蛋白尿和血清白蛋白水平对血清肿瘤标志物水平的影响

目的了解24h尿蛋白（Upro）水平和血清白蛋白（Salb）水平对慢性肾脏疾病（CKD）患者血清甲胎蛋白（AFP）、癌胚抗原（CEA）、糖蛋白抗原199（CA199）、糖蛋白抗原125（CA125）、糖蛋白抗原724（CA724）、糖蛋白抗原153（CA153）、前列腺特异抗原（PSA）、游离前列腺特异抗原（fPSA）、神经元特异性烯醇化酶（NSE）、细胞角化素蛋白片段19（CYFRA21-1）和鳞癌抗原（SCC）血清浓度的影响。方法根据Upro将232例CKD患者分为Upro〈1．5g／d组，Upro 1．5～3．5g／d组和Upro〉3．5g／d组，比较各组肿瘤标志物水平；再根据Salb水平将上述患者分为Salb〈25g／L组、Salb25-35g／L组和Salb〉35g／L组；对其中的男性患者亦按上述方法分组，比较各组PSA和fPSA水平。结果CA125、CA153、CYFRA21-1、NSE和SCC水平在不同蛋白尿组间差异存在统计学意义，相关分析显示其血清水平均与Upro呈正相关，而CEA、CA199、AFP、CA724、PSA和fPSA水平在各组间差异无统计学意义；CA199、CA125、CYFRA21-1、NSE和SCC水平在不同Salb组间差异存在统计学意义，且其血清水平均与Salb水平呈负相关，而CEA、AFP、CA153、CA724、PSA和fPSA水平在各组间差异无统计学意义。结论在大量蛋白尿伴或低白蛋白血症的患者中，部分血清肿瘤标志物诊断相应肿瘤的假阳性率增高。     

多肿瘤标志物蛋白芯片检测对原发性肝癌的诊断价值

【目的】探讨12种肿瘤标志物（testingmulti—tumor，TM）联合检测对原发性肝癌的诊断价值。【方法】应用蛋白芯片技术（C-12）定量测定62例原发性肝癌患者、53例良性肝病患者血清中糖类抗原-199（CA199）、神经原特异性烯醇化酶（NSE）、癌胚抗原（CEA）、糖类抗原-242（CA242）、铁蛋白（SF）、β-绒毛膜促性腺激素（β-HCG）、甲胎蛋白（AVP）、游离前列腺特异性抗原（Free—PSA）、前列腺特异性抗原（PSA）、糖类抗原125（CA125）、人生长激素（HGH）、糖类抗原-153（CA153）等12种TM的浓度。【结果】通过12种TM联合检测将原发性肝癌组阳性检出率提高到了100％；良性肝病组阳性检出率为22．6％；原发性肝癌组的TM测定值明显高于良性肝病组，有显著性差异，其中AFP最为显著（P〈0．001），其次为CA199、CEA、CA125（P〈0．01）；CA242、SF、β—HCG（P〈0．05）。两组比较无统计学意义为NSE、Free—PSA、PSA、HGH、CA15—3（P〉0．05）。原发性肝癌组TM阳性检出率由高到低依次为：AFP〉CA199〉SF〉CA125〉CEA〉CA242〉β—HCG〉CA153。【结论】应用12种TM联合检测原发性肝癌、良性肝病，可以为临床诊断提供更多的指标，提高辅助诊断的准确性，弥补单一TM特异性不强和敏感性较低的不足，有效地筛选出肿瘤高危人群，对原发性肝癌的早期发现、早期诊断具有重要意义。     

血清肿瘤标志物诊断胆道良恶性病变的价值

目的:探讨血清肿瘤标志物检测在鉴别胆道良恶性病变中的诊断价值。方法:选取我院2015年3月至2018年9月首次诊断为胆道癌病例171例作为实验组,胆囊良性疾病病例65例作为对照组。采用免疫化学发光法检测所有病例血清肿瘤标志物CA211、CA199、CEA、CA125、CA153、CA724、AFP和SCC表达水平,计算单个、联合标志物诊断胆道癌的灵敏度和特异度,计算受试者工作特征(ROC)曲线下面积。结果:胆道癌组血清中CA211、CA199、CEA、CA125、CA153、CA724的水平高于胆囊良性疾病组(P<0. 05)。CA211+CA199联合检测诊断胆道癌的ROC曲线下面积(AUC)为0. 899,大于CA199+CEA的0. 829(P<0. 01)。结论:CA211、CA199、CEA、CA125、CA153、CA724检测有助于鉴别胆道良恶性病变,CA211+CA199联合检测可提高诊断胆道癌的灵敏度,有助于早期诊断。     

AFP、CEA、CA199、CA125及CA153联合检测诊断原发性肝癌的价值研究

目的研究甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原-199(CA199)、糖类抗原-125(CA125)及糖类抗原-153(CA153)联合检测诊断原发性肝癌(PHC)的价值。方法选择2019年1月至2020年12月我院治疗的70例PHC患者并作为PHC组,同时选取同期在我院治疗的75例良性肝病患者并作为良性肝病组,选取同期到我院体检的健康人群70例作为对照组。采集三组患者晨起空腹静脉血4mL,采用化学发光法测定AFP、CEA、CA199、CA125及CA153水平。比较三组AFP、CEA、CA199、CA125及CA153水平,并计算AFP、CEA、CA199、CA125及CA153单项及联合诊断PHC的敏感度、特异度。结果PHC组AFP、CEA、CA199、CA125及CA153水平>良性肝病组>对照组,差异有统计学意义(P<0.05);AFP+CEA+CA199+CA125+CA153诊断PHC敏感度高于各单项指标检测结果,诊断PHC特异度高于AFP、CEA,差异有统计学意义(P<0.05)。结论PHC患者血清AFP、CEA、CA199、CA125及CA153水平呈高表达,联合检测上述指标有利于提升PHC诊断准确率,为临床诊治PHC提供帮助。     

肿瘤标志物联合检测在乳腺癌诊断中的价值

目的 探讨微阵列酶联免疫法( Array-ELISA)检测肿瘤标志物诊断乳腺癌的价值.方法 采用Array-ELISA对146例乳腺癌患者、64例乳腺良性疾病患者及119例健康体检者的血清进行甲胎蛋白(AFP)、癌胚抗原(CEA)、癌抗原125(CA125)、癌抗原153(CA153)、糖链抗原199(CA199)、前列腺特异抗原(PSA)6种肿瘤标志物检测.应用Logistic回归和ROC曲线对各指标进行分析.结果 乳腺癌组CA153、CA125均明显高于乳腺良性疾病组与正常对照组(P＜0.05);其他四种肿瘤标志物(AFP、PSA、CA199、CEA)在3组间差异无统计学意义(P＞0.05).CA153、CA125两项联合检测,其敏感性为81.51％、准确度为86.93％、阴性预测值为86.08％,与单项指标比较差异均有统计学意义(P＜o.05).CA153、CA125两项肿瘤标志物单独检测时,CA153 的AUC为0.874较CA125大;两项联合指标的AUC达0.913,大于各单项肿瘤标志物(P＜0.05).结论 CA153、CA125是乳腺癌的肿瘤相关性标志物,CA153对于乳腺癌的诊断价值更大.2项指标联合检测优于单一的肿瘤标志物,可提高诊断乳腺癌的正确性.Array-ELISA检测多种肿瘤标志物可应用于乳腺癌的诊断.     

C-12肿瘤标志物蛋白芯片检测对胰腺癌的诊断价值

目的研究C-12肿瘤标志物蛋白芯片检测在胰腺癌中的诊断价值。方法 应用C-12肿瘤标志物蛋白芯片检测37例胰腺癌患者血清中12项肿瘤标志物：AFP、CEA、NSE、CA125、CA153、CA242、CA199、PSA、f-PSA、FER、β-HCG及HGH。结果 标志物阳性率由高至低顺序为CA199（48．7％），CA125（43．2％），FER（43．2％），CA242（40．5％），CEA（35．1％），CA153（29．7％），β-HCG（27．0％），AFP（21．6％），NSE（16．2％），PSA（13．5％），f-PSA（8．1％）及HGH（5．4％）。胰腺癌血清肿瘤标志物检测CAl99、NSE、CEA、CA242、CA125五项指标与正常人和良性病变有显著差异（P〈0．05）。五项指标联合检测阳性率为64．9％，明显较单项检测阳性率高。结论 蛋白芯片检测中，CA199、NSE、CEA、CA242、CA125五项指标对胰腺癌的诊断有较高的临床应用价值。     

卵巢肿瘤患者中5种肿瘤标志物检测的临床意义

目的探讨在卵巢肿瘤的诊断中5种肿瘤标志物的检测意义及其价值。方法选取不同性质的卵巢肿瘤患者,对所有研究对象的CA125、CA724、CA199、CEA、AFP水平进行检测。结果与卵巢良性肿瘤比较,5种肿瘤标志物在卵巢癌患者中均具有较高水平（P〈0．05）,良性肿瘤中CA125水平显著高于交界性肿瘤患者（P〈0．05）。将CA724和CA125进行对比分析发现,对于卵巢癌的诊断CA724具有较高的特异性,而CAl25具有较高的灵敏度。CA125在恶性卵巢上皮性肿瘤中,腹水阳性时具有明显较高的水平（P〈0．05）;上皮性黏液性腺癌中CA199水平显著高于浆液性腺癌（尸〈0．05）;在恶性生殖类肿瘤中AFP明显具有较高的水平（P〈0．05）。结论在卵巢肿瘤中,对CA125、CA724、CA199、CEA、AFP等5种肿瘤标志物的检测对疾病的诊断具有非常重要的临床意义。     

不同肿瘤标志物联合检测对原发性肝癌的诊断效能分析

目的:探索不同肿瘤标志物联合检测对原发性肝癌的诊断效能,为临床诊断提供参考依据。方法:收集来我院就诊的临床诊断为原发性肝癌的患者72例作为观察组,诊断为良性肝病的患者65例作为良性肝病组,80例健康体检者作为健康对照组,所有对象采用化学发光法测定肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原-199(CA199)、糖类抗原-125(CA125)和糖类抗原-153(CA153)的含量,然后对单组患者的5种肿瘤标志物的检测结果、各指标对各组检测阳性率进行比较,并对不同肿瘤标志物单独检测与联合检测原发性肝癌的诊断价值分析。结果:观察组AFP、CA199和CA153的值高于良性肝病组,AFP、CEA、 CA199、 CA125和CA153的值高于健康对照组,良性肝病组的CA199和CA125的值高于健康对照组,差异具有统计学意义(P<0.05);AFP、CEA、 CA199和CA153对观察组的检测阳性率高于良性肝病组,AFP、CEA、 CA199和CA125对观察组的检测阳性率高于健康对照组,AFP、CEA、 CA199和CA125对良性肝病组的检测阳性率高于健康对照组,差异具有统计学意义(P<0.05);各指标联合检测原发性肝癌的灵敏度为86.4%,特异度为89.2%,正确指数为75.6%,误诊率为13.6%,漏诊率为10.8%,且联合检测比各指标单独检测的正确指数都高。结论:血清肿瘤标志物AFP、CEA、 CA199、 CA125和CA153联合检测可提高原发性肝癌诊断的灵敏度和特异度,对原发性肝癌有较好的诊断价值。     

血清肿瘤标志物水平联合检测在乳腺癌诊断中的临床价值分析

目的分析血清肿瘤标志物水平联合检测在乳腺癌诊断中的临床价值。方法选取2018年1月至2019年8月本院治疗的乳腺疾病患者105例,依据B型超声、病理诊断结果分为乳腺良性疾病组(n=51)、乳腺癌组(n=54)。采集入选者空腹静脉血,通过全自动化学发光免疫分析仪测定糖链抗原153(CA153)、糖链抗原125(CA125)、癌胚抗原(CEA)、甲胎蛋白(AFP)、糖链抗原199(CA199)水平。观察两组CA153、CA125、CEA、AFP、CA199水平,并计算CA153、CA125、CEA、AFP、CA199单项及联合诊断乳腺癌的敏感度、特异度。结果乳腺癌组CA153、CA125、CEA、AFP、CA199水平均高于乳腺良性疾病组,差异有统计学意义(P<0.05);CA153+CA125+CEA+AFP+CA199诊断乳腺癌的敏感度(94.44%)高于各指标单项诊断(75.93%、48.15%、37.04%、44.44%、68.52%),差异有统计学意义(P<0.05);CA153+CA125+CEA+AFP+CA199联合诊断乳腺癌的特异度与各指标单项诊断比较差异无统计学意义。结论乳腺癌患者血清中CA153、CA125、CEA、AFP、CA199水平升高,且将上述指标联合检测有助于提升诊断效能,为乳腺癌诊治提供确切信息。     

肿瘤标志物在特发性肺纤维化患者的表达及意义

目的探讨多种肿瘤标志物在IPF患者表达的意义。方法检测27例特发性肺纤维化患者和24例正常对照外周血多种肿瘤标志物（AFP、CEA、CA125、CA153、CA199）,同时检测了患者肺功能等临床指标。结果27例IPF患者外周血AFP、CEA、CA125、CA153、CA199均明显高于正常对照组,具有显著性差异（P〈0．05）;经激素治疗后,27例IPF患者外周血CA199、CA125、CA153明显下降（P〈0．05）,IPF患者外周血CA199与FEV1／FVC％呈明显负相关（r=-0．538,P=0．004）;各肿瘤标志物与ESR和CRP无相关（P〉0．05）。结论肿瘤标志物尤其CA199反应了IPF病情的严重度,是预后不良的指标,可能提示肺纤维化进展,但与疾病活动无关。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…