With the continued development of molecular biology technologies,circulating tumor DNA (ctDNA)has shown certain value in the diagnosis and treatment of malignant tumors. The emergence of next generation sequencing technology makes ctDNA detection more accurate and rapid. ctDNA plays a certain role in the early diagnosis,disease monitoring,therapeutic evaluation and medication guide of ovarian cancer by vir-tue of its safety and non-invasiveness. The application of ctDNA detection is insufficient at present,but with the continuous development of sequencing technology,ctDNA will play increasingly important roles in the diagno-sis,personalized treatment and prognosis evaluation of ovarian cancer.

Objective To observed the clinical efficacy and safety of high pressure-resistant double-lumen peripherally inserted central catheter (Power PICC) and central venous catheter (CVC) in patients with stem cell transplantation.Methods This was a matched cross-sectional study with 60 patients with leukemia who were treated with catheterization of central venous (30 cases receiving Power PICC vs.30 cases receiving CVC) during stem cell transplantation in the First Affiliated Hospital of Chinese PLA General Hospital.Indwelling time,success rate of catheterization,complications,velocity and stem cell engraftment time were recorded and compared between the Power PICC group and CVC group.Results There were significant differences between the two groups on indwelling time [(18.47±4.44) min vs.(14.43± 1.72) min,t =3.719,P＜0.001],complications [6.67％ (2/30) vs.30％ (9/30),x2 =48.445,P=0.002] and velocity.However,no significant difference was found in success rate of catheterization and stem cell engraftment time (P＞0.05).Conclusion Power PICC performed better than CVC with well tolerability and satisfactory efficacy,which is worthy of promotion and application in the future.

Objective To study the effect of different types of dyslipidemia on heart rate variability in patients with type 2 diabetes.Methods Cohort study was carried out at Renmin Hospital of Wuhan University during January 2014 to May 2016.Total 725 patients with type 2 diabetes were recruited,including 231 patients without dyslipidemia and 494 patients with dyslipidemia.Clinical parameters were collected from electronic medical records system.Using variance analysis,chi square test,Pearson correlation analysis and partial correlation analysis,we explored an association of different types of dyslipidemia and heart rate variability in patients with type 2 diabetes.Results TG,LDL-C,HDL-C,TG + HDL-C group significantly decreased heart rate variability compared group without dyslipidemia (P ＜ 0.05).But the partial correlation analysis showed that only atherogenic index of plasma and Triglyceride (TG) were negatively correlated with heart rate variability,HDL cholesterol was positively correlated with heart rate variability,and the difference was statistically significant (P ＜ 0.05).Conclusion Triglyceride (TG),atherogenic index of plasma(AIP),HDL cholesterol were related to the reduction heart rate variability in patents with type 2 diabetes.

Objective To compare the efficacy of empagliflozin and DDP4 inhibitors in the treatment of type 2 diabetes mellitus.Methods With Computer,we retrieval PubMed,Cochrane Library,EMbase,CNKI,CBM and Wanfang database to find all of the randomized controlled trials about the effectiveness and safety of empagliflozin and DDP4 inhibitors in the treatment of type 2 diabetes mellitus.The retrieval time was from the establishment of database to March,2016.References screen were performed manually.Meta-analysis was carried out using RevMan 5.2 software.Results A total of five studies included 1935 cases.The Meta analysis results showed that:HbA1c level (MD =-0.07,95％ CI:-0.13--0.01,P ＜0.05),fasting blood glucose (MD =-16.73,95％ CI:-21.02--12.43,P ＜ 0.01),weight loss level (MD =-2.43 95％ CI:-2.68--2.19,P ＜ 0.01) in the two groups showed statistically significant differences.Empagliflozin group was better than DDP4 inhibitors group in reducing HbA1c level,fasting blood glucose,weight loss level.Safety:hypoglycemia between the two groups were similar (OR =0.86,95％ CI:0.46-1.6,P ＞ 0.05).Empagliflozin group's genital tract infection rate was statistically significant higher than that of DDP4 inhibitors.(OR =2.85,95％ CI:1.71-4.76,P ＜ 0.01).Conclusion Empagliflozin can effectively reduce the fasting blood glucose,HbAIc,and body weight,but increase the incidence of genital infection compare with DDP4 inhibitors.

Objective: To investigate the clinical effect and safety of rock salt aerosol therapy in the treatment of occupational allergic contact dermatitis. Methods: A total of 65 patients with acute exacerbation of occupational allergic contact dermatitis who were treated in the Outpatient Service and Inpatient Department of our hospital from March 2013 to December 2015 were enrolled and randomly divided into observation group and control group using a random number table. Both groups were givensymptomatic treatment including desensitization, and the patients in the observation group were given rock salt aerosol therapy for 2 courses in addition to the symptomatic treatment. The changes in symptoms, signs, blood eosinophil count, and IgE were observed. Results: There were significant changes in symptom score at the first and second courses of the treatment (P<0.05) , and there was an interaction between time of therapy and grouping (P<0.05) . There was no significant difference in symptom score before treatment between the two groups (P>0.05) , while there were differences at the first and second courses of the treatment (P<0.05) . After the second course of treatment, the observation group had a significantly higher overall response rate than the control group (P<0.05) ; both groups had significant reductions in blood eosinophil count and the observation group had a significantly greater reduction than the control group (P<0.05) . After two courses of treatment, both groups had significant increases in the number of patients with normal IgE (both P<0.05) , and after the second course of treatment, the observation group had a significantly higher number than the control group (P<0.05) . Both groups had mild adverse events, which did not affect the treatment. Conclusion In the treatment of occupational allergic contact dermatitis, rock salt aerosol therapy has a certain effect on the recovery of symptoms, signs, blood eosinophil count, and IgE.

Objective To explore the clinical significance of expression of soluble mesothelin relatedprotein(SMRP)and carbo-hydrate antigen (CA125)in the serum and tumor tissues of the patients with ovarian cancer.Methods The preoperative and post-operative levels of SMRP and CA125 in serum and ovarian cancer tissues were detected in 82 patients with ovarian cancer (group A),76 cases of benign ovarian tumor (group B)and 53 healthy women (group C)by using ELISA and the immunohistochemical method respectively.Serum levels of SMRP and CA125 in the ovarian cancer patients were measured after one year by ELISA.The correlation among the various statistical indexes was analyzed.Results The positive expression rates of SMRP and CA125 in the group A were significantly higher than those in the group B(P <0.05);compared with the group B and C,the preoperative serum level of CA125 and SMRP in the group A was significantly increased (P <0.001);the preoperative serum CA 125 level in the group B was higher than that in the group C;compared with the stage Ⅰ and Ⅱ,the serum CA125 and SMRP in the stage Ⅲ and Ⅳ of o-varian cancer were significantly increased(P <0.05 );compared with before operation,the postoperative SMRP and CA125 levels were significantly decreased(P <0.05).After 1 year of discharge from hospital,compared with the basically stable patients,serum CA125 and SMRP levels in the patients with ovarian cancer recurrence were significantly increased(P <0.05).The sensitivity and specificity for diagnosing ovarian cancer,any single detection was inferior to the combination detection of CA125 and SMRP.Conclu-sion The combination detection of CA125 and SMRP has an important value for increasing the sensitivity and specificity of ovarian cancer diagnosis,early diagnosis,illness condition monitoring and effect evaluation.

Objective To investigate the risk factors, clinical and angiographic features of women aged 50 or less with coronary artery disease(CAD). Methods One hundred and seventy-three female CAD patients comifrmed by coronary angiographic aged 50 or less were classiifed as group A, while another 494 non-CAD women aged 50 or less as group B. The differences in CAD risk factors, clinical and angiographic features between the 2 groups were analyzed. Results There were more women with diabetes, positive CAD family history, dyslipidemia or hypertension (especially diastolic hypertension) in group A than in group B. Patient in group A had higher diastolic pressures and serum glucose level than those in group B but both groups had similar body weights, systolic pressures and menopause ages. The serum total cholesterol and triglyceride levels were higher in patients in group A than those in group B while high-density-lipoprotein (HDL) cholesterol and apolipoprotein A levels were lower in group A. The low-density-lipoprotein (LDL) and apolipoprotein B were higher in group A than in group B but without signiifcance. There were more women with positive urine protein in group A than in group B. In group A, more than 50%of patients were with single diseased artery while another 15%with slight coronary artery atherosclerosis or even normal arteries. Most of the lesions were found in left anterior descending artery (LAD) and its branches. Conclusions Risk factors of CAD included diabetes, positive CAD family history, dyslipidemia, hypertension(especially diastolic hypertension) and positive urine protein in women aged 50 or less Menopause alone, without other CAD risk factors, would not lead to CAD. Single vessel disease was more commonly found in this group of patients.

Objective To explore the impacts of subclinical hypothyroidism (SCH) on chronic complications of type 2 diabetes mellitus. Methods Totally 448 patients with type 2 diabetes were divided into diabetes plus SCH group (n=148) and control group (T2DM without SCH,n=300).The patient's general information,past medical history,chronic complications of diabetes including diabetic nephropathy ( DN ), diabetic retinopathy ( DR), diabetic peripheral neuropathy ( DPN ),peripheral arterial disease (PAD),diabetic foot (DF),ancillary and laboratory test results were analyzed. Results The age,duration of diabetes,incidence of coronary heart disease and levels of fasting C-peptide,total cholesterol,triacylglycerol,lipoprotein (a),hs-CRP,LDL-C,UAER and thyroid stimulating hormone (TSH) [(6.8 ± 3.5) mIU/L vs. (2.1 ± 1.3) mlU/L], antithyroidperoxidase antibody (TPO-Ab) [(253.6 ± 287.1 ) kU/L vs. (46.2 ± 80.7)] kU/L and thyroglobulin antibodies (TG-Ab) [( 57.8 ± 83.5 ) kU/L vs. ( 39.4 ± 45.3 ) kU/L] were significantly higher,but the ankle brachial index(ABI) and E/A value were lower in diabetes plus SCH group than in control group (P＜0.01 or 0.05).The prevalences of DN( 63％ vs.46％,P＜0.01),DR (40％vs.29％,P＜0.05),DPN (34％ vs.24％,P＜0.05),PAD (51％ vs.38％,P＜0.05) and DF (22％ vs.12％,P＜0.01) were higher in diabetes plus SCH group than in control group.Logistic regression analysis demonstrated that high level of TSH was independent risk factor for DN(β=0.1273,OR =1.1361) and DF (β=0.1153, OR =1.1222). Conclusions Subclinical hypothyroidism is an independent risk factor for diabetic nephropathy and diabetic foot,so the elderly with longer duration of diabetes should regularly be checked in thyroid ffunction to early find hypothyroidism.

Objective To investigate the relationship between serum leptin and carotid intima-media thickness in patients with type 2 diabetes mellitus. Methods 35 patients with type 2 diabetes mellitus (DM) and 16 normal controls were studied. Fasting serum leptin, fasting glucose(FBG), HbAlc, C-peptide, lipide, systolic(SBP), diastolic blood pressure(DBP), body mass index (BMI) and waist circ-umference (WC) were measured in all subjects. The intima-media thickness (IMT) of common carotid artery was measured by high-resolu-tion ultrasound imaging. Results IMT of T2DM was positively correlated with leptin concentration. Conclusion Serum leptin concentra-tion is independently associated with the IMT of carotid artery, which suggest that leptin may be an independent risk factor of atherosclerosis.

Objective To explore the association of serum high-sensitivity C reactive protein (hs-CRP) level with leptin in patients with type 2 diabetes mellitns (T2DM). Methods 35 cases of T2DM patients were involved in the study and 16 normal subjects were taken as controls. Fasting serum leptin and CRP were measured .The relationship between them were also analyzed. Results Fasting serum hs-CRP concentration in T2DM group was higher than that in healthy control group, but serum ieptin levels is the same (P > 0.05). Partial correlation analysis demonstrated that fasting hs-CRP level was positively correlated with leptin (r =0.512 ,P =0. 018). Conclusion Fasting serum hs-CRP level is significantly raised in T2DM ,which is associated with leptin. There is chronic inflammatory reaction in T2DM patients,and leptin is possibly involved in inflammatory pathogenesis of T2DM.