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Objective:To explore the identification value of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), cytokeratin 19 fragment (Cyfra211), thyroglobulin (TG), ferritin (Fer) and procalcitonin (PCT) in fine needle aspiration eluent in benign and malignant cervical nodules, and acquire the optimal diagnostic model.Methods:Three hundred and ninety-six single cervical nodule patients who underwent fine needle aspiration biopsy from August 2017 to August 2019 in the Center Hospital of Xiaogan City of Hubei Province were selected. The fine needle aspiration eluent levels of CEA, SCC-Ag, Cyfra211, TG, Fer and PCT were detected by electrogenerated chemiluminescence method. The results of cytopathological diagnosis were regard as "gold standard", and the diagnostic efficiency of single and combined indexes in fine needle aspiration eluent were analyzed by receiver operating characteristic (ROC) curve.Results:Among the 396 patients, malignant nodules was in 101 cases, and benign nodules was in 295 cases. The fine needle aspiration eluent levels of CEA, SCC-Ag, Cyfra211, TG and Fer in patients with malignant nodules were significantly higher than those in patients with benign nodules: (27.73 ± 10.63) μg/L vs. (16.81 ± 8.18) μg/L, (1.59 ± 0.74) μg/L vs. (1.09 ± 0.83) μg/L, (3.31 ± 1.48) μg/L vs. (1.66 ± 0.59) μg/L, (144.96 ± 38.93) μg/L vs. (95.03 ± 47.23) μg/L and (191.18 ± 80.13) μg/L vs. (137.87 ± 63.22) μg/L, the PCT was significantly lower than that in patients with benign nodules: (0.61 ± 0.24) μg/L vs. (1.01 ± 0.52) μg/L, and there were statistical differences ( P<0.01). The ROC curve analysis result showed that the CEA, Cyfra211 and TG had super diagnostic value (area under curve>0.7, Youden index>0.5); the area under curve of CEA, Cyfra211 combined with TG was significantly higher than other combined detection of 2 indexes ( P<0.05). Conclusions:The combined detection of CEA, Cyfra211 and TG in fine needle aspiration eluent can effectively distinguish the benign and malignant cervical nodules.
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Objective To compare Endobutton plating and clavicular hook plating for acromioclavicular joint dislocation.Methods The clinical data of 46 patients with acromioclavicular joint dislocation were retrospectively analyzed who had been treated at Department of Orthopaedics,The Seventh Affiliated Hospital to Sun Yat-Sen University from October 2015 to December 2017.They were 35 men and 11 women,aged from 18 to 60 years (mean,36.3 years).All dislocations were unilateral,involving the left side in 20 cases and the right side in 26.By the Rockwood classification of dislocations,there were 18 cases of type Ⅲ,24 cases of type Ⅳ and 4 cases of type Ⅴ.Of them,22 were treated with clavicular hook plating and 24 with Endobutton plating.The 2 groups were compared in terms of operation time,incision length,intraoperative blood loss,operation cost,visual analogue scale (VAS) and Constant-Murley scores.Results The 2 groups were comparable because there were no significant differences between them in the general clinical data before operation (P ＞ 0.05).The Endobutton plating group was significantly better than the hook plating group in the incision length (5.3 ± 0.6 cm versus 8.0±1.7 cm) and intraoperative blood loss (101.0±12.3 mL versus 135.0±8.1 mL),but significantly poorer than the latter in the operation cost (RMB 21,343 ±965.2 yuan versus RMB 16,849 ±919.7 yuan) (all P ＜ 0.05).The Endobutton plating group was also significantly superior to the hook plating group in the VAS scores (2.3 ±0.8 versus 3.6 ±0.9) and Constant-Murley scores (96.2 ±4.4 versus 89.3 ±5.2) at 6 months after operation (both P ＜ 0.05).Conclusion In the treatment of acromioclavicular joint dislocation,Endobutton plating may lead to better functional recovery of the shoulder,better pain relief and freedom from secondary surgical removal of the implant.
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Objective To investigate the clinical efficacy of lengthened proximal femoral nail antirotation (PFNA) and Gamma nail treatment of proximal femoral fractures (including the intertrochanteric and inferior intertrochanteric area) combined with ipsilateral femoral shaft fractures.Methods A retrospective case control study was made on 68 cases of proximal femoral fractures combined with ipsilateral femoral shaft fractures received from January 2013 to October 2014.According to the operation mode,the patients were assigned to PFNA group (30 cases) and Gamma nail group (38 cases).Between-group differences were compared in aspects of surgical condition,treatment effect,Visual Analogue Scale (VAS),postoperative hip function (Harris score) and living ability (Barthel index).Postoperative complications were recorded as well.Results Duration of follow-up was 12-24 months [(20.8 ± 1.9) months].Incision length in PFNA group was (5.4 ± 1.2) cm versus (7.3 ±1.7) cm in Gamma nail group (P ＜ 0.01).Operative time in PFNA group was (96.8 ± 24.7) min versus (153.5 ±30.4)min in Gamma nail group (P ＜0.01).Blood loss in PFNA group was (151.5 ±16.8) ml versus (184.7 ± 22.7) ml in Gamma nail group (P ＜ 0.01).Healing time of proximal femur fractures and femoral shaft fractures in PFNA group [(16.1 ± 2.5) weeks,(19.5 ± 3.4) weeks] were significantly less than that in Gamma nail group [(18.9 ± 2.6) weeks,(22.6 ± 2.6) weeks] (P ＜0.01).VAS was (3.4 ±0.5) points in PFNA group versus (6.2± 1.3) points in Gamma nail group (P ＜ 0.01).At postoperative 2 weeks,6 months and 12 months,Harris score in PFNA group [(62.4 ±4.9),(73.7 ± 6.3),(86.4 ± 3.7) points] were significantly higher than that in Gamma nail group [(50.1 ± 4.7),(65.5 ± 6.1),(81.0 ± 3.5) points] (P ＜ 0.01).At postoperative 6 months and 12 months,Barthel index in PFNA group (76.4 ± 6.3,88.1 ± 7.0) were significantly higher than that in Gamma group (70.4 ±5.4,81.3 ±6.9) (P ＜0.01).No implant failure,screw cut-out,coxa vara or fracture displacement occurred.One patient (3％) in Gamma nail group had surgical wound infection compared to PFNA group (P ＞ 0.05).Conclusion In treatment of proximal femoral fractures combined with ipsilateral femoral shaft fractures,the lengthened PFNA fixation has advantages over Gamma nail in terms of minor trauma,rapid postoperative recovery and significant effect.
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OBJECTIVE@#To observe the expression changes of metadherin (MTDH) and matrix metalloproteinase-9 (MMP-9) in the laryngeal squamous cell carcinoma tissues and to investigate the significance.@*METHOD@#The expression of MTDH and MMP-9 in 54 cases of laryngeal squamous cell carcinoma tissues(observation group) and 30 cases of para-carcinoma tissues (control group) was examined by immunohistochemical method, the correlation between them and their correlations with the clinicopathological parameters were analyzed.@*RESULT@#The positive expression rates of MTDH in the observation group and control group were 64.8% (35/54) and 6.7% (2/30), respectively; the positive expression rates of MMP-9 in the observation group and control group were 70.4% (38/ 54) and 13.3% (4/30), respectively; and there was a statistically significant difference between two groups (all P < 0.01). In the laryngeal squamous cell carcinoma tissues, the expression of MTDH protein was related with degree of differentiation, lymph-node metastasis and TNM stage (all P < 0.05); and the expression of MMP-9 protein was related lymph-node metastasis and TNM stage (all P < 0.05). The expression of MTDH was positively correlated with MMP-9 in the laryngeal squamous cell carcinoma tissues (r = 0.371, P < 0.01).@*CONCLUSION@#The high expression of MTDH and MMP-9 was closely related to the occurrence, development and metastasis of laryngeal squamous cell carcinoma, joint detection of the two proteins was valuable for early diagnosis and prognosis of laryngeal squamous cell carcinoma.