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Objective:To investigate the expressions of vascular endothelial growth factor (VEGF), serum insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) in patients with colorectal cancer liver metastases (CRLM), and diagnostic values of VEGF and IGF-1-to-IGFBP-3 ratio (IGF-1/IGFBP-3).Methods:The clinical data of 41 patients with CRLM (CRLM group), 70 patients with colorectal cancer (CRC group) and 85 patients with colorectal polyp (colorectal polyp group) who were newly diagnosed in Baoji Central Hospital from January 2020 to January 2023 were retrospectively analyzed, while 40 healthy volunteers who had medical checkup in the same period were selected as healthy control group. The level of VEGF was detected by enzyme-linked immunosorbent assay, the levels of serum IGF-1 and IGFBP-3 were detected by chemiluminescence immunoassay, and the results were compared. The efficacy of the above indexes alone and in combination for diagnosing CRLM was assessed using the receiver operating characteristic curve, with pathologic diagnostic results as the gold standard.Results:The levels of VEGF, IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in CRLM group, CRC group, colorectal polyp group and healthy control group decreased in steps, and the differences among different tissues were statistically significant (all P < 0.05). Furthermore, the levels of VEGF, IGF-1, IGFBP-3, IGF-1/IGFBP-3 in CRLM group were higher than those in CRC group, colorectal polyp group and healthy control group, and the differences were statistically significant (all P < 0.05). The levels of VEGF, IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in CRC group were higher than those in colorectal polyp group and healthy control group, and the differences were statistically significant (all P < 0.05). The levels of VEGF, IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in colorectal polyp group were higher than those in healthy control group, and the differences were statistically significant (all P < 0.05). The efficiency analysis of single and combined detection of the serum VEGF, IGF-1/IGFBP-3 for diagnosing CRLM showed that the sensitivity, specificity and accuracy of VEGF, IGF-1/IGFBP-3 and combination of the two were statistically significant ( χ2 values were 6.523, 11.499 and 11.194, all P < 0.05). The optimal cut-off value of VEGF alone for diagnosing CRLM was 326.83 pg/ml, and the optimal cut-off value of IGF-1/IGFBP-3 for diagnosing CRLM was 71.44. The diagnostic sensitivity and area under the curve (AUC) of VEGF alone were lower than those of IGF-1/IGFBP-3 alone, the difference was statistically significant ( P < 0.05), but the specificity and accuracy were higher than those of IGF-1/IGFBP-3, and the difference was statistically significant ( P < 0.05). The sensitivity, specificity, accuracy and AUC of combination of VEGF and IGF-1 and IGF-1/IGFBP-3 for diagnosing CRLM were higher than the single detection of the two, and the differences were statistically significant (all P < 0.05). Conclusions:The serum VEGF, IGF-1 levels and IGF-1/IGFBP-3 are high in CRLM patients, IGFBP-3 level is low in CRLM patients. The detections of these indexes have featured with rapid, accuracy and high sensitivity. Single detection has its own advantages and disadvantages, and the combined detection can complement each other and improve the diagnostic efficiency, which is of high clinical application value for the diagnosis of CRLM.
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Objective:To investigate the clinical application value of plasma SEPT9 gene methylation combined with serum carcinoembryonic antigen (CEA) and carbohydrate antigen 724 (CA724) in the diagnosis of colorectal cancer.Methods:A total of 219 patients with colorectal diseases in Baoji Central Hospital and Yunnan Province New Kun Hua Hospital from May 2018 to October 2021 were selected, including 149 cases of colorectal cancer and 70 cases of colorectal polyp diagnosed by pathology. A total of 100 healthy people in the same period were selected as the healthy control group. The methylation of SEPT9 gene in plasma was measured by using real-time fluorescent polymerase chain reaction (PCR), and the levels of serum CEA and CA724 were measured by using electrochemiluminescence. The expressions of three indicators in each group were compared, and the effect of every single indicator and the combination of the three indicators on the diagnosis of colorectal cancer was analyzed by using receiver operating characteristic (ROC) curve.Results:The positive rate of SEPT9 gene methylation in colorectal cancer group (74.50%, 111/149) was higher than that in colorectal polyp group (22.86%, 16/70) and healthy control group (1.00%, 1/100), and the difference was statistically significant ( P < 0.001). The positive rate of CEA in colorectal cancer group (46.98%, 70/149) was higher than that in colorectal polyp group (40.00%, 28/70) and the healthy control group (3.00%, 3/100) and the difference was statistically significant ( P < 0.001). The positive rate of CA724 in colorectal cancer group (38.93%, 58/149) was higher than that in colorectal polyp group (32.86%, 23/70) and the healthy control group (2.00%, 2/100), and the difference was statistically significant ( P < 0.001). The area under the curve (AUC) of ROC of SEPT9 gene methylation, CEA and CA724 in the single diagnosis of colorectal cancer was 0.823 (95% CI 0.753-0.891), 0.788 (95% CI 0.725-0.852) and 0.689 (95% CI 0.624-0.754), respectively. The optimal cut-off Ct value of SEPT9 gene methylation in the diagnosis of colorectal cancer was 36.5, the sensitivity was 90.30%, and the positive predictive value was 84.68%, which were higher than those of CEA and CA724. The optimal cut-off value of CEA in the diagnosis of colorectal cancer was 8.80 ng/ml, and the specificity (77.50%) and negative predictive value (78.48%) were higher than those of SEPT9 gene methylation and CA724. The sensitivity (97.66%), positive predictive value (93.98%), negative predictive value (81.25%) and AUC (0.846, 95% CI 0.749-0.944) of the combined detection of the three indexes taking the optimal cut-off value of every single indicator were higher than those of the single indicator. Conclusions:The combined detection of plasma SEPT9 gene methylation, CEA and CA724 in the diagnosis of colorectal cancer has high sensitivity and accuracy. The three combined detection can complement each other and improve the diagnostic efficiency, which is of high clinical value for the diagnosis of colorectal cancer.
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Objective:To explore the application value of combined detection of p16 and human papillomavirus (HPV) typing in the diagnosis of cervical intraepithelial neoplasia (CIN).Methods:A total of 8 346 patients aged between 25 years old and 65 years old at Baoji Central Hospital of Shaanxi Province from February 2019 to February 2020 were selected. There were 2 882 patients with cervical lesions diagnosed by colposcopy biopsy. Patients were divided into the different groups based on the age range, and then the condition of HPV infection in all age groups was analyzed. Taking biopsy as the gold standard and according to the pathological results, the detection rate of p16 and HPV typing and the diagnostic value of the single and combined detection in CIN were also analyzed.Results:The age group with the highest positive rate of p16 and HPV was 31-40 years old [47.42% (1 014/2 427) and 36.84% (894/2 427), respectively], followed by 41-50 years old group [30.15% (907/2 942) and 28.11% (827/2 942)], and there were statistically significant differences in positive rate of p16 and HPV in all age groups (all P < 0.05). Among 2 882 patient with cervical lesions diagnosed by pathological examination, there were 2 572 cases (89.24%) of p16 positive, and 2 169 cases (75.26%) of HPV positive. With the disease progression of cervical lesions, the positive rate of p16 and HPV was gradually increased, and the positive rate of p16 of inflammation, CINⅠ, CINⅡ, CIN Ⅲ, cervical squamous cell carcinoma (SCC) was 11.68% (23/197), 94. 85% (1 105/1 165), 93.57% (771/824), 96.76% (538/556), 96.43% (135/140), respectively; the positive rate of HPV was 17.77% (35/197), 77.60% (904/1 165), 80.22% (661/824), 80.40% (447/556), 87.14% (122/140), respectively, and HPV infection was mostly HPV16/18 infection type with the disease progression of cervical lesions. The sensitivity, specificity, positive predictive value and negative predictive value in detecting CIN of HPV was 75.26%, 81.13%, 67.78% and 86.14%, respectively; the sensitivity, specificity, positive predictive value and negative predictive value in detecting CIN of p16 was 89.24%, 84.74%, 75.51% and 93.72%, respectively; the diagnostic efficacy of p16 was higher than that of HPV in detecting CIN, and the difference was statistically significant ( P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of HPV combined with p16 in detecting CIN was 94.10%, 91.33%, 85.12%, 96.71%, which were higher compared with those of single detection (all P < 0.05). Conclusions:HPV infection mainly occurs in women aged 31-40 years old followed by 41-50 years old, and the infected population of CIN tends to be younger. p16 is superior to HPV in detecting the diagnostic efficacy of CIN; combined detection of p16 and HPV can increase the sensitivity and specificity, reduce the rate of misdiagnosis, and can play a key clinical value in early diagnosis and treatment of CIN.
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Objective:To investigate the diagnostic value of urinary nuclear matrix protein 22 (NMP22) combined with bladder tumor antigen (BTA) detection for bladder cancer, in order to provide a laboratory basis for early screening of bladder cancer.Methods:The clinicopathological data of 315 suspected bladder cancer patients in Baoji Central Hospital in Shaanxi Province from August 2018 to July 2019 were retrospectively analyzed. Among the patients, 248 patients with bladder cancer and 67 patients with urological benign disease were diagnosed by surgical pathology or cystoscope biopsy, and 100 healthy people that took the normal physical examination in the same period were selected as healthy control group. The levels of urinary NMP22 and BTA were detected by enzyme-linked immunosorbent assay (ELISA).Results:The expression levels of urinary NMP22 in the bladder cancer group, urological benign disease group and healthy control group were (28.4±8.8) ng/ml, (12.7±3.0) ng/ml and (4.3±1.5) ng/ml, and the difference was statistically significant ( F = 26.41, P < 0.05); BTA expression levels were (25.1±8.1) ng/ml, (10.4±2.9) ng/ml and (6.4±2.4) ng/ml, and the difference was statistically significant ( F = 23.62, P < 0.05). The differences in the expression levels of urinary NMP22 and BTA in bladder cancer patients with different TNM stages and pathological grades were statistically significant (all P < 0.05). The area under the receiver operating characteristic curve, sensitivity, and negative predictive value of the combined detection of urinary NMP22 and BTA were 0.895, 96.98%, and 61.11%, respectively, which were higher than the single detection, and the differences were statistically significant (all P < 0.05). The cut-off values of urinary NMP22 and BTA for diagnosis of bladder cancer were 32.42 ng/ml and 29.13 ng/ml, respectively. Conclusions:The combined detection of urinary NMP22 and BTA has a high clinical value for the diagnosis of bladder cancer. The detection has the advantages of simple, rapid, non-invasive, and mass screening, which is worthy of clinical promotion.
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We introduce the background of Shanghai medical purchasing service and supervision platform (later we call it "open platform") and the effect of its implementation. We also analyze the problems occurred by medical institutions in the management of supplies, explore how to use open platform to strengthen the management of medical supplies, further optimize the structure of supplies, standardize the clinical reasonable use and charges, and ensure the quality, safety and traceability of supplies.
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China , Equipment and SuppliesABSTRACT
This paper introduces various measures of actively developing online teaching in Shanghai Medical College of Fudan University, on the basis of in-depth analysis of the development trend of educational informatization and the large-scale online teaching in China during the COVID-19 epidemic. According to the requirement of Ministry of Education —— "Suspended Class, Ongoing Learning", our university has actively carried out online teaching, promoted the multi-platform blended online teaching, established a quality assurance system with multi-role linkage and regular feedback, focused on improving ideological and political education efficiency of online courses at the same time. By analyzing the characteristics of medical education, together with the benefits and limitations of online medical teaching, this paper demonstrates the application and development of online teaching resources and platforms in medical education, and looks into the future of online medical education as well.
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Objective To investigate the diagnostic value of ultrasound-guided fine-needle aspiration cytology (FNAC) and fine-needle aspiration washout fluid thyroglobulin (FNA-Tg) detection for neck lymph nodes metastasis in patients with papillary thyroid carcinoma (PTC). Methods A total of 214 PTC patients confirmed by pathology biopsy in Baoji Central Hospital from August 2015 to October 2018 were collected, and they all underwent ultrasound-guided FNAC, and FNA-Tg was measured by using electrochemiluminescence immunoassay. The histopathologic detection was performed for all suspicious lymph nodes after lymphadenectomy, and the results were analyzed by using statistics. Results There were 282 suspicious enlarged lymph nodes detected from 214 PTC patients. Histopathological examination showed 220 lymph node metastases were positive, 62 were negative. FNAC examination showed 193 lymph nodes were positive and 89 were negative. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNAC for diagnosing the lymph nodes of metastasis PTC was 84.55％, 88.71％, 73.26％, 96.37％,61.80％, 85.46％, respectively. FNA-Tg test showed that 198 lymph nodes were diagnosed as positive metastasis and 84 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNA-Tg for diagnosing the lymph nodes of metastasis PTC was 88.64％, 95.16％, 83.80％, 98.48％, 70.24％, 90.07％, respectively. Both FNAC and FNA-Tg test showed 215 lymph nodes were diagnosed as positive metastasis and 76 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of combined treatments were 97.63％, 87.32％, 84.95％, 95.81％, 92.54％, 96.81％, respectively. The sensitivity and accuracy of combined detection were higher than those of single detection, and there were statistically significant differences (all P< 0.05). Conclusions FNAC and FNA-Tg detection are simple, safe and accurate. The combined detection of FNAC and FNA-Tg can improve the sensitivity and accuracy for the diagnosis of PTC lymph node metastasis.
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Objective@#To investigate the diagnostic value of ultrasound-guided fine-needle aspiration cytology (FNAC) and fine-needle aspiration washout fluid thyroglobulin (FNA-Tg) detection for neck lymph nodes metastasis in patients with papillary thyroid carcinoma (PTC).@*Methods@#A total of 214 PTC patients confirmed by pathology biopsy in Baoji Central Hospital from August 2015 to October 2018 were collected, and they all underwent ultrasound-guided FNAC, and FNA-Tg was measured by using electrochemiluminescence immunoassay. The histopathologic detection was performed for all suspicious lymph nodes after lymphadenectomy, and the results were analyzed by using statistics.@*Results@#There were 282 suspicious enlarged lymph nodes detected from 214 PTC patients. Histopathological examination showed 220 lymph node metastases were positive, 62 were negative. FNAC examination showed 193 lymph nodes were positive and 89 were negative. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNAC for diagnosing the lymph nodes of metastasis PTC was 84.55%, 88.71%, 73.26%, 96.37%, 61.80%, 85.46%, respectively. FNA-Tg test showed that 198 lymph nodes were diagnosed as positive metastasis and 84 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNA-Tg for diagnosing the lymph nodes of metastasis PTC was 88.64%, 95.16%, 83.80%, 98.48%, 70.24%, 90.07%, respectively. Both FNAC and FNA-Tg test showed 215 lymph nodes were diagnosed as positive metastasis and 76 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of combined treatments were 97.63%, 87.32%, 84.95%, 95.81%, 92.54%, 96.81%, respectively. The sensitivity and accuracy of combined detection were higher than those of single detection, and there were statistically significant differences (all P < 0.05).@*Conclusions@#FNAC and FNA-Tg detection are simple, safe and accurate. The combined detection of FNAC and FNA-Tg can improve the sensitivity and accuracy for the diagnosis of PTC lymph node metastasis.
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Objective To investigate the clinical value of serum human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125) combined with risk of ovarian malignancy algorithm (ROMA) index in the diagnosis of ovarian cancer. Methods A total of 541 patients in the Department of Gynaecology in Baoji Central Hospital from August 2016 to February 2018 were collected. The serum HE4 and CA125 levels were measured by using electrochemiluminescence immunoassay in 226 cases of ovarian cancer (ovarian cancer group), 315 cases of ovarian benign disease (ovarian benign disease group) and 100 female healthy people (the control group). ROMA index was calculated according to ROMA model and the results were analyzed statistically. Results The levels of serum HE4, CA125 and ROMA index were significantly different in premenopausal and postmenopausal ovarian cancer group, ovarian benign disease group and the control group (all P<0.05). The sensitivity and Yonden's index of the three combined diagnosis of serum HE4, CA125 and ROMA for premenopausal ovarian cancer were 97.01 ％ and 77.01 ％ respectively, which were higher than those of a single detection (HE4:79.37％, 69.11％;CA125:76.06％, 66.38％;ROMA index:89.55％, 72.41％;χ2sensitivity=12.35, P=0.000;χ2Yonden's index=6.460, P=0.013. The sensitivity and Yonden's index ofthe three combined diagnosis of serum HE4, CA125 and ROMA for postmenopausal ovarian cancer were 98.99 ％ and 82.99 ％ respectively, which were higher than those of a single detection (HE4: 86.90 ％, 79.40 ％; CA125: 82.98 ％, 76.31 ％; ROMA index: 93.54 ％, 80.64 ％; χ2sensitivity = 14.25, P = 0.000;χ2Yonden's index= 4.822, P= 0.031). The area under the curve of the combined detection of three indicators was higher than that of a single detection (premenopausal group: 0.871 vs. 0.682, 0.626, 0.708; postmenopausal group: 0.981 vs. 0.724, 0.705, 0.833), and there were significant differences (premenopausal group: χ2 =11.24, P= 0.000; postmenopausal group: χ2= 16.38, P= 0.000). Conclusion The combined detection of serum HE4, CA125 and ROMA index can increase the sensitivity and accuracy for diagnosing ovarian cancer, which can provide a more reliable basis for diagnosis and screening of ovarian cancer.
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Objective To explore the features of resting state functional magnetic resonance imaging (rs-fMRI) in the patients with mild cognitive impairment (MCI) after during the process of converting to Alzheimer's disease (AD) dementia. To study the correlation of the brain function imaging and neuropsychological scores in converted MCI subjects with the purpose of finding the potential functional biomarkers which may predict the conversion of MCI to AD dementia in short term using resting state functional MRI. Methods Twenty-seven patients with MCI and 31 age, gender and years of education matched normal controls (NC) were enrolled in this study and neuropsychological assessment and rs-fMRI data were acquired respectively at the baseline and follow-up. Functional connectivity strength (FCS) analyses were used to assess the functional differences among the groups of MCI-converters (MCI-c) , MCI-non converters (MCI-nc) and NC. Variance analyses were used to compare the group differences in age, years of education and each neuropsychological assessment. In addition, Chi-squared test was used to compare group differences in gender. Then, Kruskal-Wallis test was used to compare group differences in the interval time of twice data collection. Group differences in FCS values were analyzed by general linear model. Finally, correlation analyses were used to evaluate the relationships between the FCS values of the brain regions with group differences and neuropsychological assessment scores in MCI patients. Results (1) Significant group differences of FCS among the MCI-c, MCI-nc and NC groups were observed in bilateral angular gyri, bilateral orbitofrontal cortex, right precentral gyrus, left paracentral lobule, left precuneus, right fusiform, right middle occipital gyrus, right superior occipital gyrus, left cerebellum. (2) The MCI-c showed decreased FCS in bilateral angular gyri, right middle occipital gyrus, right superior occipital gyrus, right inferior occipital gyrus, right fusiform, left precuneus, and left paracentral lobule, as compared to MCI-nc, the cluster was 149, 114, 186, 56, 48, 33, 38 and 102 voxels, respectively;P<0.05, respectively. The correlation analysis showed that the FCS values of the right angular gyrus were negative correlated with the MMSE scores (r=-0.561, P=0.017) . Conclusions This study revealed that the comparison of rs-fMRI imaging data between MCI-c and MCI-nc at baseline is of great benefits in analysing the imaging characteristics of patients during converting from MCI to AD. The feature of FCS in rs-fMRI in right angular gyrus might serve as early indicators for the dysfunction and progression from MCI to AD.
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Objective To explore the features of resting state functional magnetic resonance imaging (rs-fMRI) in the patients with mild cognitive impairment (MCI) after during the process of converting to Alzheimer's disease (AD) dementia. To study the correlation of the brain function imaging and neuropsychological scores in converted MCI subjects with the purpose of finding the potential functional biomarkers which may predict the conversion of MCI to AD dementia in short term using resting state functional MRI. Methods Twenty-seven patients with MCI and 31 age, gender and years of education matched normal controls (NC) were enrolled in this study and neuropsychological assessment and rs-fMRI data were acquired respectively at the baseline and follow-up. Functional connectivity strength (FCS) analyses were used to assess the functional differences among the groups of MCI-converters (MCI-c) , MCI-non converters (MCI-nc) and NC. Variance analyses were used to compare the group differences in age, years of education and each neuropsychological assessment. In addition, Chi-squared test was used to compare group differences in gender. Then, Kruskal-Wallis test was used to compare group differences in the interval time of twice data collection. Group differences in FCS values were analyzed by general linear model. Finally, correlation analyses were used to evaluate the relationships between the FCS values of the brain regions with group differences and neuropsychological assessment scores in MCI patients. Results (1) Significant group differences of FCS among the MCI-c, MCI-nc and NC groups were observed in bilateral angular gyri, bilateral orbitofrontal cortex, right precentral gyrus, left paracentral lobule, left precuneus, right fusiform, right middle occipital gyrus, right superior occipital gyrus, left cerebellum. (2) The MCI-c showed decreased FCS in bilateral angular gyri, right middle occipital gyrus, right superior occipital gyrus, right inferior occipital gyrus, right fusiform, left precuneus, and left paracentral lobule, as compared to MCI-nc, the cluster was 149, 114, 186, 56, 48, 33, 38 and 102 voxels, respectively;P<0.05, respectively. The correlation analysis showed that the FCS values of the right angular gyrus were negative correlated with the MMSE scores (r=-0.561, P=0.017) . Conclusions This study revealed that the comparison of rs-fMRI imaging data between MCI-c and MCI-nc at baseline is of great benefits in analysing the imaging characteristics of patients during converting from MCI to AD. The feature of FCS in rs-fMRI in right angular gyrus might serve as early indicators for the dysfunction and progression from MCI to AD.
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Objective To explore the relationship between serum pepsinogen (PG), PGⅡ, PG ratio (PGR), gastrin 17 (G17) and gastric cancer, and to provide the basis for the early diagnosis and differential diagnosis of gastric cancer. Methods Two hundred and forty-eight cases of gastric disease diagnosed with gastroscopy in Baoji Central Hospital from December 2015 to February 2017 were selected as study subjects. According to the results of histopathology, the patients were divided into 4 groups: gastric cancer group (47 cases), chronic atrophic gastritis group (52 cases), chronic non-atrophic gastritis group (81 cases), gastric ulcer group (68 cases). Meanwhile, 50 cases healthy people were enrolled as the control group. The levels of serum PGⅠ, PGⅡ and G17 were measured by enzyme linked immunosorbent assay (ELISA). Results The levels of PGⅠ and PGR in gastric cancer group were lower than those in other groups [PGⅠ: (43±7) vs. (47±7), (69±14), (75±17), (112±22) μg/L; PGR: 5.6±0.5 vs. 10.3±2.6, 10.5±2.5, 11.9±2.7, 14.6± 3.5], and there was a significant difference (PGⅠ: F= 58.42, P = 0.000; PGR: F= 6.15, P = 0.034). The level of serum G17 in gastric cancer group was significantly higher than that in other groups [(43.8±4.3) vs. (22.4±3.6), (10.7±2.1), (13.2±2.4), (5.8±1.3) pmol/L, F= 43.22, P = 0.000]; The PGⅠ, PGR and G17 combined detection of sensitivity(88.6 %), specificity(97.5 %), area under the curve(0.986) was significantly higher than that of single detection(78.3 %, 89.0 %, 88.4 %; 72.9 %, 87.0 %, 73.2 %; 0.848, 0.912, 0.923, respectively; χ2= 7.86, 6.42, 9.10; P = 0.019, 0.044, 0.012). The regression equation provided a basis for confirmation or exclusion of gastric cancer. Conclusions Serum PGⅠ, PGR, G17 and gastric cancer has a good correlation. Combined detection of serum PGⅠ, PGR and G17 could be used for the diagnosis and differential diagnosis of gastric cancer.
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Objective To investigate the expression level of hyper sensitivity C-reactive protein (hsCRP) in children infected with different pathogens in order to enhance the application value of hsCRP .Methods One hundred and one children patients with infection from March 2010 to March 2015 were selected as the research subjects and divided into the bacterial infection group (67 ca-ses) and mycoplasma infection group (34 cases) according to the hematology and bacterial culture results .Contemporaneous 50 healthy children were selected as the control group .Venous blood was collected for detecting hsCRP ,white blood cell(WBC) and neutrophil percentage(NEUT% ) .Results The levels and abnormal rates of hsCRP and WBC in the bacterial infection group were significantly higher than the those in the mycoplasma infection group and control group (P<0 .05);NEUT% and abnormal rate in the mycoplasma infection group was higher than that in the other two groups (P<0 .05) .The levels and abnormal rates of hsCRP and WBC after treatment in the bacterial infection group were lower than those before treatment ,the difference was statistically sig-nificant(P<0 .05);the area under the ROC curve of hsCRP for diagnosing bacterial infection wa maximal ,which was 0 .68 ,the sensitivity and specificity were 89 .9% and 88 .3% respectively .Conclusion The hsCRP level detection has early diagnostic value for child bacterial infection and can dynamically reflects the curative effect .
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Objective To investigate the application of alpha-fetoprotein (AFP),α-L-fucosidase(AFU),5'-nucleotidase(5'-NT) and γ-glutamyltransferase (GGT) in diagnosis of hepatocellular carcinoma(HCC),and to provide the basis for its early and rapid diagnosis.Methods The clinical data of 120 cases with initial diagnosis as hepatocellular carcinoma,150 cases with liver cirrhosis,200 cases with hepatitis were analyzed retrospectively from June 2013 to August 2014,meanwhile,100 healthy people were selected as control group.The serum AFP,AFU,5'-NT and GGT levels were measured by electrochemiluminescence immunoassay,rate method,peroxidase method and enzymatic colorimetric assay,respectively.The results were analyzed by receiver operating characteristic (ROC) curve,while the sensitivity,specificity,AUC were calculated at the same time.Results The levels of serum AFP,AFU,5'-NT and GGT were significantly different among HCC group,liver cirrhosis group,hepatitis group and control group (all P＜0.05).When tested alone,the sensitivities of AFP,AFU,5'-NT and GGT were 58.33 ％(70/120),82.50 ％(99/120),85.00 ％(102/120),78.33 ％(94/120),the specificities were 88.33 ％(106/120),73.33 ％(88/120),88.33 ％(106/120),71.67 ％(86/120),and AUC were 0.655,0.702,0.814,0.754.When four indexes were performed with combined test,the sensitivity was 98.33 ％(118/120),specificity was 96.67 ％(116/120),AUC was 0.975,which were higher than the single detection (all P＜0.05).Conclusion The combined detection of serum AFP,AFU,5'-NT and GGT can greatly increase the sensitivity and specificity for diagnosing HCC and will gain mutual complement advantages,which is of great clinical value for early and rapid diagnosis.
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Objective To investigate the clinical application of serum retinal binding protein and cystain C determination in hem-orrhagic fever with renal syndrome(HFRS).Methods The serum concentrations of RBP,CysC,Urea and Cr were detected for 124 patients with HFRS(patients group)and 100 healthy people who underwent physical examination during the same period(control group),the date were analysed by SPSS19.0 software.Results The concentrations of RBP,CysC,Urea and Cr increased signifi-cantly in febrile stage of HFRS,arrived at peak in oliguria stage,and then declined gradually,there were statistically significant differences between each stage and negative control stage(P <0.05).RBP and CysC had a good positive correlation with Urea and Cr,the correlation coefficient between RBP and Urea or Cr were 0.826 and 0.892,respectively(P <0.05)while with CysC were 0. 841 and 0.924,respectively(P <0.05).The positive rates of RBP,CysC,Urea,Cr in febrile stage were 85.48%,95.16%,69.35%, 83.06% respectively,while in convalescent stage were 67.74%,74.19%,46.77% and 58.06% respectively.Conclusion RBP and CysC are good indicators for diagnosing HFRS,which also have good correlation with Urea and Cr,which are recommended in clini-cal application.
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Objective To investigate the value of combined detection of serum alpha-fetoprotein (AFP)and Golgi protein-73 (GP73)in the diagnosis of hepatocellular carcinoma (HCC)and to provide a basis for early diagnosis and differential diagnosis of HCC.Methods A total of 408 patients hospitalized in Baoji Central Hospital from June 2012 to May 2013,as well as healthy persons who had normal test re-sults in physical examination,were included in the study,and their specimens were collected.These patients were classified into HCC group (n=142),chronic hepatitis group (n=156),and liver cirrhosis group (n=110).Serum levels of AFP and GP73 in the three groups were measured by electrochemiluminescence immunoassay and double -antibody sandwich enzyme -linked immunosorbent assay,respectively. Comparison of test results between groups was made by analysis of variance,and comparison of rates was made by chi-square test.The sen-sitivity and specificity of the two indicators for the diagnosis of HCC were calculated using MedCalc statistical software.Results The HCC group had significantly higher serum AFP and GP73 levels than the liver cirrhosis group and chronic hepatitis group (P<0.05);the liver cirrhosis group had significantly higher serum AFP and GP73 levels than the chronic hepatitis group (P<0.05).The sensitivity and speci-ficity of the two indicators for the diagnosis of HCC were 95.8% and 98.6%,respectively,showing significant differences compared with those of each indicator alone (P<0.05).Conclusion Combined detection of serum AFP and GP73 has high diagnostic value and clinical significance for HCC,and they can be used as indicators for early diagnosis and differential diagnosis of HCC.
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Objective To explore the pathogenic bacteria species of the patients with lactation acute mammitis and their sensitivities to antibiotics in order to provide a guideline in choosing antibiotics reasonably. Methods Four hundred and thirty-three samples from diseased breast(include milk,puncture fluid and secretion in ulcerateing skin)from 310 patients with lactation acute mammitis,who were treated by the center of mammary gland of Maternal and Child Health Care of Haidian district in BeiJing from Jan. to Aug. in 2012. Statistics analysis was made to analysis the pathogenic bacteria species and the characteristics of drug sensitivity. Results (1)Of the 433 samples,407 strains of pathogens were picked out,which consisted of 215 strains of Staphylococcus aureus(SAU),43 strains of methicillin-resistant staphylococcus aureus( MRSA),43 strains of coagulase negative staphylococcus(CNS),42 strains of Methicillin-resistant staphylococcus epidermis (MRSE),22 strains of Staphylococcus epidermidis(SE),12 strains of Methicillin-resistant coagulase negative staphylococci(MRScon)and 8 strains of Alpha hemolytic streptococcus.(2)There were 237 strains of G +bacteria,and the drug sensitive test showed that they were all sensitive to vancomycin(100% ),91. 8% were sensitive to penicillin,57. 0% to clindamycin( CLDM))and 69. 0% to erythrocin. Meanwhile,94. 0% were sensitive to levofloxacin,70. 0% to cephalosporins,and 80. 0% to gentamicin. In addition,there were 43 MRSA, and drug sensitivity test showed that 95. 0% were sensitive to levofloxacin,96. 0% to gentamicin,97. 0% to macrodantin,and 92. 0% to cotrimoxazole. Meanwhile,it's drug resistance rate to erythrocin was 13. 0% and 15. 0% to clindamycin( CLDM). MRSA was completely resistant to Lactam antibiotics( 100% ) such as penicillin and Cephalosporins,95. 0% to levofloxacin,96. 0% to gentamicin,97. 0% to furadantin and 92. 0% to bactrim. Conclusion The predominant pathogenic bacteria of lactation acute mammitis include SAU,MRSA, MRSA,CNS,MRSE,SE and they are all the G + bacteria. They are showed with a high rate of drug resistance, especially for the sensitive drugs which had been proved in the past. Due attention should be paid to germiculture from diseased breast and drug sensitive test as soon as possible,and to provide a guideline in choosing antibiotics reasonably.
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Purpose To investigate the significance of PET/CT in differential diagnosis of incidental thyroid benign or malignant lesions with high fluorodeoxyglucose (FDG) uptake.Materials and Methods Forty cases with focal high FDG uptake lesion in thyroid accidently detected by PET/CT were retrospectively collected. The subjects were dived into physiological uptake group (n=18), benign lesion group (n=16) and malignant lesion group (n=6) according to the pathology or follow-up examinations. The average SUVmax of different groups was analyzed, and ROC curve was used todetect benign or malignant lesions.Results The average SUVmax was 3.7±1.1 in physiological uptake group, 4.9±2.3 in benign lesion group and 9.5±4.8 in malignant lesion group. Significant difference was noticed among the three groups. The average SUVmax in malignant lesion group was higher than that of the other two groups with statistical difference (P0.05). ROC analysis showed that the sensitivity and specificity for thyroid malignant tumor were 100.0% and 87.2% at SUVmax of 8.5.Conclusion18F-FDG PET/CT plays an important role in differentiating benign lesions of thyroid from malignance, but it is not helpful to identify benign lesions from physiologic uptake.
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Objective To investigate the biology reference intervals for five parameters of thyroid gland function(TSH,T3, T4,FT3 and FT4)in Baoji area,in order to provide evidence for effective filtration and diagnosis.Methods Refer to the files recommended by (NCCLS)C28-A2 about the description of definition,establishment and confirmation,five parameters of thyroid gland function were measured in 4 820 healthy persons by using Roche E601 electrochemical immunoassay analyzer and its assemble reagent,calibration materials and quality control,the statistical method was applied to the data processing by different gender,to establish the biology reference intervals of each parameters.And compared with National Guide to Clinical Laboratory Procedures(Third Edition).Results The range of 95% normal reference intervals of TSH,T3,T4,FT3 and FT4 in male were 0.20~4.28 mIU/L,1.22~2.46 nmol/L,64.64~149.00 nmol/L,3.00~6.04 pmol/L,11.93~22.21 pmol/L respectively,and in female were 0.20~4.52 mIU/L,1.24~2.44 nmol/L,67.60~142.40 nmol/L,2.96~5.76 pmol/L and 11.86~21.54 pmol/L,respectively.Compared the level of TSH,FT3,FT4 between male and female, differences were statistical significance(t=3.962,7.570,5.132;P=0.042,0.026,0.033).Compared the level of T3,T4 be-tween male and female,there was no statistical significance (t=0.000,1.151;P=1.000,0.120).The study compared with National Guide to Clinical Laboratory Procedures (Third Edition),the results of T3,T4,FT3 and FT4 in male were statisti-cal significance (t=9.755,4.349,114.7,79.82;P=0.000,0.003,0.000,0.000),the results of TSH,T3,FT3 and FT4 in female were statistical significance (t=5.304,9.548,128.9,72.99;P=0.002,0.000,0.000,0.000).Conclusion The in-vestigation of biology reference intervals for five parameters of thyroid gland function in Baoji area can provide more precise-ly reference data for clinical diagnosis and treatment.
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Objective To investigate the relationship between nuclear factor(NF)-κB activity and lactacystin induced prostate cancer cell apoptosis.Methods Two prostate cancer cell were divided into two groups:blank control group treated with culture solution,lactacystin group treated with different concentration of lactacystin(0.5,1.0,2.0,4.0 μ mol/L),the action time were 8,16 and 24 hours.The cell survival rate was measured by MTT assay.NF-κB DNA binding activity was measured by enzyme-linked immunosorbent assay,the expression of NF-κB P65 nuclear protein was detected by Western blot assay,and caspase-3 activity was analyzed by enzyme analysis assay.Results On basal condition,the NF-κ B DNA binding activity was much higher in DU145 cell than that in LNCaP cell(t=4.728,P=0.001).Compared with blank control group,different concentration of lactacystin groups'NF-κ B DNA binding activity in both the LNCaP and DU145 cell were reduced.The expression of NF-κB p65 nuclear protein decreased along with raising of lactacystin concentration in LNCaP cell,but it did not change in DU145 cell.On basal condition,caspase-3activity in DU145 cell was higher than that in LNCaP cell(t=4.519,P=0.001).After lactacystin acting of 24 hours,caspase-3 activity increased along with raising of lactacystin concentration in both the LNCaP and DU145 cell(2.0 μmol/L lactacystin group compared with 1.0 μmol/L lactacystin group,DU145 cell P=0.000,LNCaP cell P=0.000).Conclusions Lactacystin has different killing effects on prostate cancer cell.The mechanism may be related to inducing the apoptosis by down-regulation of NF-κB activity.There may be additional cell survival/death pathway in androgen-independent prostate cancer cell.