Objective To explore the application value of Golgi protein-73 (GP73)and AFP in single and combining form in the diagnosis of primary hepatocelluar carcinoma (PHC).Methods Eighty PHC,65 liver cirrhosis,54 chronic hepatitis patients and 50 controls were selected in the First Afiliated Hospital in Xinjiang Medical University from May to September in 2011,GP73 was detected by ELISA and AFP was measured by clinical chemiluminescence.The sensitivity and specificity of each parameter in single and combining form were evaluated.Results Serum GP73 in PHC group 282.0(163.6-366.7) μg/L,liver cirrhosis group 211.8(107.5-295.7) μg/L,chronic hepatitis group 100.3(61.8-191.3) μg/L and control group 58.3(43.4-83.6) μg/L was tested by Kruskal-Wallis(H =106.6,P ＜0.01).GP73 in PHC group was further compared with liver cirrhosis group,chronic hepatitis group and control group using MannWhitney test,significance was found,(U was 1796.0,826.5,154.0,respectively,all P ＜0.01).In the single form,the sensitivity of GP73 [82.5％ (66/80)] was higher than AFP [66.3％ (53/80),x2 =4.65,P ＜0.05],but the specificity of GP73 [63.3％ (107/169)] was lower than AFP [88.7％ (150/169),x2 =28.91,P ＜0.05].There were 27 AFP negative cases in PHC group,but 22 of them were GP73 positive,making the positive rate of GP73 [81.5％ (22/27)] in PHC patients with AFP negative.There were 14 GP73 negative cases of in PHC group,but 9 of them were AFP positive,making the positive rate of AFP [64.3％ (9/14)] in PHC patients with GP73 negative.In series diagnostic test,the specificity of combining form [95.9％ (162/169)] was higher than AFP [88.7 ％ (150/169),x2 =6.00,P ＜ 0.05] ; in parallel diagnostic test,the sensitivity of combining form [93.8％ (75/80)] was higher than GP73 [82.5％(66/80),x2 =4.84,P ＜0.05].In PHC group,52 patients with HBV infection,10 patients with HCV infection and 18 patients without virus infection,GP73 was 309.5 (170.5-370.5) μg/L,351.0 (274.7-397.9) μg/L and 210.1 (156.8-306.7) μg/L,respectively,no significance was found (H =4.0,P ＞0.05).Conclusion GP73 and AFP have a complementary feature of sensitivity and specificity in the early diagnosis of PHC,some PHC cases with AFP negative can be avoided missing efficiently by parallel diagnostic test.

Objective To investigate the correlation between apolipoprotein and homocysteine levels with the stability of carotid plaque and the degree of stenosis??Methods One hundred elderly patients with acute cerebral infarction from January 2017 to December 2017 were collected continuously in Harbin Fourth Hospital,All patients underwent color Doppler ultrasound examination of carotid artery??They were divided into stable plaque group and unstable plaque group according to the results of color Doppler ultrasound,then according to the degree of stenosis they were divided into intimal thickening group with 23 cases, mild stenosis (stenosis degree＜50%) with 26 cases,moderate stenosis group (50%≤stenosis degree＜70%) with 28 cases,severe stenosis group (70%≤stenosis degree) with 23 cases??All the patients were selected to collect the blood of the elbow in the early morning to detect the level of apolipoprotein B and Hcy??Results Compared with unstable plaque group, smoking, drinking, hemoglobin A1c ( HbA1c), ApoB and Hcy had significant differences (all P＜0??05)??Gender,history of diabetes mellitus,history of hypertension,systolic pressure,diastolic pressure,low density lipoprotein cholesterol (LDL?C),triglyceride (TG) There was no significant difference in total cholesterol ( TC) and total cholesterol ( all P＞0??05)??Multivariate logistic regression was performed after correcting the related risk factors excluding blood lipids??The results showed that alcohol ( OR＝ 1??247 ( 95%CI: 0??626－1??958), P＝ 0??043), Hcy ( OR＝ 3??163 ( 95%CI: 1??824 －4??772),P＝0??045), bloodpressure ( OR＝1??286 ( 95%CI: 0??688－2??005), P＝0??027), HbA1c ( OR＝3??671(95%CI: 1??904－6??630),P＝0??011),ApoB (OR＝1??717(95%CI: 1??005－2??634),P＝0??036), LDL?C(OR＝1??516(95%CI: 0??968－2??489),P＝0??024),TC( OR＝1??403( 95%CI: 0??801－2??343),P＝0??030) and TG ( OR＝1??342 ( 95%CI: 0??712－2??198), P＝0??019) are independent risk factors for unstablecarotid plaque and severe carotid stenosis??Conclusion Apolipoprotein and homocysteine may be independent predictors of unstable carotid plaque and severity of carotid stenosis??

Objective:To investigate the radiologic, pathologic, and molecular features of simple bone cysts (SBC), and their differential diagnoses.Methods:Fourteen cases of SBC were collected at the Department of Pathology, the First Affiliated Hospital of Nanjing Medical University from 2017 to 2022, and fluorescence in situ hybridization (FISH) was performed for retrospective analysis.Results:There were 14 patients, including 7 females and 7 males, with age range of 7 to 45 (median 29) years. The most common complaint was pain, including 4 cases with pathological fracture and 5 with history of previous trauma. The tumor size ranged from 3.4 to 13.5 (median 5.6) cm. The lesion involved the femur ( n=4), humerus ( n=5) and iliac bone ( n=5). Radiologic diagnoses included SBC, aneurysmal bone cyst, and giant cell tumor of the bone or its combination with aneurysmal bone cyst-like region and fibrous dysplasia. Histologically, the cyst walls of the lesions were composed of fibrous tissue, fibrin-like collagen deposits, bone-like matrix and occasional woven bone. The lesional cells were spindled to ovoid, with scattered osteoclast-like giant cells, foamy histiocytes, hemosiderin deposits and cholesterol clefts. In 6 cases there were nodular fasciitis-like areas. Immunohistochemically, the spindled to ovoid cells were positive for SMA, EMA and SATB2 in varying degrees. FISH detection was performed in all 14 cases and EWSR1/FUS rearrangement were found in 9 cases. One case of FUS::NFATC2 fusion was detected by next-generation sequencing. Nine cases of SBC with the rearrangement were more cellular, and there were more mitotic figures in the recurrent FUS::NFATC2 fusion tumor. Clinical follow-up was obtained in all 14 cases with the time ranging from 5 to 105 (mean 46) months. Amongst them, the tumor with FUS::NFATC2 rearrangement had local recurrence twice after the first local excision, but had no more recurrence or metastasis 34 months after the subsequent segmental resection. The other 13 cases had no recurrence. Conclusions:EWSR1 or FUS rearrangement is most commonly identified in SBC, suggesting that SBC might be a neoplastic disease. In cases where the radiologic appearance and histomorphology are difficult to differentiate from aneurysmal bone cyst, FISH detection can aid in the definitive diagnosis.