Objective To investigate the influence of different treatments for tubal pregnancy on ovarian reserve function by transvaginal color Doppler ultrasonography.Methods One hundred and twentyfour cases of tubal pregnancy were divided into three groups according to the treatment,group A with 45 cases under the salpingectomy,group B with 36 cases under the laparoscopic conservative surgery for retaining oviduct,group C with 43 cases taken by Methotrexate.On the day of a spontaneous cycle,all the cases' antral follicles,the ovarian volume,peak systolic velocity (PSV),resistance index (RI),pulsatility index(PI) were measured by transvaginal color Doppler ultrasound.Results The antral follicles,varian volume and PSV of diseased side in group A were lower than those of the other side(P ＜0.05).The antral follicles,varian volume and PSV of diseased side in group A were lower than those of other groups (P ＜0.001).The PI and RI of diseased side in group A were higher than those of the unaffected side.The PI and RI of two sides in group B and C were not significantly different(P ＞0.05).Conclusions Salpingectomy affects the ovarian reserve function.Methotrexate and conservative surgery could not reduce the ovarion reserve.

Objective To observe the effect of leptin on proliferation and apoptosis of breast cancer MCF-7 cell line,and to explore the effect of leptin on occurrence and development of breast cancer.Method The MCF-7 cell line was treated with different concentration of leptin in vitro.Cell proliferation was evaluated by MTT assay. Distribution of cell cycle was determined by flow cytomery, meanwhile the rates of apoptosis were estimated on the basis of Annexin V-FITC/PI apoptosis detection. Results When treated with different concentration of leptin for 24 h, 48 h and 72 h, they could significantly induce the proliferation of MCF-7 cells by MTT method.There was not interaction between concentration of leptin and time course (F=0.919,P=0.523).The main effect of concentration of leptin and time course was statistically significant (F=12.699,P=0.000;F=647.881, P=0.000). Compared 200 ng/ml and 400 ng/ml with the control group, we found the difference was statistically significant by multiple comparison (P=0.007,P=0.000,respectively).The difference was also statistically significant among time course by multiple comparison (P=0.000,respectively).By the flow cytometry analysis,it was found that the 100 ng/ml and 400 ng/ml leptin groups could change the distribution of cell cycle of MCF-7 cell line after 48 h. Compared with control group, the cell number decreased by 14.42 ％ in G0/G1 phase (F=10.464, P=0.044),but increased by 7.57 ％ and 22.19 ％ respectively in S phase (F=47.361,P=0.005).The difference was not statistically significant in G2/M phase (F=1.77, P=0.311).However, the effect of apoptosis inhibition was not obvious. Conclusions Leptin could stimulate the proliferation of MCF-7 cell line and change the distribution of cell cycle.But leptin could not inhibit apoptosis of MCF-7 cell line.It suggested that leptin may serve as a risk factor of breast cancer development.

ObjectiveTo study the value of serum phosphopyruvate hydratase PH protein for the diagnosis of cerebral injuries in patients with brain malignant tumor.MethodsSerum PH protein levels were detected by enzyme-linked immunosorbent assay in 56 patients with brain malignant tumor. Compare the differences among the status of cerebral injuries.And compare the differences among the patients with general with different radiotherapy methods 32 cases,three dimensional conformal radiothrapy 24 cases,and different peritumoral brain edema levels(cmild 18 cases, moderate ao cases severe 30 cases). Results Before radiotherapy the levels of serum PH protein in patients and the health control were (4.12±0.56),(4.66±0.62)μg/L,no significant differece(P＞0.05).And there was also no significant difference between the before and after radiotherapy for the cerebroma,the levels were(7.84±0.72) μg/L,(t=3.89,P=0.001 ).The PH levels of general radiation therapy and three dimensional comformal radiotherapy were (13.59±0.92),(6.14±0.52)μg/L.There was cignificant difference(P=0.002) After radiotherapy,The levels of serum PH protein of the different dropsical degree,mild,moderate and severe were(4.47:±0.55),(6.17±0.62),(15.21±0.86) μg/L, respectively,showing significant difference(F=15.61,P=0.0001).The therapies influenced the serum PH levels(P＜0.05)ConclusionHigh levels of serum PH protein are associated with severe cerebral injuries in brain malignant tumor.So high serum PH level may serve as an progressive predictor of the injury.

Objective To analyze the correlation between the levels of squamous cell carcinoma antigen (SCCAg)and the clinicopathological characteristics of patients with cervical squamous carcinoma.To study the relationship of serum SCCAg levels of patients with recurrent cervical squamous carcinoma and disease prognosis and to investigate the survival rate of patients with recurrent cervical squamous carcinoma.Method ELISA method was used to determine the serum SCCAg levels for the patients,which included 300 cases before treatment and 500 cases after treatment.Results(1)Single factor analysis indicated that,before the treatment,the serum SCCAg levels were closely related to clinical stages,lymphatic metastasis,and deep myometrial invasion (t =3.01,P ＜ O.05 ; t =6.81,P ＜ 0.001 ; t =3.01,P ＜ 0.05 ; respectively).However,they were not related to patient's age,vascular embolization and tumor growth type(t =0.77,t =1.12,t =1.06 ; respectively,all P ＞ 0.05).Multifactor logistic regression analysis showed that the pretreatment SCCAg levels of patients were related to clinical stages,cavum pelvis lymphatic metastasis and myometrial invasion(x2 =2.88,P =0.0084; x2 =2.612,P =0.0156; x2 =2.570,P =0.0171 ; respectively).(2)Overall,recurrent disease developed in 180 of the 500 patients with cervical squamous carcinoma.One hundred and sixty-one recurrent patients showed elevated SCCAg levels(161/180,89.4％).For the 60 patients who showed elevated.SCCAg levels without any clinical symptoms as well as no sign of tumors by iconography,the median time for signs of elevating levels of serum SCCAg was 2.3 months.The longest time range was 150d between the increasing levels of the tumor markers and the appearance of the imaging features of pachygyria while the patients condition was going on.The 160 patients out of the 180 cases with recurrent cervical squamous carci noma who were followed up had a median survival time of 9 months,with an average of 20 months.The total 3 year survival rate and 5 year survival rate was respectively 23.4％ and 17.8％.(3)Single factor analysis indicated that recurrent patients’clinical stages,recurrent region and recurrent post treatment SCCAg levels were closely related with patients' survival time(x2 =10.26,P＜0.005; x2 =14.65,P ＜0.005; x2 =8.97,P＜0.01; respectively).There was no statistical difference between the survival rate of recurrent patients with increased SCCAg level and patients without increased SCCAg levels(x2 =0.89,P ＞ 0.05).Multiple factor analysis indicated that the clinical stages,recurrent post treatment SCCAg levels of patients with recurrence were independent prognostic factors(x2 =10.3372,P =0.0013 ; x2 =4.3889,P =0.0362; respectively).Conclusion The pretreatment SCCAg levels are closely related to patients'clinical stages,cavum pelvis lymphatic metastasis and deep myometrial invasion.Serum SCCAg levels are important for the advanced detection of cervical squamous carcinoma recurrence and prognosis prediction.

Objective To evaluate the association of expressions and gene polymorphism of leptin receptor (LEPR) in breast cancer with tumorigenesis,development and clinicopathologic factors.Methods The immunohistochemical method and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to evaluate LEPR expressions and LEPR Gln223Arg polymorphism in 150 cases with breast cancer,80 cases with benign breast lesions,50 cases with corresponding normal breast tissue and 128 healthy controls.Results The expression rate of LEPR genes in breast cancer tissues was significantly higher than that in benign breast lesions and that in corresponding normal breast tissues [70.67 ％ (106/150) vs 56.25 ％ (45/80) vs 44.00 ％ (22/50),P ＜ 0.005].In breast cancer patients,LEPR gene Gin223Arg genotype polymorphism (GG,GA and AA) frequencies were 70.00 ％ (105 cases),16.67 ％ (25 cases) and 13.33 ％ (20 cases),which were significantly different from those in the benign breast lesions [82.50 ％ (66 cases),13.75 ％ (11 cases),3.75 ％ (3 cases)],those in corresponding normal breast tissues [82.00 ％ (41 cases),14.00 ％ (7 cases),4.00 ％ (2 cases)] or those in the health controls [82.81％ (106 cases),14.85 ％ (19 cases) and 2.34 ％ (3 cases)] (X2 =11.56,P =0.003),while the differences of GG,GA and AA genotype requencies among the breast benign disease group,cancer adjacent normal breast group and healthy control group were not statistically significant (P ＞ 0.05).The frequencies of alleles genes in breast cancer patients (G and A) were 78.33 ％ (235 cases) and 21.67 ％ (65 cases),and the differences were statistically significant compared with those in the benign disease group or in healthy control group (X2 =12.52,P =0.001).The positive expression rate of LEPR gene in patients with lymph node metastasis was 87.8 ％,which was higher than that in patients with no lymph node metastasis (60.2 ％) (P =0.02).According to the results of multivariable analyses,high expression of LEPR gene,LEPR Gin223Arg gene polymorphisms and increased waist-hip ratio (WHR) were risk factors for breast cancer (all OR ＞ 1).Conclusion High expression of LEPR,LEPR Gln233Arg polymorphism and the elevated WHR may be correlated with breast cancer.

Objective To study the clinical diagnosis value and the clinical significance of combined measurement of CEA, DR70, NSE and CYFRA21- 1 in patients with lung cancer. Methods The serum levels of CEA, DR70, NSE and CYFRA21- 1 were determined by ELISA in 130 patients with lung cancer, 50 patients with benign pulmonary disease and 100 cases of normal controls. Results The levels of serum CEA, DR70, NSE and CYFRA21- 1 in lung cancer patients were significantly higher than that in benign pulmonary disease patients and controls (P

0.05). (2) The serum leptin and TG concentration in breast cancer group were significantly higher , the HDL level was significantly lower than those in the groups of breast benign disease and healthy control (P0.05).(3) Multiple logistic regression analysis reveal statistically significant association between serum leptin, TG , ApoA1 and HDL-C levels and breast cancer incident.(ORLeptin=1.14, 95% confidence interval CI:1.076-1.210, ORTG =2.663, 95% CI:1.65-6.82; ORApoA1=5.726, 95%CI : 1.238 - 26.480 and ORHDL=0.035, 95% CI : 0.007 - 0.162, respectively). Conclusion:The increased serum leptin and ApoA1 levels and decreased HDL-C level may be the risk factors of breast cancer.

Objective Toevaluatethediagnosticvalueofhumanepididymisprotein4(HE4)andcar-bohydrate antigen 1 25 (CA1 25 )for distinguishing between benign and malignant ovarian neoplasms.Methods 1 1 09 patients with ovarian neoplasms were enrolled in this study,serum concentration of HE4 and CA1 25 was assayed using ELISA technique.And the markers were evaluated for significance separately and in combination. Results 1SerumlevelsofHE4andCA125weresignificantlyhigherinpost-menopausalwomenthanthosein pre-menopausal women(t=8.40,P<0.05;t=7.02,P<0.05).In addition,the more children the patients born,the higher serum levels of these two markers were(F=1 5.36,P<0.05;F=1 3.00,P<0.05).2 Serum HE4 levels were significantly higher in the ovarian cancer patients compared with those seen in patients with benign or borderline tumor(t=1 3.68,P<0.05;t=1 4.94,P<0.05).Serum CA1 25 levels were significantly higher in the ovarian cancer patients compared with those seen in patients with benign or borderline tumor(t=1 4.1 6,P<0.05;t=1 7.27,P<0.05).Morever,it also appared in the ovarian cancer patients with ascites and vascular embolism.Morever,the levels of HE4 were significantly higher in the ovarian cancer with ascites and vascular embolism than without it(t=7.08,P<0.05;t=4.41,P<0.05),the levels of CA125 were signifi-cantly higher in the ovarian cancer with ascites and vascular embolism than without it(t=9.67,P<0.05;t=4.75,P<0.05).3 During follow-up,serum HE4 and CA1 25 levels significantly decreased at 3 months after operation(t=9.86,P<0.05;t=5.12,P<0.05).4 Receiver operating characteristic curve,ROC)analysis revealed that no difference was observed in AUC values for HE4,CA1 25 and risk of ovarian malignancy algo-rithm(ROMA).5 Compared to CA1 25 ,HE4 had significantly higher specificity and lower sensitivity.Howev-er,sensitivity were increased when the two markers were combined with each other.However,the sensitivity of combination with two markers was higher than single detection and ROMA,but the specificity was lower in com-bination with two markers than single detection and ROMA.If we divide the ROMA by a woman′s menopausal status,ROMA has a higher sensitivity (73.84%,84.1 9%) and lower specificity (66.06%,66.67%). Conclusions ThelevelsofCA125hasahighsensitivity,andthelevelsofHE4isahighspecificity.CA125 combined with HE4 can provide a more sensitivity and accurate predictor of ovarian cancer than either alone.

Objective The purpose of this study was to discuss the clinical significance of serum levels of Pro-gastrin-releasing peptide (ProGRP) in diagnosis,therapy monitoring and prognosis in patients with small cell lung cancer (SCLC).Methods Clinical diagnostic trial.Serum levels of ProGRP were measured by ELISA assays in 413 SCLC patients,418 NSCLC,120 with benign pulmonary diseases patients and 200 healthy subjects.Patients were recuited by the Shanxi Cancer Hospital from Dec.2005 to Oct.2008.Three hundreds and sixty-eight patients with SCLC were followed up from Dec.2005 to Oct.2011.The receiver operating characteristic curves (ROC) was used to set the cut-off value of ProGRP and the area under ROC (ROC-AUC).The sensitivity and specificity of ProGRP were analyzed for diagnosing SCLC.The survival analysis was performed by the Kaplan-Meier method and Cox's proportional hazards model for multivariate analysis of prognosis.Results Using healthy subjects group as control,the largest Youden index point of ROC was used to set the cut-off values of ProGRP and NSE (45.3 ng/L and 12.4 ng/L).The ROC-AUC of ProGRP was 0.798 (95％ CI:0.746-0.850)the sensitivity and specificity were 79.2％,98.1％ respectively.The AUC of NSE was 0.786(95％ CI:0.726-0.746),the sensitivity and specificity were 71.9％,96.7％ respectively; Combing detection of ProGRP and NSE,the sensitivity and specificity were 88.1％,95.8％ respectively.Serum levels of ProGRP in healthy subjects,benign pulmonary diseases,NSCLC and SCLC groups were 6.9 (5.3-8.6),36.8 (26.3-43.4),21.3 (18.6-35.2) and 1758.7 (368.4-2967.3) μg/L respectively.The serum levels of ProGRP in SCLC groups were significantly higher than those in the healthy group,benign pulmonary diseases group and NSCLC group (H =103.66,P =0.000).Serum levels of ProGRP in SCLC at stage Ⅰ-],stage m,stage Ⅳ were 543.3 (256.8-843.2),1440.6 (1042.4-2543.3) and 1897.6 (1586.5-3958.7) μg/L,respectively (H =25.974,P =0.000).Serum levels of ProGRP in 165 SCLC patients with complete remission(CR) were significantly declined after treatment (U =11.65,P ＜ 0.01).The levels of ProGRP in 146 SCLC patients with partial remission(PR) slowly decreased (U =9.17,P ＜ 0.01).Thirty-nine cases with progressive disease (PD)and 63 cases with stable disease(SD) presented elevated ProGRP levels (U =3.314,P ＜ 0.001 ; U =2.54,P ＜ 0.01,respectively).By the end of October 31st 2011,a total of 368 cases with SCLC were followedup.Ratio of follow-up was 89.1％.There were 56 deaths in 119 SCLC patients with ProGRP ＜ 1000 μg/L (median time =16.0 months,4-23 months) ; 159 deaths in 249 with ProGRP ＞ 1000 μg/L (median survival time =12.0 months,2-18 months).Median survival time of the two groups showed significant differences(x2 =11.04,P =0.001).Multivariate analysis by Cox's proportional hazards model revealed that ProGRP was independent prognostic factor related to the overall survival (OS) of SCLC patients.Conclusions The serum ProGRP is valuable tumor marker for diagnosis,treat monitoring and prognosis of SCLC.It's important to predict relapses and recurrence of diseases earlier,instruct therapy and prognosis assessment.

Objective To study the clinical values and relativity of serum levels of NSE and ProGRP (P31-98) in patients with small-cell lung cancer. Methods Serum levels of NSE and ProGRP (31-98) was measured by ELISA in 159 patients with small cell lung cancer(SCLC), 99 patients with benign lung diseases, and 100 healthy subjects, 141 SCLC patients before and after treatment were also measured. Results The medians of NSE and ProGRP (31-98) was 21.33 μg/L and 323.70 pg/ml in patients with SCLC, 4.24 μg/L and 11.94 pg/ml in patients with benign lung diseases, 5.82 μg/L and 8.54 pg/ml in healthy subjects respectively,significantly increased in patients with SCLC as compared to that of the other two groups (P ＜0.01).Given the cut-off levels of 10.35 pg/L for NSE and 47.98 pg/ml for ProGRP(31-98), the sensitivity of diagnosis in SCLC was 71.1% and 88.7 %, respectively.The combination sensitivity and specificity of NSE and ProGRP(31-98)was 95.6 % and 96.8 %. The medians of NSE in SCLC patients with extensive and limited disease was 14.75 μg/L and 34.10 μg/L, the sensitivity was 51.14 % and 93.44 %, respectively; ProGRP (31-98) in the two groups was 143.14 pg/ml and 1061.14 pg/ml, 80.61% and 98.61%, respectively.In SCLC patients with remission after treatment the levels of NSE and ProGRP31-98 was significantly lower than that before treatment, but the levels without remission had no significantly change. There was significant relationship between NSE and ProGRP(31-98) in serum levels of patients with SCLC (r =0.379, P ＜0.01).Conclusion The serum levels of NSE and ProGRP (31-98) in patients are both increased, there are a significant relationship.But ProGRP(31-98) is a more specific and sensitive marker than NSE for the diagnosis of SCLC.The combination of the two markers can improve positive rate and validity.