Objective To analyze the clinical significance of the single detection or the combination detection of 3 kinds of tumor marker alpha-fetoprotein(AFP),alpha-fetoprotein-L3(AFP-L3)and DKK1 for the diagnosis of primary hepatic carcinoma(PHC). Methods AFP,AFP-L3 and DKK1 in the PHC group,benign hepatic diseases group and control group were detected by adopting the ECLIA,affinity adsorption chromatography and ELISA methods respectively.The ratio of AFP-L3 in AFP was calculated.Re-sults In the single detection,the sensitivity of AFP,AFP-L3 and DKK1 was 60.9%,76.8% and 69.6% respectively and the speci-ficity was 88.7%,91.5% and 95.8% respectively.In the combination detection,the sensitivity and specificity were 91.3% and 87.3% respectively,the differences between the single detection and the combination detection had statistical significance (P <0. 05).Conclusion The combined examination of serum AFP,AFP-L3 and DKK1 can elevate the sensitivity and specificity,which is much better and more accurate for diagnosing PHC than most of traditional combination detection at present.

Objective To investigate the clinical values of CA199 ,CA242 and DKK1 in diagnosing pancreatic cancer (PCA). Methods The serum levels of CA199 ,CA242 and DKK1 were measured with ECLIA and ELISA method in 112 patients with PCA ,58 patients with benign pancreatic disease and 62 individuals undergoing physical examination.The Kruskal-Wallis single fac-tor analysis of variance (ANOVA) and Mann-Whitney rank-sum test were adopted to conduct the statistical comparison.The ROC curve was drawn by using the Logistic regression model and the area under curve (AUCROC ) was calculated.Results The levels of serum CA199 ,CA242 and DKK1 in the patients with pancreatic cancer were significantly higher than those in the benign pancreatic disease group and healthy normal control group ,the difference was statistically significant ( H=76.30 ,61.2 ,47.60 ,P<0.05);the sensitivities of CA199 ,CA242 and DKK1 for diagnosing pancreatic cancer were 76.7% ,69.6% and 85.7% respectively ;the speci-ficities were 95.0% ,96.7% and 92.5% respectively ;the accuracies were 86.2% ,83.6% and 89.2% respectively.The sensitivity , specificity and accuracy of combined detection of CA 199 ,CA242 and DKK1 by the Logistic regression equation P= 1/[1 +e-(-4.163+0.21X1+0.156X2+0.342X3) ] were 94.4% ,90.8% and 92.2% respectively ;AUC of CA199 ,CA242 ,DKK1 and pre-1 were 0.736 , 0.862 ,0.886 and 0.949 ,respectively.Conclusion Serum CA199 ,CA242 and DKK1 levels have an important value in the diagnosis of pancreatic cancer ,and their combined detection could significantly improve the sensitivity and accuracy of pancreatic cancer diag-nosis.

Objective To investigate the expression of NAP in patients with acute myeloid leukemia (AML). Methods Expression of NAP of peripheral blood was assessed by flow cytometry. The serum levels of G-CSF, NE and IL-18 in 53 patients with AML and 50 healthy controls were examined by ELISA. Results The expression of NAP in AML patients [1 159(563 ~ 2 033)AB/c] was decreased than that of healthy controls [1 862 (1 345 ~ 2 382)AB/c], (P < 0.05). The serum levels of G-CSF, NE and IL-8 from AML patients [34.36 (25.17 ~ 47.24) ng/L, 397.56 (324.63 ~ 563.84) pg/mL, 585.34 (403.61 ~ 866.54) pg/mL] were significantly lower than those of healthy controls[54.52(46.27 ~ 77.14) ng/L, 689.74(496.78 ~ 899.14) pg/mL, 832.36(625.17 ~ 998.24) pg/mL] (P < 0.05). The expression of NAP in AML patients was positively correlated with the serum level of G-CSF (r = 0.621, P = 0.007). Conclusions The decreased expression of NAP, G-CSF, NE and IL-8 in the peripheral blood with AML could speculated that neutrophils immune function in patients with AML was restrained.

Objective In order to evaluate the present status of Radiation Oncology in China,the Chinese Society of Radiation Oncology performed the 6th continent prefecture of China e survey.Methods Questionnaire forms were sent by mail,e-mail,telephone and FAX.Results By August 31 st,2011,there were 1162 radiation oncology centers.There was a total of 30985 employees,including 9895 doctors,1887 physicists,11689 nurses,6103 technicians and 1411 engineers.There were 1296 linear accelerators,286 telecobalt units,81 deep x-ray machine,1040 simulators,376 CT simulators,317 brachytherapy units,1427 treatment planning system,1041 dosimeters,410 X-knife,and 230 γ-knife (122 for head only,108 for head and body).There were 56847 beds for inpatients (4 centers did not report the number of beds).More than 58000 patients were treated per day ( no report from 9 centers ),and 569056 new patients were treated annually (no report from 38 centers).Conclusions Radiation oncology was developed rapidly in the last 5 years,either in personnel,equipment,and new techniques.They are still insufficient in proportion to our population.

Objective To discuss the clinical value of new- utility anal vacuum tube in preventing anastomotic fistula after colorectal cancer anterior resection. Methods Ninety-six patients having underwent the colorectal cancer anterior resection were divided into new-utility anal vacuum tube group and normal anal vacuum tube group by random digits table method with 48 cases each. The complication, anus exhaust time and postoperative drainage volume were compared between 2 groups. Results The incidences of tube defluxion, proctalgia, anus skin damage, bed sheet pollution and anastomotic fistula in new-utility anal vacuum tube group were significantly lower than those in normal anal vacuum tube group: 6.25% (3/48) vs. 31.25% (15/48), 10.42% (5/48) vs. 41.67% (20/48), 0 vs. 25.00%(12/48), 6.25%(3/48) vs. 60.42%(29/48), 2.08%(1/48) vs. 12.50%(6/48), the anus exhaust time was significantly shorter than that in normal anal vacuum tube group:(44.1 ± 8.9) h vs. (48.9 ± 9.6) h, the postoperative drainage volumes form the first day to fifth day were significantly more than those in normal anal vacuum tube group: (31.2 ± 15.1) ml vs. (15.6 ± 8.2) ml, (25.3 ± 13.2) ml vs. (15.8 ± 6.5) ml, (15.6 ± 9.1) ml vs. (10.3 ± 4.5) ml, (104.3 ± 38.2) ml vs. (90.6 ± 12.3) ml and (93.7 ± 32.5) ml vs. (80.7 ± 18.9) ml, and there were statistical differences (P<0.01 or <0.05). The patients in new-utility anal vacuum tube group had different symptoms, but patients could tolerate. Conclusions The new-utility anal vacuum tube can reduce the incidence of anastomotic fistula, and be safe and reliable, which is worthy of wide application.

Objective To investigate the expressions of TK1 (thymidine kinase 1) in PHC (primary hepatic carcinoma). Methods TK1 and AFP in serum of 33 cases of PHC (primary hepatic carcinoma), 38 cases of hepatic cirrhosis,36 cases of hepatitis and 35 cases of healthy people were detected by means of Western blot—enhanced chemiluminecence and electrochemiluminescence. Results The difference of TK1 level in PHC group indicated significance when compared with that in hepatic cirrhosis group , hepatitis group and control group (U value was 436.4, 352.1, 163.6, respectively, all P < 0.01). TK1 level in patients with PHC was related with differentiation (χ2 = 7.476,P < 0.05) and TNM stage (χ2 = 7.227,P < 0.05),but not with sex, age, tumor diameter, number of tumors, vascular invasion, lymph node metastasis (P > 0.05). Kaplan-Meier curve analysis revealed that PHC patients with TK1≤ 2.0 pmol/L had a significantly shortened overall survival when compared with those with TK1 > 2.0 pmol/L (χ2 = 3.954,P < 0.05). Multivariable Cox regression analysis indicated that the level of TK1 and TNM stage were the independent risk factors for patients with PHC (all P <0.05). Conclusions The detection of TK1 has a certain clinical value in the diagnosis, monitoring and evaluation of the prognosis of the PHC.

Objective To detect the serum levels of 25‐hydroxy vitamin D[25‐(OH)D] ,homocysteine(HCY) andβ2‐microglob‐ulin(β2‐MG) in the patients with type 2 diabetes mellitus (T2DM ) and to investigate the relationship between serum HCY and β2‐MG with 25‐(OH)D and its clinical significance .Methods A total of 139 cases of T2DM were selected anddivided into 3 groups , the normal albuminuria group for [urinary albumin to creatinine ratio (UACR)< 30 mg/gCr ,45 cases] ,microalbuminuria group (UACR ≥ 30 mg/gCr and < 300 mg/gCr ,48 cases) and massive proteinuria group (UACR ≥ 300 mg/gCr ,46 cases) according to the urinary albumin to creatinine ratio (UACR) .Other 45 individuals undergoing the physical examination were selected as the con‐trol group .The serum 25‐(OH)D level was measured by electrochemiluminescence .Serum HCY level was determined by the enzy‐matic method .Serum β2‐MG level was measured by the latex enhanced immune turbidity method .At the same time ,the biochemical indicators of FBG ,HbA1C ,serum calcium and phosphorus were measured .Results The serum 25‐(OH)D level was decreased with the increase of urinary albumin in the DM patients .And the serum 25‐(OH)D level in the microalbuminuria group and the massive proteinuria group was significantly decreased compared with the normal albuminuria group and the control group ,the difference was statistically significant(P<0 .01) .The serum HCY and β2‐MG levels in the microalbuminuria group and the massive proteinuria group were significantly increased compared with the healthy control group ,the difference was statistically significant (P<0 .05) . Conclusion The serum 25‐(OH)D level is decreased with the increase of urinary albumin in the diabetic patients .The serum HCY andβ2‐MG levels are increased with the increase of urinary albumin and serum 25‐(OH)D level is negatively correlated with the HCY andβ2‐MG levels .

OBJECTIVETo explore the clinical application of laparoscopy in gastrointestinal abdominal emergency operation for patients over 65 years old.

METHODSClinical data of 138 cases (age>65 years) with acute abdomen undergoing laparoscopic surgery from January 2006 to June 2014 were analyzed retrospectively. Data of 170 cases treated by laparotomy during the same period were enrolled as controls.

RESULTSThe laparoscopy group and the laparotomy group showed statistically significant differences in blood loss [(107.1±47.7) ml vs. (163.6±106.5) ml, P=0.000], postoperative complications rate [2.9%(4/138) vs. 12.9%(22/170), P=0.022], hospital stay [(10.5±7.5) d vs. (16.5±9.9) d, P=0.044], postoperative ambulation time [(25.6±7.7) h vs. (33.2±5.6) h, P=0.020], and recovery time of postoperative gastrointestinal function [(36.9±9.1) h vs. (49.3±10.6) h, P=0.031]. Patients with acute appendicitis, upper digestive tract perforation and bowel obstruction in the laparoscopy group were superior to those in the laparotomy group in hospital stay, postoperative ambulation time, recovery time of postoperative gastrointestinal function and intraoperative blood loss(all P<0.01), while no significant differences in colon perforation and mesentery diseases were found in hospital stay, intraoperative blood loss and recovery time of postoperative gastrointestinal function between the two groups (all P>0.05).

CONCLUSIONSCompared with laparotomy, the laparoscopy offers the advantages of less trauma, faster recovery, shorter hospital stay, and lower postoperative complications rate for patients over 65 years with acute abdomen.

Abdomen, Acute ; Acute Disease ; Aged ; Appendicitis ; Blood Loss, Surgical ; Digestive System Surgical Procedures ; Humans ; Intestinal Obstruction ; Intestinal Perforation ; Laparoscopy ; Laparotomy ; Length of Stay ; Postoperative Complications ; Postoperative Period ; Retrospective Studies

Objective To study the clinical efficacy of Bikini incision minimally invasive total hip arthroplasty on elder patients with femoral head necrosis and its effect on bleeding.Methods Seventy-six elder patients with femoral head necrosis in Sanmenxia Central Hospital from January 2015 to December 2016 were randomly divided into the study group(38 cases)and the control group(38 cases).The patients in the study group were treated with Bikini incision minimally invasive total hip arthroplasty by anterior approach,while the control group underwent total hip arthroplasty by anterolateral approach.Harris score and WOMAC score were used to evaluate the clinical function of hip joint.The operation time,length of incision,intraoperative blood loss, blood transfusion,hospitalization time,hemoglobin level at 72 h after surgery,the first ambulation time,the lower limb length discrepancy,postoperative complication were recorded and compared between two groups.Results The Harris scores at 1,2,4 months after operation in the two groups were significantly improved(P<0.05), while WOMAC scores of patients at 1,2,4 months after operation were significantly lower than those before treatment(P<0.05).However,there were no significant differences at different time between the groups(P>0.05).The hospitalization time and the first ambulation time in the study group were significantly shorter than those in the control group((6.1±2.8)d vs.(7.9±3.2)d,P=0.011;(5.3±1.5)d vs.(6.4±1.7)d,P=0.004).After 4 months of treatment,the lower limb length discrepancy in the study group was less than that of the control group((6.5 ± 2.3)mm vs.(10.4 ± 3.5)mm,P<0.01).In addition,there were no significant differences between two groups in the operation time,length of incision,complication occurrence,intraoperative blood loss and blood transfusion(P>0.05).Conclusion Treating femoral head necrosis with Bikini incision minimally invasive total hip arthroplasty can achieve favorable effectiveness,with no increase in intraoperative blood loss and rapid recovery of postoperative joint function,but further follow-up is needed.

PURPOSE: Periostin mediates critical steps in gastric cancer and is involved in various signaling pathways. However, the roles of periostin in promoting gastric cancer metastasis are not clear. The aim of this study was to investigate the relevance between periostin expression and gastric cancer progression and the role of stress-related hormones in the regulation of cancer development and progression. MATERIALS AND METHODS: Normal, cancerous and metastatic gastric tissues were collected from patients diagnosed with advanced gastric cancer. The in vivo expression of periostin was evaluated by in situ hybridization and immunofluorescent staining. Meanwhile, human gastric adenocarcinoma cell lines MKN-45 and BGC-803 were used to detect the in vitro expression of periostin by using quantitative real-time polymerase chain reaction (PCR) and western blotting. RESULTS: Periostin is expressed in the stroma of the primary gastric tumors and metastases, but not in normal gastric tissue. In addition, we observed that periostin is located mainly in pericryptal fibroblasts, but not in the tumor cells, and strongly correlated to the expression of α-smooth muscle actin (SMA). Furthermore, the distribution patterns of periostin were broader as the clinical staging of tumors progressed. We also identified a role of stress-related signaling in promoting cancer development and progression, and found that isoprenaline upregulated expression levels of periostin in gastric cancer cells. CONCLUSION: These findings suggest that the distribution pattern of periostin was broader as the clinical staging of the tumor progressed and found that isoprenaline upregulated expression levels of periostin in gastric cancer cells.
Adenocarcinoma/*metabolism/pathology ; Adrenergic beta-Agonists/pharmacology ; Aged ; Blotting, Western ; Cell Adhesion Molecules/drug effects/*metabolism ; Cell Line, Tumor ; Fibroblasts/*metabolism ; Gene Expression Regulation, Neoplastic/*drug effects ; Humans ; Isoproterenol/*pharmacology ; Male ; Neoplasm Staging ; RNA, Messenger/genetics/metabolism ; Real-Time Polymerase Chain Reaction ; Signal Transduction ; Stomach/metabolism/pathology ; Stomach Neoplasms/*metabolism/pathology ; Up-Regulation