Objective To evaluate the clinical value of bone alkaline phosphatase in early diagnosis and treatment effect of chil-dren′rickets and to understand the incidence rate of rickets in children in the local region by the detection of neonatal bone alkaline phosphatase(NBAP).Methods 2 184 children with physical examination in our hospital from January to December 2013 were se-lected and divided into the infants,young children,preschool and school-age children groups according to age.The finger blood was collected for detecting the bone alkaline phosphatase in the peripheral blood by the bone alkaline phosphatase reagent kit provided by Beijing Jinyu diagnosis technology Co.,Ltd.Results Among detected 2 184 children,the detection rate of clinical rickets(NBAP>250 U/L)was 10.1 %,moreover the smaller the age,the higher the detection rate;the detection rate of subclinical rickets(NBAP 200~250 U/L)was 65.5%,indicating that most children in Baoji region were in sub-health state;the detection rate in spring and winter was higher than that in summer and autumn;the detection rate of NBAP had no gender difference.Conclusion Children are in the rapid growth and development period,easy to suffer from vitamin D deficiency,the activity detection of NBAP has important clinical value in the early diagnosis of rickets caused by vitamin D deficiency.Prevention should begin from perinatal period and NBAP should be timely detected in order to conduct early diagnosis and early treatment.

Objective To investigate the expression level of hyper sensitivity C-reactive protein (hsCRP) in children infected with different pathogens in order to enhance the application value of hsCRP .Methods One hundred and one children patients with infection from March 2010 to March 2015 were selected as the research subjects and divided into the bacterial infection group (67 ca-ses) and mycoplasma infection group (34 cases) according to the hematology and bacterial culture results .Contemporaneous 50 healthy children were selected as the control group .Venous blood was collected for detecting hsCRP ,white blood cell(WBC) and neutrophil percentage(NEUT% ) .Results The levels and abnormal rates of hsCRP and WBC in the bacterial infection group were significantly higher than the those in the mycoplasma infection group and control group (P<0 .05);NEUT% and abnormal rate in the mycoplasma infection group was higher than that in the other two groups (P<0 .05) .The levels and abnormal rates of hsCRP and WBC after treatment in the bacterial infection group were lower than those before treatment ,the difference was statistically sig-nificant(P<0 .05);the area under the ROC curve of hsCRP for diagnosing bacterial infection wa maximal ,which was 0 .68 ,the sensitivity and specificity were 89 .9% and 88 .3% respectively .Conclusion The hsCRP level detection has early diagnostic value for child bacterial infection and can dynamically reflects the curative effect .

Objective To explore the clinical application of single or combined detection of serum Cys-C,5'-NT and AFP in hepatocellular carcinoma (HCC) in order to provide the platform for early diagnosis and prognosis evaluation.Methods The serum levels of Cys-C,5'-NT and AFP from 148 cases of HCC patients (HCC group),135 cases of liver cirrhosis patients (LC group) and 155 cases of hepatitis (hepatitis group) and 100 healthy people (control group) were measured by latex-enhanced immunoturbidimetric assay (LEITD),peroxidase method and electrochemiluminescence immunoassay (ECLI),respectively.Then their differences had been compared.The sensitivity,specificity and Youden's index were calculated and the results were analyzed by receiver operating characteristic (ROC) curve.Results The levels of serum Cys-C,5'-NT and AFP were significantly different in 4 groups.The differences were statistically significant (F =12.35,42.25,58.12,P =0.000).The sensitivity of three indicators for diagnosing HCC was 100 ％,which was higher than that of single or two combined detection (P ＜ 0.05),and the specificity was 78.97 ％.The area under ROC curves of combined detection of three indicators was 0.977,which was also higher than single or two combined detection (P ＜ 0.05).Conclusions The combined detection of serum Cys-C,5'-NT and AFP can greatly increase the sensitivity and accuracy for diagnosing HCC,which has an important clinical value for early diagnosis.Therefore it is worth popularizing and applying on clinic.

Objective To investigate the application of alpha-fetoprotein (AFP),α-L-fucosidase(AFU),5'-nucleotidase(5'-NT) and γ-glutamyltransferase (GGT) in diagnosis of hepatocellular carcinoma(HCC),and to provide the basis for its early and rapid diagnosis.Methods The clinical data of 120 cases with initial diagnosis as hepatocellular carcinoma,150 cases with liver cirrhosis,200 cases with hepatitis were analyzed retrospectively from June 2013 to August 2014,meanwhile,100 healthy people were selected as control group.The serum AFP,AFU,5'-NT and GGT levels were measured by electrochemiluminescence immunoassay,rate method,peroxidase method and enzymatic colorimetric assay,respectively.The results were analyzed by receiver operating characteristic (ROC) curve,while the sensitivity,specificity,AUC were calculated at the same time.Results The levels of serum AFP,AFU,5'-NT and GGT were significantly different among HCC group,liver cirrhosis group,hepatitis group and control group (all P＜0.05).When tested alone,the sensitivities of AFP,AFU,5'-NT and GGT were 58.33 ％(70/120),82.50 ％(99/120),85.00 ％(102/120),78.33 ％(94/120),the specificities were 88.33 ％(106/120),73.33 ％(88/120),88.33 ％(106/120),71.67 ％(86/120),and AUC were 0.655,0.702,0.814,0.754.When four indexes were performed with combined test,the sensitivity was 98.33 ％(118/120),specificity was 96.67 ％(116/120),AUC was 0.975,which were higher than the single detection (all P＜0.05).Conclusion The combined detection of serum AFP,AFU,5'-NT and GGT can greatly increase the sensitivity and specificity for diagnosing HCC and will gain mutual complement advantages,which is of great clinical value for early and rapid diagnosis.

Objective To investigate the clinical value of serum human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125) combined with risk of ovarian malignancy algorithm (ROMA) index in the diagnosis of ovarian cancer. Methods A total of 541 patients in the Department of Gynaecology in Baoji Central Hospital from August 2016 to February 2018 were collected. The serum HE4 and CA125 levels were measured by using electrochemiluminescence immunoassay in 226 cases of ovarian cancer (ovarian cancer group), 315 cases of ovarian benign disease (ovarian benign disease group) and 100 female healthy people (the control group). ROMA index was calculated according to ROMA model and the results were analyzed statistically. Results The levels of serum HE4, CA125 and ROMA index were significantly different in premenopausal and postmenopausal ovarian cancer group, ovarian benign disease group and the control group (all P<0.05). The sensitivity and Yonden's index of the three combined diagnosis of serum HE4, CA125 and ROMA for premenopausal ovarian cancer were 97.01 ％ and 77.01 ％ respectively, which were higher than those of a single detection (HE4:79.37％, 69.11％;CA125:76.06％, 66.38％;ROMA index:89.55％, 72.41％;χ2sensitivity=12.35, P=0.000;χ2Yonden's index=6.460, P=0.013. The sensitivity and Yonden's index ofthe three combined diagnosis of serum HE4, CA125 and ROMA for postmenopausal ovarian cancer were 98.99 ％ and 82.99 ％ respectively, which were higher than those of a single detection (HE4: 86.90 ％, 79.40 ％; CA125: 82.98 ％, 76.31 ％; ROMA index: 93.54 ％, 80.64 ％; χ2sensitivity = 14.25, P = 0.000;χ2Yonden's index= 4.822, P= 0.031). The area under the curve of the combined detection of three indicators was higher than that of a single detection (premenopausal group: 0.871 vs. 0.682, 0.626, 0.708; postmenopausal group: 0.981 vs. 0.724, 0.705, 0.833), and there were significant differences (premenopausal group: χ2 =11.24, P= 0.000; postmenopausal group: χ2= 16.38, P= 0.000). Conclusion The combined detection of serum HE4, CA125 and ROMA index can increase the sensitivity and accuracy for diagnosing ovarian cancer, which can provide a more reliable basis for diagnosis and screening of ovarian cancer.

Objective To observe and analyze the effect of HbA1c level on macular microcirculation in patients with type 2 diabetes mellitus (T2DM).Methods A cross-sectional study.One hundred and twenty-four T2DM patients (124 eyes) without diabetic retinopathy who diagnosed by the examination of fundus color photography in Lixiang Eye Hospital Of Soochow University during September to December 2017 were enrolled in this study.There were 59 males (59 eyes) and 65 females (65 eyes),with the mean age of 65.06±7.99 years old.All patients underwent BCVA,fundus color photography,and OCT angiography (OCTA).The history of diabetes,hypertension and dyslipidemia were recorded in detail.According to the HbA 1 c level,patients were divided into three groups,HbA1c ideal control group (group A,HbA1c ＜7％,67 eyes),HbA1c control group (group B,7％≤HbA1c≤9％,44 eyes),and HbA1c poor control group (group C,HbA1c＞9％,13 eyes),respectively.The 3 mm × 3 mm range of the macular area was scanned by OCTA instrument.The vascular density (VD) and skeleton density (SD) of nonsegmented retinal layer (NRL),superficial retinal layer (SRL) and deep retinal layer (DRL) in the macular area and foveal avascular zone (FAZ) area,non-circularity index,axial rate (AR) of SRL were measured.The correlation between HbA1c,BCVA and VD,SD ofNRL,SRL,DRL was analyzed statistically with Spearman correlation test.The correlation between systemic factors and the above indicators was analyzed statistically with linear regression analysis.Results The results of linear regression analysis showed that HbA1 c was significantly correlated with VD (t=-3.237,-3.156,-2.050) and SD (t=-0.3.45,-3.034,-2.248) of NRL,SRL and DRL (P＜0.05);but no correlation with FAZ,non-circularity index and AR (t=1.739,0.429,1.155;P＞0.05).The differences of VD (F=6.349,5.981,3.709),SD (F=7.275,6.085,1.904) and AR (F=0.027) of NRL,SRL and DRL in group A,B and C were statistically significant (P＜0.05);but the differences of FAZ (F=1.904),non-circularity index (F=0.280) was not statistically significant (P＞0.05).Significant differences (P＜0.05) of VD and SD of NRL were found between group A and B (t=1.987,2.201),group A and C (t=3.365,3.572),group B and C (t=2.010,2.076).Significant differences (P＜0.05) of VD and SD of SRL were found between group A and B (t=2.087,2.168),group A and C (t=3.197,3.194).There were significant differences (P＜ 0.05) in SD of DRL between group A and B (t=2.239),group A and C (t=-2.519).There was significant difference in VD of DRL between group A and C (t=2.363).The results of Spearman correlation analysis showed that HbA1c was negatively correlated with VD (r=-0.273,-0.255,-0.222;P=0.002,0.004,0.013) and SD (r=-0.275,-0.236,-0.254;P＜0.05) ofNRL,SRL,DRL;positively correlated with FAZ and BCVA (r=0.221,0.183;P＜0.05).BCVA was negatively correlated with VD (r=-0.210,-0.190,-0.245) and SD (r=-0.239,-0.207,-0.296) of NRL,SRL,and DRL (P＜0.05),but not correlated with FAZ (r=0.099,P＞0.05).Conclusion The decrease of macular perfusion and the morphological change of FAZ accompanied by HbA1c increased.

Objective: To investigate the diagnostic value of ultrasound-guided fine-needle aspiration cytology (FNAC) and fine-needle aspiration washout fluid thyroglobulin (FNA-Tg) detection for neck lymph nodes metastasis in patients with papillary thyroid carcinoma (PTC). Methods: A total of 214 PTC patients confirmed by pathology biopsy in Baoji Central Hospital from August 2015 to October 2018 were collected, and they all underwent ultrasound-guided FNAC, and FNA-Tg was measured by using electrochemiluminescence immunoassay. The histopathologic detection was performed for all suspicious lymph nodes after lymphadenectomy, and the results were analyzed by using statistics. Results: There were 282 suspicious enlarged lymph nodes detected from 214 PTC patients. Histopathological examination showed 220 lymph node metastases were positive, 62 were negative. FNAC examination showed 193 lymph nodes were positive and 89 were negative. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNAC for diagnosing the lymph nodes of metastasis PTC was 84.55%, 88.71%, 73.26%, 96.37%, 61.80%, 85.46%, respectively. FNA-Tg test showed that 198 lymph nodes were diagnosed as positive metastasis and 84 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNA-Tg for diagnosing the lymph nodes of metastasis PTC was 88.64%, 95.16%, 83.80%, 98.48%, 70.24%, 90.07%, respectively. Both FNAC and FNA-Tg test showed 215 lymph nodes were diagnosed as positive metastasis and 76 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of combined treatments were 97.63%, 87.32%, 84.95%, 95.81%, 92.54%, 96.81%, respectively. The sensitivity and accuracy of combined detection were higher than those of single detection, and there were statistically significant differences (all P < 0.05). Conclusions FNAC and FNA-Tg detection are simple, safe and accurate. The combined detection of FNAC and FNA-Tg can improve the sensitivity and accuracy for the diagnosis of PTC lymph node metastasis.