Objective The aim of this study was to assess the clinical value of pro-gastrin releasing peptide (ProGRP) , squamous cell carcinoma antigen (SCC-Ag), cytokeratin 19 fragment antigen 21-1 (Cyfra21-1) and carcino-embryonic antigen (CEA) in the diagnosis and clinical stage of lung cancer in Chinese patients.Methods Patients with lung cancer and benign lesions confirmed by pathology were enrolled in Peking Union Medical College Hospital from January 2013 to October 2014.The serum levels of four tumor markers (ProGRP, SCC-Ag, Cyfra21-1 and CEA) were measured using immunoassays before treatment.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the areas under the receiver operating characteristic curve (AUCROC) of these four tumor biomarkers were analyzed for the diagnosis of lung cancer.Results A total of 134 patients were finally analyzed, including 73 patients with lung cancer and the other 61 patients with benign lung disease.The diagnostic sensitivity of serum Cyfra21-1 to lung cancer was 67.1％, the specificity 45.1％, the AUCROC 0.658.The diagnostic sensitivity of the panel including ProGPR, Cyfra21-1 and CEA to lung cancer was 75.3％ , the specificity 57.4％ , the AUCROC 0.702.In the lung cancer group, the AUCROC of ProGRP over 65 ng/L to diagnose small cell lung cancer was 0.954;the AUCROC of SCC-Ag over 1.5 μg/L to diagnose squamous cell lung cancer was 0.788;the AUCROC of Cyfra21-1 to diagnose non-squamous-non-small-cell lung cancer was 0.716.In small cell lung cancer patients, the level of ProGRP in limited-disease small cell lung cancer (LD-SCLC) were significantly higher than that in extensive-disease small cell lung cancer (ED-SCLC) (P =0.005).Conclusion This panel of serum tumor markers including ProGRP, Cyfra21-1 and CEA improves the diagnostic specificity and sensitivity in patients with high-risk lung cancer.The serum CEA level of advanced lung cancer patients is significantly increased.The high level of serum ProGRP predicts the ED-SCLC.

50%) underwent renal artery stent implantation and percutanous coronary intervention, only 10 of them with merely renoarterial stenosis undergone renal artery stent implantation. The successful rates of the procedure and complication together with the volumes of contrast media were recorded respectively. And the serum creatitine before and 12 hours after the successful procedure were also measured. Results Both rates of procedural success and complication were similar among the three groups. The serum creatitine levels, 12 hours after the procedure, showed no difference in comparing with the baseline. Conclusion Non-ionic contrast media (Iopamiro 370) could be safely used in patients with RAS.

Objective To evaluate the efficacy and safety of Firebird drug-eluting stent (DES) in the treatment of de novo native coronary artery lesions.Methods 60 patients underwent coronary artery stenting with Firebird DES (Firebird group), 52 patients with Cypher DES (Cypher group) and another 20 patents with Mustang bare stents (Mustang group). The instant and short term follow-up outcomes were compared among the three groups. Results The procedural successful rates (98.3%vs 100.0%vs 100.0%), nitrate cessation (32.1%vs 33.3%vs 29.4% ), re-admission(5.6%vs8.3%vs11.7%) and follow-up rates (88.3%vs 92.3%vs 85.0%) did not significantly differ among the three groups. As compared with Firebird group, patients in Mustang group had more MACE(17.6%vs 0), higher occurrence rates of restenosis(17.6%vs 0) and target vessel revascularization(17.6%vs 0)(P

0.05) were of no significance between the 2 group. There was no difference in recurrent agina and improvement of blood pressure. But rates of re-admission (26.9% vs 7.3%) and comorbity of renal failure (23.1% vs 1.8%) in group Ⅰ were significantly higher than those in group Ⅱ ( P

Objective To determine the long-term outcomes of renal interventional therapy in patients with renal artery stenosis. Methods One hundred thirty-four consecutive patients reveived renal stenting in our hospital. The changes of BP and serum creatitine were measured 24 hours after the procedure and during the first and second year of follow-up. Results All procedures were performed successfully. The mean serum creatitine level increased [(109.8?24.6) ?mol/L vs (99.4?27.8 baseline level) ?mol/L] and the glomerular filtration rate decreased [(57.6?19.3)mL/min vs (68.5?18.9) mL/min] significantly after the procedure. However during the first and second year of follow-up, the serum creatitine level returned to the pre-procedure level. Sixty-four patients attained benefit of BP improvement at about 6 months after renal artery stenting. The mean systolic pressure 6 months after the procedure was (148.6?22.6) mm?Hg (1 mm?Hg=0.133 kPa), which was significantly lower than the baseline level. During the first and second year of follow-up, there were 56 patients (50.6%) and 50 patients (49.6%) achieved BP improvement from renal stenting respectively. Conclusion Renal stenting is efficient and has satisfactory long-term outcomes in treating renal artery stenosis.

Objective To investigate the preventive effects of anti-viral therapy in combination with transcatheter arteria chemoembolization (TACE) on recurrence of HBV-related hepatocellular carcinoma (HCC) after operation. Methods According to selection standards, 49 patients treated in this hospital from January 2003 to June 2009 were enrolled in this study and divided into a control group and combined group.The cumulative tumor-free survival rate, cumulative survival rate, the 1-, 2- and 3-year recurrence rates and cumulative recurrence rates were determined in all the patients and compared between the 2 groups. Results The cumulative tumor-free survival rate and cumulative survival rate were significantly higher in the combined group than in the control group (P=0. 019, 0. 008). The 1-, 2-, and 3-recurrence rates were 24% vs. 38.9%, 28% vs. 33.3%, and 28% vs. 22.2% in the combined group and control group, respectively. The 1-, 2-, and 3-year cumulative recurrence rates were 24% vs. 38. 9%, 52% vs. 72. 2%, and 80% vs.94. 4% in the combined group and control group, respectively. Conclusion Anti-viral therapy in combination with TACE can exert significant preventive effects on recurrence of HBV-related HCC after operation.

Objective To investigate the clinical application value of the laparoscopic intraoperative cholan-giography in laparoscopic cholecystectomy,and summarize the experience.Methods The clinical data of 169 cases of laparoscopic cholecystectomy intraoperative cholangiography were analyzed retrospectively.Results 169 patients were successfully completed,131 cases recovered well and no complications occurred after operation.29 patients showed hyperamylasemia,of which 3 patients had intractable hyperamylasemia,8 patients complicated with secondary acute pancreatitis,with fasting,gastrointestinal decompression,enzyme inhibition(plus somatostatin)and acid,analgesic, anti infection,rehydration treatment after remission.Conclusion Laparoscopic cholecystectomy intraoperative cholan-giography is a safe and reliable diagnostic technique,on the occurrence of biliary residual stones in prevention of post-operative prevention and timely detection of bile duct injury during operation and improves the success rate of repair of bile duct injury has important clinical value;control adaptation of intraoperative cholangiography has important clinical significance of reasonable application license.

Objective To evaluate the clinical value of the isothermal RNA amplification assay (SAT) for detection of Mycobacterium tuberculosis in sputum samples.Methods Sputum specimens from 230 patients with diagnosed tuberculosis and 78 cases of other respiratory diseases during September to December 2011 were detected using SAT,BD960 culture,LowenStein-Jensen( L-J ) culture and concentrated smear simultaneously.The samples with different results between SAT and BD960 culture were tested by Mycobacterium tuberculosis PCR fluorescence diagnosis kits.Strains were identified by amplification and sequencing the BD960 culture-positive isolates and SAT amplification products.Positive detection rate of SAT and other three methods for patients with tuberculosis were compared by chi-square test.Results Using the results of BD960 culture as the golden standard (7 cases of pollution bacteria in BD960 culture was rejected ),the sensitivity,specificity,positive predictive value,and negative predictive value of SAT was 90.5％ (95/105),84.2％ (165/196),75.4％ (95/126),94.3％ (165/175),respectively.The agreement rate of SAT and BD960 culture was 86.4％ (260/301).For 223 tuberculosis patients,the positive detection rate of SAT,BD960 culture,L-J culture and concentrated smear was 56.5％ ( 126/223 ),45.7％ ( 102/223 ),41.7％ ( 93/223 ) and 37.2％ ( 83/223 ) respectively.The positive detection rate of SAT is significantly higher than the other three methods (x2 =4.087,P ＜ 0.05 ).Conclusion SAT,as a new technology for laboratory diagnosis of TB,has high specificity and sensitivity.The operation is fast and simple,and the pollution rate is low.It is a promising laboratory diagnosis method.

Objective Plasma levels of matrix metalloproteinase-9 ( MMP-9 ) and serum level of high-sensitivity C reactive protein (hs-CRP) were detected to investigate their distributions between patients with stable stroke and those with asymptomatic intracranial artery stenosis and to explore their clinical significance. Methods The mean level of the serum hs-CRP of the group with recurrent stroke (2.34 mg/L)was the highest, followed by that of the group with the stable stroke( 1.45 mg/L),asymptomatic intracranial artery stenosis ( 1.31 mg/L) and control group (0.96 mg/L) ( P = 0.001 ). The level of the MMP-9 was in sequence of recurrent stroke group ( 121.82 ± 72.99 ) μg/L ＞ asymptomaticintracranial artery stenosis group ( 119.18 ± 80.01 ) μg/L ＞ stable stroke group( 112.76 ± 59.66) μg/L,while no statistical significance was found among groups( P = 0.947 ). However, the level of MMP-9 of three patient groups( 118.08 ± 71.06 ) μg/L was significant higher than control group( 57.55 ± 10.44 )μg/L (P ＜0.001 ). The spearman analysis for the relationship showed that the concentration of MMP-9 was positively associated with that of hs-CRP ( r = 0.337, P ＜ 0.001 ). Conclusions The hs-CRP maintained a high level in stable stage of stroke. The MMP-9 level in the patients group was significant higher than control group and the level of MMP-9 was positively associated with that of hs-CRP which suggested MMP-9 might be correlated with atherosclerosis other than stroke occurrence.

Objective To explore the risk factors for methicillin-resistant Staphylococcus aureus (MRSA)infection of refractory wound,and provide reference for clinical prevention and control.Methods Clinical data of patients who were isolated Staphylococcus aureus (SA)from wound at the burn ward in a hospital from January 2006 to December 2013 were analyzed,patients were divided into four groups according to whether the isolated SA were MRSA and whether SA were from refractory wound or from non-refractory wound.Risk factors for MRSA infection of refractory wound were analyzed. Results A total of 112 isolates of SA were isolated from wound,statistical differences existed in the length of hospital stay,recent invasive operation,and recent antimicrobial use between patients in refractory wound MRSA group and refrac-tory wound methicillin-sensitive SA (MSSA)group (all P <0.05);non-conditional logistic regression analysis revealed that length of hospital stay>30 days (OR 95% CI :1.14-30.69)and recent invasive operation (OR 95% CI :1.41 -17.84) were independent risk factors for refractory wound MRSA infection.There were statistically differences in previous MRSA infection,burn depth,recent operation and recent antimicrobial use between refractory wound MRSA group and non-refrac-tory wound MRSA group(all P <0.05);non-conditional logistic regression analysis revealed that recent antimicrobial use (OR 95% CI :2.080-26.800)was independent risk factor for the persistence of MRSA infection of refractory wound. Conclusion Shortening the length of hospital stay,reducing invasive operation,and using antimicrobial agents ra-tionally are helpful for the prevention and control of MRSA infection of refractory wound.