVS. The interval of treatment was 2 weeks till varices disappeared. All patients were followed up for 18 months with endoscopy and endoscopic ultrasonography(EUS). The efficacy,changes of esophageal varices and perforating veins, varices recurrence and rebleeding were observed. Results There was no significant difference of complete cure rate between EVLS group and EVL group[67.9%(19/28)VS 62.5%(15/24),P>0.05]. The mean session of treatment(2.68±1.0 VS 1.83±0.7,P<0.05), and perforating veins obliteration rate after treatment in EVLS group was higher than that in EVL group[70.8%(17/24)VS 23.8%(5/21),P<0.05]. During 18 months of follow?up,there was no significant difference of rebleeding rate between the two groups[3.6%(1/28)VS 12.5%(3/24),P>0.05],and the varices recurrence rate was higher in EVL group than that in EVLS group[77.3%(17/22)VS 44.0%(11/25), P<0.05]. Child?Pugh class B patients in EVL group had a higher varices recurrence rate compared to that in EVLS group[75.0%(9/12)VS 31.5%(5/16), P<0.05]. Endoscopic recurrences occurred in patients with non?occlusive perforating veins. Conclusion EVL plus EVS sequential procedure is safe and effective for treatment of esophageal varices hemorrhage,especially for Child?Pugh class B patients.Perforating veins may play a key role in the development of esophageal varices and recurrence after endoscopic therapy. EUS findings can direct the endoscopic therapy and predict the variceal recurrence.