Objective To study the application of combined examination of the serum level of VEGF and AFP in the diagnosis of primary liver carcinoma.Methods Enzyme-linked immunosorbentassay(ELISA)and radioimmunoassy(RIA)were used to detect the serum levels of VEGF in 40 patients with liver cancer and those with 30 liver cirrhosis patients and 30 normal health as control.Results Serum VEGF level in liver cancer(444.8±220.9)pg/ml was significantly higher than those of liver cirrhosis(102.6±47.6)re/td and healthy subjects(78.9±24.2)pg/ml (P＜0.01).There was no significant difference in serum levels of VEGF between live subjectsr cirrhosis and healthy(P＞0.05).The high flerum level of VEGF had no significant relationship with AFP.The positve rate could be adranted from 76.3%in single examination to 84.9%when combined examination was carried out.Conclusion The serum VEGF was an independent indicator.which cooperate with AFP codd advance the detective rate of primary liver carcinoma.

Objective]To investigate the clinical efficacy of Yiqidaozhi decoction on spinal fracture dislocation patients postoperative abdominal distension pain. [Methods]From April 2012 to July 2014 the inpatient treatment of spinal fracture dislocation postoperative abdominal distension pain 172 cases patients,according to the random number table method combined with the admission number ,patients were divided into observation group(n=97) and control group(n=75),patients in observation group were given Yiqidaozhi decoction,while the control group was given conventional western medicine treatment,observed two groups patients after 48h treatment abdominal distension pain ,during the 5d treatment degree of pain and TCM syndrome integral improved etc.[Results]The observation group the total effective rate was 95.88%,significantly higher than 70.67%in the control group,the difference was statistically significant(P<0.05);The patients in the observation group after treatment 1,2,3,4d TCM syndrome integrals were (12.16 ±2.15) points,(7.28± 1.32) points,(5.11 ±1.18) points and (3.53±1.01) points respectively,significantly lower than the control group,the difference was statistically significant (P<0.05);Observation group after treatment 5d TCM symptoms integral compared with control group had no statistical significance( P>0.05);observation group treatment 1,2d TCM symptoms integral decline was obviously higher than that of the control group,the difference was statistically significant(P<0.05);The patients in the observation group treatment 1,2,3d VAS scores were (5.36±1.03) points,(4.56±0.95) points and (1.74±0.87) points respectively lower than that of the control group,the level of the same period,for the difference was statistically significant(P<0.05).[Conclusion]Yiqidaozhi Decoction on spinal fracture dislocation postoperative abdominal distention pain has better therapeutic effect ,and helps relieve pain.

Objective To evaluate the consistency of estradiol kits between E2-Ⅲ and the upgraded Enhanced Estradiol(eE2)kit with chemiluminescence immunoassay analyzer Siemens ADVIA Centaur.Methods Used duplicate samples and removed outliers to test the two reagents′stability;document EP9-A2 were used as reference to do the methodological comparison and bias estimation. Results There was good correlation between the two reagents with different concentrations,the correlation coefficients were grea-ter than 0.975;the percentage of bias was varied among different groups.Conclusion It is effective to reduce the interference of up-dated estradiol kits on the assisted reproduction treatment cycles by assessing the bias through comparison tests of the two kits in advance.

Tumor necrosis factor-like attenuated apoptosis inducer (TWEAK) is a new member of the tumor necrosis factor super family.TWEAK regulates cellular proliferation,differentiation,migration,apoptosis and inflammation by binding its receptor,fibroblast growth factor-inducible 14 (Fn14),through the interaction between cells or in a paracrine fashion.The role of TWEAK / Fn14 signaling pathway in the development of lung diseases such as lung injury,asthma and lung cancer has drawn increasing attention.

Objective:To investigate the role of m.4435A>G and YARS2 c.572G>T(p.G191V)mutations in the development of essential hypertension.Methods:A hypertensive patient with m.4435A>G and YARS2 p.G191V mutations was identified from previously collected mitochondrial genome and exon sequencing data.Clinical data were collected,and a molecular genetic study was conducted in the proband and his family members.Peripheral venous blood was collected,and immortalized lymphocyte lines constructed.The mitochondrial transfer RNA(tRNA),mitochondrial protein,adenosine triphosphate(ATP),mitochondrial membrane potential(MMP),and reactive oxygen species(ROS)in the constructed lymphocyte cell lines were measured.Results:Mitochondrial genome sequencing showed that all maternal members carried a highly conserved m.4435A>G mutation.The m.4435A>G mutation might affect the secondary structure and folding free energy of mitochondrial tRNA and change its stability,which may influence the anticodon ring structure.Compared with the control group,the cell lines carrying m.4435A>G and YARS2 p.G191V mutations had decreased mitochondrial tRNA homeostasis,mitochondrial protein expression,ATP production and MMP levels,as well as increased ROS levels(all P<0.05).Conclusion:The YARS2 p.G191V mutation aggravates the changes in mitochondrial translation and mitochondrial function caused by m.4435A>G through affecting the steady-state level of mitochondrial tRNA and further leads to cell dysfunction,indicating that YARS2 p.G191V and m.4435A>G mutations have a synergistic effect in this family and jointly participate in the occurrence and development of essential hypertension.

Objective:To observe Leber's hereditary optic neuropathy (LHON) microperimetry features, discuss its significance in diagnosis and treatment of LHON assessment.Methods:A retrospective clinical study. A total of 13 LHON patients (25 eyes) diagnosed in Department of Ophthalmology of the First Affiliated Hospital of Army Medical University from May 2015 to May 2020 (disease group) were included in the study, including 9 males (18 eyes) and 4 females (7 eyes), and beginning with the age of 15.0 (10.0, 57.0). Ten healthy volunteers (19 eyes) were selected as the normal group, including 7 males (13 eyes) and 3 females (6 eyes), aged 22.0 (6.0, 46.0) years at the first diagnosis. According to the course is divided into: asymptomatic group (carriers), subacute (<6 months), the dynamic group (6-12 months), chronic group (>12 months). There were 7, 6, 5 and 7 eyes, respectively. All eyes underwent best corrected visual acuity (BCVA) and microperimetry. BCVA test was performed using the international standard visual acuity chart, which was statistically converted to the logarithm of the minimum Angle of resolution (logMAR) visual acuity. MP-3 microperimetry was used to perform microperimetry, and the mean sensitivity (MS) values of five regions were recorded: center, superior, temporal, inferior, and nasal. Mann-Whitney U test was used for comparison between two groups, and Kruskal-Wallis H test was used for comparison between multiple groups. Results:Compared with the normal group, MS in the center, superior, temporal, inferior and nasal of the diseased group decreased, and the differences were statistically significant ( Z=-5.629, -4.906, -5.630, -5.631, -5.227; P<0.05). There were significant differences in different regions of MS between different course groups ( H=12.296, 11.583, 10.110, 12.994, 8.663; P<0.05). There were significant differences in logMAR BCVA and central MS between asymptomatic group and subacute group ( P=0.040, 0.007). There were significant differences in temporal, inferior and superior MS between subacute group and dynamic group ( P=0.026, 0.017, 0.018). Dynamic and chronic group, MS above the difference was statistically significant ( P=0.031). Idebenone treatment significantly improved visual field defects in 4 of 23 eyes. Conclusions:In the early stage of LHON, the central visual field defect gradually progresses to the temporal, inferior and superior areas, and the temporal and inferior areas are more severe. Visual field defects reached a stable level at 6-12 months. MP-3 can assist in early diagnosis of LHON, and provide reliable basis for efficacy evaluation.

Objective To explore the value of axis shift between the baseline normal sinus rhythm (NSR) and WCT in diagnosis of wide QRS-complex tachycardia (WCT). Methods 390 surface ECGs of 186 patients with WCT were obtained from April 2012 to April 2018 at Ningbo Medical Center Lihuili Hospital at which the arrhythmia diagnosis was proven by intracardiac electrophysiological study. The axis shift between the baseline NSR and WCT was calculated by table lookup method. Then we analyzed the role of axis shift in diagnosis of WCT. Results Among the 186 patients with WCT, 147 (79.03％) were ventricular tachycardia (VT) , and 39 (20.97％) were supraventricual tachycardia (SVT) with conduction abnormalities. In the 95％ confidence interval, the axis shift showed an outstanding discrimination performance. The area under the ROC curve is 0.708 (0.579-0.817, P =0.007). Compared with left axis deviation, right axis deviation, the right axis deviation of LBBB morphology, the axis shift> 68 degree is more sensitive (53.06％) , and the specificity (91.43％) is also more desirable. Moreover, if the axis shift set> 130 degree, the specificity can reach 100％, and the sensitivity (12.24％) is equivalent to northwestern axis. Conclusion A significant axis shift between the baseline NRS and WCT can distinguish WCT accurately. Given the ease of grasping, it can probably be feasible to popularize as a routine diagnosis method for WCT in primary hospitals.

Objective To explore the influence of preoperative transarterial chemoembolization on short-term prognosis in patients with hepatocellular carcinoma after liver transplantation Methods From Jan 2006 to Sep 2016 in Ruijin Hospital 21 patients received preoperative hepatic transarterial chemoembolization (TACE) before liver transplantation,the other 30 patients undergoing upfront liver transplantation served as control group.Results No statistical difference was found in the total operation time (401 ± 72) min vs.(377 ± 100) min,blood loss (2 785 ± 25 56) ml vs.(4 199 ± 3 748) ml and length of hospital stay (32-± 16) d vs.(28 ± 17) d between two groups,and the occurrence rate of vascular complications (14.3％ vs.0) or biliary complications (9.5％ vs.6.7％) also showed no difference (P ＞ 0.05).Although more patients were diagnosed with postoperative infection in the observation group (81％ vs.40％) (P ＜ 0.05),there was no statistically significant difference in complication grade and perioperative mortality between two groups (P ＞ 0.05).There's no remarkable difference in the liver function recovery level between two groups in terms of postoperative indexs of liver function such as TBL,ALT,AST,and there was also no statistical difference between two groups in 1-year,2-year and 3-year overall survival (P ＞ 0.05).The waiting time in the study group was significantly longer than that in the control group (P ＜ 0.05),and the incidence of postoperative immune dysfunction was lower than that of the control group (P ＜ 0.05).Conclusion Preoperative TACE does not affect liver function recovery and perioperative safety after liver transplantation.