Objective:To investigate the clinical significance and correlation of serum alpha fetoprotein(AFP), alkaline phosphatase (ALP), and protein induced by vitamin K antagonist-Ⅱ(PIVKA-Ⅱ) in patients with primary hepatoculellar carrcinoma (PHC).Methods:A total of 72 patients with PHC who admitted to Dajiangdong Hospital from May 2017 to June 2019 were selected as observation group and they were divided into metastasis group (25 cases) and non-metastasis group (47 cases) according to the presence or absence of lymph node metastasis.Another 72 healthy people who had physical examinations during the same period were selected as the control group.The serum levels of AFP, ALP and PIVKA-Ⅱ were measured in all patients.ROC curves were used to analyze the clinical value of these three indicators in the early diagnosis and prognosis of PHC.The correlation between serum AFP, ALP, PIVKA-Ⅱ levels and clinical stage of PHC was analyzed by Pearson method.Results:The serum levels of AFP, ALP and PIVKA-Ⅱ in the observation group were significantly higher than those in the control group( t=36.64, 24.53, 47.89, P=0.012, 0.005, 0.001). The serum AFP, ALP and PIVKA-Ⅱ levels were higher in the metastasis group than in the non-metastatic group( t=20.98, 38.12, 54.17, P=0.04, 0.001, 0.000). ROC analysis showed that the serum AFP, ALP and PIVKA-Ⅱ had diagnostic value for PHC, and the combined detection had higher diagnostic efficacy ( P=0.021, 0.014, 0.003, 0.001). Compared with single index, the clinical value of three indicators in predicting whether PHC had lymph node metastasis increased significantly( P=0.036, 0.027, 0.018, 0.005). The specificity(89.57%), sensitivity(92.60%), positive predictive value(89.53%) and negative predictive value(83.75%) of the three indicators in detecting PHC increased significantly( P<0.05). Pearson analysis showed positive correlations between serum AFP, ALP, PIVKA-Ⅱ and tumor stage( P<0.05). Conclusion:Serum AFP, ALP and PIVKA-Ⅱ have certain clinical value in the early diagnosis of PHC, and the combination of these three indicators can improve the diagnostic efficacy.

Sodium glucose cotransporter 2 inhibitor (SGLT2i) emerged as a new hypoglycemic agent, which can inhibit glucose reabsorption and thus play a hypoglycemic role. Recent studies have shown that SGLT2i not only lowers blood glucose, but also has a protective effect on the cardiovascular system, which may benefit patients with heart failure.The specific mechanism of action is still not fully elucidated. This paper aims to summarize the latest research results of SGLT2i in the treatment of heart failure, and analyze the possible mechanisms for clinical guidance.