血清CA125、CA199、CEA及AFP水平检测对卵巢巧克力囊肿诊疗价值的探讨

目的 探讨血清肿瘤抗原125（CA125）、肿瘤抗原199 （CA199）、甲胎蛋白（AFP）及癌胚抗原（CEA）水平对卵巢巧克力囊肿临床的诊断、治疗的价值.方法 回顾性的分析和比较经手术确诊的卵巢巧克力囊肿疾病患者183例（患病组）、卵巢恶性肿瘤患者60例（病例对照组）以及进行健康体检的正常育龄妇女60例（正常对照组）血液中4种肿瘤标记物检测结果,并分析4种指标高低与疾病预后的关系.结果 对照组血清CA125、CA199、AFP及CEA检测值的中位数和阳性率分别为22.55 U/ml、5.2％,19.40 U/ml、11.1％,1.40 ng/mi、0、0.78 ng/ml、0.卵巢巧克力囊肿组血清CA125、CA199、AFP及CEA检测值的中位数及阳性率分别为37.95 U/ml、23.03％,29.67 U/ml、42.41％,1.95 ng/ml、2.14％,0.56 ng/ml、0.轻度（Ⅰ～Ⅱ期）患者血清CA125、CA199、AFP及CEA中位数和阳性率分别为25.25 U/ml、0,20.16 U/ml、23.53％,1.50 U/ml、0和0.58 U/ml、0;中重度（Ⅲ～Ⅳ期）卵巢巧克力囊肿患者血清CA125、CA199、AFP及CEA中位数和阳性率分别为41.55 U/ml、25.31％,31.29 U/ml、44.68％和2.05 U/ml、2.42％,0.56 U/ml、0.卵巢恶性肿瘤CA125、CA199、AFP及CEA检测值的中位数和阳性率分别为188.4 U/ml、81.70％,150.75 U/ml、51.67％,6.9 ng/ml、26.67％,4.40 ng/ml、16.7％.卵巢巧克力囊肿患者血清CA125、CA199和AFP的灵敏度、特异度及正确度分别为23.30％、95％及41.18％,42.41％、90％及55.50％,2.19％、100％及31.5％.卵巢巧克力囊肿患者血清CA125、CA199浓度和阳性率明显高于对照组,差异有统计学意义（均P＜0.05）,AFP的浓度与对照组相比,差异有统计学意义（P＜0.05）,但是阳性率比较差异无统计学意义（P＞0.05）.CEA差异无统计学意义（P＞0.05）.卵巢巧克力囊肿患者血清CA125、CA199、CEA及AFP水平和阳性率血清明显低于恶性卵巢肿瘤组,差异有统计学意义（P＜0.05）.结论 测定血清CA125、CA199水平可协助卵巢巧克力囊肿的诊断、病情判断和指导治疗,二者联合测定可提高疾病诊断敏感性.同时AFP及CEA虽然对于协助卵巢巧克力囊肿的诊断无意义,但是对于鉴别诊断有明显意义.而且CA125和CA199水平是影响卵巢巧克力囊肿预后的因素之一.     

肾功能及血透对慢性肾脏疾病患者血清肿瘤标志物的影响

目的:探讨不同肾功能及维持血液透析治疗对慢性肾脏疾病患者血清肿瘤标志物水平的影响。方法:根据肌酐清除率(Ccr)水平将92例未行透析的慢性肾脏疾病患者分为Ccr≤30mL/min组,30mL/min相似文献   

肿瘤标志物联合检测诊断卵巢癌的实验研究

【目的】探讨糖类抗原125（CA125）、糖类抗原19-9（CA19-9）、癌胚抗原（CEA）、前列腺特异性抗原（PSA）、甲胎蛋白（AFP）、游离前列腺特异性抗原（f-PSA）六种肿瘤标志物联合检测时卵巢癌的诊断价值。【方法】用酶联免疫分析方法联合检测30例良性卵巢疾病患者，22例卵巢癌患者和26例健康对照者，分析各指标组间的差异和单项、联合检测对卵巢癌患者的检出率。【结果】卵巢癌组单项阳性率由高至低依次为：CA125 63．63％（14／22）、CA19-9 54．54％（12／22）、CEA 31．8l％（7／22）、AFP 13．63％（3／22）、f-PSA 9．09％（2／22）、PSA 0％（0／22）。经卡方检验，良性卵巢疾病组和卵巢癌组有显著性差异。去除PSA后，采用五指标联合检测，敏感性为90．91％，特异性为73．33％，诊断效率达80．77％。【结论】肿瘤标志物CA19—9、CA125、CEA、AFP、f-PSA联合检测可提高卵巢癌的诊断效率，对其早期诊断有一定价值。     

化学发光法联合检测PSA和fPSA在前列腺疾病中的诊断应用

目的探讨化学发光法（CLIA）测定前列腺特异抗原（PSA）及游离前列腺特异抗原（fPSA）在诊断前列腺疾病中的准确性及其意义。方法采用化学发光法检测187例泌尿外科男性患者血清PSA及fPSA水平,并计算游离前列腺特异抗原/总前列腺特异抗原（F／T）比值。结果前列腺疾病（前列腺炎、前列腺增生和前列腺癌）患者血清PSA和fPSA含量以及F／T值与正常人差异显著（P〈0．01）。结论化学发光法联合检测PSA和fPSA能够较好地提高前列腺癌诊断的特异性,有助于前列腺疾病的鉴别诊断,方法简便,值得推广。     

CEA、CA19-9、CA125、AFP在血液透析CKD合并恶性肿瘤患者中的表达及其诊断效能研究

目的探讨癌胚抗原(CEA)、糖类抗原(CA)19-9、CA125、甲胎蛋白(AFP)在血液透析慢性肾脏病(CKD)合并恶性肿瘤患者中的表达及其诊断效能。方法选取2017年9月至2020年3月在该院进行血液透析的68例CKD合并恶性肿瘤患者作为研究组、68例血液透析CKD无恶性肿瘤患者作为对照A组及68例非血液透析CKD合并恶性肿瘤患者作为对照B组。比较3组患者肾功能指标[尿酸(UA)、尿素氮(BUN)、肌酐(Cr)]、血清CEA、CA19-9、CA125、AFP水平,并比较不同CKD分期患者血清CEA、CA19-9、CA125、AFP水平及其与肾功能指标、CKD分期的相关性,探讨各项指标诊断血液透析CKD合并恶性肿瘤的效能。结果研究组患者UA、BUN、Cr水平均高于对照B组,研究组患者血清CEA、CA19-9、CA125、AFP水平均高于对照A组,CA125水平高于对照B组,差异均有统计学意义(P0.05);随着CKD分期增加,血清CEA、CA19-9水平逐渐升高,各分期比较,差异均有统计学意义(P0.05);血清CEA、CA19-9与UA、BUN、Cr及CKD分期均呈正相关(P0.05);血清CEA、CA19-9、CA125、AFP联合检测诊断血液透析CKD合并恶性肿瘤的受试者工作特征曲线下面积为0.894,大于各项指标单项检测,各项指标联合检测的最佳诊断灵敏度、特异度分别为80.88%、82.35%。结论血清CEA、CA19-9与CKD患者肾功能、CKD分期均呈正相关,血液透析可导致血清CA125水平升高,从而影响合并恶性肿瘤的诊断效能,血清CEA、CA19-9、CA125、AFP联合检测对血液透析CKD合并恶性肿瘤有较高的诊断效能。     

肿瘤标记物在原发性肾脏疾病患者中的血清学浓度改变

目的：了解24h尿蛋白定量、血浆白蛋白、肌酐清除率(Ccr)水平对原发性慢性肾脏病患者血清甲胎蛋白(AFP)、癌胚抗原(CEA)、糖蛋白抗原19-9(CA19-9)和糖蛋白抗原125(CA-125)血清浓度的影响。方法：测定92例非透析慢性肾脏病患者上述4种肿瘤标记物血清浓度．根据其Ccr、24h尿蛋白定量以及血浆白蛋白浓度进行分组，并对数据进行统计学分析。结果：24h尿蛋白定量和血浆白蛋白浓度对血清CA125水平有显著影响，尿蛋白定量增加及血浆白蛋白浓度降低着血清CA125均值升高。不同蛋白尿或Ccr组以上其他3种肿瘤标记物的血浓度无明显差异。结论：尿蛋白定量增加和血浆白蛋白降低的慢性肾病患者．其血浆CA125浓度升高时并不一定提示恶性肿瘤．Ccr、24h尿蛋白定量、血浆白蛋白水平对AFP、CEA、CA19-9无明显影响。     

血清肿瘤标志物检测诊断消化系统肿瘤的价值

目的探讨血清肿瘤标志物检测在消化系统肿瘤诊断中的价值。方法 692例消化系统疾病患者中恶性肿瘤204例（恶性组）、良性消化系统疾病488例（良性组）,应用化学发光法检测2组患者血清癌胚抗原（CEA）、甲胎蛋白（AFP）、糖类抗原153（CA153）、糖类抗原199（CA199）、糖类抗原125（CA125）水平。结果胃癌、食管癌、结直肠癌CEA的阳性率为52.8%,胰腺癌CA199阳性率为93.1%,肝癌AFP阳性率为89.5%。恶性组CEA、CA199、CA125均高于良性组,差异均有统计学意义（P〈0.05或P〈0.01）;肝癌、胃癌、食管癌和胰腺癌患者CA153高于良性组,差异均有统计学意义（P〈0.05）;肝癌患者AFP明显高于其他疾病患者,差异均有统计学意义（P〈0.01）。结论 CEA、AFP、CA153、CA125、CA199可作为消化系统恶性肿瘤的诊断指标,联合检测可提高诊断的敏感性。     

血清肿瘤相关物质联合检测对常见恶性肿瘤的临床应用

目的探讨甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原199（CA199）、糖类抗原724（CA724）、糖类抗原125（CA125）,联合检测对常见恶性肿瘤的诊断作用。方法应用电化学发光法联合检测AFP、CEA、CA199 CA724、CA125,在各种常见恶性肿瘤中的含量,比较其相应的敏感性和特异性。结果肝癌患者AFP及CA199、CA724敏感性高。肺癌CEA、CA125明显升高。大肠癌患者CEA及CA199明显升高。胰腺癌CA199、CA724明显升高。卵巢癌中CA125、CA199明显升高。与其他良性疾病组及健康对照组比较,差异有统计学意义。结论联合检测肿瘤标志物有助于提高常见恶性肿瘤的早期检出率。     

血清4项肿瘤标志物联合检测诊断原发性肝癌的价值

目的探讨血清癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原125(CA125)和糖类抗原199(CA199)联合检测诊断原发性肝癌的价值。方法选取41例原发性肝癌患者为肝癌组,39例肝部良性病变患者为良性组,以及40例健康体检者为对照组。比较3组血清CEA、AFP、CA125、CA199水平及检测阳性率,计算4项指标联合检测诊断原发性肝癌的敏感度、特异度和准确度。结果肝癌组血清CEA、AFP、CA125和CA199水平均高于良性组和对照组,差异有统计学意义(P 0.05)。肝癌组血清CEA、AFP、CA125、CA199检测阳性率以及联合检测阳性率高于良性组和对照组,差异有统计学意义(P 0.05)。血清CEA、AFP、CA125、CA199联合检测的诊断敏感度、准确度均高于各项指标单独检测的结果,差异有统计学意义(P 0.05)。联合检测特异度为89.87%,与单项检测结果比较,差异无统计学意义(P 0.05)。结论血清CEA、AFP、CA125和CA199联合检测对诊断原发性肝癌有重要价值,可提高检测效能。     

血清CEA、CA199、CA125、CA153、AFP联合检测对胃癌的诊断价值

目的 探讨血清癌胚抗原（ CEA） 、糖链抗原199（ CA199） 、糖链抗原125（CA125）、糖链抗原153（CA153）、甲胎蛋白（AFP）单检和联检在胃癌中的诊断价值.方法采用化学发光免疫分析法检测50 例胃癌患者和65 例正常对照组的血清CEA、CA199、CA125、CA153、AFP的含量,分析五种肿瘤标志物单个检测和联合检测的敏感度、特异度.结果 胃癌患者的血清CEA、CA199、CA125的含量明显高于正常对照组（P＜0.05）;采用单项肿瘤标志物诊断胃癌时,灵敏度最高的为CEA和CA199,特异度最高的为CA153,ROC曲线下面积最大的为CEA;采用不同肿瘤标志物的组合诊断胃癌时,灵敏度和特异度均较好的为CEA、CA199与CA125组成的组合.联合检测和单独检测相比,敏感度显著提高,特异度有所下降.结论 联合检测可提高胃癌诊断的敏感度,为早期诊断及早期治疗提供有力的依据.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."