ObjectiveTo evaluate the value of 24 h dynamic electrocardiogram (DCG) and treadmill exercise testing(TET) in diagnosing coronary heart disease(CHD),and analyze relevant index between coronary arteriography(CAG) and treadmill exercise testing.MethodsOne hundred and forty-nine borderline cases of coronary heart disease were enrolled.Every patient was examined by DCG,TET,and CAG,compared the diagnostic value of TET combined with DCG and TET or DCG alone,and record the increased heart rate during the first minute( △ HRl min) of TET and systolic blood pressure(SBP) recovery.The patients were divided into a CHD group and a non-CHD group according to the results of coronary angiography.ResultsThe sensitivity rate was 78.57％ and specific rate was 70.77％ by means of TET.The sensitivity rate was 61.90％ and specific rate was 66.15％ by means of DCG.The sensitivity rate was 95.23％ ,specific rate was 55.38％,positive predictive value was 73.39％ and negative predictive value was 90.00％ by parallel way of DCG and TET,its sensitivity rate (95.23％) and negative predictive value (90.00％ ) were more than those of DCG or TET alone.The sensitivity rate was 52.38％,specific rate was 95.38％,positive predictive value was 93.62％ and negative predictive value was 60.78％ by serial way of DCG and TET,its specific rate (95.38％) and positive predictive value (93.62％ ) were more than those of DCG or TET alone.The number of men in the CHD group was higher than the number of women.Ratio of systolic blood pressure recovery(rSBPR) in the CHD group was significantly higher than that in the non-CHD group ( P ＜ 0.01 ).Conclusion It can obviously enhance the sensitivity rate and specific rate if combined TET with DCG.Patients with CHD have a delayed decline in SBP during recovery which can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.

Objective To systematically review the diagnostic value of microRNA(miRNA) quantitation in breast cancer .Meth-ods Literatures about miRNA and breast cancer diagnosis were selected by retrieving Medline ,Embase and Cochrane Library .Ac-cording to the inclusion and exclusion criteria ,the literatures were independently screened ,and a 2 × 2 contingency table was con-structed .Quality of literatures was assessed by quality assessment of diagnostic accuracy studies(QUADAS) .Statistical analysis was performed by employing Meta-Disc 1 .4 software and STATA 11 .0 .Results 16 studies were included ,which contained 1 303 patients and 711 control samples .There were threshold effects among these studies (the spearman′s correlation coefficient was-0 .758 ,P=0 .001) .A random effects model was used for meta-analysis .The summary sensitivity ,specificity ,positive likelihood ratio ,negative likelihood ratio ,and diagnostic odds ratio for miRNA in breast cancer diagnosis were 0 .77(95% CI:0 .75 -0 .79) , 0 .77(95% CI:0 .74-0 .80) ,4 .19(95% CI:2 .79-6 .30) ,0 .25(95% CI:0 .19-0 .35) ,19 .91(95% CI:9 .68-40 .95) .The area un-der curve of SROC was 0 .895 0 .Conclusion These results suggest that miRNAs have potential value to diagnose breast cancer . However ,effective diagnosis of breast cancer still needs to be conducted with assistance of clinical findings and traditional lab inves-tigations .

Objective To analyze the mutations of FMS-like tyrosine kinase 3 internal tandem duplication (FLT3/ITD) in bone marrow cells of patients with newly-diagnosed acute myeloid leukemia (AML).Methods The mutations of FLT3/ITD in 96 AML cases were detected by polymerase chain reaction (PCR)and the clinical features of FLT3/ITD positive patients were analyzed.Results FLT3/ITD mutations were identified in 18 patients (18.8 ％),2 cases were M2,11 cases were M3,2 cases were M4,3 cases were Ms.Patients with FLT3/ITD mutations presented higher initial white blood cell count than that of patients without FLT3/ITD mutations [18.0×109/L (3.6×109-137.6×109/L) vs 6.3×109/L (4.5×109-113.0×109/L),t =3.04,P ＜ 0.05].Out of FLT3/ITD positive patients,13/16 (81.3 ％) obtained complete remission and 13 patients remained in first remission in a median follow-up of 10 months(6-15 months).Conclusion The mutations of FLT3/ITD are frequently identified in newly-diagnosed AML patients,patients with FLT3/ITD mutations present high white blood cell count.

Background and purpose: DNA methylation is an important mechanism for regulating gene expression, and plays an important role in the tumorigenesis. Study shows that DNA methylation is a potentially promising biomarker in tumor diagnosis, prognosis as well as treatment selection. This study aimed to analyze the methylation status and assessed possible clinical value of 3 DNA repair genes BRCA1, GSTP1 and MGMT in breast cancer samples of Chinese women. Methods:Using methylation speciifc PCR (MSP), we analyzed the methylation status of 3 DNA repair genes BRCA1, GSTP1 and MGMT in 106 paired breast tumors and corresponding normal tissues. Results: The methylation rates of BRCA1, GSTP1 and MGMT were 24.5% (26/106), 29.2% (31/106) and 18.9%(20/106) in breast cancer tissues, which were higher than those (7.5%, 11.3%and 4.7%) in paired normal breast tissues, respectively (P<0.01). Methylation in at least one of the genes was found in 50.9%(54/106) of the breast cancer and 19.8%(21/106) in paired normal breast tissues. And the mean number of genes hypermethylated in each tumor and paired normal breast tissues were 0.73 and 0.24, respectively (P<0.000 1). The methylation status of BRCA1 was more frequent in the younger patients than in the older patients (P=0.007) and most BRCA1 methylated patients were ER negative (P=0.020). Methylation status of GSTP1 was signiifcantly correlated with tumor size, lymph node metastasis (P=0.028 and 0.033, respectively). MGMT methylation was significantly correlated with tumor stage, higher tumor grade and lymph node metastasis (P=0.016, 0.025 and 0.030, respectively). High frequency simultaneous methylation of these 3 genes was more often in those with higher tumor stage and lymph node metastasis (P=0.028 and 0.007, respectively). Conclusion:Hypermethylation of BRCA1, GSTP1 and MGMT genes may be linked to various known clinicopathological features of breast cancer in Chinese women, and the increasing multiple gene methylation in tumors may indicate an aggressive phenotype for breast cancer. Detection of the methylation status of these genes may be useful for identifying patients at high risk for breast cancer.

70% for 9 patients;the positive rate was between 30-70% for 4 patients;the positive rate 0.05). Conclusion Tamm-Horsfall detection of RBC in urine could be used as one of the Identification indicators for DN hematuria, and it can provide a basis for diagnosis and treatment of DN.

Objective: To discuss the significance of neoadjuvant chemotherapy followed by surgery in the treatment of local advanced esophageal cancer. Methods:A total of 272 cases of local advanced esophageal cancer were studied in retrospect. Out of the 272 cases, 112 were treated with neoadjuvant chemotherapy followed by surgery (CT-S), whereas the remaining 160 cases underwent surgical treatment (S) only. Complications and survival state after surgery were compared. Results: The rate of complications after surgery was as follows: CT-S: 34.8% (39/112); S: 29.4% (47/160), P=0.50. The five-year survival rate was 35.7% and 29.4%, respectively, P<0.05. The CT-S patients were divided into partial remission (PR) and stable disease (SD)/progressive disease (PD) groups according to the effect of the chemotherapy. The five-year survival rate was 38.5% and 30.1%, respectively, P<0.01. Conclusion: Neoadjuvant chemotherapy is available for local advanced esophageal cancer. Postoperative complications are not increased by chemotherapy, and the survival rate for local advanced esophageal cancer is improved by neoadjuvant chemotherapy. PR has better prognosis compared with SD/PD.

Objective To study the efficiency and safety of short-term combination therapy with e-tanercept, methotrexate and eyclophosphamide in the patients with active rheumatoid arthritis. Methods Eighty-four patients with rheumatoid arthritis were included into this study. However, only fifty-six patients were treated with either twice-weekly subcutaneous etanercept, weekly oral MTX and CTX injection every three weeks or twice-weekly subcutaneous etanercept only. The American College of Rheumamatology (ACR) criteria for improvement was used for clinical efficacy assessment and the following laboratory papameters were analyzed:blood routine test, ESR, liver enzymes and renal function parameters, RF and anti-CCP antibody at baseline and the 2,4,8,12,24,36,52 weeks .At the same time ,all the adverse events were monitored throughout the study. Results The improvement of patients who received etanercept shortly, MTX and CTX periodically was as rapid as that of the patients who only received etanercept in ACR20, ACRYO, ESR and CRP (P>0.05). At the end of 36 weeks treatment, the level of anti-CCP antibody in the control group was higher than that of the test group. There was no significant difference between the two groups in adverse events (P<0.05). Conclusion The efficacy and safety of treatment with etanercept, methotrexate and cyclophosphamide in the patients with active rheumatoid arthritis is good.

Objective To explore the relative expression of plasma miR-199a-5p and miR-200c-3p in gastric adenocarcinoma cancer(GAC) patients and its clinical value.Methods Case-control study was used in this research.The relative expression of plasma miR-199a-5p and miR-200c-3p from 47 GAC patients and 50 healthy controls were determined by RT-PCR ( TaqMan Probe method).Meanwhile, the association with age, gender, tumor location, size, degree of differentiation, TNM stage, lymph node metastasis and other clinical pathological parameters were analyzed.The expression of these two miRNAs in plasma of 30 GAC patients during preoperation was compared with their expression 6-8 days after radical surgery.The sensitivity and specificity of plasma miRNAs expression for the diagnosis of GAC were analyzed using the receiver operating characteristic ( ROC ) curve.SPSS20.0 statistical software was used for statistical analysis.T-test, paired t-test and one-factor ANOVA were used for normal distribution of quantitative data.Results The plasma level of miR-199a-5p in GAC patients was significantly lower(1.05 ±0.22) (t =3.058,P =0.003), while miR-200c-3p was significantly higher(15.15 ±3.02) (t =-2.854,P=0.006), when they were compared with those in controls(26.80 ±8.38, 3.39 ±0.87).Low miR-199a-5p expression in GAC patients were associated with lymph node metastasis ( F =4.725, P =0.029) and the differentiation degree of gastric cancer(F=3.854,P=0.032).The relative expression of miR-199a-5p in postoperative plasma was significantly increased(t=-3.814,P=0.001), but the relative expression of miR-200c-3p was significantly reduced when compared to the preoperative samples(t=2.978, P=0.006).Area under the ROC curve of miR-199a-5p, miR-200c-3p and combined miR-199a-5p and miR-200c-3p were 0.692, 0.792 and 0.798, the sensitivity and specificity were 87%,97%,92.5% and 43%,54%, 65%, respectively.Conclusion Combined detection of miR-199a-5p and miR-200c-3p in plasma has a higher sensitivity and specificity than the conventional tumor marker CEA and CA19-9, and may be a useful combination for gastric cancer diagnosis.

Background and purpose:Aberrant DNA methylation that leads to the inactivation of tumor suppressor genes plays important roles in development and progression of breast cancer. Clinically, related gene methylation is considered to be a promising biomarker for tumor diagnosis and prognosis. This study aimed to investigate the methylation status ofSox17 gene in breast cancer tissue and its corresponding plasma circulating DNA, as well as to investigate its value in breast cancer early diagnosis and prognosis.Methods:TheSox17 gene promoter methylation status was detected by MSP in 86 cases of breast cancer, 36 normal breast tissues and its paired plasma DNA, the results were analyzed with corresponding clinical and pathological features.Results:The frequency ofSox17 gene methylation rate among 86 breast cancer tissues was 77.9%(67/86), and was 61.6%(53/86)in plasma circulating DNA, however, noSox17 gene methylation was found in normal breast tissues.Sox17 gene promoter methylation in plasma circulating DNA was signiifcantly associated with the methylation status in tumor tissues (r=0.502,P=0.000). In breast cancer tissue specimens,Sox17 methylation status was significantly correlated with tumor stage (χ2=6.18,P=0.041) and lymph node metastasis (χ2=13.54,P=0.001);Sox17 gene methylation rate was signiifcantly correlated with tumor stage (χ2=27.06,P=0.000), tumor size (χ2=9.65,P=0.007) and lymph node metastasis (χ2=20.80,P=0.000) in plasma samples, and there was no signiifcant difference ofSox17 gene methylation between patient age, histological grade and ER, PR, HER-2/neu status.Conclusion:Sox17 gene promoter methylation plays an important role in the carcinogenesis and development of breast cancer, and may be associated with the prognosis of breast cancer. Furthermore, methylatedSox17 gene may be a useful tumor biomarker in plasma circulating DNA for breast cancer detection and disease monitoring.

Objective To investigate the anatomical relation between Zuckerkandl's tubercle and recurrent laryngeal nerve and the superior parathyroid glands anatomy in endoscopic thyroidectomy.Methods From Jul.2012 to Jun.2014 implementation of the 120 cases of endoscopic thyroid surgery (at least one side of the line lobectomy) intraoperative Zuckerkandl tubercle of the presence, all the patients from Subei People's Hospital and location of the relationship between anatomy recurrent laryngeal nerve and superior parathyroid glands.Zuckerkandl tubercle identified by intraoperative recunent laryngeal nerve to expose and superior parathyroid glands.Results Zuckerkandl tubercle appear in the vast majority of cases: on the left is 86％ (51/59), 88％ in the right side (65/74), most of superior parathyroid glands were located on the top of Zuckerkandl tubercle.Looking for recurrent laryngeal nerve by Zuckerkandl tubercle method is more direct, can reduce surgical bleeding and shmten the operation time.Conclusion Recurrent laryngeal nerve and superior parathyroid glands and have close anatomical relationship with Zuckerkandl tubercle.In endoscopic thyroidectomy by intraoperative discern Zuckerkandl tubercle can better avoid injury recurrent laryngeal nerve and superior parathyroid glands.