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Objective To evaluate the diagnostic value of combined serum tumor marker CA19-9 with CT scanning in the patients with pancreatic cancer.Methods A total of 89 patients with suspected pancreatic cancer diagnosed by CT scanning were selected at our hospital from May 2012 to December 2016.The detected results of serum CA19-9 were recorded,and the specificity,sensitivity,positive and negative predictive value of serum CA19-9 in the diagnosis of pancreatic cancer were statistically calculated and analyzed.The correlations between the pre-and post-operative serum levels of CA19-9 and the survival time in pancreatic cancer patients undergoing operation were analyzed.Results The specificity,sensitivity,positive predictive value and negative predictive value of serum CA19-9 combined with CT scanning in the diagnosis of pancreatic cancer were 97.2％,86.4％,100.0 ％,94.0 ％ respectively.With the increase of preoperative serum levels of CA19-9,the resection rate and median postoperative survival time gradually decreased.Patients with normal serum levels of CA19-9 after operation had longer postoperative survival time than patients with high postoperative serum levels of CA19-9.Conclusions As one of the tumor markers of pancreatic cancer,serum CA19-9 detection has a high diagnostic sensitivity.Combined with CT scanning,serum CA19-9 detection can significantly improve the diagnostic accuracy of pancreatic cancer.Serum CA19-9 can also be used as a mean of efficacy evaluation after radical resection of pancreatic cancer.
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Unsteadiness and falls in the elderly are a common complaint in primary care and their incidence is expected to increase as the population ages. These patients are physiologically less able to withstand traumatic forces than their younger counterparts and are thus more prone to morbidity and mortality. Aside from intrinsic and extrinsic risk factors, there may be more sinister pathologies underlying these events. We report a case of an elderly gentleman who presented with unsteadiness, clumsiness and recurrent falls. The patient’s son brought to our attention subtle suspicious findings which eventually led to further evaluation. The patient was found to have had bilateral acute on chronic subdural haemorrhages with associated mass effect, underwent emergent decompression surgery and showed marked functional recovery. We review the incidence and outcomes of recurrent falls in the elderly, as well as the incidence, risk factors and varied presentations of subdural haemorrhage in the primary care setting. The case also reminds clinicians of the tendency to overlook and undermanage such patients with seemingly “minor” falls, and the value of family members’ inputs during consultation. It highlights the need for a high index of suspicion and the necessity of lower referral thresholds for further evaluation if indicated.
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Objective To study the effect of the cord blood stem cell transplantation therapy in patients with severe hepatitis. Methods Forty patients with severe hepatitis were randomly divided into control groups (n=20) and observed group (n=20). The patients in two groups were treated with the conventional liver protective therapy respectively, such as compound glycyrrhizin and glutathione. The patients in observed groups were performed with the cord blood stem cell trans-plantation therapy. After isolation and purification, the cells were transplanted into the liver via hepatic artery and then were transplanted via peripheral veins. The biochemical indices of albumin (ALB), prothrombin activity (PTA),alpha-fetoprotein (AFP)and clinical symptoms were detected at different times after therapy. Results After 4-week therapy, the levels of PTA (%)and AFP(μg/L)were significantly increased in observed group compared with those of control group (53.56 ± 5.15 vs 48.26±5.53,92.16±9.09 vs 43.57±11.33,P＜0.01). After 8-week therapy, the levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and AFP were significantly decreased in observed group than those of control group. The level of PTA was sig-nificantly higher in observed group than that of control group (62.61±4.35 vs 54.95±3.01,P＜0.05 or P＜0.01). There were no significant differences in levels of ALB and blood ammonia between two groups (P>0.05). There were no serious complications and adverse reactions in two groups of patients. There was no significant difference in mortality between two groups ( 20%vs 35%,χ2=0.818,P>0.05). Conclusion Cord blood stem cell therapy has a good effect on treating severe hepatitis, which is safe and no significant adverse reactions, and can be used as a new method for treating the severe hepatitis.
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AIM: To observe the effects of aspirin and prostaglandin E_2 (PGE_2) on the cell viability and cell cycle in SW1990 human pancreatic carcinoma cell lines, and to investigate the mechanisms of aspirin-induced growth inhibition and cell cycle arrest. METHODS: After incubated with aspirin or PGE_2 and their combination, the viability of SW1990 cells was measured by MTT assay. The levels of intracellular PGE_2 were determined by ELISA. The effects of aspirin or PGE_2 on cell cycle were investigated by flow cytometry (FCM). The expression of p21~ Wafl/cipl and p27~ Kipl/pic2 (the cyclin-dependent kinase inhibitors) were analyzed by Western blotting. RESULTS: Aspirin could inhibit the growth of cells and level of intracellular PGE_2 in a dose-dependent manner. Aspirin enhanced the expression of p21~ Wafl/cipl and p27~ Kipl/pic2 and induced cell cycle arrest at G_0/G_1 phase. PGE_2 increased the cell viability of SW1990 cells. However, it couldn't antagonize the changes of cell viability and cell cycle that induced by aspirin. CONCLUSIONS: The inhibitory effects of aspirin on growth and cell cycle of pancreatic carcinoma cells might not be mediated by a COX-dependent pathway completely. Cell cycle arrest induced by aspirin might be associated with up-regulation of p21~ Wafl/cipl and p27~ Kipl/pic2 .