Objective To explore the clinical value of combined detection of CA15-3, TSGF, OPN and CA125 in the diagnosis and treatment of breast cancer. Methods The serum specimens from 187 patients with breast cancer (cancer group) were collected, tumor markers CA15-3 and CA125 were detected with electrochemiluminescence method, TSGF was detected with chemocolorimetry, and OPN was detected with enzyme-linked immunosorbent assay. Compared with 50 cases of patients with benign breast disease (control group), The relationship between these marker and clinical stage, recurrence and metastasis of breast cancer were analyzed. Results The serum levels of CA15-3, CA125, TSGF and OPN in cancer group were significantly higher than those in control group (P ＜0.05). Four markers in high clinical stage(Ⅲ and Ⅳ stage)[(83.21±28.67), (89.13±32.34), (278.66±137.23) U/ml and (97.4±11.7) ng/ml, respectively] were higher than those in low stage( Ⅰ and Ⅱ stage) [(60.03±19.35), (58.21±17.56), (155.79±113.11) U/ml and (77.5±10.81) ng/ml,respectively] (P ＜0.05), and those in lymphnode metastasis patients and in recurrence patients were significantly higher than those in corresponding groups (P ＜0.05). The sensitivity and specificity of the combined detection of four tumor markers were 96.3 % (180/187) and 80.0 % (40/50), respectively. The average time of combined detection of serum tumor markers was 2 months ahead of the mammographic features in the recurrence patients with breast cancer. Conclusion The dynamic combined detection of CA15-3, TSGF, OPN and CA125 are better markers for monitoring recurrence and metastasis of breast cancer,which are benefit to early diagnosis and interference.

Objective To compare the safety and efficacy of oblique supine position and lithotomy position in suctioning flexible ureteroscopic lithotripsy. Methods 82 patients with upper urinary calculi were divided into two groups. Group 1 included 47 patients who were treated by suctioning flexible ureteroscopy in oblique supine position. Group 2 included 35 patients who were treated in lithotomy position. There was no significant statistical difference in age, gender and complications between the two groups before surgery (P > 0.05). The operative time, stone-free rates at postoperative 30 d, renal pelvic pressure (RPP), postoperative complications (graded by the Clavien system) and length of stay were compared. Results Retrograde Intrarenal Surgery (RIRS) was successful in 73 cases, and 9 cases of patients were done successfully after indwelling DJ tube 2 weeks. Compared with lithotomy position, a significantly greater stone-free rate of 30 d, shorter operative time (P < 0.05). There was no difference in complication rate of Clavien grade I and Clavien grade II, RPP and length of stay (P > 0.05). Conclusions Suctioning flexible ureteroscopic lithotripsy in the oblique supine position is safe, and more effective than supine lithotomy position.

Objective To evaluate the application value of contrast-enhanced ultrasound (CEUS) in the diagnosis of vascular complication (VC) of transplanted kidney. Methods Imaging data of conventional ultrasound and CEUS in 28 patients suspected with VC of transplanted kidney were analyzed retrospectively.The results of computed tomography angiography (CTA)or digital subtraction angiography (DSA)were served as the diagnostic standard. The value of CEUS in diagnosing VC of transplanted kidney was analyzed. Results No adverse reaction related to contrast agent was observed in 28 patients during the CEUS examination. And 22 cases with VC were confirmed. VCs were detected correctly by CEUS in 17 cases,but 5 cases with transplant renal artery stenosis (TRAS ) were missed and 1 case with focal infarction in transplanted kidney was misdiagnosed. The diagnostic sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV)and accuracy of CEUS for VC of transplanted kidney were 0.77,1.00,1.00,0.55 and 0.82, respectively. The diagnostic sensitivity,specificity,PPV,NPV and accuracy of conventional ultrasound and CEUS for TRAS were 0.37 and 0.74,0.89 and 1.00,0.88 and 1.00,0.40 and 0.64,0.54 and 0.82, respectively. There were significant differences in the sensitivity and accuracy between conventional ultrasound and CEUS (both in P<0.05 ). Conclusions CEUS is an effective method for detecting VC of transplanted kidney.

OBJECTIVE To provide computed tomographic reference for the infralabyrinthine approach to the internal auditory canal.METHODS Temporal bone CT images of forty patients(80 sides) were randomly selected without ear lesions,and some relative structures were observed and measured.RESULTS The mean distance from the inferior edge of the posterior semicircular canal to the superior edge of the jugular bulb was (4.69±2.91)mm left and (3.10±3.01)mm right,the mean thickness of the bone inferior to the posterior semicircular canal was (0.92 ± 0.37)mm left and (0.69 ± 0.37)mm right,the mean distance from the vertical portion of the facial nerve to the anterior edge of the sigmoid sinus was (8.66±2.71)mm left and (7.74± 1.99)mm right,the mean distance from the superior edge of the jugular bulb to the internal auditory canal was (6.32 ± 2.88)mm left and (5.39 ± 2.61) mm right,the mean distance from the superior edge of the jugular bulb to the single foramen was (6.82 ± 3.02)mm left and (5.84 ± 2.82)mm right,the mean distance from the external aperture of vestibular aqueduct tothe posterior edge of internal acoustic porus was (14.38 ± 2.56)mm left and (14.12±2.76)mm right,the mean distance from the external aperture of vestibular aqueduct tothe midpoint of internal auditory canal was (12.02 ± 2.46)mm left and (11.91 ± 2.53)mm right.There were statistical differences in distances of different sides among the anterior three groups,no statistical differences were seen in distances of different sides among the posterior four groups.CONCLUSION The temporal bone CT images are helpful to the infralabyrinthine approach to the internal auditory canal.

Percutaneous nephrolithotripsy is the first line treatment for complete staghorn calculi, but there are risks such as renal function damage, bleeding, and infection. A case of complete staghorn calculi 8.3 cm×4.5 cm and mean CT value of 1 321 HU was reported. Urine culture suggested proteus mirabilis infection. The patient was given sensitive antibiotics for 3 days, and was treated with one session of natural orifice transluminal endoscopic lithotripsy with intelligent control of renal pelvic pressure. KUB on the first postoperative day showed residual stones of 1.0 cm×0.5 cm. There were no complications.