Objective To investigate the diagnosis significance of human epididymis (HE4),cytokeratin-19-fragment (CYFRA21-1),carbohydrate antigen 199 (CA199) on the malignant ovarian tumor,and to evaluate the value of individual and combined detection in judging high risk ovarian cancer.Methods The serum HE4,CYFRA21-1,CA199 levels of 45 patients with primary ovarian cancer,56 patients with benign ovarian tumor and 50 healthy check-up women in our hospital were detected by electrochemiluminescence immunoassay (ECL).The positive rates and coincidence rates of them were analyzed and the diagnostic value of them were compared.Results HE4 and CYFRA21-1 levels of ovarian cancer group were significantly higher compared with the benign tumor group and healthy control group and the differences were statistically significant (Z=-8.61,P＜0.001;Z=-8.39,P＜0.001;Z=-8.60,P＜0.001;Z=-8.39,P＜0.001),however there is no difference between benign tumor group andcontrol group(Z =-1.31,P =0.189;Z =-1.29,P =0.191).The difference of CA199 between benign tumor group and control group was statistically significant (Z =-8.79,P ＜ 0.001).For the malignant tumors,the specificity and positive predictive value of HE4 (99.8％,99.7％),CYFRA21-1 (99.0％,96.7％) were very high and the diagnostic accordance rates were relatively high (93.4％,88.7％),but the sensibilities of them were lower compared with CA199.CA199 was increased both in benign and malignant ovarian tumors with different degrees,but the specificity was not very high (85.8％),and the positive predictive value and the diagnosis accordance rate were low (70.6％,84.1％).The combined detection of HE4,CYFRA 21-1 and CA199 could improve the sensitivity and of the diagnosis of ovarian cancer (100％) and accuracy (89.4％).Conclusions HE4 and CYFRA21-1 only increas in malignant ovarian tumors,and they are mainly used for the diagnosis of ovarian cancer;CA199 level is increased both in benign and malignant ovarian tumors,but the extent is different and it can be used for distinguishing and diagnosing of benign and malignant ovarian tumors.Combining the three indexes can improve the sensitivity and accuracy of the diagnosis of ovarian cancer,and has an important significance for the early diagnosis and treatment of ovarian cancer.

Berberine is an alkaloid initially isolated from some Chinese medicinal herbs,such as Rhizoma coptidis(Huanglian),preferable for its inexpensiveness and low adverse effects as a broad-spectrum antibiotic in the treatment of various infectious diseases.More and more investigations have shown that berberine has a great potential for the treatment of digestive tract diseases.This paper updates the recent discoveries in the clinical and basic studies of berberine for the treatment of digestive tract diseases.

Objective and accurate assessment of liver fibrosis in patients with chronic hepatitis B (CHB)helps to choose the correct therapeu-tic scheme and guide the clinical treatment.In recent years,the noninvasive diagnostic models for liver fibrosis have been constantly emerging, but no consensus has been reached in this regard.The research advances in noninvasive regression models for liver fibrosis in patients with CHB are reviewed according to different staging methods for liver fibrosis,and the existing models are analyzed in terms of problems and shortages. It is thought that further studies should be done to establish simpler,more effective models that have higher diagnostic values.

The pro-inflammation cytokine is secreted by cells,and the function is to promote and regulate inflammatory reactions.They include IL-1,IL-6,TNF-? and IFN-?.Researchs have revealed that the levels of serum pro-inflammation cytokinemight increase notably in inflammatory bowel disease patients and they could cause the change of intestinal epithelium tight junctions.

Objective To observe the clinical efficacy of psoriasis treated with avermectin A and astragalus and detect the changes of TNF-a in serum. Preliminarily study the anti-inflammatory and immunomodulatory mechanism of avermectin A and astragalus in the treatment of psoriasis. Methods 20 patients were randomly recruited into a control group (9 cases) and a treatment group (11 cases). Another 20 healthy people were recruited for comparison. The control group was administrated with avermectin A orally, 0.2±0.6 mg/kg·d, with the symptoms turning better, reduced the dosage till the recovery, the treatment group was injected with astragalus injection on the therapeutic basis of the control group. Detect and compare the levels of TNF-α in the serum of the patients with psoriasis before and after the treatment in both groups, then make a contrast to the healthy people. Results 20 patients got clinical cure. The level of TNF-α in the serum of healthy persons is 11.7± 6.7 ng/L, and the level of TNF-α in the serum of psoriasis patients before treatment is (45.4±12.4) ng/L and (46.4±16.9) ng/L in the treatment group and the control group respectively. Compared with healthy control group, the difference is significant. After treatment, is the TNF-αlevels dropped to (13.8± 5.4) ng/L and (20.9±6.3) ng/L in the treatment group and the control group respectively, showing no significant difference compared with healthy control group. The difference between the two group is also significant. Conclusion The efficacy of treating psoriasis with avermectin A and astragalus is better than using avermectin A exclusively. The mechanism may lie in its inhibiting the formation of TNF-α and so thus exerting the anti-inflammatory and immune regulatory functions.

Objective:To observe the clinical efficacy and safety of docetaxel combined with 5-fluorouracil in the treatment of pa-tients with advanced gastric cancer. Methods:Totally 84 cases of gastric cancer patients were randomly divided into group A and group B with 42 ones in each. Group A was given chemotherapy of docetaxel combined with 5-fluorouracil, and group B was treated with chemotherapy of Tegafur combined with docetaxel. One cycle was 21 days, and the patients were given at least two cycles of chemother-apy. The recent clinical curative effect, physical state improvement and adverse reactions in the two groups after the treatment were ob-served. Results:The total effective rate of the two groups showed no significant difference (P<0. 05), however, the physical state improvement rate of group A (40. 48%) was significantly higher than that of group B (20. 24%) with statistical significance (P<0. 05). The incidence of thrombocytopenia and neutropenia decrease of group A was significantly lower than that of group B with statis-tically significant difference (P<0. 05). Conclusion:The treatment of advanced gastric cancer patients with docetaxel combined with 5-fluorouracil can achieve significant clinical efficacy with relatively mild toxicity,it can significantly improve the physical state of pa-tient.

Objective To investigate the influence of Jianpi Bufei Huatan Recipe (JBHR), a Chinese herbal compound with the actions of strengthening spleen, tonifying lung and resolving phlegm, on the pulmonary function of childhood bronchial asthma at remission stage, and to explore the possible therapeutic mechanism. Methods Sixty bronchial asthma children at remission stage were divided into treatment group and control group, 30 cases in each group. Both groups were treated with inhalation of fluticasone propionate, and additionally, the treatment group was given oral use of JBHR(mainly composed of Radix Astragali, Radix Pseudostellariae, fried Rhizoma Atrctylodis Macrocephalae, Radix Saposhnikoviae, Poria, Pericarpium Citri Reticulatae, Rhizoma Pinelliae, prepared Radix Glycyrrhizae, calcined Os Draconis, calcined Concha Ostreae, and Semen Lepidii seu Descurainiae). The therapeutic effect of the two groups was evaluated after treatment, and the changes of peak expiratory flow(PEF), peak expiratory flow variation(PEFv) were also observed after treatment for 1, 2, 3, 6, 9, a nd 12 month(s). Results (1)The total effective rate of the treatment group was 93.33%, and that of the control group was 83.33%, the difference being significant(P<0.05). (2) During the treatment, PEF was higher and PEFv was lower in the treatment group than those in the control group(P<0.05). Conclusion JBHR could relieve the clinical symptoms, improve the pulmonary function and decrease the hyperactivity of airway of pediatric bronchial asthma at remission stage with lung-spleen qi deficiency.

Objective To evaluate the application effect of clinical nursing pathways in acute myocardial infarction patients by using the Meta-analysis.Methods Published randomized controlled trials (RCT) in acute myocardial infarction patients were searched and screened in CNKI,VIP,Wanfang database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.0 software was taken for analysis.Results Totally 18 studies including 1877 cases were eligible to the criteria (894 in the experimental group and 983 in the control group) altogether.The Meta-analysis showed there was significant difference between the experimental group and the control group in hospitalization days,patients' satisfaction degree and rate of mastering knowledge.Significant difference existed between the experimental group and the control group in bedridden time,complication rate and the recurrence rate of myocardial infarction.Conclusions Application of clinical nursing pathway in acute myocardial infarction patients can shorten hospitalization days,increase patients' satisfaction degree and rate of mastering knowledge,decrease bedridden time,complication rate and the recurrence rate of myocardial infarction.

OBJECTIVE:To study in vitro anticancer activity of conjugated linoleic acid-gemcitabine conjugate (CLA-GEM). METHODS:IC50 of different tumor cells (breast cancer MCF-7 cell,breast cancer MDA-MB-231 cell,lung cancer A549 cell, small cell lung cancer NCI-H446 cell,glioma C6 cell)were investigated after treated with different concentrations(0.001-100μmol/L)of CLA-GEM and gemcitabine(GEM)for 72 h;survival rates of MCF-7 cell were investigated after treated with above so-lution for 24,48 and 72 h. The dependence of 0.001-100 μmol/L CLA-GEM and GEM to nucleoside transporter was investigated (by IC50)through MCF-7 cells and MDA-MB-231 cells treated with nucleoside transporter inhibitors(NBMPR,100 μmol/L)and di-pyridamole(4 μg/ml). The change of MCF-7 cell cycle was investigated after treated with 1 μmol/L CLA-GEM and GEM for 24 h. RESULTS:Compared with GEM,IC50 of MCF-7,MDA-MB-231 and NCI-H446 cells became lower after treated with CLA- GEM (P<0.01),there were no statistical significances in IC50 between A549 and C6 cells(P>0.05). Survival rate of MCF-7 cells de-creased significantly after treated with GEM for 48 h and CLA-GEM for 24 h. Survival rate of MCF-7 cells was the lowest,being 21% after treated with GEM for 72 h,while tumor cells were sacrificed by CLA-GEM completely. Compared with GEM or CLA-GEM,IC50 of MCF-7 and MDA-MB-231 cells increased significantly after treated with NBMPR,dipyridamole combined with GEM (P<0.01);there were no statistical significance in IC50 after treated with NBMPR,dipyridamole combined with CLA-GEM (P>0.05). Compared with GEM,CLA-GEM could prolong 6% of S stage of MCF-7 cells (P<0.01). CONCLU-SIONS:Compared with GEM,CLA-GEM exhibits significant antitumor activity and rapid action,and it isn’t influenced by nucle-ic acid transportation.

OBJECTIVE:To provide reference for rational use of anticoagulant drugs in the clinic. METHODS:Medical or-ders of anticoagulant drugs were collected from hospital information system of our hospital during 2013-2015. Those medical orders were analyzed in respects of consumption sum,DDDs,DDC and drug utilization. RESULTS:During 2013-2015,the sum tatio of Low-molecular-weight heparins calcium injection(6000 AXaIU),Enoxaparin sodium injection(6000 AXaIU),Dalteparin sodium injection(5000 IU) and Rivaroxaban tablets(10 mg)were on the rise,while those of Nadroparin calcium infection(6150,4100 AXaIU)and Fondaparinux sodium injection(2.5 mg)were in the decline. DDDs of Nadroparin calcium injection(4100 AXaIU), Dalteparin sodium injection(5000 IU)and Enoxaparin sodium injection(6000 AXaIU)took up the first 3 places. DDC of Rivar-oxaban tablets was the highest,being 167.60-180.25 yuan. The utilization of Nadroparin calcium injection(6150,4100 AXaIU), Low-molecular-weight heparins calcium injection (6000 AXaIU),Fondaparinux sodium injection(2.5 mg) and Warfarin sodium tablets(3 mg)showed good synchronization within 3 years,and the values of B/A ranged 0.50-1.50. Both consumption sum and utili-zation rate of rivaroxaban took up the first place in vascular surgery department. CONCLUSIONS:Based on the spectrum of diseases, the features of drugs and ADR,the utilization of anticoagulant drugs in our hospital is rational during recent 3 years. However,the uti-lization of anticoagulant drugs should be still used as routine pharmaceutical monitoring content.