Objective To evaluate the clinical significance of combined detection of phosphatidyhnositol 3 proteoglycans (GPC3) and alpha-fetoprotein heterogeneity (AFP-L3) and total bile acids (TBA) in diagnosis of primary hepatocellular carcinoma.Methods Collected 154 cases of primary hepatocellular carcinoma patients (hepatocellular carcinoma group) and 78 cases of cirrhosis patients (cirrhosis group) and 56 normal controls (control group) from May 2011 to December 2012.The level of GPC3,AFP-L3 was measured by enzyme-linked immunosorbent assay,the level of alpha-fetoprotein (AFP) was determined by mdioimmunoassay,and the level of TBA was measured by enzymatic cycle,and they were compared.Results The level of GPC3,AFP-L3 and TBA was (10.70 ± 3.10) μ g/L,(338.60 ± 379.20) μ g/L,(79.91 ± 70.64) μ mol/L in hepatocellular carcinoma group,which was higher than that in cirrhosis group [(2.70 ±0.71) μg/L,(6.45 ±2.79) μg/L,(33.10 ±21.90) μmol/L] and control group [(1.28 ± 0.60) μ g/L,(0.68 ± 0.56) μ g/L,(5.40 ± 2.20) μ mol/L],the level of GPC3,AFP-L3 and TBA in cirrhosis group was higher than that in control group,and there was significant difference (P＜ 0.01).The sensitivity of three tumor markers combined detection was 97.2％ (280/288),which was significantly higher than that of individual detection of GPC3 (72.1％,111/154),AFP-L3 (53.2％,82/154),TBA (94.8％,146/154),the difference was statistically significant (P ＜ 0.01).Conclusion Serum GPC3,AFP-L3 and TBA combined detection can improve the sensitivity of primary hepatocellular carcinoma and has important chnical significance in early diagnosis of primary hepatocellular carcinoma.

Objective To study the application of the combined detection of Golgi glycoprotein 73(GP-73),phosphatidylinositol proteoglycan 3(GPC3 )and percentage of AFP heteroplasmon(AFP-L3%)in the diagnosis of primary hepatocellular carcinoma (PHC).Methods The concentrations of GP-73,GPC3 and AFP-L3 were detected by enzyme-linked immunosorbent assay(ELISA) in 154 patients with PHC(PHC group),78 patients with cirrhosis(cirrhosis group)and 56 healthy subjects(control group).Then the detection results were statistically analyzed.Results The levels of GP-73,GPC3 and AFP-L3% in the PHC group were signifi-cantly higher than those in the liver cirrhosis group and the control group(P <0.05).The positive rates of GP-73,GPC3 and AFP-L3% in the PHC group were 66.2%,72.1% and 53.2% respectively.The positive rate in the combined detection of these three in-dices could reach 97.9%,which was higher than the sensitivity and accuracy in any single index detection and the combination de-tection.In the PHC group,the comparison between different levels of GP-73 and AFP-L3% with the AFP levels showed the statis-tically significant difference(P <0.05 ).Conclusion The combination detection of GP-73,GPC3 and AFP-L3% can improve the sensitivity and accuracy for diagnosing PHC and has reference significance in the differential diagnosis of early PHC.

Objective To establish the modified Ziehl-Neelsen acid -fast staining method and to investigate the value of modi-fied Ziehl-Neelsen acid-fast staining method of bronchoalveolar lavage fluid in the diagnosis of pulmonary tuberculosis(TB)with negative sputum specimen.Methods 50 cases of negative sputum pulmonary TB were performed the bronchoalveolar lavage by the fiberoptic bronchoscope before the treatment,at the same time,the bronchoalveolar lavage fluids were collected and detected by the two methods of the traditional and modified Ziehl-Neelsen staining.The diagnostic positive rates were compared between the two groups.Results The positive rates of the two kinds of acid-fast staining method were 38% and 82% respectively,the difference showing statistical significance(P <0.05 ).Conclusion The modified Ziehl-Neelsen acid-fast staining of bronchoalveolar lavage fluid can highly improve the positive diagnostic rate of pulmonary TB patients with negative sputum and deserves to be clinically promoted.

Sal-like 4 (SALL4) plays an important role in promoting the cellular proliferation and maintaining the pluripotency of embryonic stem cells and tumor cells.In fully differentiated cells,the expression of SALL4 is silenced or down-regulated.However,the expression of SALL4 is found to be restored or up-regulated in a variety of non-germ cell tumors.Besides,the expression of SALL4 is often associated with disease progression,treatment effect and prognosis.Therefore,examining the expression level of SALL4 will be of great importance in the diagnosis of disease and monitoring the disease progression for non-germ cell tumors.

Objective To investigate the clinical value of the ratio of ADA and CysC in the Pleural effusion and serum for the di-agnosis of Tuberculous pleural effusion .Methods In the first half of 2014 ,50 cases from a random sample of patients with tubercu-lous pleurisy admitted in our hospital were chosen as tuberculosis group ,20 cases of patiente with lung cancer pleural effusion as malignant group and 30 cases of patiente with hepatic hydrothorax as control group .The concentrations of CysC and ADA in the pleural effusion and serum were detected ,and the ratios of these two indexes in the pleural effusion and serum were calculated .Re-sults (1)The results in three groups including PADA and SADA ,SCysC and PCysC ,PCysC/SCysC and PADA/SADA were com-pared ,and the differences were statistically significant (P<0 .05) .(2) According to the ROC curve ,the critical value of PADA/SA-DA and PCysC/SCysC were set as 1 .58 and 2 .30 ,respectively ,and area under the curve of PADA/SADA and PCysC/SCysC were 0 .880 and 0 .786 respectively .Conclusion The diagnostic value of PADA/SADA and PCysC/SCys for tuberculous pleural effusion is higher than that of PADA ,SADA ,PCysC or SCysC alone ,which can be used for the differential diagnosis of tuberculous pleural effusion index for clinical application .

Objective To analyze the evaluation value of the standard deviation of erythrocyte volume distribution width(RDW-SD),erythrocyte volume distribution width standard deviation and platelet ratio(RPR)and erythrocyte volume distribution width standard deviation and lymphocyte ratio(RLR)in the de-compensation stage of cirrhosis in primary biliary cholangitis(PBC).Methods The blood routine indexes of 68 patients with PBC admitted and treated in this hospital from January 2019 to June 2021 were retrospective-ly analyzed and divided into the compensation stage(n=36)and decompensation stage(n=32)according to the diagnostic standard.2 mL venous blood was extracted from the patient on an empty stomach in the early morning.The red blood cell(RBC),mean corpuscular volume(MCV),hemoglobin(Hb),hematocrit(HCT),mean erythrocyte hemoglobin content(MCHC),RDW-SD,white blood cell(WBC),neutrophil absolute value(N#),lymphocyte absolute value(L#),platelet count(PLT),mean platelet volume(MPV),platelet volume distribution width(PDW),etc.were detected.The platelet to lymphocyte ratio(PLR),RPR and RLR were calculated.The influencing factors of decompensation stage of PBC cirrhosis were analyzed by binary logistic regression,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic values of different indicators in the decompensation stage of PBC cirrhosis.Results There were statistically significant differences in age,RBC,Hb,HCT,RDW-SD,L #,PLT,RPR and RLR between the compensation group and decompensation group in PBC cirrhosis(P＜0.05).The binary logistic regression analysis showed that the age[odds ratios(OR)=1.087,95％confidence intervals(CI):1.015-1.165,P＜0.05],RDW-SD(OR=1.144,95％CI:1.030-1.270,P＜0.05)and RLR(OR=1.041,95％CI:1.007-1.075,P＜0.05)were the independent risk factors for progressing to the decompensation stage in the patients with PBC cirrhosis com-pensation stage.The ROC curve analysis showed that the areas under ROC curve(AUC)of RDW-SD,RPR and RLR for the diagnosis alone of decompensation stage of PBC cirrhosis were 0.726,0.778 and 0.798,re-spectively,and the differences were not statistically significant(P＞0.05).Conclusion Combined with the age factor,regular monitoring of RDW-SD,RPR and RLR levels has a high predictive value for the develop-ment of PBC cirrhosis compensation stage to decompensation stage.