CA153、CA125和CEA检验在肺癌临床诊断中的应用意义探讨

目的 探讨CA153、CA125和CEA检验在肺癌临床诊断中的应用意义.方法 收集本院2014年5月~2016年2月109例肺部疾病患者,其中56例肺癌患者,53例肺部良性病变患者,将其设定为对照组,对比两组患者血清中的癌胚抗原(CEA)、糖类抗原153(CA153)、糖类抗原125(CA125)水平,观察3种肿瘤标志物联合使用的灵敏度及特异度;观察不同病理类型的肿瘤标志物表达.结果 肺癌组的CA153、CA125和CEA异常率与对照组相比显著提高(P<0.05);3种肿瘤标志物联合使用的灵敏度为85.71%;CA125检测非小细胞癌时显著上升,CEA对腺癌检测时水平显著上升.结论 CA153、CA125和CEA检验在肺癌临床诊断意义明显,可提高肺癌检出率,有效评定肺癌组织学类型,临床应用价值较高.     

CA125、CA153及CEA肿瘤标志物联合检测在非小细胞肺癌早期诊断中的价值

目的:探讨糖类抗原125(CA125)、糖类抗原153(CA153)及癌胚抗原(CEA)肿瘤标志物联合检测在非小细胞肺癌早期诊断的价值.方法:将68例非小细胞肺癌患者纳入研究组,另将同期68例肺良性病变患者纳入对照组,所有患者均行CA125、CA153及CEA肿瘤标志物检测,对比两组CA125、CA153、CEA水平以...     

血清多种肿瘤标志物联合检测对肺癌的诊断价值

目的 探讨多肿瘤标志物联合检测对肺癌诊断的临床价值.方法 应用蛋白芯片法检测肺癌组(n=1 021)及健康体检者(n=827)血清中糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、糖类抗原125(CA125)及糖类抗原15-3 (CA15-3)的表达水平.结果 不同病理类型肺癌中,4种血清肿瘤标志物在非小细胞肺癌中的阳性率均明显高于小细胞肺癌,差异有统计学意义(P＜0.05).CA19-9、CEA、CA125及CA15-3 4种肿瘤标志物单项检测对肺癌诊断的敏感性、特异性均不高;联合检测时诊断敏感性未见明显改善,但随着联合检测标志物种类的增加,特异性明显增加,均在98％以上.4项联合检测时对肺癌诊断具有最高的特异性(100％).结论 CA19-9、CEA、CA125及CA15-3 4种肿瘤标志物联合检测能明显增加诊断的特异性.     

EGFR基因突变检测与肿瘤指标相关性研究

目的分析非小细胞肺癌患者(NSCLC)中表皮生长因子(EGFR)基因突变与相关肿瘤指标:癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)之间的相关性。方法对笔者医院2010年1~10月间78例非小细胞肺癌患者术前进行肿瘤指标(CEA、CA125、CA199)检测,同时手术切除肿瘤标本进行EGFR基因检测,对所得结果进行统计分析。结果 78例患者EGFR突变率为55.1%,其中16例患者发生了第19号外显子缺失突变,突变率为20.5%,27例患者发生了第21号外显子L858R点突变,突变率为34.6%。37例NSCLC患者的CEA表达阳性,占47.44%,均为腺癌患者。28例患者CA125表达阳性,占35.90%。11例患者CA199表达阳性,占14.1%。结论 EGFR基因突变阳性与血清肿瘤指标CEA表达阳性具有统计学意义,而与CA125、CA199表达无统计学意义。因此,对不能进行外科手术治疗的晚期肺癌患者,同时无法获取满意组织标本进行EGFR基因检测时,若肿瘤指标CEA阳性时,可能具有更高的EGFR基因突变率。     

肺癌血清肿瘤标志物与病理特征及转移的关系

目的分析肺癌血清肿瘤标志物与病理特征及转移的关系。方法选取2018年1月-2019年6月成都市第三人民医院、北京大学第三医院收治的肺癌患者(n=100,肺癌组)、肺部良性病变者(n=80,良性组)、同期健康体检者(n=40,对照组),测定三组入院时神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、鳞状细胞癌抗原(SCC-Ag)、胃泌素释放肽前体(ProGRP)、糖类抗原125(CA125)、糖类抗原153(CA153)水平,分析上述6种血清肿瘤标志物与病理类型、TNM分期、转移的关系及对肺癌转移的预测价值。结果肺癌组入院时血清NSE、CYFRA21-1、SCC-Ag、ProGRP、CA125、CA153水平明显高于良性组和对照组(P0.05),良性组、对照组各指标比较差异亦有统计学意义(P0.05)。肺癌患者中,腺癌CYFRA21-1、CA125、CA153水平高于鳞癌和小细胞肺癌,鳞癌SCC-Ag水平高于腺癌和小细胞肺癌,小细胞肺癌NSE、ProGRP水平高于鳞癌和腺癌(P0.05)。随肺癌患者TNM分期增加,血清NSE、CYFRA21-1、SCC-Ag、ProGRP、CA125、CA153水平有增加趋势(P0.05);肺癌转移患者血清NSE、CYFRA21-1、SCC-Ag、ProGRP、CA125、CA153水平高于未转移者,肝转移患者NSE、CYFRA21-1表达水平最高,骨转移患者SCC-Ag、CA125表达水平最高,脑转移患者ProGRP表达水平最高(P0.05)。ROC曲线分析显示,血清NSE、CYFRA21-1、SCC-Ag、ProGRP、CA125、CA153联合预测肺癌转移的曲线下面积为0.871,高于各指标单独预测。结论肺癌患者血清NSE、CYFRA21-1、SCC-Ag、ProGRP、CA125、CA153呈高表达,且其表达水平均与肺癌病理类型、转移类型有一定关联,血清NSE、CYFRA21-1、SCC-Ag、ProGRP、CA125、CA153联合对肺癌转移有较高预测价值。     

血清CEA、CA153和CA125联合检测在肺癌诊断中的应用价值

目的 评价肺癌患者血清肿瘤标志物癌胚抗原(CEA)、糖类抗原153(CA153)、糖类抗原125(CA125)联合检测的临床意义.方法 以135例肺癌患者、130例肺部良性疾病患者、130例健康人为研究对象,采用化学发光法检测其血CEA、CA153及CA125水平.结果 肺癌组血清CEA、CA153及CA125的水平明显高于肺部良性病变组和健康对照组(P<0.01),三项联合测定的敏感度(80.2%)和准确性(85.2%)均明显高于单一检测.结论 血清肿瘤标志物联合检测有助于肺癌的临床诊断.     

肺腺癌EGFR基因突变与血清肿瘤标志物的关系

目的:分析肺腺癌患者EGFR基因突变与血清肿瘤标志物CEA、CA125和CYFRA211水平之间的关系。方法:收集2012年7月至2013年9月在郑州大学第一附属医院行EGFR突变检测的肺腺癌患者528例,采用电化学发光免疫法检测血清中CEA、CA125、CYFRA211的水平,分析EGFR基因突变与血清肿瘤标志物水平之间的关系。结果:肺腺癌患者中CEA、CA125、CYFRA211处于不同浓度梯度时,EGFR突变率差异均有统计学意义(P<0.05)。EGFR突变率随着CYFRA211水平的升高而降低;在CEA≤200 ng/ml的情况下,EGFR突变率随CEA水平升高而升高;当CEA>200 ng/ml或CA125>100 U/ml时,EGFR突变率降低。结论:肺腺癌患者中血清CEA、CA125、CYFRA211在一定程度上可以预测EGFR突变情况。     

乳酸脱氢酶和5种血清肿瘤标志物检测在肺癌早期诊断中的价值

目的:探讨乳酸脱氢酶(LDH)和神经元特异烯醇化酶(NSE)、可溶性片段(CYFRA21-1)、糖类癌抗原(CA125)、癌胚抗原(CEA)、糖类抗原(CA199)5种血清肿瘤标志物在肺癌早期诊断中的临床价值。方法:通过电化学发光法和酶法检测并比较292例肺癌患者(研究组)、201例肺部良性病患者(良性病组)和215例健康体检者(健康组)的LDH和NSE、CA125、CYFRA21-1、CA199、CEA水平。结果:研究组LDH和5种血清肿瘤标志物水平均高于良性病组和健康组(P<0.05);其中非小细胞肺癌和腺癌NSE和LDH水平明显低于小细胞肺癌(P<0.05),腺癌CA199、CEA及鳞癌CYFRA21-1水平均低于小细胞肺癌(P<0.05),鳞癌CEA水平低于腺癌,LDH水平高于腺癌(P<0.05);研究组IV期CA199水平明显高于I/II和III期(P<0.05);腺癌患者CYFRA21-1阳性率低于鳞癌患者,腺癌患者NSE和LDH阳性率均低于小细胞肺癌患者(P<0.05);联合检测的阳性率、敏感度及准确性均明显优于单项检测(P<0.05)。结论:LDH和NSE、CYFRA21-1、CA125、CA199、CEA 5种血清标志物在肺癌患者中呈高水平表达,联合检测能显著提高肺癌早期诊断的灵敏度和准确性。     

五种血清肿瘤标志物联合检测对肺癌的临床诊断价值

目的探讨五种血清肿瘤标志物癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21—1）、神经元特异性烯醇化酶（NSE）、糖类抗原125（CA125）和糖类抗原242（CA242）联合检测对肺癌临床诊断的价值和意义。方法选择57例初诊肺癌患者作为实验组,选择同期55例良性肺疾病患者作为对照组。采用化学发光法（CLIA）检测血清肿瘤标志物CEA、CYFRA21—1、NSE、CA125和CA242的水平,比较分析五种血清肿瘤标志物检测在肺癌临床诊断中的价值。结果实验组五种肿瘤标志物的水平均明显高于对照组（P均〈0．05）;且五种血清肿瘤标志物在不同病理类型肺癌中有不同水平,CEA、CA125、CA242在腺癌中表达较高,而CYFRA21。1在鳞癌中表达较高,NSE在小细胞癌中表达较高;联合检测时对诊断的灵敏度和准确率分别为92．8％和89．6％,明显高于各单项检查（P均〈0．05）。结论血清肿瘤标志物CEA、CYFRA21—1、NSE、CA125和CA242联合检测可以提高肺癌诊断的灵敏度和准确率,可应用于肺癌的生物学诊断。     

CEA、CA125和CA153联合检测在小细胞肺癌诊断中的应用

目的探讨CEA、CA125和CA153三种肿瘤标志物联检在小细胞肺癌诊治中的应用前景。方法采用化学发光免疫分析法分别测定50例小细胞肺癌和22例肺良性疾病患者血清中CEA、CA125和CA153水平。结果小细胞肺癌患者血清中CEA为（8.18±13.84）ng/ml,CA125为（65.13±9.97）ng/ml,CA153为（16.73±9.77）ng/ml,均显著高于肺良性疾病组的血清水平（P〈0.05）。三项标志物对小细胞肺癌诊断的敏感性分别为32%、54%、18%;两两联检之后CEA/CA125、CEA/CA153、CA125/CA153的敏感性分别为70%、50%、64%;而三项联检对小细胞肺癌的敏感性达80%,特异性100%。结论联合检测CEA、CA125和CA153三项标志物可有效提高小细胞肺癌诊断的敏感性。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.